Compassion Fatigue, Compassion Satisfaction and Work Engagement in Residential Childcare Presentation to: 08/11/18 Dr Kerry Audin, Consultant Clinical Psychologist Independent Practice
Vol 17, No 3 Dr Kerry Audin, Dr Jolanta Burke, Dr Itai Ivtzan MSc Applied Positive Psychology, University of East London
Aims: • Give a summary of the study • Prompt reflection & discussion Why? • It’s important... • It’s timely…
Some definitions… • Compassion : requires connection with, & motivation to reduce the distress of others • Compassion fatigue : negative psychological state resulting from helping people • Burnout: emotional exhaustion from stress at work; detaching from the caring role • Secondary traumatic stress: caused by indirect exposure to trauma
Some more definitions… • Compassion satisfaction: positive feelings from helping others; buffers compassion fatigue • Work engagement: • enthusiasm, pride, commitment, involvement • associated with staff well-being, attendance, creativity, effort, performance, retention, morale & finance Emotions in teams are contagious!
Compassion Fatigue • Associated with: • staff turnover & absenteeism • low motivation & morale • employee performance (poor judgement, decision-making, quality of care) • Impacts on relationships: 1. emotionally detached & disengaged 2. perceived as uncaring & rejecting 3. increased anxiety & aggression 4. increased compassion fatigue
Secondary Traumatic Stress • Reflects symptoms experienced by individuals who were directly exposed to trauma • Sleep problems • Anxiety • Irritability • Hyper-arousal or emotional numbing • Intrusive thoughts • Avoidance, (or preoccupation with) the trauma • Quicker onset than burnout
Residential Childcare… • Requires staff to be resilient • Exposure significant distress & distressing information • Requires significant empathy, consistency, stability • Requires effective use of relationships • Provides opportunities to make a difference
Challenges… • Limited training, support, supervision, pay, recognition… • Associated with increased compassion fatigue, particularly the emotional exhaustion & reduced morale of burnout • Contributes to high levels of staff turnover • Negative consequences for staff, organisations, children & young people
Addressing the research gap • Compassion fatigue, compassion satisfaction & work engagement are highly relevant in our sector • Studied across health & social care but very few studies in residential childcare
Design & Sample • Online survey via ICHA, TCTC & services known to KA • 100 in the final sample residential childcare workers, therapeutic care 51 practitioners & senior care practitioners team leaders & registered managers 31 directors & senior managers 18
Measures • Utrecht Work Engagement Scale-9 (UWES-9) Three 3-item scales: vigour, dedication & absorption • Professional Quality of Life (ProQOL-5) Three 10-item scales
ProQOL Results (n=100) Compassion Burnout Secondary Satisfaction Traumatic Stress Mdn 51.30 48.35 48.83 Range 19.96-66.97 30.08-76.78 33.30-81.64 % Low 25 24 32 Average 52 44 42 High 23 32 26
UWES-9 Results (n=100) Vigour Dedication Absorption UWES-9 Full Scale Mdn 4.00 5.00 4.33 4.44 Range 0.67-5.67 2.00-6.00 1.33-6.00 1.56-5.89 % Very Low 2 0 0 1 Low 17 4 2 2 Average 51 45 37 54 High 27 38 51 37
Correlations • Work engagement (UWES-9 full scale) & compassion satisfaction were strongly positively correlated : • higher levels of work engagement were associated with greater compassion satisfaction. • the correlation held for all three UWES-9 subscales; vigour, dedication & absorption
Correlations • Work engagement (UWES-9 full scale) & burnout were negatively correlated • as work engagement increased, burnout decreased & as burnout increased, work engagement decreased • the correlation with burnout held for all three UWES-9 subscales; vigour, dedication & absorption
Correlations • No correlation between work engagement (full scale) & secondary traumatic stress • no correlation between secondary traumatic stress & either vigour or dedication • however, absorption & secondary traumatic stress were mildly positively correlated; higher levels of absorption were associated with increased secondary traumatic stress
Correlations • No correlation between years working in residential childcare and: • burnout • secondary traumatic stress • Compassion satisfaction • Work engagement full scale • Work engagement subscales
Additional analyses • No difference between males & females on work engagement, burnout, compassion satisfaction or secondary traumatic stress • No correlation between age & the key variables except for absorption, which was mildly positively correlated: as age increased so did absorption
Additional analyses • Management (directors, senior managers, registered managers, assistant/deputy managers, & team leaders, n=49), & non-management (RCWs & senior RCWs, n=51) • ‘Managers’ had higher levels of work engagement (higher vigour & absorption scores) • ‘Managers’ scored higher on compassion satisfaction • No differences on dedication, burnout or secondary traumatic stress
Discussion • Results consistent with research: • compassion fatigue is a concern in residential childcare, • strong commitment but depleted energy levels • no clear relationship; years of experience & compassion fatigue • Levels of absorption were high…but…is this desirable…? • Correlation between absorption & secondary traumatic stress -- which influences which?
Discussion • Managers scored higher on absorption, but no difference on secondary traumatic stress…. • Managers had higher levels of vigour & compassion satisfaction which may buffer against secondary traumatic stress • Managers may be less exposed to young people’s distress which may protect against secondary traumatic stress despite higher levels of absorption
Practical implications • Work engagement: access to support, opportunities to use skills, sense of control, clear goals & expectations, variety, pay, physical safety, recognition • Balance: help staff to maintain boundaries & protect well- being; regular supervision • Training: so staff feel knowledgeable & skilled • Reflective practice: to develop understanding & sense of meaning; helps with compassion satisfaction • Outcomes monitoring: being able to identify progress made by young people
Practical implications • Burnout prevention: manageable tasks & workloads • Managers: recognise compassion fatigue & tailor support, supervisor training • Help staff recognise compassion fatigue & adopt good self- care - social, physical, emotional & spiritual • But…care staff can struggle to spot compassion fatigue in themselves; encourage a ‘tuned in’, supportive team culture
Practical implications • Group supervision & debriefings • Leadership: positive, collaborative environment, build trust, open culture so staff feel able to ask for help • Secondary traumatic stress: more intense, specialist & targeted support - trauma training, clinical supervision & self-care focusing on specific symptoms • Regulators: have a role in ensuring organisations have adequate systems for compassion fatigue…(?)
Limitations • Correlational study; can’t make causal inferences • Didn’t record direct contact with children & young people • More engaged workers may have been more motivated to complete the survey; those experiencing severe compassion fatigue may have been unable or unavailable to participate • Potential for social desirability bias • Only surveyed independent services, no local authorities
Future research • More research is needed…..!....! • to explore risk and protective factors for compassion fatigue & compassion satisfaction • to identify drivers & barriers of work engagement • to assess the relationship between work engagement & compassion fatigue over time and with larger samples
Conclusion • Compassion fatigue is a concern in residential childcare • Residential childcare staff are typically engaged & highly dedicated, though greater absorption in role was associated with greater secondary traumatic stress • Staff need to recognise the signs of compassion fatigue & adopt good self-care • Organisations need to provide adequate support to sustain their colleagues
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