Healing the Mind,Body & Spirit- Natural Approach

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Empathy Fatigue Dealing Effectively with the
Stress and Grief Reactions of Extraordinary
Stressful and Traumatic Events

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Empathy Fatigue Healing the Mind, Body, and
Spirit

• Personal Testimonials of Persons
• Experience of Empathy Fatigue

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Purpose and Intent

• Identify Recognize Critical Pathways to Empathy
  Fatigue (EF) and other professional fatigue
  syndromes.
• Describe Cumulative effects and Impact on the
  professional counselor which leads to the
  deterioration of the counselors empathic
  engagement with their clients.
• Provide Self-care Strategies for
  pre-professionals, counselor educators and
  supervisors that cultivate healthy coping and
  resiliency.

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A Consciousness Shift in the Counseling and
Allied Helping Professions

• September 11, 2001 (2,996 deaths)
• War in Afghanistan Iraq (4,493 U.S. Soldiers
• 88,456 Iraqi Civilian deaths )
• Tsunami December 26th 2004 (275,000 deaths in 11
  countries
• Hurricane Katrina 2005 (70 deaths )
• Child Deaths by intentional-unintentional gun
  violence (3,024yr)
• School deaths due to violence (92-98 171 99-08
  250)
• Cumulative AIDS-related deaths in U.S (through
  2002 501,669d) Ethiopia (1.8 mil predicted by
  08)

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Healthy Occupational Outlook for Counselors

• Fire
• Flood
• Hurricanes/Tornados
• Ice storms
• Plane crashes
• Volcanoes
• Earthquakes
• Epidemics

• Workplace violence
• Traumatic injury in the workplace
• School shootings
• Bioterrorism
• Transportation Accidents
• Civil Unrest
• 2nd Depression

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A Constant State of Disaster Preparedness Crisis
Response Teams

• ARC/State Disaster MH
• EMS/IC-EM
• Law/Fire
• Public Health
• DSS
• School Counselors
• CISM Teams
• MH/LME
• EAPs

• Baptist Men
• Salvation Army
• United Way
• FEMA
• National Guard/Military
• Insurance Adjustors
• Media
• Airline Industry
• Banks/Financial Institutions

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Empathy Fatigue (EF)

• A dynamic state of psychological, emotional,
  social, physical, occupational, and spiritual
  exhaustion that occurs on a continuum, resulting
  from the helpers own wounds that are continually
  revisited by their clients life-stories of
  stress, chronic illness, mental/physical
  disability, trauma, grief, and loss.

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EF-The Wounded Healer Experience

• Traditional Native American teachings each time
  you heal someone you give away a piece of
  yourself until at some point you require
  healing.
• The wounded healer phenomenon has been noted
  throughout the history of counseling, psychology,
  and through spiritual leaders (Jung Nouwen,
  Rogers, Dali Lama)
• Journey to become a counselor, healer, or Shaman
  comes with the understanding that there is a cost
  to M-B-S.

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Professional Fatigue Syndromes A Concern for the
Helping Professions

• APA - Advisory Committee on Colleague Assistance
  Impaired Professionals.
• AMA- Physician Impairment physical, mental, and
  behavioral disorder that hinders the physicians
  ability to safely treat patients safely.
• American Nurses Association- Compassion
  Fatigue.
• ACA Task Force on Counselor Wellness and
  Impairment
• Educate counselors on prevention strategies
• ID resources counselors
• Intervention and treatment recommendations
• Advocate for professional counseling associations
  to establish programs on counselor impairment

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Ethical Considerations in EF

• Counselors are alert to the signs of impairment
  from their own physical, mental, or emotional
  problems and refrain from offering or providing
  professional services when such impairment is
  likely to harm a client or others
• Counselors shall seek assistance for problems
  that reach the level of professional impairment,
  and if necessary, they limit, suspend, or
  terminate their professional responsibilities
  until such time it is determined they may be safe
  to resume their work

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Epidemiology of Empathy Fatigue How is EF
Experienced?

• Empathy and compassion is the foundation of
  counselor pre-professional training (Rogers
  Corey Corey Ivey Ivey)
• Intense interactions requires intense listening
  and results in intense parallel experiences.
• Many counselors spend a tremendous amount of
  energy trying to understand the meaning of their
  clients exp.
• Theres a cost for counselors searching through
  their clients emotional scrapbook looking for
  all the losses, grief, pain, and suffering.

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Theoretical EF Critical Pathways

• Counselors who use empathy-focus therapeutic
  interactions may be more at risk for EF.
• EF is an unconscious process where the
  professional and those around them may not
  recognize counselor fatigue.
• EF can occur early-on developmentally in
  supervisees due to pre-existing personality
  traits, general coping resources, age,
  counselor-developmental factors, opportunities in
  clinical experiences to build resiliency,
  organizational, and environmental supports.
• EF is cumulative and ranges on a continuum of
  low, moderate, and high levels of
  physical-emotional-mental spiritual, and
  occupational exhaustion. Can be both acute and
  cumulative.

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Theoretical Empathy Fatigue

• EF (is much like stress) can be experienced by
  the pre-professional professional as both an
  acute, chronic, delayed onset reaction ranges on
  a continuum.
• EF experienced by person dealing with a variety
  of issues- clients daily hassles, stress, grief,
  loss, addictions, or trauma.
• Cumulative effects of EF leads to higher levels
  of the deterioration in the pre-professional
  counselors coping abilities and resiliency.

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Consequences of Empathy Fatigue?

• - Depletion of the counselors interpersonal
  effectiveness
• - Reduced warmth, compassion, intuitiveness
• - Physiological type of chronic fatigue
• - Social and Peer-professional withdrawal
• - Lack of mental focus
• - Decreased meaning in ones career
• - Existential confusion
• - Loss of connection with spiritual or religious
  practices
• - Parallel experience with client living life
  out of balance

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Philosophy of EF

• It is not necessarily the nature of the clients
  stress, trauma, loss, grief, daily hassles,
  unhealthy coping, or disability adjustment issues
  that creates a sense of EF rather, it is the
  counselors perception towards that particular
  client the counselors attributes that determines
  the professionals response to it As a
  consequence, leads to a diminished capacity to
  listen, respond empathically, and provide
  competent professional servicesoverall effects
  on M-B-S.

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What Are EF Risk Factors?

• Personality Traits
• History of MH Problems
• Maladaptive Coping Behaviors
• Age and Experience-Related Factors
• Organizational Factors
• Job Duties within the Organization
• Socio-Cultural Factors
• Persons Response to Past Events
• Level of Support

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Global Assessment of EF Rating ScaleA
Theoretical Measure

• Theoretical scale ranging from
• Level 5(H-EF) Level 1(L-EF).
• Constellation of States, Traits, Behavioral
  Dimensions Cognitive Behavioral Spiritual
  Process Skills Emotional Physical Occupation.
• Suggested use Self-ratings Ratings by clients
  Independent peer-observer Independent
  researcher.

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EF Assessment for Counselor Supervisors Share
Your Experiences

• I chose the field/occupation of counseling
  because
• I work best with clients who are
• I feel good and am encouraged by my clients
  success when they
• I am most negatively affected by my clients who
• My needs are met when they
• I generally do not work well under conditions
  that involve
• If I could make any change(s) in my situation I
  would

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Ethical Review Checklist for Counselor Supervisors

• Does the Supervisee
• Have the necessary and sufficient skills and
  competencies to provide services to
  clients/consumers at least provisionally?
• Possess training that has reached an acceptable
  level of competency in the specialty area that
  they practice?
• Have the ability to control or cope with the
  personal, emotional, psychological stress of
  their job?
• Possess enough self-awareness to limit or suspend
  their practice when they are at risk for EF?

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Resilient Professionals

• Convey a sense of genuine commitment and
  confidence to help with their clients stress
  levels and critical issues- despite dealing with
  ones own level of life difficulties.
• Communicate competence and have a good sense of
  mastery with handling challenging and difficult
  clients- without depletion of ones own mind,
  body, and spirit.
• Feel optimistic, positive, and energetic about
  the good work they do and have good coping
  resources- even in tough times.
• Have a purpose-driven life, find meaning in their
  profession and practice good self-care
  techniques.
• Maintain excellent interpersonal insight and
  still have the capacity for warmth, caring, and
  empathy.

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The Resiliency Advantage

• 1. Making conscious choices in life.
• 2. Power of Positive Thinking.
• 3. Take responsibility.
• 4. Internal locus of control.
• 5. Self motivate yourself.
• 6. Dont fear trying-out new things.
• 7. Take control of your life.
• 8. Practice positive approaches to life.

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Adaptive Coping Healing Strategies
Organizational

• Skilled Competent clinical supervision
• Mentoring approaches
• Peer-supervision
• Shift focus of treatment team meetings
• Re-structure organizational philosophy to a
  healthy person-centered M-B-S

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• Show-up
• Pay Attention
• Be Open to the Outcomes

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Wellness Approaches

• Breathing
• Meditation
• Visualization