Safe Ships

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Safe Ships

• Linda Robb, Social Work Consultant
• Kate Black, Clinical Psychologist

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Safe Ships Aims

• To provide a forum to reflect on the professional
  experience of bearing witness to distressing and
  violent events
• To consider how supportive structures can be
  implemented at individual, team and
  organisational levels

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Safe Ships Outline

• Rationale
• Risks within the professional role
• Safety within the professional role
• (strategies and systems)
• Reflection and planning

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Safe Ships Rationale
Vs
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Safe Ships Rationale
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Safe Ships Professional Role

• How well do we look after ourselves within our
  professional role?
• 0 100
• Abysmally Amazingly

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Professional role risks

• Emotions are contagious
• Those we work with can hitch a ride home with
  us and become visitors to our non-work roles
• As helping professionals, our emotions are
  vulnerable to provocation through infection with
  our clients feelings. Sometimes this is an
  advantage, helping us to feel inside their
  worlds. At other times, it is not advantageous to
  be infected by a clients state....
• Does the same tool that that facilitates our
  understanding of our clients also threaten our
  well-being at times? The short answer is yes.
• Rothschild, 2006

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Professional role
WORKER
YP
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Professional role risks

• Working directly with people that have
  experienced trauma can impact on our emotions,
  our relationships and our view of the world
• Compassion fatigue - a general term applied to
  anyone who suffers as a result of undertaking a
  helping role
• Vicarious Traumatisation - negative changes in
  workers thoughts regarding trust, safety, power,
  independence, self-esteem and intimacy as a
  result of contact with traumatised clients.
• Secondary Traumatisation -when workers start to
  experience symptoms of PTSD, as a direct
  consequence of their engagement with traumatised
  clients rather than a result of their own
  traumas.
• Burnout - more general term referring to the
  emotional exhaustion, demoralisation and feelings
  of ineffectiveness caused by demanding work
  environments. This can vary from needing an
  extra day off work, to experiencing a high degree
  of dysfunction with the professional role.

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Professional role

• How do we protect the safety of our emotional,
  psychological and physical well being when faced
  with upsetting and frightening narratives on a
  frequent basis?
• How do we maintain and/or refuel our empathy and
  compassion, especially when working with young
  people who may present high risks, reject our
  support, or who are indifferent to our support?

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Professional Role Safety
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Professional Role Safety
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Professional rolesafety systems

• Various models of reflective practice
• Use of reflective practice and/or external
  consultants for complex cases (Quality Standard
  for the health and well being of looked after
  children and young people, NICE, 2013 National
  Guidance for the External Management of
  Residential Childcare Establishments in Scotland,
  2013)
• Also evidence building for therapeutic models
  that are based on reflection as the key skill for
  staff (e.g. AMBIT)
• Specific systems designed for individuals who are
  at particular risk of exposure to violence or
  harm within their professional role (e.g.
  Debriefing Defusing)

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Professional Role safety systems

• Debriefing originally designed as an intervention
  for those exposed to traumatic or stressful
  events as part of their occupational roles
  (Adler, Castro McGurk 2009)
• Model for supporting staff after a specific
  incident
• Use of these models has been considered
  controversial in the past
• Used within the Metropolitan Police, Royal
  Marines and parts of the UK prison service

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Professional Rolesafety systems

• Some studies show that post incident support
  offered to staff on a group basis can be helpful
  with respect to
• Reducing anxiety
• Reducing depression
• Reducing post traumatic stress symptoms after 1
  month
• Reducing levels of alcohol misuse
• Staff satisfaction with support
• (Ruck et al 2013, Healy Tyrrell, 2013, Deahl et
  al 2001, Adler, 2008)

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Professional RoleSafety Systems

• Studies suggest that post incident support can
  be helpful when offered under following
  conditions
• - opt-in basis
• - shortly after incidents
• - pre-established occupational groups
• - using educational models
• - provision of appropriate supervision
• - pre-established safe environment

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Reflection and Planning
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Safe Ships
In groups, consider your professional role, your
young people, the team you work with, and your
service/organisation. What compartments of the
ship are full and at risk of flooding? What
strategies or systems might be helpful within
your individual role/team/ service/organisation?
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Questions/comments/reflections
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References I

• Looking After Yourself Working with people who
  have experienced trauma Trauma and Homelessness
  Team, Carswell House NHS Greater Glasgow and
  Clyde
• Golding, K S Hughes, D A (2012) Creating Loving
  Attachments Jessica Kingsley Publishers, London
• Golding, K S (2008) Nurturing Attachments
  Supporting Children who are Fostered or Adopted
  Jessica Kingsley Publishers, London
• Rothschild, B, Rand, M (2006) Help for the
  Helper The Psychophysiology of Compassion
  Fatigue and Vicarious Trauma Norton Company,
  New York
• http//www.childtraumaacademy.com/
• http//www.annafreud.org/training-research/trainin
  g-and-conferences-overview/training-at-the-anna-fr
  eud-centre/ambit-multi-team-training/

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References II

• Ardino, V (2012) Offending Behaviour the role of
  trauma and PTSD, European Journal of
  Psychotraumatology , 3 18968
• Cloitre, M, Cohen, L R, Koenen, K C (2006)
  Treating survivors of childhood abuse
  Psychotherapy for the interrupted life. The
  Guildford Press, New York
• Herman, J (1992) Trauma and Recovery From
  domestic abuse to political terror. Pandora,
  London
• Perry, B D (1997) Incubated in Terror
  Neurodevelopmental factors in the cycle of
  violence In Children, Youth and Violence The
  Search for Solutions (J Osofsky, Ed.) Guilford
  Press, New York,pp 124-1488
• Rothschild, B (2010) 8 Keys to Safe Trauma
  Recovery Take-charge strategies to empower your
  healing. WW Norton, New York
• Rothschild, B (2000) The Body Remembers The
  Psychophysiology of Trauma and Trauma Treatment,
  WW Norton Company Ltd, New York