Building emotional resilience in helping professionals Professor - PowerPoint PPT Presentation

Building emotional resilience in helping professionals Professor Gail Kinman University of Bedfordshire

Summary  Building a culture of compassionate care  Benefits for service users  Impact on helping professionals  What underpins emotional resilience and wellbeing?  The organisation’s duty of care  Building resilience: an ecological model  Multi-level interventions

Caring for a living  Compassion, rapport and empathy - the cornerstones of health and social care  A ‘vocation’ or ‘calling’ – motivated by intrinsic rather than extrinsic factors  Guided by an altruistic desire to improve individual and societal conditions Kinman & Grant, 2011; Kinman et al. 2011; Mathews, 2015

Compassion: benefits for professionals Compassion satisfaction Work-life enrichment Positive experiences at work A sense of fulfilment derived from working in helping, care-giving engender positive experiences and systems and reducing human suffering outcomes in other life domains Personal growth Learning, flourishing, life satisfaction, happiness, emotional resilience ALL UNDERPIN MENTAL HEALTH AND PROTECT AGAINST BURNOUT Kinman et al. (2016); Donoso et al. (2014); Radley & Figley (2007)

Wellbeing in health and social care Health and social care : The 2 nd highest rate of work-related stress, anxiety and depression Stress = Primary reason for wishing to leave Also high levels of ‘presenteeism ’ Labour Force Survey 2011 – 2015; Szymczak et al. 2015

Burnout – running on empty Emotional Decreased Depersonalisation exhaustion personal accomplishment disengagement Feeling over- from one’s job/ extended and Poor sense of cynicism/ drained of achievement, alienation from emotional and low enjoyment helping role and physical and sense of other resources doing a good people/revision of job values Maslach & Jackson, 1981

Burnout - outcomes  Ill-health; secondary traumatic stress via compassion fatigue  Absenteeism, presenteeism and attrition  Impaired performance via poor quality care/poor decision making/incivility/poor team-working/error making  Poor recovery via time commitment and affective rumination  BUT a dual-process model - high EE + high PA Curtis et al. 201; Kinman & McDowall, 2014

Protective factors  Prioritising self care: not an ‘indulgence’  Self compassion: self kindness, common humanity, mindfulness  Psychological capital: hope/optimism/self efficacy/resilience RESILIENCE: “The capacity for  Emotional resilience - a core competency flexible and resourceful adaptation to external and internal stressors” ( Klohen, 1996) Kinman & Grant, 2016; ,Luthans et al. 2015; Neff, 2015

What is emotional resilience? Grant and Kinman (2014)

What underpins emotional resilience? *Emotional Literacy/self efficacy Mental and physical *Bounded health Empathy Self care/self Emotional compassion Resilience Enhanced practice? *Reflective ability Social resources Support/confidence Organisational factors: culture, demands, control, support, role clarity, support, supervision, change management, communication, training *Coping flexibility Kinman & Grant, 2011; Grant & Kinman, 2014

Predicting wellbeing and Previous care experience retention in student nurses Moderate intrinsic motivation PsyCap (optimism, hope, self efficacy, resilience) Mental/physical health Reflective ability Retention Social network/emotional support Psychological flexibility A single cohort followed over 36 months Survey data (n = 153) and interviews (n = 20 Belongingness/positive placement experiences Sharples & Kinman, in prep.

How can we build resilience? Reflective • Reflective supervision ability • Mindfulness Social • Time management/organisation resources • Peer support/coaching • Stress management/appraisal Coping • CBT skills flexibility • Mindfulness Bounded • Reflective supervision empathy • Mindfulness • Mindfulness Emotional • Reflective supervision literacy • Emotional disclosure/writing

Emotional writing intervention: trainees  Emotional disclosure has many health benefits  Wait-list controlled study using mixed methods: a) survey (3 time points); b) interviews  Utilised framework by Salovey et al (2008)  Benefits for emotional literacy, empathy, wellbeing  But low reflective ability at T1 = little improvement Grant, Kinman & Alexander, 2015

Tool-box intervention – Child protection  Multi-modal intervention (wait-list controlled) – 3 time points (1 wk pre, 4/12 wks post)  Peer coaching, goal setting/coping skills, CBT, mindfulness and reflection Study group Control group Benefits for emotional self efficacy, Self compassion and wellbeing compassion satisfaction, decreased and compassion psychological flexibility, self fatigue increased over time compassion and wellbeing Also increased knowledge of organisational responsibilities and assertiveness Kinman & Grant, 2016

Mindfulness intervention Measure T1 (2 wks pre); T2 (2 wks post), T3 (3 mths post) Emotional self efficacy Increased between T1 and 2, some improvements maintained at T3 Compassion satisfaction Increased between T1 and 2, some improvements maintained at T3 Compassion fatigue Decreased between T1 and 2, maintained at T3 Psychological distress Increased between T1 and 2, some improvements maintained at T3 Reflective ability No benefits found Self compassion No benefits found Kinman et al (in press)

Benefits of mindfulness  “It is my secret space and stops me  “ It helps me clear my mind before meetings” spiralling out of control”  “It helps me stop over -planning and let things  “It helps me think before I speak; to not happen more naturally” fear silence” “It helps me realise that I must stop work in my   “It helps me listen and avoid mind as well as my body” misunderstandings”  “It helps me focus on the things that have gone right as well as wrong”  “It stops me from running on autopilot”

The organisation’s duty of care – don’t blame the victim!  Individual-focused approach – are we  What can organisations do? pathologising a ‘failure’ to cope?  Consider workload, control, reward,, PE  Is burnout a clinical disorder or a logical fit, fairness/equity, change reaction to emotionally demanding work? management  Work should not be intrinsically hazardous  BUT organisationally-focused interventions are challenging in public services undergoing continual change  The most powerful sources of stress are often organisational not occupational

Manager competencies • How the emotional demands of the job affect wellbeing • Availability of training and support Knowledge • The need for respite and recovery • The importance of reflective supervision • The key role of support from managers and colleagues • Develop a culture that de-stigmatises emotional distress • Role model self care/compassion as well as resilience Skills • Identify signs of stress at an early stage • Take responsibility, but empower staff • Anticipate the impact of changes • Emotional literacy, self awareness and reflection Attributes • Appropriate empathy • Self efficacy to facilitate change • Forward thinking and creativity • Compassion, integrity, authenticity and a sense of equity

Building resilience and wellbeing: a systemic approach Public Policy The organisation Social environment/ support Individual Competencies Kinman & Grant, 2014

Priorities  How can we enhance compassionate care while protecting the wellbeing of staff?  What works for whom under what circumstances?  What underpins flourishing, not just dysfunction and distress?  How can we ensure that public policy and organisations recognise the longer-term risks of helping work and provide the resources needed?

Gail.kinman@beds.ac.uk