10. Debriefing, burnout and compassion fatigue (Index)




SESSION 1:  DEFUSING                                                                                                 

Davis, Weaver, Meichenbaum, Roos & Du Toit

·        Important aspects to keep in mind                                                                

·     The aims of trauma defusing                                                      

·     Different role players and their responsibility on a

trauma scene                                                                               

·        Practical guidelines                                                                                           

  • Gaining the confidence of the victim                                    

o    Calm the victims                                                                                           

o    Establish what happened                                                                          

  • Provide emotional support                                                                        
  • Provide practical assistance for physical needs                                 
  • Assist victims in regaining control and routine                                   
  • Protect victims against secondary traumatisation                             

o       Provide clear information about the process                                       

  • Ensure the victims' safety                                                                         

·        Emotional reactions of defusers                                                                    

·        Final remark                                                                                                         


SESSION 2:  DEBRIEFING                                                                                    

Davis, Weaver, Meichenbaum, Roos & Du Toit

·        What is debriefing?                                                                                           

·        Characteristics of trauma debriefing                                                            

·        Goals of trauma debriefing                                                            

  • Create a safe place                                                                    
  • Reality testing                                                                                               
  • Re-establish control                                                                                          
  • Cognitive redefinition                                                              
  • Prevention of posttraumatic stress disorder (PTSD)                     

·        Practical guidelines                                                                                           

·        Trauma debriefing models                                                                              

  • Phase 1:  Defusing on or near to the trauma scene                           
  • Phase 2: Initial debriefing                                                                          
  • Phase 3: Formal CISD-model                                                                   

§         One: Introductory stage                                                                       

§         Two: Facts stage                                                                                   

§         Three: Thinking cognitive stage                                                        

§         Four: Emotions stage                                                                           

§         Five: Symptoms stage                                                                          

§         Six: Teaching stage                                                                              

§     Seven: Re-entering stage                                                                    

o    Phase 4: Follow-up CISD                                                                           

o    Adapted debriefing-model                                                                         

§         Recognition of spiritual needs                                                           

§         Phases of the adapted trauma debriefing model                          

·        Debriefing session handout                                                                           

o       Initial phase                                                                                                   

o       Fact phase                                                                                                     

o       Thought phase                                                                                             

o       Reaction phase                                                                                            

o       Symptom phase                                                                                           

o       Teaching phase                                                                                            

o       Re-entry phase                                                                                             


SESSION 3: WARNING SIGNS OF BURNOUT                                                          

Minirth, Hawkins, Meier & Flournoy

·        Warning symptoms of burnout                                                                      

  • Exhaustion                                                                                                    
  • Detachment                                                                             
  • Boredom and cynicism                                                          
  • Increased impatience and irritability                                    
  • A sense of omnipotence                                                        
  • Feelings of being unappreciated                                          
  • Change of work style                                                             
  • Paranoia                                                                                  
  • Disorientation                                                                         
  • Psychosomatic complaints                                                   
  • Depression                                                                              
  • Major depression                                                                    
  • Suicidal thinking                                                                     

·        The workaholic - candidate most likely                                                        

·        The spiritual element                                                                                         

·        A time for action                                                                                                 

o   Measuring burnout                                                                                      

o   Burnout inventory                                                    

·        Shalom                                                                                                                  


SESSION 4: THE WORKAHOLIC                                                                         

Minirth, Hawkins, Meier & Flournoy

·        The workaholic's inner voices                                                                       

  • Voice from childhood                                                                                 
  • Voice of the depraved self                                                                         
  • Voice of colleagues                                                                
  • Voice of reality                                                                        
  • Voice of the Holy Spirit                                                          

·        Checklist for workaholic burnout                                                                  


SESSION 5: BITTERNESS                                                                                    

Minirth, Meier, Hawkins, Thurman & Flournoy

·     The symptoms of bitterness                                                       

  • Griping                                                                                                            
  • Interpersonal conflict                                                                                  
  • Intense emotions                                                                                         
  • Unrealistic expectations                                                                            
  • Inability to trust                                                                                             
  • Denial                                                                                                              
  • Lack of gratitude                                                                                          
  • A calloused approach to life                                                                     



·        There is a cost to caring        

·        The role of unresolved trauma

o       The human brain                                                                                          

·        Counter transference                                                                                               

o       Counter transference reactions with regard to incest                       

·        The conspiracy of silence                                                                               

·        The role of compassion fatigue within other disciplines                        

o       Journalism                                                                                                     

o       Police work                                                                                                    

o       Social work                                                                                                    

o       Veterinarians                                                                                                 

o       Nursing                                                                                                           

o       Paramedics                                                                                                    

o       Care for the elderly                                                                                      

o       Jurors                                                                                                              

o       Educators                                                                                                      

o       Museum staff 

·        Compassion satisfaction

·        Training of counselors                                                                                     

·        Factors that can stimulate or prevent compassion fatigue

  • The risk with novice therapists                                                                
  • The importance of supervision                                                                

·        Summary of important criteria for evaluating compassion fatigue      

o       Possible signs and symptoms of compassion fatigue                      

o       What we can do to help prevent and deal with compassion



SESSION 7: CONCLUSION                                                                                   

·        The rewards of doing trauma therapy                                                          

·        Transformation of the therapist as therapist                                              

·        Transformation of the therapist as person                                                 

·        Our role as witnesses                                                                                       

·        Glimmers of wisdom                                                                                         

·        A spiritual journey                                                                                              

·        Always remember                                                                                              




APPENDIX 1: Relationship between a balanced lifestyle and burnout