“Burnout” and how to fight with that

1. “Burnout” and how to fight with that “No More Victims” Conference March 2011 Presented by Dr Jo Clarke Consultant Forensic Psychologist University of York

2. Setting the Scent: Pt 1 A Critical Occupation One where there is a high risk of exposure to potentially traumatic events or material, that may, under certain circumstances, exert critical impact on the psychological well being of those within it Paton & Violanti, 1996

3. What the early literature told us • Consistently across studies between a fifth and a quarter of facilitators report negative effects (e.g. Farrenkopf, 1992;), broadly divided into: • Cognitive • Emotional • Behavioural • Sexual

4. Examples of Cognitive Changes • Increased difficulty making decisions (Bird Edmunds, 1997) • Intrusive visual imagery about sexual violence (Jackson et al., 1997) • Ruminating over offence details (Turner, 1993) • Doubts about competence (Ellerby et. al., 1993) • Increased cynicism and suspicion of others (Farrenkopf, 1992)

5. Examples of Emotional Changes • Decreased sensitivity and dulling of emotion (Farrenkopf, 1992) • Feelings of anger, frustration, disillusionment, depression, inadequacy and guilt (Ellerby et al., 1993) • Heightened anxiety and fear (Jackson et al., 1993) • Increased feelings of helplessness (Bird Edmunds, 1997)

6. Examples of Behavioural Changes • Sleep disturbance,increased alcohol/drug use, increased absenteeism (Bird Edmunds, 1997) • Deceased sense of humour (Farrenkopf, 1992) • Avoidance of physical contact with children (Turner, 1993) • Increased general irritability (Bird Edmunds, 1997) • Depersonalising clients (Hill, 1995)

7. Examples of Changes in Sexual Behaviour • Reduced interest in sex • Reduction in sexual behaviour • Avoidance of sexual behaviour • Distraction during sex (Ellerby et al., 1993) • Impotence • Intrusive sexual imagery (Turner, 1993)

8. Shortcomings of what we know • Symptoms made to fit existing conceptualisations • Burnout (e.g. Farrenkopf, 1992) • Secondary Traumatic Stress (e.g. Ellerby) • Vicarious Trauma (Rich, 1997) • Compassion Fatigue (e.g. Figley, 1995) • Based on poorly constructed and/or non-validated and/or general measures • Most commonly used is the Maslach Burnout Inventory (MBI – Maslach and Jackson, 1981) • 3 dimensions • Emotional Exhaustion • Depersonalisation • Reduced personal accomplishment

9. Shortcomings of Literature (cont’d) • Based on cross sectional methodology • Over reliance on self-report • Studies are generally descriptive • Assumption that effects should be attributed to nature of material • No comparison with other mental health professionals

10. Setting the Scene: Pt 2 Caring about members of Critical Occupations means working to ensure that “any damage is only temporary, and that they will succeed in their struggle to restore their psychological integrity” Adapted from Lazarus (1999)

11. The Rewards • Kadambi and Truscott, 2003 • Protection of the public • Offender change and wellness • Connection to colleagues • Enjoyment of counselling • Offender specific change • Socially meaningful curiosity • Professional benefits

12. Working with the Sex Offenders: The Impact Statistics About a quarter of people in Critical Occupations experience negative impact (that they attribute to their work) at any given time.

13. About 75% don’t • People don’t feel bad all of the time • Probably, over time, all of us experience some sort of negative impact MOST OF US RECOVER!

14. Model of Dynamic Adaptation (Clarke 2004) Positive Psychological Outcome Static Factors Critical Occupation The Person Negative Psychological Outcome Stable Factors Dynamic Factors

15. About the Factors Static Factors Factors that are fixed or unchanging or change in a highly predictable way, e.g. gender, qualifications, age Stable Factors Factors that are potentially changeable but relatively stable; factors that under normal circumstances only change slowly, e.g. coping style, perspective taking skills Dynamic Factors Factors that change rapidly and/or unpredictably, e.g. changes in organisational structure, events not under personal control (accident)

16. About the factors Critical Occupation This includes all the “on-the-job” type factors, such as types of unit/prisoners, colleague relationships, policies and procedures Positive Psychological Outcome Anything rewarding about the job, from working with a great team, to a previously highly aggressive prisoner getting through the day without hitting anyone! Negative Psychological Outcome Any cost, such as feeling irritable, tired, suspicious of others, anxious when alone, anxious around others etc

17. The Model of Dynamic Adaptation (Clarke, 2004) • Protection of the public • Offender change and wellness • Connection to colleagues • Enjoyment of counselling • Offender specific change • Socially meaningful curiosity • Professional benefits POSITIVE OUTCOME STATIC FACTORS Age Gender Time in Role Ever a victim Living status Parent Facilitator Status CRITICAL OCCUPATION Colleagues Environment Funding Resources Organisational policies, practices and culture The Person Disrupted schema Intrusive imagery Rumination Difficulty making decisions Heightened fear and anxiety Feelings of anger, guilt, frustration, disillusionment, depression, inadequacy Decreased sensitivity and dulling of emotion… NEGATIVE OUTCOME STABLE FACTORS Coping style Perspective taking Emotion control Emotional sensitivity Social Support Skills - Modelling Personal trauma Health Family Management DYNAMIC FACTORS

18. Hot off the Press • The 3 most important MDA factors associated with resilience are:- • Age (static) • Organisational Culture (dynamic/critical occupation) • Detached Coping (stable) Fox & Clarke, 2010

19. Model of Dynamic Adaptation (Clarke 2004) Intervention 2 Positive Psychological Outcome Static Factors Critical Occupation Negative Psychological Outcome Stable Factors Dynamic Factors Intervention 4 Intervention 3 Intervention 1

20. Future Research? • Determine predictors of resilience and job satisfaction among European Union member states probation officers • Identify good organizational practice in minimizing risk of negative outcome and maximizing likelihood of positive outcome for EU probation staff • Develop a more detailed understanding of organisational culture and the impact of individual differences • Evaluate of a range of interventions, including training in detachment (Roger, 2004) • Implement a longitudinal study to develop a better understanding of the Process of Dynamic Adaptation