The following are free-form notes, though not an exact accurate transcript, of Bob Phillips’s presentation to accompany the slides. Follow along with the session slides, above.
New Mexico workforce coalition… How are we going to replace an aging workforce, and how are we going to bring people from the bottom up? Sounds like many of you are struggling with those things in your organizations…
Human services organizations in New Mexico have about the same turnover as 7-11 stores. Our data suggests that turnover is even worse among administrators—that they may turnover even more often than direct service staff.
You have some people who come and stay for five minutes, but then you have people who’ve been around forever that maybe should be gone… it’s about filling the middle.
Occupational health stressors drive people out of these jobs and careers—in particular, my work is about understanding the risk and protective factors around compassion fatigue and burnout.
It’s quite shocking to me that these things aren’t addressed more systematically than they are. Firefighters are prepared for danger—and they’re trained to save each other first. The danger is part of what attracts them to that work, in my experience. But how many people in human services come to the work fully understanding that the work has inherent stressors… that these things can be quite distressing… some of the people I’ve interviewed thought they were going to do this forever and save the world, but they find it’s not what they thought it would be.
Why don’t we show them? We’re afraid to run them off… We struggle with mental health stigma…
Stressors may affect people out of the blue in some cases. I hope that people will share this information with their staff and people they care about—and I think we need to measure this consistently.
People can and do recover from these things, and more often than not—when they do recover, they recover stronger than they were before. How we can cultivate in organizations protective factors to inoculate staff or have staff recover more quickly from these things?
Burnout is acquired through consistent contact with emotionally demanding situations. It’s a process, not a lightbulb. Unlike compassion fatigue, it’s a gradual erosion of commitment, etc. It’s acquired over time. But you can see it from people new in the field—in my experience that means they come to the field with something in their lives that’s already burning them out.
Compassion fatigue is an accessible, kind of friendly term for vicarious traumatization or secondary traumatic stress… We see a lot of compassion fatigue in our work, but Interestingly, you’ll actually see this a lot in journalism. In journalism schools they’re talking about this more than we are in social work schools.
The recognition that people can be traumatized directly or indirectly. Traumatic syndromes, by definition, have to have some external reference point where something outside overwhelmed a person’s coping ability. The only people that don’t have to worry about compassion fatigue are people that never cared. That’s unusual in this field—empathy may be a vector for this that’s powerful. A strong emotional connection… you’ve opened up this mainline that’s capable of transmitting whatever they’re feeling to what you’re feeling.
In those with compassion fatigue, particularly what I’ve seen a lot is a sense of foreshortened future—they can’t see tomorrow. They don’t know what life’s going to do next or what it’s going to be. That’s very common in my experience. People doing a job for 15 years and suddenly they feel they can’t do it one more day, and they don’t know what else they can do.
52 percent of us are at HIGH risk for compassion fatigue. And burnout is around 26 percent. These are not rare or even uncommon. Does that seem right in your experience?
How effective we are at developing relationships is a huge factor in helping—in outcomes. And to do that we need empathy—we won’t be helpful unless we create these relationships. But once we’ve done that, we’ve created this mainline from their pain to ours.
Most people have experienced some trauma in their own lives. However, you’ve recovered from that, compartmentalized that—one always has the risk of over-generalizing your experience to the experience of other people. Most people are deeply affected by children’s suffering.
Most of the people who work in this area have these things, but we rarely train for it or supervise around these issues in the field.
In order to cope, we often disengage, which sets off a whole chain of things… troubled and fascinated about disengagement from social relationships, which is massively hazardous to your health.
We spend a ton of time at work. “The great, good place” – the sociology of those “third places” where we find social connections outside of family and work. Number one predictor of longevity of health is the density and quality and nature of social relationships—that study has been generalized to tons of other populations as well. The worst thing you can do is solitary confinements where you disconnect and disengage, it’s the most painful kind of human emotion—loneliness, rejection, same pathways in the brain as physical pain.
If you are strongly socially connected—you reduce your risk of dying of anything by 50 percent. How many people can I call to help me out, who will really be there for me? The density of how many relationships like that you have. How many people could just walk in and have “refrigerator rights.” Who cares about you—who you can count on—the number and quality of those relationships. 1000 weak supports might be as good as 10 really huge supports. But the number and frequency of that kind of thing is huge….
Facebook is somewhat negatively correlated with mental health. There’s two things that happen that produce a depression—making social comparisons, they have that and I don’t… Fear of Missing Out (FOMO) on guard duty all the time. Social media outlets have their place and usefulness, but they do not take the place of real friends.
Disengagement in the workplace, from the work family—is that a sign? Is that too simplistic to say that that’s compassion fatigue? No—I don’t think so, those may be initial symptoms of that compassion fatigue. These things are isomorphic—if it’s happening here, it’s probably happening there. If it’s happening at work, it’s probably also happening at home or in third places. The cost of caring is too high, so they stop caring. Family place or third place to refill that cup… but in general, these things happen across all three places.
Something encouraging—political activism, when people give a damn about what’s happening around them in society—in real life, not on Facebook—those things powerfully connect us to something larger than ourselves… political activism is strongly negatively correlated with compassion fatigue.
What do you do about it? Are there ways to inoculate against it? We’ve identified a lot of the risks, but you may also have a ton of protective factors. Risks are only half of the story. If people are exposed to risk without a lot of protective factors, that’s a danger.
Compassion satisfaction or compassion exhilaration—helper’s high. The more of that you can get in your life, the better. Build in a lot of successes in your work. The measurement and cultivation of HOPE—how you keep hope alive in your work. Resiliency training.
Whatever’s going on for you—if you can make it (1) comprehensible. If it stays senseless, you can’t cope with it. It has to make sense in some way. It has to be (2) manageable, you have to be able to calm down, etc. And you have to be able to go back and make something that happened to you (3) meaningful. Sense of coherence is hugely negatively associated with compassion fatigue.
Fun—what percentage of your life do you consider fun? Whatever that is for you… what percentage of your life would you say is fun? We found a cut score that says—40 percent or more, they’re remarkably protected against these things. Less than 40 percent, not so much. “Cultivated positive emotion.”
Crisis has an element of danger and opportunity in it. Traumatic growth.
The Gallup organization—takes the results of polls and surveys and takes them into the world of management consulting. But they began to recognize based on data from 2 million people! (We have nothing like this in academics.) That shows how some organizations are remarkably resilient… Measuring the strengths of an organization is a huge deal.
All of these things contribute—there’s not a bad one on the list, but some are more important than others… [see Gallup workplace questionnaire]…
With regards to research, community colleges are agile in working with these things—establish some official relationships. You might find people who love to crunch numbers, like me. You never know what kind of partnership you might set up….
Motivational Interviewing was born here in New Mexico. Took thirty years to make it a success. Applications from the success of the Military’s Master Resiliency Training. We can train it. There’s ample evidence there, for that…
When is the last time you asked yourself what you wanted to be? Personal equity evaluation.
You are: your rolodex, your projects, your clients. Business = rolodex, again, social connections. Independent contractor mindset—free agent nation. We should teach social workers how to market themselves, how to develop products, operations, client services, information management, time management, planning—those are skills people need in the modern workplace that people often don’t get trained in. Think about other kinds of things that make people’s work better. If they can do these things better, they are less likely to burn out. To have those satisfying skill sets… Less anxiety about letting people go, they have less anxiety about going because you’ve given them skillsets…
With regards to using the ProQOL to measure potential stressors – probably, formally, use it at least once a year. But you can also use it just to structure an interview.
Being able to assess the cost of burnout or compassion fatigue in an organization—what’s the cost of care?… Correlation for SRS measurements to estimate the prevalence of high risk for compassion fatigue or burnout, there might be a way to pair those up. To see if the performance outcomes would be different—to extrapolate cost offsets, if you do something to inoculate people to this. The cost off-sets of additional training. There’s a cost related to having a staff member focus on taking care of staff (like at Children’s Bureau), but there’s outcomes there—lower turnover saves money.