Provincial Wellness Team Project

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    Eddie Wong
    Keymaster

    Provincial Wellness Team Project

    Supporting APBVSA Program Managers and Volunteers
    Victims of crime cannot be provided with optimum service and assistance, if the very people operating the programs and providing that support, are unable to continue due to the psychological consequences of the work.

    Provincial Wellness Team Project

    CURRENT CHALLENGE
    Program Managers
    Retention of victim service program managers has long been a major concern of APBVSA. Many highly skilled and passionate program managers have left their position as a result of various combinations of compassion fatigue; multiple demands of the position; frustration and burnout.
    There has been an increase in serious and traumatic events in recent years that has led to an increased demand for service to victims through 24/7 crisis calls and court support. Research indicates that working with victims of crime and trauma leads to psychological consequences that require acknowledgment, and an action plan, by both the organization providing the service to victims and those providing the frontline support to victims of crime.
    While many Program Managers and volunteers are taking advantage of their Employee Assistance Plan through their benefits, or contacting a counselor for debriefing and assistance, there are still Program Managers and volunteers suffering from the effects of compassion fatigue or vicarious trauma who are turning to co-workers, police, friends and other volunteers for debriefings (Attachment “A”). This lack of on-going professional support has resulted in the loss of experienced Program Managers and volunteers who are unable to cope with the effects on their own. In addition, if Program Managers are not in a position to address and support compassion fatigue or vicarious trauma in themselves, how can they support their volunteers (Attachment “B”) resulting in higher attrition rates for volunteers, consequently leading to increased demands on Program Managers.
    Victims of Crime
    Victims of crime cannot be provided with optimum service and assistance, if the very people operating the programs and providing that support, are unable to continue due to the psychological consequences of the work. These consequences include increased pressure of competing role demands and/or vicarious trauma.

    THE PROJECT
    The proposed Provincial Wellness Team Project will be a two year pilot project that has three distinct components that are interrelated in terms of the concepts of vicarious trauma, health and wellness, and criminal justice.
    Outcome
    The outcome will focus on the retention and emotional wellness of the victim service program managers and their staff operating across Alberta. Recognizing that programs have numerous staff members, depending on the size and location of the program, this project will examine and provide support to all program managers with police-based victim services in Alberta. There will be direct support and assistance to program managers, direct support to the volunteers and the program through training of the wellness model, and ongoing communication through best practices (research).

    Project Design and Development Timeline
    The project has three distinct components:
    1) Ongoing and Direct Support to Program Managers
    • Providing incident debriefing for coordinators (24 months)
    • Implementation and online support (21 months)
    • Gathering provincial program statistics and distributing a regular newsletter (24 months)
    • Support for implementation of the Provincial Wellness Team Model (18 months)

    Outcome
    • On-going support will address the burnout and vicarious trauma on program managers and reduce overall turnover for the program staff.
    • Build wellness and resiliency for program managers within police-based victim service programs (assistance and support).
    • The Project will ensure that program managers, who support victims of crime and their own volunteers 24/7, are provided professional, on-going support.

    2) Ongoing and Direct Support to Volunteers and Programs
    • Development of training resources and training schedule (6 months)
    • Provide vicarious trauma training for staff and volunteers within police-based victim service programs in all 11 Regions to provide knowledge and understanding (18 months)

    Outcome
    • Build wellness and resiliency for staff and volunteers within police-based victim service programs (assistance and support).
    • Support will reduce individual traumatic impact and increase overall retention of the volunteers, which reduces the pressure of competing role demands of the program manager.
    • Training will be systemic and consistent across the province.

    3) Research Project
    (Conducted by Centre of Criminology and Justice Studies – Mount Royal University)
    • Establish guidelines and completion of the ethics proposal; and conduct a literature review (3 months)
    • Completion of research data, statistical analysis, and research article (21 months)

    Outcome
    • Enhance the concept an awareness of the carious trauma for first responders.
    • Examine the various components of the provincial wellness team project, analyze its effectiveness, and best practice approaches.

    Project Partners
    APBVSA, Calgary Police Service Victim Assistance Unit, Mount Royal University – Center for Criminology and Justice Research, and Dr. Scott McLean (private practitioner)

    Reporting and Responsibilities
    The director/team lead of the project will report to the board of directors of the APBVSA and performs the following duties:
    • Provide incident stress debriefing to program managers within the province.
    • As the lead contact, provide ongoing support to program managers, trainers, and clinical practitioners.
    • Develop the training material and related schedules.
    • Deliver the training modules to provincial regions.
    • Assist the APBVSA to enhance program components and procedures regarding the wellness model.
    • Assist in the administration of the research project.
    • Compiles provincial statistics and develops on going newsletter.
    • Travel around the province as required.

    Budget
    The financial costs for this project is approximately $100,000/per year or a total of $200,000 over the two-year project.

    The estimated itemized breakdown is as follows:

    • Director/Team Lead (10.00% – $20,000)
    • Direct support to program managers (37.50% – $75,000)
    • Direct support programs and volunteers (training) (37.50% – $75,000)
    • Research project ( 7.50% – $15,000)
    • Equipment, supplies, and technical services ( 7.50% – $15,000)

    PROJECT FRAMEWORK
    Background
    • There are psychological consequences of working with victims of trauma and crime.
    • Research shows that listening to a victim relive a traumatic experience (helplessness, shock, horror, court) can lead to compassion fatigue and vicarious trauma.
    • Working with victim services increases the risk of compassion fatigue and vicarious trauma.
    • Acknowledgment from the program that this is a work related condition.
    • Acknowledgment from the volunteer/advocate providing the frontline work that this is a work related condition.
    • There is an ethical obligation to provide training and support to volunteer/advocate to manage compassion fatigue and vicarious trauma impacts.
    Model of Support

    Given the complexities of trauma work, program managers need support to clarify issues, while at the same time building resiliency. The team approach has proven to be effective and can assist program managers identify and deal with their reactions to both victim trauma stories and their own experiences (Geller, Madsen, & Ohrenstein, 2004). As suggested by the US Department of Health and Human Services (2005), a variety of strategies will form the Provincial Wellness Team Model including on-going support for program managers; training material and delivery; and the research project, which will compare the differences between urban and rural programs in Alberta.

    This Project will provide the framework for support and wellness that can be utilized by programs that vary in location, size, number of volunteers and number of paid staff. It can be adapted to isolated, rural or municipal programs. These strategies are focused on support and building resiliency for victim service practitioners as well as the service group. Below is an illustration of the concepts discussed.

    Activity and Related Tasks

    Activity Role
    Managing the Wellness Project
    o Coordination of the project
    o Managing and monitoring all financial matters and related considerations.
    o Ongoing internal communication with the APBVSA, programs, and consultants. Director or Team Lead
    Orientation Training (2 hours)
    o Awareness and understanding of compassion satisfaction and compassion fatigue.
    o Recognition of resiliency and self-care practices. Facilitator
    Advanced Training (6 hours)
    o Compassion satisfaction characteristics
    o Compassion fatigue characteristics
    o Completion of ProQOL* standardized questionnaire
    o Building resiliency
    o Individual and group self-care practices Facilitator
    Program Manager Review Meetings – Monthly(3 hours)
    o Each program coordinator shares their experience in working with crime victims and/or in a traumatic situation and/or organizational concerns (round table forum)
    o Available coordinators (on-line (Adobe Connect) or teleconference model) attend Clinical Practitioner

    Incident Debriefing (3 hours)
    o Within 72 hours of the incident, for program manager and potentially volunteers involved.
    o Psychological debriefing and discussing the impact of the traumatic experience.
    o Assessment to the functioning of the program manager and/or volunteers (recommendations)
    o Referral to short term counselling, if needed. Clinical Practitioner

    Short-term Intervention (1-4 sessions)
    o Provide brief intervention
    o Focus is on problem solving and the impact of trauma
    o Referral to employee assistance program (EAP). Clinical Practitioner
    Self-Care Group Activities
    o Occasionally through-out the year
    o Opportunity for volunteers and staff to enjoy planned activities or events Program Manager

    Research Component
    o Establish the guidelines for participation (ethics proposal)
    o Conduct a literature review
    o Administer the standardized questionnaire.
    o Complete a statistical analysis
    o Author a research article Researcher

    Standard Questionnaire*
    To determine the effectiveness of the Provincial Wellness Team Project, and to examine compassion satisfaction and compassion fatigue in victim services, basic demographics will be collected including questions related to age, gender, marital status, ethnic background, educational level, average hours per month volunteering, and the number of years with victim services. Participants will complete the ProQOL questionnaire on three (3) occasions: at the beginning of the Project, a year into the project, at the conclusion of the second year. Responses to the questionnaire will be compared and analyzed. Results of the general characteristics of vicarious trauma will be examined as a group without individual identification.
    The Professional Quality of Life Scale (ProQOL – Stamm, 2005) is a commonly used measure reviewing positive and negative effects of helping others who experience suffering and trauma (Craig & Sprang, 2010). The measure has been in use since 1995 and is comprised of three separate scales, measuring Compassion Satisfaction (the constructiveness that one derives from being in a helping role and being able to do ones work well); Burnout (feelings of exhaustion, tension, and difficulties in dealing with work-related concerns or being able to complete the role effectively); and Compassion Fatigue/Secondary Trauma (work-related that is impacted by the secondary exposure to extremely stressful events) (Sprang, Clark, & Whitt-Woosley, 2007).
    Overall, the ProQOL measures the professional quality of life as indicated above. While the negative effects of helping should not be minimized, viewing it from a practical and supportive perspective makes it easier for police-based organizations to support constructive system change to ameliorate and reinforcement the positive effects of providing support to victims. The project intends to create an environment that promotes wellness and builds resilience. Building a level of awareness, understanding, and resiliency provides an environment for victim service practitioners to address vicarious traumatization and to successfully adapt in the midst of challenging and often complex situations (McLean, 2003).

    Roles and Mandates

    Director/Team Lead
    • Overall coordination of the project.
    • Managing and monitoring all financial matters and related considerations.
    • Supporting programs with the development of the consultants (trainers/clinical practitioners).
    • Ongoing internal communication with the APBVSA, programs, and consultants.
    • Completing necessary internal paperwork.

    Facilitator
    • Knowledge and/or experience in the area of compassion fatigue and vicarious traumatization.
    • Competency (knowledge and administration) in the use of the ProQOL standardized questionnaire.
    • Provide basic and advanced training content that is engaging to participants (sharing professional experiences, statistics, and creative interactive activities).

    Clinical Practitioner
    • Clinical skills in vicarious trauma and intervention (counselling, trauma, compassion fatigue).
    • Sufficient education (minimum of a Master’s degree in psychology, social work or counselling) and registration/certification within the province or in Canada (Psychologists Association of Alberta, Alberta Association of Social Workers, Canadian Certified Counsellor – Canadian Counselling and Psychotherapy Association).
    • Professional liability insurance.

    Research Investigator
    • Recognized researcher associated with the University and or research center.
    • Completion of a recognized research ethics course such as the Tri-Council Policy Statement: Ethical conduct for research involving humans and/or a course on ethics (TCPS).

    Training (compassion fatigue and vicarious trauma)
    o SESSION 1 (orientation)
    • definition and introduction of the topic
    • basic information of the potential impact
    • acknowledgment from the organization that this is a work hazard
    o SESSION 2 (advanced training)
    • an in-depth examination and understanding of the topic
    • completion of questionnaires for self-reflection
    • consideration of individual risk factors and protective factors (strengths)
    • strategies to manage compassion fatigue and vicarious trauma
    • strategies to build individual and program resiliency

    Program Manager Review Meetings
    o MONTHLY MEETINGS
    • A format of a ‘round table’ where everyone has an opportunity to discuss via Adobe Connect or teleconferencing.
    • The meetings will be dedicated exclusively to debrief the successes and challenges of this work (overall perspective or a specific situation)
    • Involvement includes program managers and clinical facilitator

    Incident De-Briefing
    • Program Manager or program involved in incidents will have contact within 72 hours of the event (phone, technology, face-to-face).
    • The debriefing will be facilitated by the clinical practitioner
    • An outcome may be for an individual to have a one-on-one incident debriefing or a referral to Psychological Services for longer term support and assistance.

    Short-term Intervention
    o INDIVIDUAL
    • A program manager may request or be referred for support and assistance.
    • Service to provide brief intervention
    • Focus is on problem-solving and the impact of trauma
    • From the clinical practitioner’s perspective, a discussion and/or referral to employee assistance programs (EAP) when there are clinical issues impacting the program manager’s emotional functioning (Note: this may be due to compassion fatigue/vicarious trauma or overall functioning and related to the work within victim services).

    Self-care Group Activities
    o GROUP
    • Occasionally throughout the year.
    • Opportunity for volunteers/advocates and staff to enjoy planned activities or events.

    Appendix A

    (COORDINATOR STATISTICS AND CURRENT DEBRIEFING PROCESS)

    The genders, cultures and backgrounds represented within APBVSA program managers are diverse. The effects of compassion fatigue or vicarious trauma may be enhanced by any or all of the life experiences of program managers. To address these concerns; professional intervention, training and support at the program manager level is required. This project addresses the fundamental reason that workers leave their positions.
    1. Average years a program manager is with victim services:
    o 3-5 years (32% in 2010 (2010 APBVSA Personnel Survey)
    o 3-5 years (32% in 2013 (2013 APBVSA Personnel Survey)

    2. Reasons for leaving position:
    o Burnout / Vicarious Trauma – Too many demands of the job; *on-call hours, **traumatic crisis calls; volunteer management, hiring, training, retention; board issues; conflicts
    APBVSA Personnel Survey 2011 2013
    Emotional support for coordinators (debriefing) comes from: 40% – Coordinator in another program 35% – Coordinator in another program
    35% – Police 30% – Police
    34% – Family/Friends 30% – Advocates
    22% – Advocates 27% – Co-worker
    22% – Co-worker 20% – Family/Friends
    20% – No debriefing occurs 17% – No debriefing occurs
    11% – Alberta Health/Mental Health 10% – Alberta Health/Mental Health
    7% – Psychologist 10% – Psychologist
    o Lack of professional/appropriate emotional support (debriefing).

    APBVSA Personnel Survey
    (Contributing Factors)
    2011 2013
    Program Managers Average Working Hours Per Week 36% – 35-40 hours a week
    23% – 40+ hours a week 36% – 35-40 hours a week
    36% – 40+ hours a week
    *Program Managers doing On-Call Hours 82% 90%
    **Program Managers Attending Crisis Call 91% 95%
    Total Number of Volunteers in Programs Collectively 746 589

    Appendix B
    (VOLUNTEER/ADVOCATE COMPARISON 2011 VS 2013 DEBRIEFING PROCESS)

    APBVSA Personnel Survey
    2011 2013
    Total Number of Volunteers in Programs Collectively 746 589

    APBVSA Personnel Survey 2011 2013
    Emotional support for advocates/volunteers (debriefing) comes from: 96% – Coordinator 100% – Coordinator
    50% – Advocates 32% – Advocates
    27% – Family/Friends 25% – Police
    29% – Police 12% – EAP Benefits
    15% – Co-worker 12% – Co-worker
    11% – Alberta Health/Mental Health 12% – Family/Friends
    2% – No debriefing occurs 5% – Psychologist
    9% – Psychologist 0%- No debriefing occurs

    The statistics show the overall number of volunteers has declined leading to additional demands on the program manager. Additionally as indicated above, the percentage of emotional support or volunteer tends to rest program managers (coordinators) and other advocates. The model addresses this through a structured and team approach including a greater emphasis on the role of the clinical practitioner.

    References

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-V) (5th ed.). Washington, DC: Author

    Craig, C.D. & Sprang, G. (2010). Compassion satisfaction, compassion fatigue, and burnout in a national sample of trauma treatment therapists. Anxiety, Stress & Coping. 23(3), 259-280. DOI: 10.1080/10615800903085818

    Ehrenreich, J. (October, 2001). Coping with disasters: A guidebook to psychosocial intervention. Mental Health Workers Without Boarders website (www.mhwwb.org).

    Geller, J.A., Madsen, L.H., & Ohrenstein, L. (2004). Secondary trauma: A team approach. Clinical Social Work Journal. 32(4), 415-430. DOI: 10.1007/s10615-004-0540-5

    Hargave, P.A., Scott, K.M., & McDowell, J. (2006). To resolve or not to resolve: Past-trauma nd secondary traumatic stress in volunteer crisis worker. Journal of Trauma Practice. 5(2), 37-55. DOI: 10.1300/J189v05n02-03.

    Heese, A. R. (2002). Secondary trauma: How working with trauma survivors affects therapists. Clinical Social Work Journal. 30(3), 293-309.

    Hill, J. K. (2009). Working with victims of crime: A manual applying research to clinical practice (2nd Edition). Department of Justice Canada. Ottawa: Ontario

    McLean, S. L. (2003). Chapter 3: Social Issues. In D. Clark (Ed) Foundations of children’s mental health: A Canadian perspective. (51-88). Calgary, AB: Mount Royal University.

    Sprang, G., Clark, J. J., & Whitt-Woosley, A. (2007). Compassion satisfaction, compassion fatigue, and burnout: Impacting a professional’s quality of life. Journal of Loss & Trauma. 12(3), 259-280, DOI: 10.1080/15325020701238093

    Stamm, B. H. (2005). The ProQOL Manual: The Professional Quality of Life Scale: Compassion Satisfaction, Burnout & Compassion Fatigue/Secondary Traumatic Scale. Baltimore: Sidran Press.

    US Department of Health and Human Services (2005). A guide to managing stress in crisis response professionals. Rockville, MD: Author.

    #2529

    apbvsa
    Keymaster

    Thankyou Paul and Scott for all your work and commitment to this project.

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