Fluent Essays

Annotated bibliography This assignment gives you the opportunity to expand your knowledge base in a specific area of challenge in social work practice.You will focus on the academic literature available on the topic as a beginning place to build your understanding of the issue. Select a topic that will be discussed at some point in this course.You can stick with the topic as it is defined and discussed in the course material or you can go outside of those definitions to consider another way of seeing the issue.You can also select topics that connect to the course material but may not be specifically addressed in the course.This is an invitation to focus on an issue that is relevant to you and your personal practice. This assignment connects directly to assignment number 3 as the topic remains the same. Begin with an introductory section describing the issue you are focusing on for your assignment.You can talk about what made you choose this topic and tell me the frame for your reading. Review at least 2 academic resources (e.g. peer-reviewed journal articles or book chapters).Summarize the material then discuss both the quality of the resource and your personal response to the reading. This is an excellent resource to help you understand annotated bibliographies. https://owl.purdue.edu/owl/general_writing/common_writing_assignments/annotated_bibliographies/index.html copassion_fatigue_among_social_workers.pdf self_care_behaviours_and_their_relationship_with_satisfaction_and_compassion_fatigue_levels_among_social_workers.pdf Unformatted Attachment Preview American Journal of Orthopsychiatry 2006, Vol. 76, No. 1, 103–108 Copyright 2006 by the American Psychological Association 0002-9432/06/$12.00 DOI: 10.1037/0002-9432.76.1.103 Compassion Fatigue and Psychological Distress Among Social Workers: A Validation Study Richard E. Adams, PhD Joseph A. Boscarino, PhD, MPH New York Academy of Medicine New York Academy of Medicine and Mount Sinai School of Medicine Charles R. Figley, PhD This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Florida State University Few studies have focused on caring professionals and their emotional exhaustion from working with traumatized clients, referred to as compassion fatigue (CF). The present study had 2 goals: (a) to assess the psychometric properties of a CF scale, and (b) to examine the scale’s predictive validity in a multivariate model. The data came from a survey of social workers living in New York City following the September 11, 2001, terrorist attacks on the World Trade Center. Factor analyses indicated that the CF scale measured multiple dimensions. After overlapping items were eliminated, the scale measured 2 key underlying dimensions—secondary trauma and job burnout. In a multivariate model, these dimensions were related to psychological distress, even after other risk factors were controlled. The authors discuss the results in light of increasing the ability of professional caregivers to meet the emotional needs of their clients within a stressful environment without experiencing CF. Keywords: compassion fatigue, secondary trauma, occupational stress researchers have indicated that therapists who work with traumatized clients often show signs of psychological distress as a result of these interactions (Figley, 1995; Nelson-Gardell & Harris, 2003; Schauben & Frazier, 1995). The adverse impact of working with clients who have a history of psychological trauma (e.g., sexual and physical abuse, military combat, or community disaster) has been described under a variety of terms: vicarious traumatization, secondary traumatic stress, and compassion fatigue (CF; Jenkins & Baird, 2002). Although the psychological consequences of providing social support and care to traumatized individuals have been noted for over 2 decades, relatively few studies have focused on formal caregivers (i.e., therapists, child protection workers, nurses, etc.) and their emotional response to dealing with traumatized clients (Figley, 1995). Studies have shown that providing such care can be both highly rewarding and highly stressful (Ohaeri, 2003). Individuals working in the caring professions, though, may have occupational environments and caregiving demands that increase the likelihood of adverse psychological outcomes (Figley, 2002a; Sabin-Farrell & Turpin, 2003). Theoretically, individuals working in the caring professions often attempt to alter the behaviors and emotions of their clients by providing emotional support (e.g., empathy), strategies for coping with emotions, or better cognitive management skills (Boscarino, 1997; Francis, 1997; Thoits, 1986). Within the context of formal caregiving, providing therapy to clients who have survived a traumatic event can be particularly stressful (Figley, 1995). Many Compassion Fatigue (CF) For the present study, we use the term CF. Consistent with most current usage, we defined this as the formal caregiver’s reduced capacity or interest in being empathic or “bearing the suffering of clients” and is “the natural consequent behaviors and emotions resulting from knowing about a traumatizing event experienced or suffered by a person” (Figley, 1995, p. 7; see also Figley 2002a, 2002b). Thus, CF is a hazard associated primarily with the clinical setting and with first responders to traumatic events. With the inclusion of posttraumatic stress disorder in the third edition of the Diagnostic and Statistical Manual (American Psychiatric Association, 1980), common symptoms related to severe psychological trauma were defined as a psychiatric disorder. Figley (1995) developed the concept of CF when he began to focus on the unique work environment of trauma workers and mental health professionals and how they appeared to vicariously experience the effects of trauma. In particular, CF appeared to be the consequence of working with traumatized individuals, if the professional was exposed to significant numbers of them and had a strong empathic orientation (Figley, 1995). Empathic engagement with traumatized clients often requires the professional to discuss details of the Richard E. Adams, PhD, Division of Health and Science Policy, New York Academy of Medicine; Joseph A. Boscarino, PhD, MPH, Division of Health and Science Policy, New York Academy of Medicine, and Departments of Internal Medicine and Pediatrics, Mount Sinai School of Medicine; Charles R. Figley, PhD, Florida State University Traumatology Institute and College of Social Work, Florida State University. Joseph A. Boscarino is now at Geisinger Health System, Danville, PA. This work was supported in part by National Institute of Mental Health Grant R01 MH66403 and by grants from the Green Cross Foundation, Florida State University, to Joseph A. Boscarino. For reprints and correspondence: Joseph A. Boscarino, PhD, MPH, Center for Health Research, Geisinger Health System, 100 N. Academy Avenue, Danville, PA 17822-3003. E-mail: jaboscarino@geisinger.edu 103 This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. 104 ADAMS, BOSCARINO, AND FIGLEY traumatic experience, including role playing and dramatic reenactment of the events, which are thought to be vital to the therapeutic process but can have an adverse emotional impact on the caregiver (Figley 2002a, 2002b). This type of vicarious trauma often is referred to as secondary traumatic stress in the literature (Boscarino, Figley, & Adams, 2004). Thus, when therapists, doctors, nurses, or child protection workers report symptoms related to reexperiencing the client’s traumatic event, wishing to avoid both the client and reminders of the client’s trauma, and feeling persistent arousal due to intimate knowledge about the client’s traumatic experiences, they are likely suffering from secondary trauma (Figley, 1995, 2002b; Jenkins & Baird, 2002; Schauben & Frazier, 1995). More recently, Figley (1995, 2002a, 2002b) and others (e.g., Gentry, Baranowsky, & Dunning, 2002; Jenkins & Baird, 2002; Nelson-Gardell & Harris, 2003; Salston & Figley, 2003; Stamm, 2002) have observed that secondary trauma and what has been termed job burnout overlap, in that both are characterized by the emotionally exhausting nature of working with survivors of trauma. Figley (2002b) has suggested, however, that secondary trauma is not the same as burnout syndrome and that each should be treated as having a unique effect on a professional’s well-being (see also Jenkins & Baird, 2002; Sabin-Farrell & Turpin, 2003; Salston & Figley, 2003). Burnout syndrome is often defined as a response to prolonged exposure to demanding interpersonal situations and is characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment (Maslach, Schaufeli, & Leiter, 2001). High emotional involvement without adequate social support or feelings of personal work accomplishments (i.e., job satisfaction) may leave the caring professional vulnerable to burnout. Thus, we suggest that both secondary trauma and job burnout are likely central and critical clinical features of CF. In this study, we assess the extent to which secondary trauma and job burnout are related to and independent of one another. In their review of the literature on CF, Sabin-Farrell and Turpin (2003) suggested several possible psychological and psychoanalytic mechanisms (e.g., countertransference, emotional contagion) by which working with clients may result in CF (see also Salston & Figley, 2003). In this study, we conceptualize CF within a stress process framework (Pearlin, 1989; Thoits, 1995). This framework contends that challenging environments (stressors) typically require individuals to respond both physiologically, through alterations in the neuroendocrine and hormonal systems (Boscarino, 1997), and psychologically, usually through alterations in cognitive functioning (Francis, 1997; Thoits, 1995). Both stress (Thoits, 1995) and CF researchers (Figley, 1995, 2002b; Kassam-Adams, 1999) have also suggested that other aspects of the formal caregiver’s life can influence his or her likelihood of developing CF. For example, a history of trauma, lower social support, and an inability to cope with the demands of caregiving are thought to increase the likelihood of developing CF. Previous research has tended to support the hypothesized relationships between these risk factors, CF, and psychological distress (Figley, 1995, 2002a; Nelson-Gardell & Harris, 2003; SabinFarrell & Turpin, 2003; Salston & Figley, 2003; Schauben & Frazier, 1995). Schauben and Frazier (1995), for example, found that female psychologists and violence counselors with a higher percentage of sexual violence victims as clients reported more vicarious trauma and that this was related to greater psychological problems. A history of personal trauma is also related to poor psychological health among child welfare workers (NelsonGardell & Harris, 2003) and psychotherapists (Kassam-Adams, 1999). Despite these findings, research on CF has had several problems. First, there has been a lack of conceptual clarity about what constitutes CF and how it differs from other adverse work outcomes, such as job burnout (Jenkins & Baird, 2002). There are also a number of CF scales, with many dissimilar items (e.g., Figley, 1995; Gentry et al., 2002; Stamm, 2002). Finally, no study fully incorporates all aspects of Figley’s (1995, 2002b) description of CF or key variables in the stress process model. To address these gaps in previous research, we focused on social workers in clinical practice in a region recently affected by a major traumatic event—the September 11, 2001, terrorist attacks in New York City. We were interested in this caregiving profession because the work environment of social workers is often characterized by high case loads and inadequate resources (Duffy et al., 2003). In addition, the delivery of mental health care services is increasingly being performed by social workers (Mechanic, 1999). Method The data for this study are from a survey of social workers living in New York City. The sampling frame included all social workers with a master’s degree in social work or higher who were current members of the National Association of Social Workers (NASW). The NASW is the main national social work organization, with approximately 50\% of all practicing social workers as members. From the membership list, we randomly selected 600 individuals to be sent a mailed questionnaire between May 12 and May 15, 2003. We mailed a second questionnaire 2 weeks later and a follow-up letter 2 weeks after the second mailing, reminding the person to return the survey. We accepted returned surveys until August 31, 2003. Because we were mainly concerned with social workers who potentially suffered from CF, we asked those who were not engaged in direct practice to return the survey indicating that they were not involved in clinical practice. We eliminated these surveys from our study. Overall, 236 social workers returned completed surveys, and 38 returned surveys indicating that they were not providing services. All of the addresses appeared to be correct, as none of the questionnaires/letters from the three mailings was returned by the post office. Thus, the overall survey completion rate (returned surveys [274]/all surveys sent [600]) was 46\%. The Institutional Review Board for the New York Academy of Medicine reviewed and approved the study’s protocols. Dependent Variables Our study focused on two conceptual domains: CF and psychological distress. We measured CF using the 30-item Compassion Fatigue (CF) Scale—Revised (Gentry et al., 2002). This scale was developed by Figley (1995) on the basis of clinical experience, and versions of the scale have been used in several previous studies (Jenkins & Baird, 2002; Stamm, 2002). The scale was designed to assess both vicarious trauma and job burnout. The present study, however, was the first to assess the basic psychometric properties of this scale. The survey asked respondents to consider each scale item and indicate how closely it currently reflects their experience, using a 10-point, visual analog–type Likert scale (rarely/ never ⫽ 1 to very often ⫽ 10). We assessed general psychological distress using the 12-item version of the General Health Questionnaire (GHQ-12; Goldberg & Huxley, 1992; McDowell & Newell, 1996). This scale, based on a 4-point Likert scale, was designed to be a broad screening instrument for psychological problems in a general population and has excellent validity and reliability COMPASSION FATIGUE (McDowell & Newell, 1996). In our study, the GHQ-12 (Cronbach’s ␣ ⫽ .80) was scored so that higher scores reflected poorer psychological status (M ⫽ 24.2, SD ⫽ 3.5, range ⫽ 15–38). This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Independent Variables On the basis of Figley’s (1995, 2002b) conceptional of CF and psychosocial stress theory (Pearlin, 1989; Thoits, 1995), we included demographics, stressor exposures, and psychological resources as independent variables. The five demographic variables were gender, race/ethnicity, age, marital status, and years working in professional counseling. Age and years in professional counseling were coded to the nearest year (age, M ⫽ 55.9, SD ⫽ 8.0; years in counseling, M ⫽ 23.4, SD ⫽ 7.9). Gender, marital status, and race/ethnicity were coded as binary variables, with male, not married/not living together, and person of color coded as 0. We included four variables measuring exposure to stressful events. First, the survey inquired about eight negative life events (e.g., getting divorced, having problems at work) that could have happened to the respondent in the past 24 months (Freedy, Kilpatrick, & Resnick, 1993). We summed these events to produce a negative life events scale (M ⫽ 1.1, SD ⫽ 1.2). Second, we asked about eight lifetime traumatic events (e.g., attacked with a gun, a situation where being killed was possible) that could have happened during the respondent’s lifetime (Freedy et al., 1993). As with negative life events, we summed these events to produce a lifetime traumatic events scale (M ⫽ 1.9, SD ⫽ 1.4). Third, there were seven questions about whether or not the respondent counseled people exposed to the September 11 World Trade Center disaster (WTCD), such as counseling those who directly witnessed the events or who lost a spouse. We summed these questions into a September 11 counseling experience scale (M ⫽ 3.2, SD ⫽ 1.6). As a measure of exposure to other traumatized clients, we asked participants what percentage of their clients were survivors of physical or sexual violence. We coded responses into a binary variable, indicating low exposure if fewer than 20\% of the clients were survivors of violence and high exposure if 20\% or more were survivors. The measures of negative life events, traumatic events, and counseling individuals exposed to the WTCD discussed were used and validated in other WTCD studies in New York City (Boscarino, Galea, et al., 2004; Boscarino et al., 2002; Galea et al., 2003). Finally, we assessed three measures of psychological resources: having information to work effectively with clients, social support, and sense of mastery. Work information was the sum of two items (“Information needed to enhance the delivery of my services to my clients or patients has been readily available to me,” and “I have adequate information about how to control my emotional fatigue through such strategies as deep breathing, positive self-talk, and the appropriate use of humor”) and related to how organizations helped formal caregivers cope with the stressful events associated with their work (Figley, 1995, 2002b). The response options for these two questions were based on 5-point Likert scales, ranging from strongly disagree (1) to strongly agree (5). Higher scores indicated greater agreement that information to be an effective social worker was available (M ⫽ 8.3, SD ⫽ 1.2). The Social Support Scale (Sherbourne & Stewart, 1991) consisted of four items (e.g., someone was available to confide in), summed so that higher scores reflected higher social support, based on a 4-point Likert scale ranging from none of the time to all of the time (M ⫽ 12.8, SD ⫽ 3.2; Cronbach’s ␣ ⫽ .89). Finally, we measured sense of mastery (Cronbach’s ␣ ⫽ .76) using six items from Pearlin, Lieberman, Menaghan, and Mullan’s (1981) Sense of Mastery Scale. The response categories were based on a 5-point Likert scale (strongly disagree ⫽ 1 to strongly agree ⫽ 5). These items were summed, with higher scores on this scale indicating a greater sense of mastery (M ⫽ 23.4, SD ⫽ 3.8). Both the Social Support Scale and the Sense of Mastery Scale have been validated in previous studies and showed good reliability (Boscarino, Galea, et al., 2004; Boscarino et al., 2002; Pearlin et al., 1981). 105 Statistical Analysis Our analytical goals were to develop a measure of CF that was parsimonious, measured core dimensions, was valid and reliable, and was a good predictor of psychological distress. To achieve these aims, we used principal-components analysis with a varimax rotation to identify the number of underlying factors in the CF scale (Pett, Lackey, & Sullivan, 2003). Once the factor analyses specified items to be included, we used reliability analyses, using Cronbach’s alpha, to assess item consistency within each scale. After establishing that the scales measured only one factor and had acceptable internal reliability, we assessed the validity of the scales by correlating them with stress exposure, psychological resource, and psychological distress variables and to each other. Finally, to test the predictive utility of the scales, we estimated a series of ordinary leastsquares (OLS) regressions, with the GHQ-12 as the dependent variable and the demographics, stress exposure, psychological resource, and CF scales as independent variables, respectively. We used SPSS Version 11.5 for all data analysis, and all significance values shown were based two-tailed tests. Results As the demographic profile of our sample has been discussed elsewhere (Boscarino, Figley, & Adams, 2004), we present only a brief description here. The sample was predominately female (80\%), White (89\%), in a long-term relationship (married or living as if married; 63\%), and older, with more than 80\% of the respondents 50 years or older. The majority of the sample also had more than 20 years experience in professional counseling and had had at least one negative life event in the past 2 years and at least one traumatic event in their lifetime. Finally, our sample was very involved in working with clients who had some exposure to the events of September 11, 2001, with 94\% reporting at least some involvement. Conversely, fewer than 20\% had a practice with a high percentage of clients who were survivors of violence. Because a central focus of the study was ... Purchase answer to see full attachment