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Prevent Child Abuse Ohio publishes a quarterly newsletter. Please take a moment to browse through our current newsletter and our archive!
Help for the Helper: A Look at Self-Care and Vicarious Trauma Prevention Social workers know a thing or two about stress. They wear it like a winter coat, layering on the problems of family, friends and clients until the weight threatens to topple them over. The topic of stress and its effects brought over a hundred participants to the quarterly Statewide Network meeting held at Nationwide Children’s Hospital in November. The meeting focused on vicarious trauma and ways to prevent it. Vicarious Trauma, or VT, is defined as the cumulative response and transmission of traumatic stress through the observation and/or hearing of other’s stories of trauma events. “You know those stories? Those ones you just can’t shake? Those are the ones that cause us stress. Cause us to burn out,” says Diane Lampkins, MA, LSW a forensic interviewer with the Center for Child and Family Advocacy at Nationwide Children’s Hospital. She and Lois Stepney, MSW, LISW, co-presented the day’s training.
Vicarious Trauma (VT): Who’s at Risk? How did first responders deal with the aftermath of 9-11? How did social workers handle the emotional turmoil of counseling victims of the Oklahoma City bombing? Current research outlines the lasting effects of how major disasters affect health care professionals. “Very little research exists on vicarious trauma,” starts Lampkins, of the effects of smaller, daily traumas and the collective effect they have on the helper.
With 20 years in the field, Lampkins remembers hundreds of stories that she couldn’t shake. “I worked in a youth living center, a home with kids that didn’t fit foster care and couldn’t be adopted. I got to know these kids. I felt it and I was taking it home.” Lampkins actively grieved for all the things these kids wouldn’t know: the stability of a two-parent home, the calming influence of a loving and engaged parent, lost opportunities to help them build a bright future. It became too much. She eventually left the living center and found another job.
Lots of things contribute to vicarious trauma. Certain personality characteristics may lead more often to VT. To prove her point, Stepney asked each member of the audience to silently list the three most important people in his or her life. Using a touchpad to answer and calculate the audience’s responses, Stepney then asked, “How many of you listed yourself as one of those people?” Ninety-eight percent of those responding answered no. Point proved. Those susceptible to VT identify in the caregiver role. Too well. “They don’t take time for their own interests. They are not impaired,” says Stepney. She then instructed the group to say “no” in unison. “How did that feel?” Her question is met with laughs. “We must learn to put our self first, that’s what will make professionally and most meaningful personal life.” “A lot of how you deal with stress is where you are on your path. I came from a family with a single parent who was a caregiver.” Lampkins modeled her mother’s care giving behavior and put herself last. “It’s impossible to sit with people, families and clients, and listen to their stories and not take on a little of what they have. There come some feelings with those words.”
In social work, one often confronts the worst of humanity. One hears horrific stories everyday. One witnesses the aftermath of devastating acts of cruelty. It’s only natural to feel pain and to become apprehensive and afraid. Another work-related risk is the amount of time a social worker invests in his or her clients. When working at the Hannah Neil Center in Columbus, she made herself available twenty-four hours per day, seven days per week to foster parents. “Being always accessible, that creates a lot of stress,” she admits. “I’d take care of my patients and clients and do better for them than I would for myself.” Signs and Symptoms When you start hearing about abuse and thinking “that’s not so big a deal,” you know you’re in trouble. A loss of empathy is a sign that you may be experiencing vicarious trauma. “If you find yourself getting angry with your clients, that’s bad,” Lampkins says. Some turn to alcohol, drugs or food to escape the pressures of work. Others slip into depression, sleeping more or less than usual. Isolating and denying the existence of VT tends to contribute to increased symptoms of stress. What can one do about vicarious trauma? “Reconnect with the ‘why’. For me, I like what I do. Knowing I can do something about it (vicarious trauma) affects my lifestyle choices. I make different choices,” explains Stepney. The Cost of Stress Experts attribute 90 percent of disease and illness, including cancer and diabetes, to stress. “You have to be aware of how your body feels stress. I get it right here,” Lampkins raises her hand to the back of her neck. Audience members nod in agreement. Studies have found evidence that stress can alter brain cells, brain structure and brain function. Memory problems and the development of some mental diseases, including depression, may erupt. The list of stress-related diseases is long. Irritability. Diarrhea. Muscle Tension. Arthritis. Eczema. Sexual Problems.
What is Burnout? Vicarious trauma doesn’t necessarily lead to burnout, but few who suffer from burnout don’t also suffer from vicarious trauma. “You’re literally worn out from the work that you do. Your passion’s depleted. You become empty,” adds Stepney. Saying inappropriate things in front of clients, failing to set boundaries with clients, talking negatively with one another, and gossiping are all signs of burnout. One way to avoid burnout is checking work at the front door. Find a place in your home to unwind and refresh. Create a ritual. “I have a corner of my bedroom that’s all mine,” says Lampkins. She’s created a sanctuary inside her bedroom complete with fountain and aromatherapy. “As helping professionals, we are energetic, compassionate. (It’s important to) safeguard that energy and rejuvenate. The rewards of this job outweigh the difficult and painful things. There’s a reason why you are drawn to this field.”
Practice Self-Care Find ways to replenish during days off. Remember it’s ok to say no. “This only works when you commit to yourself to do it,” says Lampkins. “Find things that you can put into practice, things that will keep you going.” Eat healthy. Sleep more. Practice deep breathing. Read for pleasure. Incorporate self-care into your professional and personal life.
Be aware of the effects of burnout and when you feel that you have had enough. Take a break. Take responsibility for your career success. Lampkins recommends you develop a board of your own advisors. Add members of the community who can keep you posted on trends. Pick colleagues who can assess your strengthens and keep you accountable. Get their honest feedback a couple of times per year.
Practice mindfulness. To demonstrate this point, meeting attendees are asked to eat three raisins in three minutes. “Feel that raisin. Smell the iron and calcium. Savor the raisin,” instructs Stepney. Network members laugh and slowly start to chew. “I tasted flavors I didn’t know existed!” quips one attendee. That’s the point of the exercise. Take your time. Be in the moment. “When you’re having a bad day, choose to smile. It’s a way we empower ourselves to take back control,” Stepney.
“This work will affect you. Repeat it as a group,” instructs Stepney. A hundred voices rise together in response. “This work will affect you.” Sometimes it’s important to say it out loud. “Keep asking yourself what brought you here. Connect with the reasons why. That’s the path back to wellness,” says Stepney.
Online resources to learn more about vicarious trauma prevention and treatment:
Bell, H., Kulkarni, S., & Dalton, L. (2003) Organizational Prevention of Vicarious Trauma. Families in Society: The Journal of Contemporary Human Services, 84, 463-470. www.familiesinsociety.org Clemans, Shanith E. (2004) Understanding Vicarious Traumatization - Strategies for Social Workers. Social Work Today, 4, 13. www.socialworktoday.com/archive/swt_0204p13.htm Farrar, Anne Ranee, MA. (2002) Vicarious Traumatization of the Mental Health Professional. www.apa.org/apags/profdev/victrauma.html Levin, Andrew P., MD., Scott, Greisberg, MA. (2003) Various Trauma in Attorneys. www.giftfromwithin.org/html/vtrauma.html Nelson, Terri Spahn, MSSW, LISW. (2008) Vicarious Trauma: Bearing Witness to Another’s Trauma. www.uic.edu/orgs/convening/vicariou.htm
Caring For Yourself In The Face of Difficult Work Get enough sleep Get enough to eat Vary the work that you do Do some light exercise Do something pleasurable Focus on what you did well Learn from your mistakes Share a private joke Pray, mediate or relax Support a colleague
Pinwheels For Prevention, Prevent Child Abuse Ohio's statewide public awareness campaign, is designed to bring attention to child abuse and neglect in communities throughout Ohio. In April, in communities throughout the state of Ohio, colorful children's pinwheels will be planted in front of courthouses, playgrounds, libraries and parks. In addition to the pinwheel displays, education and media campaigns will complement these displays to raise awareness on child abuse and neglect. To learn more about Ohio's Pinwheels For Prevention campaign, please visit our website at http://www.pcao.org/programs/pinwheels.cfm. If you have any questions or if you would like to be a part of the Pinwheels For Prevention Campaign, please contact Amy Roberts, Project Coordinator at Amy.Roberts@NationwideChildrens.org or (614) 722-6803. To learn more about the national Pinwheels For Prevention campaign through Prevent Child Abuse America, please visit http://www.pinwheelsforprevention.org.
Registration for the 2009 Protecting Ohio's Children Conference is now open!
7th Annual Protecting Ohio's Children Conference Friday, April 3, 2009 The Conference Center at NorthPointe, Lewis Center, Ohio The keynote of the conference is Jacqueline Wynn, Ph.D., Director, Center for Autism Spectrum Disorders, Nationwide Children's Hospital who will address "Caring for Children with Autism Spectrum Disorders: Managing Stressors." Additional sessions offered at the conference include:
$120.00 regular registration fee (postmarked by Monday, March 23, 2009) $135.00 walk-in registration will be accepted on the day of the conference (on a space-available basis) To view and print a copy of the conference brochure, please visit our website at http://www.pcao.org/programs/pdfs/2009ProtectingOhio'sChildrenConferenceBrochure.pdf. If you have any additional questions or concerns, please contact Amy Roberts, Project Coordinator, at (614) 722-6803 or Amy.Roberts@NationwideChildrens.org .
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