"empathic discernment " by dr. charles figley
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Empathic Discernment:
The Key to Preventing Compassion FatigueCharles R. Figley, Ph.D.Professor and the Henry Kurzweg, MD Chair in Disaster Mental HealthTulane University School of Social Work, New Orleans, USA
Purpose:
Recognize and avoid the Compassion Fatigue and promote resilienceCaring as much for ourselves as we care for the traumatizedAppreciate the importance of empathic discernment for both.
Objectives:1. Appreciate the various sources of stress among
counselors including the demand to be compassionate with suffering clients – especially fellow survivors of Katrina.
2. Define the critical concepts, including empathic discernment.
3. Describe two useful models for predicting compassion fatigue and the role of empathic discernment.
4. Note the various ways counselors cope with these demands – effectively and ineffectively.
5. Be better prepared to prevent and be resilient in a post-Katrina work environment.
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Basic Caregiver Resilience Assumptions1. Working with the suffering requires
compassion2. Compassion requires empathy, interest,
and contact3. Exposure to clients’ distress can be
distressing for the caregiver, particularly if the distress is associated with the counselor’s own experiences.
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Basic Assumptions (cont.)4. Exposure can also be inspiring. The
services provided generate a sense of pride and satisfaction.
5. Most counselors have the ability to survive, be resilient, and thrive
6. Resilience is the antidote to compassion fatigue.
Definitions of Critical Concepts
Work-related stress: The demands of one’s job that are applied in the work setting but affect other settings as well.Caregiver Resilience: The tendency to cope with the work-related stress naturally or through the help of others (organization and or colleagues, friends, and family
Psychological Burnout:the experience of long-term exhaustion and diminished interest in one’s work that is most often corrected by changing work settings or clients (Altman & Jackson, 2005).
Compassion stress
The perceived demands derived from experiencing the suffering of others and wanting to help relieve their suffering in some way (Figley, 1995; 2002)
Compassion Satisfaction
The perceived joys derived from experiencing the suffering of others and succeeding in helping to relieve their suffering in some way (Figley, 2002)
Empathic Discernment
Effectiveness in accurately selecting and using the best empathic response for both client and self (Radey & Figley, 2007)
Compassion Fatigue (CF) is
the experience of short-term exhaustion and traumatic stress reactions associated with exposure to the suffering one’s clients (Boscarino, Figley & Adams, 2004).
Plain old job burnout stems from dissatisfaction with the work environment
compassion fatigue stems from absorbing the suffering of clients
Vs
Empathic Discernmentis the key ingredient for
Avoiding both burnout and compassion fatigueA case example: Animal caregivers
Humane Society of the US
Organization dedicated to helping and managing abused, neglected, and abandoned animalsMembers of the animal care community include those who rescue animals, care for their medical and psychological needs, or who must euthanize them.Here is a short film about compassion fatigue
Compassion Fatigue Research
Example of the Animal Care Community research (2003-2006)Resulting in a book and a short film
National sample of animal care workers (Roop & Figley, 2006) (cont.)
Compassion Fatigue risk53.1% extremely high risk12.4% high risk11.9 %moderate risk
Burnout risk45.6% extremely low 35.9% moderate risk
Compassion Satisfaction43.0% good21.4% high3.9% extremely high
CF Theory: Based on more than 10 years of research
The following 11-factor model identifies the major factors contributing to compassion stress, fatigue, and management.
The Compassion Fatigue Process:
The Compassion Fatigue Process (Figley, 2001)
..
.
10
Other LifeDemands
Concern
Sense ofSatisfaction
Exposure to Suffering
Detachment
CompassionFatigue
Prolonged Exposureto Suffering
Traumatic Memories
9
1
3
2
5
4
6
7
8
ResidualCompassion
Stress
EmpathicAbility
EmpathicResponse
Implications
1. Compassion fatigue hurts counselors of the suffering2. Compassion fatigue blues can be avoided or stopped3. The way to do it is focusing on EMPATHIC DISCERNMENT
Figure 1: Transformation to compassion fatigue or compassion satisfaction: ROLE OF POSITIVE AFFECT (Radey & Figley, 2007)
CompassionSatisfaction
CompassionFatigue
Direct Practice with the Suffering
Level ofEmpathic
Discernment
Affect Self-care
Resources
(Positive) Affect
Provides essential foundation in meeting client needs (e.g., empathic response, therapeutic alliance) as well as the caregiver needs (e.g., joy of service and its appreciation by all).
Figure 2: Transformation to compassion fatigue or compassion satisfaction: SELF CARE!
CompassionSatisfaction
CompassionFatigue
Direct Practice with the Suffering
Level ofEmpathic
Discernment
Affect Self-care
Resources
Self-careSelf-care involves
Self-monitoringSocial supportive monitoringUtilizing an individually-designed and updated self-care planFollowing recognized standards of self-care
Self-care (cont.)
The negative consequences of poor self-care:Harm to clientsLowered compassion satisfactionHarm to the caregiver’s health and relationships
Figure 2: Transformation to compassion fatigue or compassion satisfaction: Increasing RESOURCES (Radey & Figley, 2007)
CompassionSatisfaction
CompassionFatigue
Direct Practice with the Suffering
Level ofEmpathic
Discernment
Affect Self-care
Resources
Resources ARE IMPORTANT
They include Intellectual, unit morale, effective leadership, and physical resources Intellectual resources includes helping and other practice skills
Resources (cont.)
Physical Resources fromEnhanced recreational resourcesOpportunities to exercise Good nutrition through the cafeteriaContact with nature Personal space and opportunities to use it
Figure 2: Transformation to compassion fatigue or compassion satisfaction: EMPATHIC DISCERNMENT (Radey & Figley, 2007)
CompassionSatisfaction
CompassionFatigue
Direct Practice with the Suffering
Level ofEmpathic
Discernment
Affect Self-care
Resources
Empathic Discernment
Helps in balancing and increasing three independent factors in the process of human services with the suffering: Resources, Affect, and Self-care (RAS)
It is the gateway to determining how much fatigue and satisfaction can be derived from the work of caregiving
Thus, empathic discernment ultimate is a measure of caregiver resilience
Stress Management Strategies for Enhancing Empathic Discernment
Stress Management Resiliency
In vivo (working with clients)Breath-workSelf-talkPhysical movement (walking, bikes, basketball, etc.)
Stress Management Resiliency (cont.)
Between Clients at Work Breathing Meditation Prayer and Meditation Visualization (e.g., safe place) Dance and Other Kinesthetic Treatments
Stress Management Resiliency (cont.)
Journaling Art Therapy Music Therapy Poetry Therapy All hobbies and absorbing activities Music and Other Creative Therapies
Treating Compassion Fatigue
Caregivers deserve as good a treatment as they are providing.Most treatments of anxiety disorders are relevant for CFThe challenge is establishing and maintaining a strong therapeutic alliance with the caregiver client
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Treatment Implications
Focusing on Desensitization of the traumatized worker
Assessment of currently available approaches
Conclusions
1. You deserve as good a treatment as you provide the traumatized2. Caring for yourself results in being a more effective counselor,Family member and friend, andHuman being
