Vol. XXIX, No. 4
Fall 2017
Text Only Version
In This Issue
Regular Features
Editor's Note
President's Message
FAQ
Why is Juvenile Polygraph Not Recommended by ATSA?
Featured Articles
Responding to Problematic Technology Use:
Creating a Therapeutic Toolbox
Looking After Ourselves and Each Other
Utilizing Recreation Therapy as Part of the Treatment Model
Understanding and Preventing Adolescent Pedophilia TEDMED Talk
Step One of Cultural Competency Addressing Privilege & Power
Students' Voice
Assessment of Deviant Preferences Using Novel Behavioral Assessment Procedures
A Studentís Guide to the ATSA 2017 Conference
Book Review
RNR Principles in Practice In the Management and Treatment of Sexual Abusers
ATSA News
2017 ATSA Conference Events
Preventing Harmful Sexual Behaviors in Youth: An Infographic from the ATSA Prevention Committee
Welcome Incoming Board Members
2017 ATSA Awards
ATSA Professional Code of Ethics 2017 Revisions and Additions
New ATSA Members
Newsletter Tools
Search Past Issues
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Forum Team
David Prescott
Book Review Editor

Sarah Gorter
Production Editor

Forum Editor
Contact the editor or submit articles to:

Heather M. Moulden, Ph.D.
Forensic Program
St. Joseph's Healthcare
Hamilton, Ontario, Canada
E: hmoulden@stjoes.ca
P: (905) 522-1155 ext. 35539
Looking After Ourselves and Each Other
Robin J. Wilson. Ph.D., ABPP
McMaster University, Hamilton, ON
Wilson Psychological Services LLC, Sarasota, FL


Why do we do this work?

A long time ago, most of us who work in sexual violence prevention made a few critical decisions. We were bright-eyed, bushy-tailed teenagers who had no idea what we wanted to do when we “grew up.” In high school we talked with our friends and family about the sorts of things we’d like to study in college or university. I initially thought I would go to medical school and become a surgeon, but shaky hands put the boots to that idea. That’s how I found psychology. I suspect many of you also had academic dilemmas with which to contend, but you ultimately found yourself in the humanities or studying something that would eventually lead to work in social services.

Interestingly, I didn’t pick sexual violence prevention as a career; it sort of chose me. After my third year of full-time study in psychology at the University of Toronto, I needed a break and went looking for a job. I managed to secure a position at the university’s psychiatric teaching hospital, working for a Czech psychiatrist named Kurt Freund who, it turned out, was the pioneer of the phallometric test (or penile plethysmograph as it’s known more broadly in the USA). Working for Dr. Freund was the single greatest influence on my future and after having had the opportunity to conduct research, study human sexuality, and to rub shoulders with other great practitioners in Canada, my career path was set. I’ve never looked back and I can honestly say that I’ve never had a boring day at work. However, that’s not to say that I haven’t also had some very upsetting days at work.

We work in a field that brings us in contact with people who have been harmed in a particularly intimate way, as well as with the people who have harmed them. We’re in the public safety business. We work with victims of sexual offenses to help them survive their experiences, knowing that some of them – particularly young persons – may find themselves engaging in abusive behaviors in the future. These abusive behaviors are not necessarily always sexual in nature,  nor are they always directed at others; they may be more inwardly destructive. In our work with offenders, we try to help them become desisters, instead of persisters.

So, why do we do this work? Because we want to make a difference. We care about our families, friends, and communities and through our interventions we strive to achieve the ATSA goal of making society safer. But, this potentially comes at a cost to each and every one of us. We know that the work we do can be hugely exhilarating when we see the successes of our clients, but we shouldn’t kid ourselves that there aren’t darker experiences of which we need to be mindful.

Why do we keep doing this work?

There is no denying that working with persons with sexual behavior problems and antisocial orientations is challenging (see Edmunds, 1997; Ellerby, 1998; Ennis & Horne, 2003). Some of our clients are really good at “pushing our buttons.” How do we offset our natural tendencies to be empathic and helpful with our natural tendencies to be angry and upset at what our clients have done (or continue to do)? Because we know the consequences of such strong emotional responses in clinical environments. We also know that it is unconscionable to do nothing. So, we work to reduce the number of potential victims, knowing that poorly managed clients have the capacity – already demonstrated – to do tremendous harm. We work to ensure that clients receive appropriate treatment and care according to evidence-based practices, like the Risk-Need-Responsivity framework with which we’re all so familiar.  We work to ensure that our clients are able to approximate a quality of life as close as possible to that of others without sexual behavior problems – that’s the essence of the Good Lives Model.

One of my absolutely most favorite concepts I learned in school is that of the “balanced, self-determined lifestyle.” I try to include this phrase in almost everything I write (as I just did here) and I try to follow it myself and to instill it in others around me. I co-opted this concept from the YWCA’s Life Skills Coach Training program in Canada, as they did from Saskatchewan NewStart. NewStart was a basic job readiness training program for Aboriginal Canadians in the mid-60s. Search it out on Google, if you like; it bears a striking resemblance to many aspects of the GLM, but some 30 years earlier. At its heart, a balanced, self-determined lifestyle means making time for all the important elements of life – self, others, community, job, leisure. And, it also encourages people to think about the range of opportunities they have in life and to make good choices while learning from mistakes. Clearly, our clients have not always done both of these things, and that is perhaps why they land themselves in trouble.

Vicarious Trauma

Job stress is the result of a complex interaction between the individual and the challenges of the job. Burnout involves physical, mental and emotional exhaustion that is attributable to work-related stress (Leiter & Maslach, 2009; Mayo Clinic, 2012). It is a uniquely human phenomenon that if a person holds the capacity for empathy, he or she will experience distress when hearing about terrible things that have happened to others. Have any of you ever experienced anything like that – during an assessment, when reading police reports or victim impact statements, or during a group or individual treatment session?

Even though we weren’t there when our clients committed their offenses, we are privy to intimate details of what happened. This can lead to what is known as vicarious trauma (www.headington-institute.org; Pearlman & McKay, 2008). Because we are caring people and because we express empathy and feel compassion, we often experience characteristics of victimization just by hearing about what happened to others. This emotional contagion can sometimes lead to compassion fatigue – a key component in burnout. Ultimately, this is the cost of caring, but there are things we can do about it.

High Risk Professionals

The first thing we need to acknowledge is that we are members of a select group of persons who are at higher risk for vicarious trauma and compassion fatigue. These workers include, but are not restricted to:

  • Counselors, Psychologists, Social Workers
  • Health/Hospital Staff
  • Emergency Workers
  • Child Protection Workers
  • Corrections Staff
  • Law Enforcement Officials
  • Court Officials
  • Volunteers

The effects of vicarious trauma and compassion fatigue can be particularly pertinent to people who interview and counsel trauma victims, those who work with victims and their families and, notably for us, people who work with clients who have abused others.

Predictors and Mediators of Secondary Traumatic Stress Effects

It’s important to recognize that not everyone will be affected by troubling information or traumatic stress in the same way. Some of us are really resilient and it doesn’t seem to matter much what we see or hear – we get past it. Others, however, may find certain situations or scenarios much more difficult to manage. The research on self-care and burnout tells us that there are individual factors to consider, as well as situational and environmental factors at play. This shouldn’t surprise us, as this is pretty much the case with virtually everything in social services – it’s a mix of internal and external variables.

Individual Factors

A good bit of how we respond to traumatic stress has to do with our personal history; that is, our personal experiences of trauma, loss, and victimization and how we’ve managed to cope (or not) with situations throughout our lives. Our personality style (and ego defenses) will influence our coping style and the mechanisms we use to deal with difficult situations – either at work or in other environments (e.g., have you ever found yourself bringing work crap home with you?).

Another important consideration is current life context. What’s happening for you outside of the work environment? Is your teenage daughter or son having difficulties, are you having problems in important relationships, has someone in your family or friend circle just experienced a situation of abuse? All of these private life situations can affect our ability to cope with difficult situations at work.

Here are some individual risk factors to consider (see Pearlman & Caringi, 2009; Pearlman & McKay, 2008):

  • Lifestyle balance
  • Sense of control
  • Perceptions of organizational intentions/commitment
  • Perceptions of fairness
  • Fit between values of self and organization
  • Coping skills and strategies

What can we do to protect ourselves? I won’t get too far into that right now, but some obvious recommendations are to take opportunities to increase our training base and to take the time to debrief situations we experience at work with our colleagues and trusted confidantes. And, keep in mind that we may need to practice what we preach: If you have problems you can’t manage, maybe think about seeking professional help.

Situational Factors

As much as there are factors we bring to the table in terms of our own personal makeup and experience bases, there are factors over which we have a lot less control. In the beginning part of this article, I suggested that we all made a choice to work in the field of sexual violence prevention. I guess that means that we probably can’t, at this point, change the nature of the work we do. Nor are we able to change the nature of our clientele; at least, not without leaving the field.

At many of the workshops I do, I often ask participants whether or not they work for an agency that has too much money or too many staff. I’m never surprised by their answers. I also typically ask them whether or not they feel like they have enough time in a day to do all the things expected of them – either by superiors or their own work ethic. Workload is a big factor. The more we do in a compacted work week, the less time we have to step back and inoculate ourselves from the cumulative exposure to trauma material. This can affect our relationships with co-workers, which can sometimes lead to the “cubicle-effect” in which people keep their heads down, working away in isolation and ultimately losing important social and cultural contexts and opportunities present in the work environment.

Here are some workplace risk factors to consider (see Pearlman & Caringi, 2009; Pearlman & McKay, 2008):

  • Role ambiguity
  • Role conflict
  • Availability of tangible and intrinsic rewards
  • Workload
  • Recognition that work is valuable
  • Social support

Over the years, I’m moved away from direct service provision and more into administration and consultation. As a worker, I knew all too well that there were expectations on me and that there were minimum production quotas (e.g., three psychotherapy clients a day, two groups a week, two assessments, etc.). I, too, worked in relative isolation with little opportunity to debrief my work experiences with others. As an administrator, I became keenly aware of the need for “real” supervision – not the annual performance appraisal, but REAL supervision. Frankly, the last performance appraisal I got was emailed to me by a supervisor who cared very little for my experience of my job.

As a word, “supervision” connotes a certain cringe-worthy experience. None of us like being informed of our faults, nor do we like being told what to do. As such, it’s something of an unfortunate choice of word and many of us may have experienced supervision as a chore. However, when I say supervision here, I mean something wonderful – the opportunity to sit down with someone who cares about you and the work you do enough to listen like David Prescott, consider the information provided like Karl Hanson, and give advice like Robin McGinnis. Supervision is the opportunity to share what you’re proud of, as well as what causes you to quietly freak out. Regularly sharing your work experiences with concerned peers or supervisors – either individually or as a group – can have profound effects on quality of life, both professionally and personally. And, we don’t do it often enough. Period.

Mitigation Factors

Maintaining a balanced, self-determined lifestyle is central to effective self-care. How well are you taking care of yourself? Of course, self-care needs to be practiced in the workplace as much as in your personal life. We’ve seen the effects of the holistic revolution in our treatment approaches with clients. Why shouldn’t we also apply these ideas to aspects of our lives? The more balanced we are across the full range of personal care, the more we are able to cope with the stresses and demands that we will face in our admittedly very challenging professional experiences.

People are at less risk for burnout if they feel they have some degree of control or influence over their work situation, believe that they are important enough to be treated fairly, and value the work they do and are committed to it. We need to create opportunities for renewal, but this is a shared responsibility. We need to get out of our cubicles and talk to one another! We need to recognize that when someone is cooped-up in their cubicle that that’s a cause for concern and requires a check-in.

“How are you doing?”

“Is everything OK?”

“Do you want to come out for lunch with us?”

These are the sorts of questions we owe  to ourselves and others to ask. It’s often been said that there is safety in numbers, and there is a lot of truth to this when we think about how we can lessen the negative effects of trauma we may experience as sexual violence preventers.

If you’ve been reading between the lines in this article, you may have noticed that a lot of the concepts we apply to our clients who have sexually offended may also hold some worth for us. Many of you will know that I have spent a lot of time in my career working in a framework known as Circles of Support & Accountability. One key idea behind CoSA is that “nobody does this alone” – meaning that reintegration to the community after incarceration should not be a solitary endeavor. I would extend the CoSA idea to other domains, including high-risk professionals as noted above – that means us. We need a strong, interactive, and reciprocal social support network to keep us on the right track, too. So, look out for yourselves and your colleagues as you continue to make society safer.

References:

Edmunds, S.B. (1997). Impact: Working with sexual abusers. Brandon, VT: Safer Society Press.

Ennis, L. & Horne, S. (2003). Predicting psychological distress in sex offender therapists. Sexual Abuse, 15, 149-157.

Leiter M.P. & Maslach C. (2009). Banishing burnout: Six strategies for improving your relationship with work. San Francisco, CA: Jossey-Bass.

Mayo Clinic (2012). Job burnout: how to spot it and take action. Available at: http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642

Pearlman, L.A. & Caringi, J. (2009). Living and working self-reflectively to address vicarious trauma. In C.A. Courtois & J.D. Ford (eds), Treating complex traumatic stress disorders: An evidence-based guide, New York: The Guilford Press.

[1]Pearlman, L.A. & McKay, L. (2008). Understanding and addressing vicarious trauma: Online training module four. Pasadena, CA: Headington Institute.  Available at: http://www.headington-institute.org/files/vtmoduletemplate2_ready_v2_85791.pdf



[1] Laurie Anne Pearlman is a powerhouse in the burnout and vicarious trauma research and practice world. This online resource – and the others that go with it – is particularly helpful. Visit http://www.headington-institute.org.


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