Participant Manual - Module 23 - Self Care PDF

Module 23: Self Care 1  2 Objectives  Making Yourself a Priority  Vicarious Trauma  Compassion Fatigue  ProQOL  Compassion Fatigue Prevention Toolkit 2 ...

Module 23: Self Care 1  2 Objectives  Making Yourself a Priority  Vicarious Trauma  Compassion Fatigue  ProQOL  Compassion Fatigue Prevention Toolkit 2  3 Making Yourself a Priority 3  4 Make Your Wellness and Recovery a Priority  Your number one priority is you and your own wellness and recovery.  Often those who are focused on caring for others begin to stop caring for themselves, placing others needs before theirs. When this happens, it can lead to peer drift, compassion fatigue, and burnout.  Remember that it is hard to care for someone else if you are not caring for yourself. In peer support, it is essential for you to make your own wellness and recovery a priority. Often those who are focused on caring for others begin to stop caring for themselves, placing others needs before theirs. When this happens, it can lead to peer drift, compassion fatigue, and burnout. As a CPSP, you must remember that it is hard to care for someone else if you are not caring for yourself. Your number one priority is you and your own wellness and recovery. 4  5 Peer Identity Peer Drift Comfort using recovery Uncomfortable in story as tool sharing recovery story Peer Drift Peer support as an opportunity of mutual Peer support as opportunity to instruct How to detect learning whether you may be experiencing peer Focus on strengths, Focus on barriers, drift opportunities & skills symptoms & diagnoses Find your voice, make Defer decisions, avoid decisions, take risks challenge & stress Self-confidence, security Self-doubt, insecurity and pride and shame Review the Peer Identify and Peer Drift section comparing the two. Peer Identity Peer Drift Comfort using recovery story as tool Uncomfortable in sharing recovery story Peer support as an opportunity of mutual learning Peer support as opportunity to instruct Focus on strengths, opportunities & skills Focus on barriers, symptoms & diagnoses Find your voice, make decisions, take risks Defer decisions, avoid challenge & stress Self-confidence, security and pride Self-doubt, insecurity and shame 5  6 Vicarious Trauma 6  7 Understanding and Coping With Vicarious Trauma 7  8 Vicarious Trauma  Intrusive or obsessive thoughts or difficult emotions  Feeling over-responsible; overworking  Physical health problems  Feelings of distrust or excessive concern for loved ones  Loss of hope or a diminished sense of control over one’s fate  Over-identification or disconnectedness, and callousness are common  Feeling angry for no reason Helping professionals can go through changes as a result of empathic engagement with trauma survivors. This is sometimes called vicarious trauma because changes may parallel trauma responses: Intrusive or obsessive thoughts or difficult emotions. Feeling over-responsible; overworking. Physical health problems. Feelings of distrust or excessive concern for loved ones. Loss of hope or a diminished sense of control over one’s fate. Over-identification or disconnectedness, and callousness are common. Feeling angry for no reason. As a peer in a helping profession be aware if you begin to experience any of these changes or responses in your work. If you do, consult with your supervisor to find solutions to reduce and eliminate this vicarious trauma and take care of your own health and wellbeing. 8  9 Compassion Fatigue Vicarious Trauma and Compassion Fatigue are closely aligned. We will now discuss Compassion Fatigue 9  10 Compassion Fatigue: What is it and do you have it? 10  11 Compassion Fatigue A state of tension and preoccupation with the individual or cumulative trauma of others and/or the natural consequence of stress resulting from caring for and helping traumatized or suffering people. A state of tension and preoccupation with the individual or cumulative trauma of others as manifested in one or more ways including re-experiencing the traumatic event, avoidance/ numbing of reminders of the event, and persistent arousal; and/or the natural consequence of stress resulting from caring for and helping traumatized or suffering people. 11  12 Compassion Fatigue  Compassion is the deep awareness of the suffering of another coupled with the wish to relieve it  Compassion Satisfaction (CS) are the positive aspects of working as a helper  Compassion Fatigue (CF) are the negative aspects of working as a helper Compassion Fatigue Compassion is the deep awareness of the suffering of another coupled with the wish to relieve it Compassion Satisfaction (CS) are the positive aspects of working as a helper Compassion Fatigue (CF) are the negative aspects of working as a helper  14 Join the Poll by Web PollEv.com/cpspuser1 Or Scan with your phone 14 15  16 Types of Symptoms  Three types of symptoms experienced by individuals who are experiencing compassion fatigue: o Intrusive o Avoidance o Arousal Being aware of these symptoms can allow you as a CPSP seek help before burnout happens Three types of symptoms are experienced by individuals who are experiencing compassion fatigue: o Intrusive o Avoidance o Arousal 16  17 Intrusive Symptoms  Thoughts and images associated with other’s problems and pain  Obsessive or compulsive desire to help certain people  Caring of others encroaching on personal time  Inability to “let go” of mission related matters  Perception of others as fragile and needing your assistance  Sense of inadequacy  Sense of entitlement  Perception of the world in terms of victims and perpetrators  Personal activities interrupted by the mission Intrusive Symptoms Thoughts and images associated with other’s problems and pain Obsessive or compulsive desire to help certain people Caring of others encroaching on personal time Inability to “let go” of mission related matters Perception of others as fragile and needing your assistance Sense of inadequacy Sense of entitlement Perception of the world in terms of victims and perpetrators Personal activities interrupted by the mission 17  18 Avoidance Symptoms  Silencing Response (avoiding others)  Loss of enjoyment/cessation of self-care activities  Loss of energy  Loss of hope/sense of dread working with certain people  Loss of sense of competence/potency  Isolation  Secretive self-medication by using substances, work, sex, food, spending, etc.  Relational dysfunction Avoidance Symptoms Silencing Response (avoiding others) Loss of enjoyment/cessation of self-care activities Loss of energy Loss of hope/sense of dread working with certain people Loss of sense of competence/potency Isolation Secretive self-medication by using substances, work, sex, food, spending, etc. Relational dysfunction 18  19 Arousal Symptoms  Increased anxiety  Impulsivity/reactivity  Increased perception of demand/threat  Increased frustration/anger  Sleep disturbance  Difficulty concentrating  Change in weight/appetite  Somatic symptoms Arousal symptoms Increased anxiety Impulsivity/reactivity Increased perception of demand/threat Increased frustration/anger Sleep disturbance Difficulty concentrating Change in weight/appetite Somatic symptoms 19 20 20  21 Zealot Phase  Committed, involved, available  Solving problems/making a difference  Willingly go the “extra mile”  High enthusiasm  Volunteers without being asked Zealot Phase Committed, involved, available. Solving problems/making a difference. Willingly go the “extra mile”. High enthusiasm. Volunteers without being asked. Possibly ask for a volunteer to share an experience related to the zealot phase (if time.) Menu of Misconceptions Associated with the Zealot Phase I will “fix” the problem…make everything O.K… save the world… I am responsible for outcomes. If I care enough, everything will be O.K. The sufferer/victim will appreciate everything I do for them. I will have enough resources (time, money, material, skills and training) to fix everything. Significant people in my life support and approve my absence from our relationship while I invest in this compassionate mission. I know what I’m getting into. I can do it alone. If I’m spiritual enough, I can deal with the stress of working with suffering people. 21  22 Irritability Phase  Begin to cut corners  Begin to avoid others  Begin to mock those we care for  Begin to criticize/disparage the people we care for  Use of humor is inappropriate  Oversights, mistakes and lapses of concentration  Start distancing ourselves from friends and fellow caregivers Irritability Phase Begin to cut corners Begin to avoid others Begin to mock those we care for Begin to criticize/disparage the people we care for Use of humor is inappropriate Oversights, mistakes and lapses of concentration Start distancing ourselves from friends and fellow caregivers 22  23 Withdrawal Phase  Enthusiasm turns sour  Those we care for become irritants, instead of persons  We make complaints about our work life and our personal life  Tired all the time, don’t want to talk about what we do  We start to neglect our family, those we serve, and ourselves  We try to avoid our pain and sadness Withdrawal Phase Enthusiasm turns sour Those we care for become irritants, instead of persons We make complaints about our work life and our personal life Tired all the time, don’t want to talk about what we do We start to neglect our family, those we serve, and ourselves We try to avoid our pain and sadness 23  24 Zombie Phase  Hopelessness turns to rage  Disliking/hating people  Others appear incompetent  Develop a real distain for those we care for  Lacking patience  Lacking time for things you enjoy Zombie Phase Hopelessness turns to rage Disliking/hating people Others appear incompetent Develop a real distain for those we care for Lacking patience Lacking time for things you enjoy 24  25 Discussion What do you think are some results of compassion fatigue?. 25  26 Prevention and ProQOL 26  27 Prevention  Is there a balance in their lives?  Do they have access to regular exercise, non-work interests, personal debriefing?  Are they caregivers to everyone or have they shut down and cannot give any more when they go home?  Are they relying on alcohol, food, gambling, shopping to de-stress? Helpers need to carefully and honestly assess their life situation: Is there a balance between nourishing and depleting activities in their lives? Do they have access to regular exercise, non-work interests, personal debriefing? Are they caregivers to everyone or have they shut down and cannot give any more when they go home? Are they relying on alcohol, food, gambling, shopping to de-stress? Helpers must recognize that theirs is highly specialized work, and their home lives must reflect this. Some employers reward behaviors that can lead to compassion fatigue. It is important to guard against extra work. 27  28 The Professional Quality of Life Scale (ProQOL)– Identifying Compassion Fatigue  A free, 30 item self-report measure of the positive and negative aspects of caring  It measures Compassion Satisfaction and Compassion Fatigue  It is NOT a “psychological test” nor a “medical test” The ProQOL is a free, 30 item self-report measure of the positive and negative aspects of caring. It measures Compassion Satisfaction and Compassion Fatigue. Compassion Fatigue includes two subscales: Burnout and Secondary Trauma. The ProQOL is the most widely used measure of the positive and negative aspects of helping in the world. The ProQOL has proven to be a valid measure of compassion satisfaction and fatigue. It has been used for over 15 years. The measure was developed with data from over 3000 people. It helps understand the positive and negative aspects of helping. It is NOT a “psychological test” nor a “medical test”. It can be viewed as a screening for stress-related health problems. You can take it online: www.proqol.com 28 29 30 31  29 Self-Assessment  Using a scale of 1 to 10 (10 being the worst you have ever felt about your compassion work and 1 being the best you have ever felt)  Learn to identify what a 7, 8 or a 9 looks like for you  Being able to recognize when your level of compassion fatigue is creeping up to the red zone is the most effective way to implement strategies immediately before things get worse You can also learn to identify your own compassion fatigue symptoms Using a scale of 1 to 10 (10 being the worst you have ever felt about your compassion work and 1 being the best you have ever felt). Learn to identify what an 8 or a 9 looks like for you. For example, “when I’m getting up to an 8, I notice it because I don’t return phone calls, think about calling in sick a lot and can’t watch any violence on tv” or “I know that I’m moving towards a 7 when I turn down my best friend’s invitation to go out for dinner because I’m too drained to talk to someone else, and when I stop exercising.” Being able to recognize when your level of compassion fatigue is creeping up to the red zone is the most effective way to implement strategies immediately before things get worse. 32  30 Compassion Fatigue Prevention Toolkit 30  31 The Importance of Self Care Authentic and Sustainable Self Care Begins with You  Be kind to yourself  Understand that those close to you may not be there when you need them most  Clarify your personal boundaries. What works for you; what doesn't.  Express your needs verbally  Take positive action to change your environment What does self-care include for you? Improved self-care is the cornerstone of compassion fatigue prevention. Most helpers tend to put their needs last and feel guilty for taking extra time out of their busy schedules to take care of themselves. If you don’t care for yourself, physically, emotionally and spiritually, then eventually there will not be enough of you left to care for anyone else. Ask for what you need. Don’t expect others to ‘just know’. Authentic and Sustainable Self Care Begins with You Be kind to yourself. Enhance your awareness with education. Accept where you are on your path at all times. Understand that those close to you may not be there when you need them most. Exchange information and feelings with people who can validate you. Listen to others who are suffering. Clarify your personal boundaries. What works for you; what doesn't. Express your needs verbally. Take positive action to change your environment. 31 Authentic self-care includes: Health-building activities such as exercise, massage, yoga, meditation. Eating healthy foods. Drinking plenty of water. Using natural healing products to care for and heal your body. Practicing the art of self-management. Just say no. Developing a healthy support system: people who contribute to your self-esteem, people who listen well, people who care. Organizing your life so you become proactive as opposed to reactive. Reserving your life energy for worthy causes. Choose your battles. Living a balanced life: Sing, dance, sit with silence. 31  32 Build Emotional Resilience  Begin with acceptance  Increase self-efficacy and self- monitoring skills  Nurture caring and supportive relationships  Put your well-being first Build Emotional Resilience Begins with acceptance Increase self-efficacy and self-monitoring skills. Nurture caring and supportive relationships Place your well-being at the top of your priority list. Know the differences between “true care” and “over-care”. 32  33 Discussion - Building a Prevention Toolkit for Compassion Fatigue  What would go in that toolkit?  What are my warning signs – on a scale of 1 to 10, what is a 4 for me, what is a 9?  What things do I have control over?  What things do I not have control over?  How often do I use this toolkit? 33  34 Discussion - Building a Prevention Toolkit for Compassion Fatigue  What stress relief strategies do I enjoy?  What can I do to reduce stress?  What stress resiliency strategies can I use? o Stress resiliency are relaxation methods that we develop and practice regularly, such as meditation, yoga or breathing exercises. What stress relief strategies do I enjoy? (taking a bath, sleeping well or going for a massage) What can I do to reduce stress? What stress resiliency strategies can I use? Stress resiliency are relaxation methods that we develop and practice regularly, such as meditation, yoga or breathing exercises. 34  35 What if someone close to me is suffering from Compassion Fatigue?  One negative effect is that some helpers have felt blamed for their compassion fatigue.  There is a strong message that “if you feel burnt out, it means you are not taking good enough care of yourself”.  Talking about the effects of the work can be helpful and a good entry point. No one likes to feel blamed; unfortunately, one negative effect is that some helpers have felt blamed for their compassion fatigue. There is a strong message that “if you feel burnt out, it means you are not taking good enough care of yourself”. This can further silence people in pain and ignores a key contributing factor that most individual helpers have no or little control over the demands on their caregiving. Be kind and supportive and start small. Talking about the effects of the work can be helpful and a good entry point. 35  36 Join the Poll by Web PollEv.com/cpspuser1 Or Scan with your phone 36  37 QUIZ CPSP’s are potentially at risk for Compassion Fatigue. Which of the following reduces the likelihood of developing Compassion Fatigue: A. Ensuring appropriate levels of self-care. B. Remembering that if I am spiritual enough, I can handle anything. C. Believing that the outcomes of those I support are my responsibility. 37  38 10 Things to Do Each Day 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Question: What 10 things can you do each day that will help you? 38  39 Self-Monitor for Signs of Stress  Early warning signs: ▪ Profound sadness, grief or anger ▪ Changes in eating and sleep habits ▪ Increased conflict in relationships ▪ Lack of interest in normal activities Be familiar with the signs of too much stress. Early warning signs: Profound sadness, grief or anger Changes in eating and sleep habits Increased conflict in relationships Lack of interest in normal activities 39  40 Indiana Resources  Indiana 211 for Statewide Behavioral Health Support or Social Services Call 211  Key Consumer Warmline: 1-800-933-5397  NAMI Indiana Helpline: 1-800-677-6442  988 Indiana Resources Indiana 211 for Statewide Behavioral Health Support or Social Services Call 211 Key Consumer Warmline: 1-800-933-5397 NAMI Indiana Helpline: 1-800-677-6442 988 40  41 National Resources  www.proqol.org - Resource Page with further links  www.compassionfatigue.org - Resource Page with further links  SAMHSA’s free 24-hour Disaster Distress Helpline (lonely or depressed) 1-800-985-5990  The Crisis Text Line: 741741  The National Suicide Prevention Lifeline: 1-800-273-TALK (8255)  OK2Talk.org (Youth and Young adults and mental health) 1800-273- TALK  Soul Medic Chat : RemedyLive.com or text 494949 to chat National Resources www.proqol.org - Resource Page with further links www.compassionfatigue.org - Resource Page with further links SAMHSA’s free 24-hour Disaster Distress Helpline (lonely or depressed) 1-800-985-5990 The Crisis Text Line: 741741 The National Suicide Prevention Lifeline: 1-800-273-TALK (8255) OK2Talk.org (Youth and Young adults and mental health) 1800-273- TALK Soul Medic Chat : RemedyLive.com or text 494949 to chat 41  42 Conclusion  Making Yourself a Priority  Vicarious Trauma  Compassion Fatigue  ProQOL  Compassion Fatigue Prevention Toolkit 42  43 References in this module  https://www.opdi.org/de/cache/resources/8/rs_Avoiding%20Peer%20Support% 20Drift.pdf  Beth Hudnall Stamm, 2009. Professional Quality of Life Scale (ProQOL).  Mental Health Association of Palm Beach County, Inc. Compassion Fatigue presentation by Rev. Samuel Wood, M.Div.  Compassion Fatigue Awareness Project. www.compasssionfatigue.org  Running on Empty: Compassion Fatigue in Health Professionals By Françoise Mathieu, M.Ed  Compassion Fatigue: Tools for Building Resistance in a Stressful World. by Susan Haynes-Carabello, Kristin McCabe, and Pamela Gionfriddo in association with the Florida Public Health Institute, the Oakwood Center of the Palm Beaches and the Mental Health Association of Palm Beach County 43