Due 3/21/2019
Respond by to at least two of your colleagues postings. Be sure to respond to a colleague who chose at least one different setting than you did. Respond in one or more of the following ways: (Be very detailed in response, use 3 APA references) You have references for the assignment from initial post or your can use other APA references.
Share an insight from having read your colleagues posting.
Validate an idea with your own experience.
Expand on your colleagues posting.
Response to Nicole K
One Organizational Practice that Promotes Self-Care and One that Does Not
I worked as a case worker in a mental health facility for about 2 years and the agency did very little to promote self-care and wellness. As a case worker, the department would discuss numbers/productivity at every meeting and within all emails, as this saying was stamped next to the supervisors e-signature, productivity= paycheck. Its needed in proficient work. At this agency, each case worker was required to hit around 96% productivity each month, regardless of holidays, days off taken and length of month. If a worker went over the 96% (which was highly unlikely), then he/she would receive $11 for each percent over and this was called their incentive program. In theory this sounds great, but working hourly and not being able to receive overtime made reaching the incentive status difficult. I was able to reach it one month and discovered that I had worked over 40 hours unpaid from home throughout the month just to complete documentation.
At this same agency, one practice they implemented was giving us 5 mental health days for the year. These mental health days could not be used like normal PTO (vacations) or sick days (doctors appointments or stay home with the flu). These days were only to be used after speaking with a supervisor and describing what was going on. There were stipulations for these days and five is not nearly enough for the entire year, but I believe this was a great practice to implement while I was working there and I took full advantage.
Impact of Both Practices
The productivity incentive impacted my personal and professional life negatively. Like I stated earlier, I was working unpaid on my personal time and it impacted my daily functioning. At the time, I was planning my wedding and I would stay up until 2am-3am finishing my notes after a cake tasting or tour of a venue. Professionally, I remember my supervisor would tell me that if I did not make close to productivity or go over 3 months in a row, I was going to be put on an assistance plan. I was very upset and made the argument that none of my 57 clients complained about me or felt dis-satisfied and I should not be on this plan. I became burnt out in this job, I isolated myself at work, was frustrated 95% of the time, could not sleep and became paranoid that everyone knew I was not making my numbers.
According to Hernandez, Engstrom and Gangsei (2010), the work involved in this field is grounds for developing vicarious trauma, compassion fatigue and burn out. Hernandez et al. (2010) reported that shielding workers from trauma is impossible, but creating a safe haven with supports has been found to decrease the development of these concepts or to help work through the symptoms. This negative practice which inhibits an employee to practice self-care may perpetuate the development of vicarious trauma. Supervisions and staff meetings consisted of talking about numbers rather than client cases, caseload stresses and personal/professional struggles.
An outcome from the positive self-care practice at this agency impacted my personal and professional life in a positive way. I felt that I was allowed to take time for myself and think about what was going on. I was happy that the agency recognized the hard work we did and allowed for days to be for our mental health. Professionally, I felt that this policy/practice was a great way to show staff that their efforts were not unrecognized even though many felt that way. This practice may not stop the development of vicarious trauma because it does not promote seeking assistance, but it may help to prevent its development. Sansbury, Graves and Scott (2015) reported, self-care creates the environment that not only benefits the client but also the individual clinician and the organization. Both the client and clinician can achieve clearer thinking and emotional stability (p. 120). Therefore, the promotion of self-care in this practice may help employees struggling in their professional life. In contrast, using a mental health day does not mean the individual will actually use the entire day to be deep in thought/meditation. Many employees would sleep in and then run errands most of the day, not giving themselves that mental break from personal stressors. It is the responsibility of the employee to use his/her mental health day as a self-care day, to process or work through any professional/personal stressors so that he/she may return to work with a clear mind.
References
Hernandez, P., Engstrom, D., & Gangsei, D. (2010). Exploring the impact of trauma on
therapists: Vicarious resilience and related concepts in training. Journal of Systemic Therapies, 29(1), 6783.
Sansbury, B. S., Graves, K., & Scott, W. (2015). Managing traumatic stress responses among
clinicians: Individual and organizational tools for self-care. Trauma, 17(2), 114-122. doi:10.1177/1460408614551978
**********************************************************************
Response to Anna
Personal Experiences Regarding Organizational Practices
At almost every position I have been the only social worker, providing little support for the role. This is likely from my work at corporations, medical clinics, nursing homes, and rehabilitation settings. However, at one position at a health insurance company, I worked with other mental health colleagues. Not only was taking crisis calls with the EAP part of our job, but so was setting up CIRS, or critical incident debriefings when traumatic events occurred throughout the nation. The Virginia Tech shootings, bank robberies, were just a few of the incidents we handled. Strangely the one that had an impact on me, was when hospital staff had been traumatized. A family snuck in a butcher knife in a food basket for their family member who was dying of cancer, so she could kill herself. The staff intervened grabbing the knife, preventing injury but were very upset by the incident.
One practice that inhibits self-care and wellness from an organizational perspective is when an organization does nothing to support their employees who handle trauma. In fact, at the Health insurance company masters level clinicians would walk off the job without notice due to being berated with no foundation. Every few months management would target another employee, cycling through the employee pool. I became one of the senior employees working there three years, due to the high turnaround.
Conversely, my first job out of my masters program was at a government mental health program in South Carolina. It was a school-based mental health program for grades K-12. While this was one of the most difficult positions for me, I had a supervisor who staffed meetings to process our cases. We could openly talk about what was challenging to us, and she would guide us in our care plans for the patients. My supervisor would arrange for staff development trainings as well. According to Sansbury, Graves, and Scott (2015), it is critical for organizations to provide staff development and ongoing trainings to offset compassion fatigue and VT. Furthermore, concepts such as the SMART program that focuses on self-care techniques seem to also promote resiliency in staff who work with trauma. It has been shown that working with trauma can have a profound impact on helping professionals (Morrissette, 2004). That is why having organization systems in place to offset those effects is so critical.
Outcomes
Regarding the health insurance company that did not provide any support to the EAP specialists and CIRS coordinators, I left the position due to the lack of support. The position was very stressful in that hundreds of thousands of calls came in from across the nation for counseling and CIRS, some of those were crisis calls. The case with the CIRS that bothered me, while the outcome was that no one was hurt. I recall having these flashbacks of the knife in the food basket, and how desperate this family must have been to resort to that. I did process through it on my own, but it was difficult. This position was a telecommuting job so it was more isolative, making it impossible to connect easily with colleagues at work.
At the school-based mental health position, we had a lot of opportunities to process our cases and any traumatic events as well. I am thankful for that support to this day. Since it was my first job out of graduate school, I did not realize how uncommon this kind of support would be for me in my future career development. I do believe it help me be resilient, along with my colleagues. We also met weekly with the staff psychiatrist to staff our caseloads which was helpful as well. These experiences countered vicarious trauma and compassion fatigue, in my opinion.
References
Morrissette, P. J. (2004). The pain of helping: Psychological injury of helping professionals. New York, NY: Taylor & Francis.
Sansbury, B. S., Graves, K., & Scott, W. (2015). Managing traumatic stress responses among clinicians: Individual and organizational tools for self-care. Trauma, 17(2), 114-122.
