Building Resilience to

Combat Stress, Trauma

and Burnout.
Kenneth R. Yeager PhD
April 11, 2015

STAR/TSS Workplace Programs to Build

Resilience: Individual response to
workplace stressors

Input
Patient acuity
Family expectations
Complexity of work
Work environment
Few if any breaks

Expectations
Compassion
Fatigue

Consider
changing
jobs
Vicarious
Trauma

Desire to
help

Question
ability

You

Sense of
Accomplishment
Wellbeing

Physical
Distress

Moral
Distress

Demands
STAR Interventions
Designed to Build
Resilience and Coping

Traumatic
Stress

Stress
Anxiety/Depression
Absenteeism
Compassion Fatigue
Chronic Illness

Output

We All Experience Stress

We all face challenges

Each and every day
Sometimes we call it STRESS
Other times we call it a BURNOUT
Sometimes COMPASSION FATIGUE
3

Burnout and Compassion Fatigue

Burnout: is a prolonged psychological response to
chronic workplace stressors and is theorized to
include three dimensions: emotional exhaustion,
depersonalization or cynicism, and diminished
personal accomplishment (Maslach, Schaufeli, &
Leiter,2001)
Compassion Fatigue: The emotional residue or strain
of exposure to working with those suffering from the
consequences of traumatic events.
It differs from burn-out, but can co-exist. Compassion
Fatigue can occur due to exposure on one case or
can be due to a cumulative level of trauma.

Potential Risk for Community Workers

Community health workers deliver a broad range of
vital services and, thus, play a critical role in ensuring
the health and well-being of societys most
vulnerable members.
The high demand for their servicescoupled with
increasingly diminishing resourcescan present
significant challenges for Community Health
Workers.
Given the heavy demands placed on them, it is not
surprising that social workers often experience
psychological distress and, eventually, high levels of
burnout.

 The literature suggests that workers experiencing

burnout have an increased risk of psychological
distress, such as depression (Evans et al., 2006; N.
Stanley, Manthorpe, & White, 2007)
Research has shown that burnout can negatively
affect overall self-rated health status (Peterson et al.,
2008) and can lead to a broad range of health
problems, including:
somatic complaints (Soares, Grossi, & Sundin, 2007);
cardiovascular diseases (Melamed et al., 2006;);
sleep disturbances (Sderstrm, Ekstedt, kerstedt,
Nilsson, & Axelsson, 2004);
headaches (T. L. Stanley, 2004);
flu-like illnesses, common colds, or incidences of
gastroenteritis (Mohren et al., 2003);
6

The Need for Support Services

STAR Program Incident Response

Stages
Pre Incident Peer Support Team Development
Stage 1-3
Impact Realization
Chaos

Incident
Response

Intrusive
Thoughts

Restoring
Personal
Integrity

Triage
First Aid
Support Resources
(Peer and Manager Based)

Stage 4
Enduring the
Administrative
Review
Process

Stage 5
Obtaining
Emotional
Psychological
Support

Stage 6
Building Resilience
Isolating

Surviving

Thriving

Dropping
Out

Stabilization Resilience Building

(Figure 1. Describes wrap around services of the Healthcare Provider Incident Response
Program. adapted from Wu, 2000)

Goals of Interventions Designed

to Build Resilience

Stabilization
Symptom reduction
Return to adaptive functioning
Facilitation of access to continued care

*&^@% Frustrations!
81% reported
difficulty getting
breaks for
essentials!
Self-Care?
Self-Awareness?
Time Management?
Planning?
Lack of physical
resources?

10

Self-created and sustained

The 5 words that will get you
into big trouble:
How hard could it be?
To be effective you must have
realistic expectations.

11

12

The nega)ve screams at you, but

the posi)ve only whispers
-- Barbara Fredrickson

Genetic
Dispositions
Our Darwinian DNA utilizes some negative-emotion
mechanisms to help us pass our traits on to offspring:
- Ability to worry about the future
- Remember bad things that happened to us
- Anticipate new things that could go wrong

- These help us with survival, but not with

happiness

Demonstrated that as high of 67%

may be impacted by burnout and
compassion fatigue.

15

This study indicated 60% and

62% of front line adult and
child protective workers
experienced high levels of
both emotional exhaustion
combined with physical
illness
16

Identifies link
between quality of
patient care and
burnout .

Return On Investment?

Rondeau et al (2009) replicated Aikens (2002) findings

indicating that 41% of hospital nurses were dissatisfied with
their jobs and 22% planned to leave in the coming year.
Financial costs associated with Costs of replacing departing
nurses are significant and range from $10,000 USD to $68,000
USD per registered nurse (RN) depending on the nurse
specialty.
18

Results: Of the 27,276 physicians

who received an invitation to
participate, 7,288 (26.7%)
completed surveys. 12.9% of male
physicians and 21.4% of female
physicians met diagnostic criteria
for alcohol abuse or dependence.
Abuse of prescription drugs and use
of illicit drugs was rare.

19

Find a Sense of Purpose in Your Life

Remember why you come to work.
Put issues/experiences into perspective.
Weigh the importance of what you have
experienced.
Seek feedback from others.
Always keep in mind why you began a career in
Community health.

Dealing with difficult people

challenges if interpersonal
relationships
There are times that the
interaction with other adults
causes stress and frustration.
Can you recall a difficult
interaction that occurred
recently?
How did you characterize that
person?
21

22

Miner, A. G., Glomb, T. M., & Hulin, C. L. (2005).

Experience sampling mood and its correlates at work.
Journal of Organizational and Occupational Psychology,
78, 171-193.

Why are demeaning acts so

devastating?
30% of interactions with coworkers are positive
10% of interactions with coworkers are negative
Negative interactions had 5X stronger effect on
mood than positive interactions
Nasty people pack a lot more wallop than their
more civilized counterparts

Move away from

Seek to understand yourself

Move
toward

Move
against

Most people react in predictable ways to conflict.

Knowing how you respond to conflict is a first step
toward managing conflict.
Build skills in the responses you use the least.
Seek understanding opposed to reacting.
Use your intellectual skills to analyze the situation.
Place principals ahead of personalities.
Dont dwell on the topic take actions to clear your
head.

24

Our Tendency is to Ignore its Impact

Psychologist Hans Selye, described the General
Adaptation Syndrome (GAS) where initial
observations about infectious reactions led to the
discovery that stress can lead to infection, illness,
disease and death. There are three stages that he
discovered:
Alarm,
Resistance and
Exhaustion.

25

We Tend to Keep Our Thoughts Hidden

We see the impact of stress on our peers?
What is your natural inclination?
Do you move away from the stressed individual?
Do you move toward the stressed individual?
Do you participate in the negative discussion?
We all have a choice
One excellent outcome is to provide support, to see
difficulties as temporary and to expect to overcome
them.
Share your thoughts with others and seek their
support and feedback.
26

Live to Learn
The more you leverage challenges as opportunities
to grow and evolve the more resilient you will be.
Approach challenges with Learner Questions
Neutral,
Nonjudgemental questions such as
Whats useful here?
What are my available choices?
How can we make this better?

27

Build a Strong Social Network

Be social!
Friends lend support and perspective.
Keep people you know you can confide in close.
Talking with friends about difficult situations will not
make the situation go away but it helps to share
thoughts and gain support.

Embrace Change
Flexibility is an essential part of resilience.
By learning how to be more adaptable, you'll be
better equipped to respond when faced with a life
crisis.

Nurture Yourself
When you're stressed, it can be all too easy to
neglect your own needs.
Losing your appetite, ignoring exercise, and not
getting enough sleep are all common reactions to a
stressful/crisis situation.
Avoid checking your email before bed
Stay away from blue light
Practice relaxation techniques

Establish Goals
Crisis situations are daunting.
They may even seem insurmountable.
Resilient people are able to view these situations in
a realistic way, and then set reasonable goals to deal
with the problem.
When you find yourself becoming overwhelmed by a
situation, take a step back to simply assess what is
before you.
Brainstorm possible solutions, and then break them
down into manageable steps.

Take Steps to Solve Problems

Simply waiting for a problem to go away on its own only
prolongs the crisis.
Instead, start working on resolving the issue immediately.
While there may not be any fast or simple solution, you
can take steps toward making your situation better and
less stressful.
Focus on the progress that you have made thus far and
planning your next steps, rather than becoming
discouraged by the amount of work that still needs to be
accomplished.
Contact the STAR Program at 293-STAR! We can help.

32

Most Importantly
Take care of yourself.
Remember what is important.
Prioritize what you can do.
Get plenty of rest.
Work smarter not harder.
Record at least 3-Good Things each day.
Do something nice for a stranger.
Nurture the spiritual self.
Be kind to yourself and others.

33

Thank you for your time and attention!

Kenneth R. Yeager PhD.
Associate Professor
Department of Psychiatry
The Ohio State University
yeager.5@osu.edu
614-293-9648

34