The Argument for Comprehensive Supervision Supporting Great Staff and Good Trauma Work Crisci amp Mayer Toronto Ontario Canada Phone 416 4801611 Fax 416 4802922 nmayerckmconsultationcom ID: 765837
Download Presentation The PPT/PDF document "The Argument for Comprehensive Supervisi..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
The Argument for Comprehensive Supervision: Supporting Great Staff and Good Trauma Work Crisci & MayerToronto, Ontario, CanadaPhone (416) 480-1611 Fax (416) 480-2922 nmayer@ckmconsultation.com www.ckmconsultation.com 2011 Sexual Assault Care ConferenceNancy N. Mayer, M.S.W., R.S.W © Crisci & Mayer 2011Disclaimer/Copywrite Information:The information being presented in this workshop is copywritten and is intended for instructional use by the participants of this workshop only. Reproduction and distribution of this material is strictly prohibited. This information cannot be distributed electronically, or duplicated in any fashion without written permission of the authors.
The Argument for Comprehensive Supervision Workshop Objectives:Be able to identify the potential difficulties that workers experience when working with sexual assault victimsUnderstand how solid clinical supervision assists workers in providing good servicesUnderstand a two-tiered supervision model that accommodates staff needs for clinical supervision as well as creating a safe space to explore personal reactions to clients Recognize when to utilize external consultants to assist staff
There are significant challenges in working with people who have been sexually assaulted
Traumatic e vents result in clients being subjected tooverwhelming, uncontrollable experiences that psychologically impact them and create feelings of helplessness, vulnerability, loss of safety, and loss of control
Challenges Being able to establish safety can be difficultDeveloping a trusting therapeutic relationship is hardThrough the telling of the traumatic experience, the therapist bears witness to the abuse Empathic engagement with the client makes knowing that story more difficultPotential Involvement with justice system - Potential Impact on therapeutic alliance - Potential risks/liability to therapistTransference and counter transferenceIntersecting lines between therapists personal history and lifeImpact of workplace politicsCompassion Fatigue and Secondary Trauma
Compassion FatigueCompassion fatigue is a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper. Dr. Charles Figley
© Crisci & Mayer Vicarious Traumatization
Vicarious Traumatization refers to the transformation in the trauma worker’s inner experience resulting from empathic engagement with clients’ trauma material.Pearlman and Saakvitne, 1995© Crisci & Mayer
Through exposure to clients’ graphic accounts of sexual abuse experiences and to the realities of people’s intentional cruelty to one another, and through the inevitable participation in traumatic reenactments in the therapy relationship, the therapist is vulnerable through her empathic openness to the emotional and spiritual effects of vicarious traumatization. Pearlman and Saakvitne, 1995Vicarious Traumatization© Crisci & Mayer
These effects are cumulative and permanent, and will be evident in both the workers professional and personal life.Pearlman and Saakvitne, 1995 Vicarious Traumatization© Crisci & Mayer
It is not the responsibility of our clients, nor in any way an indictment of them. It is an occupational hazard that must be acknowledged and addressed. Pearlman and Saakvitne, 1995Vicarious Traumatization© Crisci & Mayer
Secondary Trauma is a process, not an event © Crisci & Mayer
IMPACT OF SECONDARY TRAUMA Causes Disruptions to one’s sense of:MeaningConnectionIdentity World ViewTolerancePsychological needsBeliefs about self and others Interpersonal relationshipsSensory memory Spirituality © Crisci & Mayer
CONTRIBUTING FACTORS TO VICARIOUS TRAUMATIZATION Specific Characteristics of the Therapy/Relationship and its Context Particular Characteristics and Vulnerabilities of the Listener © Crisci & Mayer
CONTRIBUTING FACTORS TO SECONDARY TRAUMA SITUATIONNature of the workNature of the clienteleCumulative exposureOrganizational contextSocial and cultural context Pearlman & Saakvitne, 1998 © Crisci & Mayer
CONTRIBUTING FACTORS TO SECONDARY TRAUMA THERAPIST/LISTENERPersonal HistoryPersonality and defensive stylesCurrent life contextTraining and professional historyPersonal TherapyPearlman & Saakvitne, 1998 © Crisci & Mayer
Very few epidemiological studies in the workplace – some with firefighters, police, soldiersStudies challenge previous belief that PTSD was a normal response to a traumatic event and can occur to anyone© Crisci & Mayer
Research suggests that those who “get” PTSD are influenced by: a specific predisposition to PTSD a predisposition to mental illness that can be triggered by adversity the actual traumatic event and the meaning of that event© Crisci & Mayer
Why a Two Tiered Model of Supervision Supports Great Staff and Good Trauma Work
Supervision Is the cornerstone to sound clinical practice. It provides oversight and accountabilityHaving others examine the work we do with clients gives us the opportunity to become knowledgeable about issues outside our awarenessGetting feedback and another point of view can improve effectiveness
It’s a Professional Thing to DoAll mental health workers will be affected by the work they do It is professional behaviour to acknowledge these feelings and examine them to ensure no harm comes to clientsNot to do so can result in unprofessional behaviour and potential professional misconduct and error
Kadushin’s Definition of Supervision A supervisor is an agency administrative staff member to whom authority is delegated to direct, coordinate, enhance, and evaluate on-the-job performance of the supervisees for whose work she/he is held accountable. In implementing this responsibility the supervisor performs administrative, educational, and supportive functions in interaction with the supervisee in the context of a positive relationship. The supervisor’s ultimate objective is to deliver to agency clients the best possible service, both quantitative and qualitative, in accordance with agency policies and procedures. © Crisci & Mayer, 2003
It is management’s job to manage and ensure implementation of the goals, missions, policies and procedures of an organization. Staff are accountable to their managers, the managers to the executive director and the executive director to the Board. The board is accountable to the funders and the wider community
Community Board E.D. Management Team Supervisor CL W Human Service Organizations
Focus of this ModelAdministrative - the promotion and maintenance of good standards of work, co-ordination of practice with policies of administration, the lines of accountability are clear Educational - the educational development of each individual worker on the staff in keeping with the organizations mission, policies and proceduresSupportive - the maintenance of a positive working relationship focused on providing the best possible service to the client’s
Limitations of Internal SupervisionClient’s needs are paramount – which may limit Organizational accountability issues and the supervisors role in performance appraisal and discipline issues can negatively effect – trust with personal informationNeed to maintain boundaries – supervisors should not become “therapists” to their staff Potential issues when supervisee’s therapists do supervision
Case for Ongoing Supervision Allows ongoing evaluation and feedbackMechanism for contact and accountabilityTool to contain anxiety and problem-solveEducational opportunity Promotes fair work evaluationSupports good casework Vehicle for Support
Case for Two Tiered Model of Supervision Internal supervision allows for ongoing evaluation of staff and accountability to the organization and its missionSince organization assumes liability, it should be responsible for setting case direction and making major case decisionsThe addition of a second form of supervision conducted by an external supervisor with groups of staff allows the staff to deal with the intersecting issues between casework and their personal life in private and without potential repercussions by organization (when the issues are not potentially libelous)
Case for Group Supervision External Supervisor Group supervision allows staff to normalize that personal issues can effect the professional work if not monitoredAllows staff to learn from each otherIs cost effective. Conducting these sessions in groups makes the cost possible for most organizationsWill promote staff cohesion
Issues with Use of External Consultants for Organizations External consultant has a responsibility to the client and the organization to report issues that come up that could lead to liability for the organization and/or harm to the clientThere should be a written contract between the external supervisor with the organization and the staff that states the aboveThe staff when ever possible will be encouraged to “report” themselves to their organization with the consultants support if necessaryExamples: sexual exploitation of clients, staff impairment that would harm client
In Summary Our experience has shown that the commonly used model of supervision with an internal supervisor has limitations, especially for trauma workThe addition of group supervision with an external supervisor with clinical knowledge of trauma better addresses the issues raised in the literature about secondary trauma and compassion fatigueTogether, both approaches provide the necessary resources to ensure good clinical work and support of good staff
In 1997, we started Crisci & Mayer, Consultation Counselling and Training, to provide services to professionals in the human services field. With our combined expertise and knowledge this partnership has been successfully offering counselling services to people seeking help for themselves or their family members and offering training to the professional community. We also provide consultation to professionals, both on an individual and an organizational basis.We are committed to improving the lives of people who have experienced trauma or who are struggling with individual, couple or family problems and to bringing innovative perspectives to our training and practice, based on the latest research and knowledge. Geraldine Crisci, M.S.W. Nancy N Mayer, M.S.W., R.S.W.© Crisci & Mayer 2006 Disclaimer/Copyright Information: The information being presented in this workshop is copy written and is intended for instructional use by the participants of this workshop only. Reproduction and distribution of this material is strictly prohibited. This information cannot be distributed electronically, or duplicated in any fashion without written permission of the authors. Crisci & Mayer 55 Eglinton Avenue East, Suite 506 Toronto Ontario Canada M4P 1G8 www.ckmconsultation.com (416) 480-1611
www.ckmconsultation.comVisit our website to learn more about upcoming training events and certification programs that may be beneficial for you