08/11/18 Dr Kerry Audin, Consultant Clinical Psychologist Independent - - PowerPoint PPT Presentation

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
• It’s important...
• It’s timely…

Why?

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
• thers; 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 practitioners & senior care practitioners 51 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 Satisfaction Burnout Secondary 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 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,
• pen 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