Burnout

Four Recommendations for Organizations       

1. The Consensus Panel [a panel of non-Federal clinical researchers, clinicians, program administrators, and client advocates that debated and discussed their particular area of expertise until they reached a consensus on best practice] makes the following recommendations about how the agency can support the counselor:

• Provide a sense of mission.
• Provide (or facilitate) ongoing, clinical supervision – if possible, by someone with a specialty in the area of compassion fatigue, abuse and neglect.
• Provide trauma training to the counselors that standardizes the procedures for handling trauma cases.
• Empower staff members by encouraging them to share their ideas on improving the program and incorporating, as appropriate, those ideas that enhance the stated mission of the agency.
• Support staff members in their efforts to stay within the limitations of their roles so that they do not take on responsibilities likely to lead to burnout.
• Support staff members in their efforts to keep caseloads at manageable levels and, at the same time, work to educate managed care about the drawback of limiting the length or intensity of services.
• Model the supportive role that the agency wants the counselors to have with their clients.
• Allow counselors unstructured time to talk to each other to give and receive support.
• Train staff on such topics as new assessment tools, research findings, suicide intervention, crisis and nonviolent management of assaultive behavior, and liability issues related to abuse and false memory accusations.
• Bring in an outside professional occasionally to hold a group session with the staff (this can encourage staff members who have been holding in or minimizing the impact of their work on themselves to open up).
• Recognize and reward the work of the staff on a regular basis (e.g., ceremonies to recognize ongoing and special contributions).
• Hold regular social events (e.g. picnics, softball games).

 * US Department of Health & Human Services, 2000, “Substance Abuse Treatment for Persons with Childhood Abuse and Neglect Issues.”

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2. The organizations and agencies that employ helping professionals and offer clinical service to survivors of trauma and abuse also must incorporate an awareness of the cost of trauma work on staff, and the toll of VT on organizations or agencies. Such recognition is evident when organizations achieve the following:

• Provide adequate clinical supervision for all staff.
• Create a climate that accepts that the work will elicit strong feelings and provides a safe setting in which to discuss such feelings.
• Offer health benefits that include good coverage for mental health services.
• Explicitly acknowledge the difficulty of the work.
• Use staffing patterns that allow backup and sharing of clinical responsibility and coverage.
• Set reasonable expectations for clinical caseloads, i.e. expectations that take into account the effects of VT.
• Affirm the reality, pervasiveness, and severity of the effects of childhood trauma.
• Work with staff to identify and address signs of VT.
• Provide opportunities for continuing education in the area of trauma and of stress management (such as training).

Some of these helpful responses reflect attitude and time management. Others require changes in the allocation of money and personnel. It is helpful for administrators to be able to justify changes in resource allotment on the basis of such factors as treatment efficacy, personnel longevity and reliability, decreased liability, and long-term cost effectiveness.

-          Saakvitne, et al, 1999, Risking Connection                                                                    

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3. The following describes the institutional environment that is most facilitative for the recovery of traumatized personnel.

• The stressors are accepted as real and legitimate.
• The problem is viewed as a problem for the entire group and not as a problem that is limited to the individual.
• The general approach to the problem is to seek solutions, not to assign blame.
• There is a high level of tolerance for individual disturbance.
• Support is expressed clearly, directly, and abundantly in the form of praise commitment, and affection.
• Communication is open and effective; there are few sanctions against what can be said. The quality of communication is good and messages are clear and direct.
• There is a high degree of cohesion.
• There is considerable flexibility of roles and individuals are not rigidly restricted from assuming different roles.
• Resources – material, social, and institutional – are utilized efficiently.
• There is no subculture of violence (emotional outbursts are not a form of violence).
• There is no substance abuse.      

Catherall, 1995, “Preventing Institutional Secondary Traumatic Stress Disorder,” referring to Figley, 1989.                      

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4. [W]e present six policy changes implied by the chapters in this book [Secondary Traumatic Stress: Self-care Issues for Clinicians, Researchers, and Educators]:

• Lower caseloads
• Telehealth support (making confidential online usage available)
• Increased staff time (regular time to discuss day-to-day operations)
• Leave time (access to adequate amount of vacation, sick, and family leave time)
• Mental health care (access to professional mental health services outside the employing organization)
• Supervision (the provision of regular professional clinical and/or administrative support from senior staff member) 

* Rudolph & Stamm, 1995, Revised 1999a, “Maximizing Human Capital: Moderating Secondary Traumatic Stress Through Administrative and Policy Action.”