Predicting Compassion Fatigue and Burnout in Practitioners

By Rachel Dorman, MS & Heidi Radunovich, PhD

In previous posts we have discussed the importance of mental health providers protecting their own well-being by being aware of risks associated with compassion fatigue, secondary traumatic stress, and burnout. Today we will continue our discussion by looking at factors that may put one at risk or protect one from both compassion fatigue and burnout.

Thompson, Amatea, and Thompson (2014) conducted an online survey to learn more about how gender, length of career, appraisal of working conditions, and personal resources relate to burnout and compassion fatigue among mental health counselors. The study consisted of 213 mental health or licensed professional counselors who completed a master’s degree in counseling, had been practicing for at least six months, and were working with clients 20 hours per week or more. Those practitioners who had positive working conditions, had worked in the field longer, and who used mindfulness were found to be less likely to experience compassion fatigue or burnout. However, maladaptive and emotion-focused coping were related to compassion fatigue and burnout. There did not appear to be a gender difference in report of burnout, but women were more likely to report compassion fatigue than men.

The authors provide many recommendations for counselors and supervisors. They suggest that counselors who are working in a less supportive environment seek support from colleagues, work with their employers to try to improve working conditions, and do what they can to take care of themselves. Supervisors should be sensitive to the possibility of burnout and compassion fatigue among their supervisees, and should try to educate their supervisees on the nature of stress in the counseling relationship, as well as making sure that they are using effective coping strategies to deal with work stress. Finally, the researchers strongly encourage practitioners to explore positive coping strategies to offset the potential negative effects of job stress, such as using mindfulness. For more information on burnout and compassion fatigue check out our previous blogs: Self-care When Caring for Others or Self-care for the Military Family Advocate.

Resource: 

Thompson, I., Amatea, E., & Thompson, E. (2014) Personal and contextual predictors of mental health counselors’ compassion fatigue and burnout. Journal of Mental Health Counseling, 36(1), p. 58 – 77. ISSN: 1040-2861

This post was written by Rachel Dorman, M.S. and Heidi Radunovich, PhD, members of the MFLN Family Development (FD) team which aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network FD concentration on our website, on Facebook, on TwitterYou Tube, and on LinkedIn.

Working with Members of the Military: Secondary Traumatic Stress

By Rachel Dorman, MS & Heidi Radunovich, PhD

Due to the growing rate of military members suffering from PTSD and seeking mental health treatment, mental health providers may be exposed to indirect trauma more than ever. As a result, providers are at risk of experiencing secondary traumatic stress. In today’s blog we will be taking a closer look at secondary traumatic stress by discussing a study conducted by Cieslak and colleagues (2013).

The researchers in this study examined indirect exposure to trauma, and its relationship to secondary traumatic stress among mental health providers working with military members. The authors defined secondary traumatic stress (STS) as having “PTSD-like symptoms” after indirect exposure to trauma. The study participants included 223 psychologists, counselors, or social workers who provide mental health services to military service members, and as a result have been exposed to indirect trauma within the past year of working. The participants completed a survey which assessed level of indirect exposure to traumatic stress, appraisal of the impact of exposure, direct exposure to trauma, symptoms of secondary stress, and workplace and professional support characteristics.

In relation to prevalence of STS, the researchers found that over 19% of the participants met the criteria of intrusion, arousal, and avoidance associated with a PTSD diagnosis. Intrusion was found to be the most common criteria at 57%, then arousal at 35%, and lastly avoidance at 30%. The researchers found that seeing higher numbers of traumatized clients in practice increased the likelihood of experiencing STS. It was also found that how practitioners viewed indirect exposure to trauma impacted likelihood of STS, such that the more negatively a practitioner felt about the indirect exposure, the higher the number of STS symptoms. Overall, having too many clients, higher levels of a personal history with trauma, and higher levels of negative appraisal of indirect exposure were the strongest predictors for STS symptoms.

The researchers call for the need for more awareness and appraisal of secondary traumatic exposure for mental health providers working with the military population. To learn more about dealing with secondary traumatic stress check out previous blogs: Self-care for the Military Advocate  or Self-care When Caring for Others.

Resource:

1. Cieslak, R., Anderson V., Bock. J., Moore, B., Peterson, A., & Benight, C. (2013). Secondary traumatic stress among mental health providers working with the military: Prevalence and its work- and exposure-related correlates. The Journal of Nervous and Mental Disease, 201(11), p. 917 – 925. DOI:10.1097/NMD.0000000000000035

This post was written by Rachel Dorman, M.S. and Heidi Radunovich, PhD, members of the MFLN Family Development (FD) team which aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network FD concentration on our website, on Facebook, on TwitterYou Tube, and on LinkedIn.

Financial Planning for the Second Half of Life

By Molly C. Herndon
Social Media Specialist

On September 23, Dr. Barbara O’Neill will present Financial Planning for the Second Half of Life. More than a webinar about retirement planning, this 90-minute session will focus on:

  • Common financial errors of older adults
  • Statistics about older adult finances
  • Common later life financial characteristics and required decisions
  • 15 key later life financial planning topics (e.g., creating a retirement “paycheck,” required minimum distributions, untitled property transfers, and leaving a legacy)
  • Personal finance resources for older adults and financial practitioners
https://creativecommons.org/licenses/by/2.0/legalcode
Photo by Jon Rawlinson. Licensed Creative Commons. 

This webinar will allow participants to engage in an interactive discussion of the realities of retirement finances, including selecting and paying for health care benefits, managing asset withdrawals, and creating workable retirement planning strategies for older adult clients.

This webinar is approved for 1.5 CEUs for AFC-credentialed participants. To join, review the slides and for more information about the speaker, click here. 

 

This post was published on the Military Families Learning Network blog on September 9, 2014.

 

Mental Health Needs of Military Wives

By Rachel Dorman, MS & Heidi Radunovich, PhD

Overcoming stigma and barriers to seeking mental health treatment is not an uncommon issue for military members and their families. Identifying barriers can help shed light on strategies needed to overcome such obstacles and how to provide care for those who need it. In today’s blog we are going to learning more about barriers military wives encounter when seeking mental health treatment.

Lewy, Oliver, and McFarland (2014) conducted a study to learn more about military wives, their mental health needs, and barriers they may have to seeking mental health treatment. The study consisted of 569 female participants who completed an online survey. The survey examined depressive symptoms, nonspecific psychological distress, and barriers to obtaining mental health services. The study found that over half (51%) of the participants reported high levels of depressive symptoms, and another 27% indicated depressive symptoms, but at a lower level. The study also found that 37% of the wives surveyed reported serious psychological distress, and 44% did not receive the mental health treatment they felt they needed (higher than the general population). Those who were older and higher levels of distress were more likely not to get needed treatment.

The most common barrier to seeking mental health treatment was finding time during the day to attend treatment (38%). Other barriers commonly mentioned included fears that the treatment would not be confidential (26%), concerns about how others in the community might perceive the treatment (19%), lack of knowledge of where to go for treatment (25%) and concerns about cost (19%). Over a third of military wives, 35%, reported concern that mental health providers would not understand the issues facing military spouses, and 29% expressed concerns about whether they could trust a therapist.

The authors recommend that clinicians seek education regarding best practices for serving military service members and their families, including programs such as RESPECT-Mil. The researchers also highlight that, because social media was found to be an effective tool in reaching military wives for recruitment in this study, it might also be an effective means of providing information about mental health services. To learn more about helping individuals overcome barriers to seeking treatment check out our previous blog, Shifting the Stigma: Mental Health and the Military 

Resource:

1. Lewy, B., Oliver, C., & McFarland, B. (2014). Barriers to mental health treatment for military wives. Psychiatric Services, Brief Reports, p. 1 – 4. doi:10.1176/appi.ps.201300325

This post was written by Rachel Dorman, M.S. and Heidi Radunovich, PhD, members of the MFLN Family Development (FD) team which aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network FD concentration on our website, on Facebook, on TwitterYou Tube, and on LinkedIn.

September Caregiving Webinar: Give Care. Take Care.

Join us on Wednesday, September 17 @ 11:00 a.m. EDT as we host our FREE monthly professional development webinar entitled, Give Care. Take Care, presented by Andy Crocker.

Watch and listen as Andy provides a sneak peek into what you can expect from the upcoming September 17th webinar.

How to Join the Webinar

*No registration is required; simply go to Give Care. Take Care. the day of the event to join. The Military Families Learning Network will be providing 1.0 National Association of Social Workers (NASW) continuing education credit to credentialed participants. Certificates of Completion will also be available for training hours as well.

The webinar is hosted by the Department of Defense so you must install security certificates if you are not located on a military installation. Instructions for certificate installation can be found by clicking on DCO Adobe Certificate Installation.

For those who cannot connect to the Adobe site, an alternative viewing of this presentation will be running on Ustream. You can connect to the Adobe webinars using iPhone, iPad, and Droid apps. Search for DCO Connect in the respective stores.


This post was published on the Military Families Learning Network blog on September 2, 2014.

Caregiver Mini Series: 444 Days in the First Year (Series Finale)

“…to this day I still cringe when someone refers to me as a widow.”

The first few days following my husband passing are still very much a blur.  I can remember the flight home, the loneliness that consumed me, and the reality that slowly began to sink in.  I was used to not having my service member home, however knowing I would never hear his voice, feel his touch, or have him hold me was almost too much for my mind to comprehend.

There was so much to do, and I was extremely overwhelmed.  I had plenty of friends and family around me but I still felt very alone.  There was so much to do and I was not quite sure where to start.  My mind raced. My heart pounded.  With every new thought I was once again reminded that I was alone.

No one could have prepared me for the transitional process, or the journey I was about to embark on.  I felt separated from those around me.  I was no longer part of the “active duty” family that I had known for so long, yet I did not quiet feel as though I fit in with the civilian world either.  I felt like an imposter in many ways, simply because I didn’t know what to feel or where I fit in.

My military friends were beginning to welcome their service member’s home, and I was in the beginning processes of “clearing housing.”  I didn’t want to be treated differently and to this day I still cringe when someone refers to me as a “widow.”  My entire world and everything in it was different.

Things moved so quickly that there was no time for me to even process what was going on around me.  Before I knew it, I was packing up our household goods and placing our entire life in boxes.  I was once again saying goodbye to something that I could never get back.  The last home Steve and I shared together would soon be occupied by another family trying to make their way in the uncertain world of the military life–I was to begin mine alone without him.

Grieving for what is Lost

For the military spouse, packing up and moving regularly is part of the military culture. However for a military spouse whose service member has passed away, the familiarity of packing up household goods, and clearing quarters quickly becomes unfamiliar territory.

Typically speaking, when a loved one passes away we are able to choose a little more freely the rate at which we will go through the grieving process.  We are able to reminisce with friends and family as we rummage through our memories, shared experiences, and material belongings or we have the ability to say, “I don’t feel up to this right now.”

When a Service Member passes away however, the entire process seems to be expedited.  Quickly quarters are to be cleared, a new home must be found, and papers must be signed. I remember feeling angry. I felt robbed of the ability to have any time to process what was going on around me, and it was the one time I wanted someone to understand and realize what it was they were asking me to do…I was a widow.

The transitional process that a military family will go through after their service member passes is different in many aspects than that of a civilian. Getting “stuck” in the grieving process is highly possible, especially for those families who never have the opportunity such as I, to be with their loved one during their final hours.

I am so grateful for the many wonderful people who were there during my time of darkness, and there are no words to describe the gratitude I have for those individuals. I realize I am blessed in many ways to have had the opportunities that I did, however I feel as though the need to take a closer look at the transitional process for the wounded family is real. I find myself wondering how many other spouses, children, mothers, fathers, and family members feel as though their ability to grieve has been stunted, or as if they are stuck within the process simply because of the expedited nature.

Missed the beginning of the series? Go to ‘The Phone Call’ to read the first installment of this caregiver series.


Tabitha_FamilyMeet Tabitha…

The caregiving mini-series, 444 Days in the First Year, was written by Tabitha McCoy. Tabitha is a contributor to the MFLN–Military Caregiving concentration team and is a former military caregiver to her husband, SGT Steve McCoy. In this mini-series, Tabitha shares her personal story of caregiving, loss, grieving, and transitioning, as well as insight and advice for both professionals and family caregivers as she recounts the 444 days following her husband’s injuries and then unfortunately his death in June 2008.

Tabitha holds a Bachelor of Science in Psychology, and is currently a graduate student at Valdosta State University where she is pursuing her Master’s degree in Marriage and Family Therapy.

This post was published on the Military Families Learning Network blog on August 29, 2014.

Intimate Partner Violence and Co-Occurring Conditions

Jay Morse and Heidi Radunovich, PhD

Last July and August, we published several blogs about domestic violence. During that month we highlighted definitions of domestic violence, pervasiveness, warning signs, how to differentiate between different types of violence, and work with different types of family violence.

In today’s blog we review Tinney and Gerlock’s (2014) recent article on distinguishing between Intimate Partner Violence (IPV) and violent behaviors associated with mental health issues. The researchers highlight a common combat-related mental health conditions including: post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), substance use disorder (SUD), suicide, and depression.

The researchers make two important distinctions when considering the interaction between IPV and other conditions: First, domestic violence can be present in many forms including coercive violence or resistive violence for instance; and second, the context of the violence (why is it occurring, and what is the impact on the victim) should be considered when making treatment recommendations. Sometimes there are co-occurring conditions, meaning that there could be IPV in addition to a mental health issue. At times it might be difficult to distinguish between what is a mental health-related issue and what is IPV.

According to the authors, “IPV occurs when there has been an act of physical or sexual violence in an intimate relationship and the range of offender behaviors continually remind victims that violence is always a possibility” [1].Tactics might include: intimidation, coercion, threats or other forms of emotional abuse. To distinguish between tactics associated with IPV, and symptoms of co-occurring disorders, the specific symptoms of the specific disorder (e.g., PTSD, TBI, or others) should be considered in relation to the tactics used in IPV (see table below).

It is important to note that these conditions do not occur only within the military, but also occur within the civilian population. In their review, the authors discuss other research studies that relate PTSD to IPV, however, any form of IPV involving military members can occur whether co-occurring conditions such as PTSD are present or not. For instance, a service member returning from combat or a civilian with a trauma history may experience PTSD symptoms including experiencing distressing events or nightmares. It can be difficult to determine whether violent acts associated with a disorder are related to IPV, or simply reflect symptoms of the disorder. Without considering the context, motivation, and possible other symptoms related to the act, the behavior may be indistinguishable. However, the authors note that all violent acts are dangerous, and potentially lethal, so regardless of the cause it is important for family members to have plans for safety in place.

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The Department of Defense offers a wide range of support programs for victims and survivors of domestic abuse through their Family Advocacy Program. The Military Families Learning Network is available to serve military family service professionals.

Information on IPV assessment and tools are available from the Centers for Disease Control and Prevention’s Measuring Intimate Partner Violence Victimization and Perpetration: A Compendium of Assessment Tools [2].

Resources:

1. Tinney, G., & Gerlock, A. A. (2014). Intimate partner violence, military personnel, veterans, and their families. Family Court Review, 52(3), 400-416. doi: 10.1111/fcre.12100

2. Thompson, M. P., Basile, K. C., Hertz, M. F. & Sitterle, D. (2006). Measuring intimate partner violence victimization and perpertration: A compendium of assessment tools. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Retrieved from http://www.cdc.gov/ncipc/pub-res/IPV_Compendium.pdf

This post was written by Jay Morse & Heidi Radunovich, PhD, members of the MFLN Family Development (FD) team which aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network FD concentration on our website, on Facebook, on Twitter, You Tube, and on LinkedIn.

 

 

 

 

 

 

 

 

Parentification in Military Families

Jay Morse & Heidi Radunovich, PhD

In a recent research article, Hooper, Moore & Smith, (2014) provide a review of the research literature on parentification in the context of military family systems and military culture. Parentification is not unique to military families, but may occur in any family where there is a role reversal between the parent and the child.

What is parentification?

The authors define parentification as the disturbance or lack of appropriate boundaries between family subsystems, resulting in functional or emotional role reversal between parents and children in the family [1]. Recently, the term parentification has been used more widely in the military family literature.

Why this is important:

  • An increasing number of individuals on active duty are supporting families with children.
  • Clinical practice should be informed by the military culture – military families face atypical stressors, such as frequent deployments.

Functional vs. Emotional Parentification

The authors distinguish between two forms of parentification: functional and emotional. Examples of functional parentification would be a child taking on additional household tasks and performing specific functions that the deployed parent might have taken care of previously, such as taking out the trash or babysitting. However, emotional parentification refers to the remaining parent using the child inappropriately for emotional support, which leads to increased emotional burden for the child. While it might be necessary and okay for children to help out in the household, and provide functional support, it is inappropriate and damaging for children to provide emotional support to their parents.

The researchers in this article state that far-reaching effects of parentified children can include poor academic performance, an inability to form positive relationships, and feeling overburdened and overwhelmed. Systematic evaluation should be used to identify the extent of parentification. While a good clinical interview should be able to help clinicians determine whether parentification is occurring, some additional tools are available:

The researchers emphasize that clinicians should consider a strength-based approach to treatment, because the child or adolescent may have experienced parentification as positive. Intervention and treatment strategies should be informed by the context and role adopted during the parentification process, according to the authors.

Resources:

[1] Hooper, L. M., Moore, H. M., & Smith, A. K. (2014). Parentification in military families: Overlapping constructs and theoretical explorations in family, clinical, and military psychology. Children and Youth Services Review, 39, 123-134. doi: 10.1016/j.childyouth.2014.02.0030190-7409.

[2] Hooper, L. M. (2009). Parentification Inventory. (Available from L. M. Hooper, Department of Educational Studies in Psychology, Research Methodology, and Counseling. The University of Alabama, Tuscaloosa, AL 35487).

[3] Jurkovic, G. J. & Thirkield, A. (1998). Parentification Questionaire (Available from G. J. Jurkovic, Department of Psychology, Georgia State University, University Plaza, Atlanta, GA 30303).

This post was written by Jay Morse & Heidi Radunovich, PhD, members of the MFLN Family Development (FD) team which aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network FD concentration on our website, on Facebook, on Twitter, You Tube, and on LinkedIn.

Military Caregiving Educational Course NOW Available!

Caregiver CourseNew military caregiving online course entitled, The Unique Challenges of Military Caregivers, is now available. The course was created under the Texas A&M AgriLife Extension Service – Wounded Warrior Program and provides insight into the life of military caregivers and identifies the many challenges they may face. Emphasis is placed on possible resources and supports that professionals can reference or share when working with military caregivers and families.

To view the course, go to The Unique Challenges of Military Caregivers.

Course Background

Spouses, partners, parents and others become a caregiver of military personnel when they learn their loved one is wounded while serving. These hidden heroes are at the bedside of their service members and with them until they learn to live a “new normal.” Military caregivers focus on their wounded warriors often at the determent of their own health and well-being. Being a military caregiver isn’t easy as they advocate for their warrior, provide medical care and deal with the uncertainty of their future. They do this while also continuing as a parent, employee, spouse or other life roles.

Professionals often don’t recognize the essential role military caregiver’s play in the service member’s healing process. The caregiver provides information to medical staff or other professionals when the wounded warrior can’t remember or doesn’t want to accept the reality of their situation. Since they are a critical part of the service member’s care team, professionals need to understand the trials and tribulations military caregivers face daily.

Upon completion of the course, professionals should be able to recognize a variety of caregiver challenges and identify resources and support services to address each challenge. *The course may take approximately 45-60 minutes to complete.


The Unique Challenges of Military Caregivers course was created by Texas A&M AgriLife Extension Service – Wounded Warrior Program. Course content was developed by Mary Brintnall-Peterson, Ph.D., owner of MBP Consulting, LLC and Professor Emeritus, University of Wisconsin-Extension.

This article was originally published Tuesday, August 19, 2014 on the Military Families Learning Network blog, a part of eXtension.

Passwords and online safety

passwordimage

In early August, the New York Times reported that Russian hackers had “amassed the largest known collection of stolen Internet credentials, including 1.2 billion username and password combinations and more than 500 million email addresses” This report is but the latest in a string of news stories about the credentials of Internet users being compromised. In the past year, there have been many data breaches including Target, Adobe, Michaels and others.

Typically, when a single site is breached, the advice is to change your credentials for that one site, and any others where you use the same credentials. However, in this instance the stolen passwords and usernames were from many websites, and a detailed list of the affected sites is not available.

This incident and similar ones should be the impetus for you to consider how you secure your identity when using websites for communication, banking, purchasing, social networking, and all the activities we do online. Good security requires sacrificing a bit of convenience, but the peace of mind is worth it.

Password Security
 – your responsibility

Most sites require you to login with a username (often an email address) and a password. Since your email address is most likely public, your password is the “secret” that you are using to prove to the website that you are who you say you are. Creating a good password and keeping it secret are vital to online security.

This article about passwords, from the Network Literacy area of the eXtension site provides information on password usage, choosing a good password, remembering passwords, and two-factor authentication.

Some key takeaways

  • Passwords should be long, complex, and different for each site you use
  • Keeping track of passwords is a key barrier to people adopting a strong password policy for themselves
  • Two-factor authentication adds another component to security, making the compromise of a password less harmful

The World Wide Web was originally developed without much thought given to security – it was a model built on trust. Incidents like this make clear that security is necessary, and that each of us is responsible for protecting our identities and credentials.

Authors: Stephen Judd (@sjudd) and Terrence Wolfork (+Terrence Wolfork, @trwolfork )

This article (Passwords and online safety) was originally published Thursday August 14, 2014 on the Military Families Learning Network blog, a part of eXtension.

Creative Commons License This work is licensed under a Creative Commons Attribution 3.0 Unported License.