Burnout, Stress, and Trauma Care

Part of the challenge in setting an organizational response is understanding the problems to be solved. 
The following are good working definitions for key terms:

• Stress:  An organism’s response to challenges, demands or threats.  Stress can be healthy or unhealthy, depending on the circumstances and the capacity to respond effectively and adaptively.
• Burnout: A constellation of symptoms associated with stress, most commonly measured using the inventory and constructs by Maslach, et al to include varying degrees of emotional exhaustion, depersonalization, and beliefs about low self-efficacy.
• Moral Distress:  A internal dissonance when one knows what is the right or ethical action but has internal/external obstacles or constraints to the performing of the action that are difficult or impossible to mitigate.  
• Moral Injury:  The syndrome of deep guilt and shame when one participates in, perpetrates, or witnesses evil/suffering, while experiencing this as both complicity and a violation of personal moral commitments.  This is classically described in the military literature, but has since been applied to other organizational settings.
• Demoralization:  The erosion of morale, optimism, hope for the future and meaningfulness in the present.  Not necessarily a pathological condition, it is also associated with existential distress in the face of suffering.
• Compassion Fatigue: Detachment and hardening/repression of emotions as a response to the suffering of others.  Often considered an overlapping syndrome with burnout, particularly in the human service fields or helping professions.
• Bereavement: The experiences of mourning or sadness after loss.  The duration of bereavement normally varies widely.  
• Complicated Bereavement: Also sometimes known as pathological grief, this is a heightened and persistent experience of mourning that resists healing and is often associated with high existential distress and difficulty functioning.
• Trauma: A subjectively distressing or disturbing experience.  Unlike past attitudes, we now know that whether or not an experience is perceived as traumatic is highly subjective and shaped by individual narratives, culture, and vulnerabilities, much of which is predetermined and not under individual control. 
• Complex Trauma: Repeated and cumulative trauma experiences, often creating an even more pervasive and persistent impact on body, psyche, and social functioning.
• Vicarious Traumatization:  A pattern of overidentifying and suffering with others’ trauma experiences and sequelae, typically associated with a longer-term role of caring for or helping the traumatized person/population.
• Acute Stress Disorder: The development of a clinically distressing or functionally impairing set of symptoms, usually within one month of the trauma and of at least 3 days duration.  The medical syndrome increases the risk of developing Post-Traumatic Stress Disorder and demands rapid psychological intervention.
• Post-Traumatic Stress Disorder:  A functionally impairing set of physical, cognitive, and emotional symptoms that develop months or years following a trauma, often with significant health, social and professional impairments and a high risk of mortality. The medical condition can be chronic and unremitting, and requires medical-psychological treatments.
• Secondary Traumatic Stress:  A subtype of PTSD, in which the trauma is an exposure to the traumatization of others, often with a sense of horror and helplessness.  This syndrome has been particularly described in first responders, in professional and familial caregivers, and in witnesses to trauma.
• Resilience: A trait, state, or cultivated capacity to respond adaptively and constructively to stress or trauma, leading to growth and ongoing sense of meaning and purpose, even through adversity.
• Post-Traumatic Growth: The experience of positive change and personal development that surpasses what was present before the trauma or crisis occurred, often with a sense of wisdom and meaningfulness in both the struggle to heal and the new perspective and coping strategies.
  

   

Our whole-person FIRST AID meets your group’s needs with expert assistance. 

• We work with the leadership to find ways to rapidly establish physical and emotional SAFETY. 
• We foster trust-worthy CONNECTIVITY for support and processing, with the most up-to-date information on human trauma-responses, symptom reduction and disease prevention. 
• We re-establish access to professional SELF-EFFICACY, using validated assessment tools, reflection, and validation to promote post-traumatic growth through core strengths and values.
• The result of this 3-part approach of Safety, Connectivity, and Self-Efficacy is accelerating healing and building resiliency.  When this is customized to listen deeply to the group’s culture, community, and existing strengths, trauma is well-managed, whether acute, chronic and/or highly complex.

Virtue Medicine Trauma-Informed Care for Groups can include:

• Expert consultation to coordinate a strategic response with the leadership.
• Educational lectures to teach groups to identify trauma, secondary trauma, bereavement, and moral injury, to recognize trauma symptoms, disorders, and to implement harm-reduction.
• Interdisciplinary healing workshops, offering hands-on interventions for the emotional and physical signs of trauma.
• Small-group facilitation for confidential support during the healing process. 

For the prevention or or early interventions for professional burnout and stress syndromes, we highly recommend our M&M Rounds 2.0: Mindfulness and Meaning Training for exploring and solidifying professional identity, efficacy, purpose, and connection in organizational groups.  This intervention utilizes empirically-validated assessment tools and expert facilitation to identify strengths and measure outcomes in professional groups, and can be adapted to groups of any size and has been effectively used through distance learning/training.