Screening and Assessment of Co-occurring Disorders Among ...
2017 Co-occurring Disorders Conference Yakima, WA A Better ...
Transcript of 2017 Co-occurring Disorders Conference Yakima, WA A Better ...
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This presentation is intended for educational use only, and does not in any way constitute medical
consultation or advice related to any specific patient.
Mountain West AIDS Education and Training Center
2017 Co-occurring Disorders Conference
Yakima, WA
Strengthen your Resilience & Communication Skills for a
Better Workplace
MT WEST AETC
NAVOS
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Disclosures
There are no conflicts of interest or relationships to disclose.
This presentation is intended for educational use only, and does not in any way
constitute medical consultation or advice related to any specific patient.
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That paperwork!
Review & completion of:
Participant Information Form
Sign-In Sheet
Evaluation
Please turn in forms to receive your treat!
Thank you!
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Learning Objectives
• Describe the characteristics of an interconnected team in the workplace that improves provider resilience
• Understand how organizational culture can help prevent burnout and compassion fatigue
• Describe the process of change for our behavioral workforce
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Our Careers
• Years working or volunteering in Behavioral Health• 1-5• 5-10• 10+
• Are numbers of years working or volunteering been in one unit or many?
• How many administrators and how many counselor/clinicians?
• Work in urban site?
• Work in rural site?
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Definitions
•Burnout is a state of physical, emotional, and mental exhaustion acquired through involvement in demanding situations without sufficient support
•Compassion Fatigue (vicarious traumatization or secondary traumatization) is the emotional residue or strain from exposure to working with those suffering from the consequences of traumatic events
•Resilience is the ability to maintain personal and professional wellbeing in the face of on-going work stress & adversity
•Advocacy is a self-initiated, strategic action that helps transform systems, improve environments & enhance policies which assist wellness of providers & clients
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Workplace Culture Can Mediate Well Being Or Stress. . . .
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Your Experience?
•Do you believe that you are experiencing or have experienced Burnout and/or Compassion Fatigue in the past?
•Yes
•No
•Did you ask for help from others at your workplace?
•In the past, what has worked to decrease Burnout and/or Compassion Fatigue?
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YOU ARE NOT ALONE!
2016 WA State Assessment of Behavioral Health Service Delivery:
4 Problem Areas
Gattman, Reule, Balassa, Skillman, McCarthy, & Schwartz, (2016). Washington’s Behavioral Health Workforce Assessment Project Phase One
Recruitment & Retention
Paperwork & Documentation
Credentialing & Licensing
Lack of Training to Implement
Integrated Teams
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Reported Problems with Recruitment and Retention
• Heavy caseloads • Relatively low pay • Time-consuming documentation
• Patients with high acuity medical needs • Social stigma
Sound familiar?
These factors contribute to
Burnout & Compassion
Fatigue!
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DON’T GIVE UP!
Good organizational supports can protect against burnout, compassion fatigue, low morale and high turnover!******************************************************
Bronkhorst, Tummers, Steijn, & Vijverberg, 2015: Crim (2017); Erwin (2017);
Skinner & Roche (2005); graphic by shuttercock
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HOW DO WE MAKE THIS CHANGE HAPPEN?
Deal and Peterson, 1990, 1993; Robbins and Alvy, 1995
We must move beyond the realm of the individual into a different dimension . . . The dimension of the culture of the workplace:
We must make a cultural shift to emphasize the well-being of the provider in community with others to reach our goal of a better workplace . . . .
Culture is an inner reality of values,
beliefs, and traditions that reflects
what organizational members care
about, what they are willing to spend
time doing, what and how they
celebrate, and what they talk about.
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A Workplace Culture of Self-Care Benefits All
SELF-CARE HAPPENS IN A SUPPORTIVE COMMUNITY!
SELF-CARE IS CLINIC TEAM CARE!
Supportive Leadership
Provider
Self-Care
Healthy Work
Culture
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And . . . Positive Cultural Change in the Workplace Requires Mutual Understanding
SHARING EXPERIENCES AND PERSPECTIVES HELPS ENSURE MUTUAL UNDERSTANDING
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Culture, Resilience, and Advocacy
• Culture of counselor affects perception of stress & burnout
• Counselor beliefs and values affect self-care and resiliency
• Cultural differences impact communication between staff
• *********EXERCISE*********
• How does your cultural identity impact your experience of communication & stress?
• What values are most important to you? Loyalty? Honesty? Compassion? Being efficient and on time? Building rapport? Meeting expectations? Self-control? Self-care?
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An Interconnected View of Work Life
Interconnections among all aspects of life and place:
Tagalik, S. (2009)
Respecting All Living Things
Maintaining Harmony &
Balance
Considering Impact on Future
Generations
Being in the Present
Working for the Common Good
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Examples of an Interconnected Work Life
• African American Reach and Teach – advocacy and health education to church congregations and community providers
• Indigenous behavioral health services, e.g., Canoe Journey concepts with providers
• Workplaces with professional spiritual care for staff
Common Characteristics of Interconnection Promote . . .
• Know oneself
• Don’t go it alone – do it together
• Recognition of our common humanity
• Stand up for marginalized individuals & communities
• Service for a greater good
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Transformational Leadership – The 5 I’s
Bass, (1990)
Influential
Inspirational Motivation
InclusiveIndividual
Consideration
Intellectual Stimulation
A transformational leader can be staff or management
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Building Resilience
Building Resilience means making space for self-care through the interaction of individual demographic, personal, professional and contextual factors that strengthens positive qualities in the provider
•What’s your work-life balance? Do you have supportive relationships? Do you have an attitude of self-care? Are youimportant to you?
• Balanced interactions enable the maintenance of personal and professional well-being in the face of on-going work stress and adversity
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Evidence Based Practices to Increase Provider Resilience
• EBPs that are person-centered and shift power to the other person (e.g., using MI to be pro-active in change)
• EBPs that build self-awareness and confidence in making self-care choices (e.g., Mindfulness)
• EBPs that build compassionate systems at work and at home (e.g., Community Readiness)
Morse et al, (2012); Tri-ethnic Center for Prevention Research (2014)
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Self-Care Includes Self-Advocacy
Self-care includes advocating for cultural shifts for a better work place
Counselor Self-Advocacy is . . .
• A blending of knowledge, ethics, and humanistic policy which are core competencies of a behavioral health professional practice
• Implementation of integrated care & client empowerment, alongside scientific evidence based practice
• An expectation that an organization will want to take steps to protect employees from Burnout and Compassion Fatigue
• Being aware of professional resources to support positive systems change in organizations
What else defines Counselor Self Advocacy?
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Steps related to Self-Advocacy
Stay committed and hopeful – reach out for resources!
International Council of Nurses, Promoting Health: Advocacy Guide for Health Professionals (2008)
Select your issue
Build your evidence base
Engage key stakeholders
Develop a relevant message
Understand the political context
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Self-Advocacy Guidelines
• Develop SMART plans: specific, measurable, achievable, realistic with resources, timed
• Implement message and plans
•Be a spokesperson – Communicate clearly
• Seize the opportunity
• Be accountable
• Take a developmental approach
• Stay committed & reach for resources
BE THE CHANGE YOU WISH TO SEE!
International Council of Nurses, Promoting Health: Advocacy Guide for Health Professionals, (2008)
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Who Are Your Allies for Change & Self Care?
• Co-workers, Supervisors, Agency Board of Directors
• DBHR Licensing & Certification WAC Violation Complaint Process
• DSHS Behavioral Health Advisory Council
• Workers Unions, e.g., SEIU-1199
• Professional AssociationsAssociation of Advanced Practice Psychiatric Nurses
Chemical Dependency Programs of Washington State
National Association of Social Workers – Washington Chapter
Washington Association for Marriage & Family Therapists
Washington Council for Behavioral Health
Washington State Association of Independent Outpatient Programs
Washington State Mental Health Counselor Association
Washington State Society for Clinical Social Work
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Exercise
• Consider the emotional impact (barriers & strengths) of your work within the clinic or agency and what has been done to improve the work environment since you’ve been there
SHOUT OUT!• What self-care practices encouraged at your work?
• What is available at your work site to holistically support staff?
- (quiet room, exercise room, lunchroom, safe walking environment, collaboration among staff and supervisors)
- Are these measures actively supported by the clinic?
• Are there policies that target good emotional health of staff?
• Designated charting time?
• Staff continuing education? Coaching for new skills or EBPs?
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We Need Your Forms!
Please turn in your forms at the back of the room!Receive your treat!
Beaded pens
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References
• Bass, B. (1990). From transactional to transformational leadership: Learning to share the vision,
Organizational Dynamics, 18, 19-31.
• Bride. B. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 51 (2),63-70.
• Crim, D. (2017). A phenomenological study of stress and burnout experienced by licensed alcohol and drug
counselors. Counselor, 18 (3), 36-40.
• Deal, T., Peterson, K. (1990). The Principal’s Role in Shaping School Culture. Sidalc.net.
• Deal, T., Peterson, K. (1993). Strategies for building school cultures: Principals as symbolic
leaders. Educational Leadership and School Culture 1, 89-99.
• Erwin, K. (2017). Addiction counselors in the Compassion Fatigue cycle. Counselor, 18 (3), 32-35.
• Gattman, Reule, Balassa, Skillman, McCarthy, & Schwartz (2016). Washington’s Behavioral Health
Workforce Assessment Project Phase I. Workforce Training & Education Coordinating Board: Olympia WA.
• Hayes, SC., Bissett, R., Roget, N., Padilla, M. (2004). The impact of acceptance and commitment training on
stigmatizing attitudes and professional burnout of substance abuse counselors. Behavior Therapy, 35 (4),
821-835.
• International Council of Nurses. (2008). Promoting Health: Advocacy Guide for Health Professionals.
Geneva, Switzerland.
• Morse, G., Salyers, M., Rollins, A., Monroe-Devita, M., Pfahler, C. (2012) Burnout in Mental Health Services:
A Review of the Problem and Its Remediation, Adm Policy Mental Health, 39 (5), 341-352.
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References
• Neff, K. D & Vonk, R. (2009) Self-compassion versus global self-esteem: Two different ways of relating
to oneself, Journal of Personality, 77, (1), 23-50.
• Ray, S., Wong C., White, D., Heaslip, K. (2013) Compassion Satisfaction, Compassion Fatigue, Work
Life Conditions, and Burnout among Frontline Mental Health Professionals, Traumatology, 19 (4), 255-
267.
• Robbins, P. & Alvy, H. (1995). The Principal’s Companion: Strategies and Hints to Make the Job Easier.
Thousand Oaks: Corwin Press.
• Skinner, N., & Poche, A. (2005). Stress & Burnout: A Prevention Handbook for the Alcohol and other
Drugs Workforce. National Centre for Education & Training on Addiction, Finders Univ: Adelaide, AU
• Sprang, G., Clark, J., & Whitt-Woosley, A. (2007). Compassion fatigue, compassion satisfaction, &
burnout: Factors impacting a professional’s quality of life. Journal of Loss & Trauma, 12, 259-280.
• Tagalik, S. (2009). Inuit Qaujimajatuqangit: The Role of Indigenous Knowledge in Supporting Wellness
in Inuit Communities in Nunavut. National Collaborating Centre for Aboriginal Health, Univ. of Northern
BC.
• Tri-ethnic Center for Prevention Research. (2014, 2d ed) Community Readiness for Community
Change. Fort Collins, CO: Colorado State University Press.
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Questions?