Update from New Orleans Co-trauma and Burnout: What Started as a Day Long Workshop

1. Update from New OrleansCo-trauma and Burnout: What Started as a Day Long Workshop Rebecca L. Toporek San Francisco State University http://online.sfsu.edu/~rtoporek

2. Community Engagement: Definition “[Community engagement is] the application of institutional resources to address and solve challenges facing communities through collaboration with these communities." (Commission for Community Engaged Scholarship in the Health Professions, 2007)

3. Partnerships Between Community and Institution • Community entity brings: • knowledge of a particular community’s needs, • potential resources such as facilities, and relationships with community members. • Institutional entity brings: • expertise such as knowledge of processes, principles, models, • content specific expertise that may be useful in meeting the community’s needs • Additionally, each entity may have access to a network that increases the resources of the other

4. Application of Themes from Social Justice, Prevention, and Multicultural Literature • Establishing community partnerships: • Sharing information and power • Inclusion • Recognizing the community as experts • Multicultural sensitivity • Collaborative efforts: • Strength based • Leave tools and resources • Multi systemic and multi level • Service driven • Reflect the community’s identification of needs within the limits of the resource and time constraints • Multicultural relevance (Bond & Hauf, 2007; Goodman et al., 2004; Toporek, Gerstein, Fouad, Roysircar, & Israel, 2006; Vera & Speight, 2003)

5. Implementation Through “Giving Back” • To enact social justice and advocacy by supporting and promoting empowerment among individuals, families, and communities • To develop a process and infrastructure for “Giving Back” to the community of each host city during the annual convention of the American Psychological Association (APA)

6. Year 1: New Orleans • The 2006 APA Convention in New Orleans was the first opportunity for Give Back implementation and we faced several challenges. • Challenges • Length of time in the area • State license constraints • Limited understanding of community • Devastation of the infrastructure • Finding local SCP members.

7. Visit to Gulf Coast Led to the planning of four important events • Goal - provide training that would benefit community long term • Culminating Events: • Louisiana Children's Museum: children's coping and reactions to disaster and trauma • Designed for parents, school personnel and community organizers • Partnership with NOMHR: a secondary trauma workshop • Continuing education units through the APA for workshop participants • Hospitality Suite presentation with Sarah Hoffpauir • Material resources (books and puppets)

8. Beyond 2006 • Presentation by 2007 APA Convention updating • Donating goods again in 2007 • Establishing research team to address workforce resilience and retention efforts • Offered ethics workshop for area providers in conjunction with 2009 National Multicultural Conference and Summit

9. In the Wake of the Storm: Environment, Disaster and Race After Katrina “Minority and low income Americans are also more likely to be underserved by government and private relief agencies before, during and after environmental calamities such as Katrina” (Pastor, Bullard, Boyce, Fothergill, Morello-Frosch & Wright, 2006, p. 1)

10. In the Wake of the Storm: Environment, Disaster and Race After Katrina • “Before a disaster, minorities are more likely to be under prepared and underinsured and to be living in unsafe, substandard housing” • During a disaster, minorities and the poor are often – due to economic and language barriers – less exposed to disaster warnings, and more likely to encounter ethnic insensitivity from relief workers and government officials” • After a disaster, minorities and low-income individuals suffer slow recoveries not only because they have less insurance and incomes, but also they receive less information, fewer loans and less government relief, and encounter bias in the search for long-term housing. (Pastor, Bullard, Boyce, Fothergill, Morello-Frosch & Wright, 2006, p. 1)

11. Two Years After Katrina: A Survey of Mental Health and Addiction Providers in New Orleans and Baton Rouge, Louisiana • Four out of five providers (86%) said their caseload had increased after Katrina • Most providers have experienced an increase in patients with specific disorders, including PTSD, depression and anxiety • Low pay and “burnout” were cited most frequently by professionals as reasons they might consider leaving the profession (respondents could give more than one reason) • Inability to rebuild their homes was the main challenge respondents face that might make them leave the area National Council for Community Behavioral Healthcare – August 22, 2007

12. Toward a Healthier Worklife: Human Service Providers in New Orleans • Combining vocational, organizational, and multicultural areas of interest and expertise, a research team was formed to facilitate Behavioral Health Action Network in understanding workforce retention and burnout issues • Team members include: Sarah Hoffpauir, LCSW, Louisiana Public Health Institute; Michael Leiter, PhD, Acadia University; Christine Maslach, PhD, University of California, Berkeley; Rebecca Toporek, PhD, San Francisco State University; and Lisanne Brown, Ph.D. of Louisiana Public Health Institute

13. Assessing Human Service Providers’ Experiences • Survey assesses nonwork demands and resources with a specific focus on participants’ experiences during and after Hurricane Katrina • Inclusion of multicultural issues such as change in client population, self-perceived cultural competence, as well as cultural understanding of colleagues and supervisors • Thus far, 224 human service providers in the Greater New Orleans area have completed online survey

14. Preliminary Findings • Problems with managing both personal and work-related demands predicted burnout, turnover intentions, as well as both mental and physical wellbeing. • Respect, a sense of control at work, and confidence in the employers’ commitment to core values predicted employees’ work engagement. • Employees’ turnover intentions were a function of personal life stressors as well as work-related challenges, including value conflicts with their employer, poor relationships with colleagues and supervisors, and low levels of involvement in their work. • Employees whose lives Hurricane Katrina disrupted continued to experience distress two years after the storm. • Specifically, those who relocated to a hotel, a shelter, or outside of New Orleans reported greater exhaustion and lower mental wellbeing than did those who remained in their homes or found other local accommodation after the storm.

15. From here… • Continuing to collect survey data • Creating focus groups to collect qualitative data regarding participants’ experiences at work • Upon completion of data collection and analysis • Develop profile information and recommendations for participating organizations • Provide resources for self-care, wellness, and burnout prevention for participants • Develop policy recommendations for recruitment and retention

16. References • Bond, L. A., & Hauf, M. M. C. (2007). Community-based collaboration: An overarching best practice in prevention. The Counseling Psychologist, 35(4), 567-575. • Commission on Community-Engaged Scholarship in the Health Professions (2007). Linking Scholarship and Communities: The Commission on Community-Engaged Scholarship in the Health Professions, Retrieved on November 14, 2007 from http://depts.washington.edu/ccph/pdf_files/commissionpresentation2.pdf • Goodman, L. A., Liang, B., Helms, J. E., Latta, R. E., Sparks, E., & Weintraub, S. R. (2004). Training counseling psychologists as social justice agents: Feminist and multicultural principles in action. The Counseling Psychologist, 32(6), 793-832. • National Council for Community Behavioral Healthcare (2007, August 22). Final Executive Summary: Two Years After Katrina: A Survey of Mental Health and Addiction Providers in New Orleans and Baton Rouge, Louisiana. Retrieved on January 11, 2009 fromhttp://www.thenationalcouncil.org/galleries/press-files/Summary%20of%20Survey%20Findings.pdf. • Pastor, M., Bullard, R. D., Boyce, J. K., Fothergill, A., Morello-Frosch, R. & Wright, B. (2006). In the Wake of the Storm. Environment, Disaster, and Race After Katrina. New York: Russell Sage Foundation./ • Speight, S. L. & Vera, E. M. (2004). A social justice agenda: Ready, or not?” The Counseling Psychologist, 32(1), 109-118. • Toporek, R. L., Gerstein, L. H., Fouad, N. A., Roysircar, G. S., & Israel, T. (2006). Handbook for social justice in counseling psychology: Leadership, vision, & action. Thousand Oaks, CA: Sage. • Vera, E. M., & Speight, S. L. (2003). Multicultural competence, social justice, and counseling psychology: Expanding our roles. The Counseling Psychologist, 31(3), 253-272.