As caring and compassionate professionals who strive to help others, we all feel distressed when people are hurt.
In my state, there have been a number of victims of the opioid epidemic
. Some incidents have been fatal. Some people have survived. And in our community mental health agency, we’ve seen profound reverberations as a result of these tragedies. The events have had various effects on our staff.
Part of my job is to educate staff on how to cope with the vocation of caring. We do that with three keys:
- Reviewing training concepts
- Debriefing incidents
Throughout the opioid epidemic, our staff debriefings have illuminated examples of staff being diligent and caring. In many cases, staff have saved clients’ lives through quick action. But the circumstances place a high degree of stress on staff providing care. Staff have felt distressed on a variety of levels.
That's where the importance of reviewing training concepts comes in. One way we do this is by working training concepts into our debriefings. Another way we do this is through a monthly newsletter column I write to provide a review of the training concepts we teach. I have named my contribution to our agency newsletter CPI: Pathway to Prevention.
Recently I shared with you some review tips on How to Stay Safe During Home Visits
. The following is a review of CPI and other related concepts to help staff cope with secondary trauma. Feel free to use this information to inspire your reviews, or share it with your staff to help them put things into perspective.
CPI defines Precipitating Factors as “internal or external causes of behavior over which staff have little or no control.”
I emphasize that these causes can be real or perceived. They can be psychological, physiological, sociological, emotional, and so on.
Understanding Precipitating Factors is critical to working with clients in crisis. It's also crucial to being compassionate with ourselves and our colleagues when we're facing conflict.
CPI defines Rational Detachment as “the ability to stay in control of one’s own behavior and not take the behavior of others personally.”
I emphasize that Rational Detachment gives staff the opportunity to act with a calm and focused disposition.
CPI defines the Integrated Experience as “the concept that behaviors and attitudes of staff impact behaviors and attitudes of those in their care and vice versa.”
I teach that the Integrated Experience is the dynamic dance between what our clients present and what we bring to the interaction (as seen in the four stages of the CPI Crisis Development Model
℠) as we continue to strive to act in the highest of professional standards. How we navigate through our own personal and social/emotional lives has a direct effect during this process.
The COPING Model℠
Our debriefing sessions are informed by CPI’s Postvention model, the COPING Model
℠. COPING is an acronym for the six steps involved: Control, Orient, Patterns, Investigate, Negotiate, and Give responsibility.
This approach can be used with both clients and staff.
As I mentioned above, we've created debriefings as opportunities for staff to explore serious incidents such as client assaultive behavior and client deaths. Our staff use these opportunities to sort through feelings, identify strengths, learn, and discover new ways to support our clients as well as each other. It’s been gratifying to hear during a number of debriefings that staff seek each other out for support, and that the support has been helpful.
This is a phenomenon that’s also called vicarious traumatization or secondary traumatization. In our work with clients we continually hear about their trauma histories and personal tragedies. Over time we can be left with an emotional residue by being regularly exposed.
Caring for yourself is like providing preventive maintenance for a vehicle. Staff expend a lot of energy in providing quality care. They also have other relationships and responsibilities outside of work.
Self-care includes intentional actions one takes to replenish one’s body, mind, and emotional well-being. These activities vary from person to person.
Remember that self-care is most effective when it’s done regularly and proactively. As energy is drained, it’s hard to be motivated to take care of one’s self, even when it’s most needed. Keeping up reserves is essential—
whether it’s through taking time to reflect alone, spending quality time with friends and family, physical activity, listening to music, etc.
Quit taking it personally
I use the acronym Q-TIP (Quit Taking It Personally) to remind us to:
- Be aware of Precipitating Factors.
- Keep rationally detached so that we can help.
- Provide effective responses during the Integrated Experience process.
The importance of refreshing concepts and skills
Our staff are entrusted to work with challenging populations in a qualitative caring way. Like so many things in the lives of our clients, the opioid crisis has life-or-death repercussions. Being reminded of the above concepts helps staff put their work experience into perspective and deliver care in planned ways.
Being proactive is essential. Hearing the various shocking stories of our clients can have a cumulative effect. Compassion fatigue can set in. But supervision, debriefing, skill review, and self-care can be the antidotes.
What helps you? Please share your strategies so we can all learn and grow together.
“Be patient with yourself. Self-growth is tender; it’s holy ground. There’s no greater investment.”
About the author
T. D. Loftus is a Senior Level CPI Certified Instructor. With a Master of Science degree from Northeastern University in Counseling Psychology and a BA in Psychology from Boston College, he’s a Licensed Mental Health Counselor (LMHC) in the Commonwealth of Massachusetts and a quality management and compliance officer in a community mental health agency. T.D. is also a Reiki Master Level II and a Kettlebell Instructor through the International Kettlebell and Fitness Federation.