Don’t You Forget About Me

Navigating The Trenches • Maintaining Our Purpose

Lisa Brooks, MSW, LCSW

Speaker, Consultant, & Transformation Guide
Founder of Wilmington Thrive Tribes

Ashley Swinson, MSW, LCSW

Certified Therapist in EMDR,
Speaker, & Consultant
Founder of TIDE Associates, PLLC
Workshop Agenda

8:30 am 9:00 am Registration & Check In

9:00 am-10:30 am The Trenches: The Continuum Model of Compassion
Satisfaction
10:30 am –10:45 am Break
10:45 am –12:00 pm Exploring Stages of Change & The Power of Congruence
12:00 pm-1:00 pm Lunch Break
1:00pm-2:30 pm Digging Deep: The Body & Parts of the Self
2:30-2:45 pm Break
2:45 pm – 4:00 pm Self-Sovereignty: Self-care Redefined
Workshop Objectives

To assess personal values and develop an action plan to reduce current

experience(s) of vicarious traumatization, moral distress, compassion fatigue,
secondary traumatic stress, and/or burnout.
To differentiate symptoms of workplace toxicity from a healthy work culture and
develop ways to intentionally contribute to a positive work environment.
To assess one’s current method of communication and develop ways to improve
congruent interactions to enhance job and life satisfaction.
To strategize new practices of provider self-care, recognizing that everyone is
just as deserving of the same exceptional care we give our clients.
Are we surprised?
A Professional Epidemic in Child Welfare

On average, employees in a Child Advocacy Center have a 3-year max in this

position if their Secondary Traumatic Stress is not managed. (Southern Regional Child
Advocacy Center, 2017)

On average, a social worker will work for 8 years before leaving the field.
(Social Workers Official)

34% of child welfare workers meet the criteria for PTSD. (Bride, Jones, & MacMaster,
2007)

Stressful work conditions are resulting in significant turnover rates in CPS

workers (26%) as compared to 15-16% for the rest of the state employee
population. (Texas Department of Family and Protective Services 2016)
Nationally, 30-45% of child welfare staff leave within 2 years. (Coyle, 2018)
A Professional Epidemic in Human
Services

15% of generalist social workers meet the criteria for PTSD. (Bride, 2007)
Training a new caseworker costs $54,000 and a significant number of caseworkers
quit after only 2 years on the job. (Texas Department of Family and Protective Services 2016)
Law enforcement professionals endorse significantly more distress on all
measures of psychological symptoms than mental health professionals. (Follette,
Polusny, & Milbeck, 1994)
Criminal lawyers who work with traumatized clients endorse significantly higher
rates of Vicarious Traumatization than other attorneys. (Vrklevski & Franklin, 2008)
A Professional Epidemic in Healthcare

Nationally, physicians experience higher rates of professional burnout than the

general population. (Shanafelt, Boone, & Tan, 2012)
Professionals with an MD or DO degree are at a greater risk of burnout than those
with a bachelor’s or master’s degree. (Shanafelt, Boone, & Tan, 2012)
For nurses, significant attrition occurs during the first 5 years of entering the
profession. (Kovner, Brewer, Fatehi, & Jun, 2014)
38% of SANE nurses (sexual assault nurse examiner) meet the criteria for
Secondary Traumatic Stress. (Wies & Coy, 2013)
The millennial generation has become the most difficult population to retain for
companies, often leaving employment positions in fewer than 3 years. (Sears, 2017)
A Professional Epidemic in Human
Services: Attrition
What’s causing this?
u Inadequate education for job duties
u Perception of work supports (consistent supervision, support for STS)
u Organizational climate (workplace toxicity, leadership style)
u Personal values (commitment to the mission of social welfare)
u Competitive job market with better pay or benefits
u Demands of the the work (traumatic exposure, caseloads)
u Millennials…
Our Why
u We are disheartened by the prevalence of
provider burnout and attrition issues in our
field, so we want to explore why this is
actually happening.
u We want to hone in on necessary
interventions to sustain provider resiliency.
u Too often, we lie to ourselves about what it
means to be a part of this field – low
income, tired all the time, limited
resources, lower standards of self-
sufficiency.
u We purposely settle and convince ourselves
that this is acceptable and normal and
supposed to be.
u We want to normalize this phenomenon by
sharing our story to debunk blame and
shame around this struggle.
u We hope to inspire you to dig into your own
story and create movement that renews
your passion and energy for the work.
u You are not stuck!
 Maintaining your pace in which personal
Defining values are congruent with practice and
communication so that you uphold the
Provider boundaries that are necessary to stay
healthy, engage others wholly, and
Sustainability succeed in your profession.
Trauma-
Informed
Care Core
Principles
u Safety & Trust
u Connection & Collaboration
u Choice & Empowerment
 PART I
Navigating the Trenches:
The Continuum Model of
Compassion Satisfaction
Compassion Satisfaction is fundamental
to Provider Sustainability.
Simply stated: the pleasure you derive from doing your job well.

I’m doing the right thing.

It’s wonderful helping people.
I did make a difference.
I’m in the right profession.
I should be here.
The rewards of my job far outweigh the challenges.
I show up on my own behalf.
I can give to myself so I can continue to give to the world.
My values are showing up in my life.
I am the most important client on my caseload.
A Continuum Model
A combined perspective based on the research of
Stamm, Richard, Mathieu, and Lewis

Safety
Season The Your Tribe
Basic
Self-care Business
Model

Moral Secondary
Compassion Distress Traumatic Stress
Satisfaction BURNOUT
Vicarious Compassion
Traumatization Fatigue

Work
Culture Systemic
Time
Constraints
Management
Spirituality
Vicarious Traumatization Defined
A change in a provider’s frame of reference or belief systems related to safety,
power, and responsibility, stemming from the exposure to our patient’s
experiences.
Examples of VT:
• The world is unsafe.
• Comparing people’s experiences.
• Resisting intimacy.
• Having more critical thoughts of others.
• “Sliming” one another.
What to do in the moment:
• Increase awareness of mimicry.
• Check-in with your body and create immediate, subtle movement.
• Practice emotional agility: transparent expression of emotion.
• Increase use of sensory anchors and grounding
• Consult with colleague or supervisor.
Moral Distress/Injury Defined

u “Moral injury” was first used to describe soldiers’ responses to their actions in
war. It represents “perpetrating, failing to prevent, bearing witness to, or
learning about acts that transgress one’s deeply held moral beliefs and
expectations.”
u Journalist Diane Silver describes it as “a deep soul wound that pierces a
person’s identity, sense of morality, and relationship to society.”
u In a healthcare setting it is being unable to provide high-quality care and
services due to systemic constraints and brokenness.
Addressing Moral Distress
u First, we must stop blaming the workers by placing our sole focus on the
individual self-care routines and work/life balance.
u Attain staff and management buy-in to address workplace culture change.
u It is an ethical responsibility for agencies to provide a healthy working
environment for staff. It is also an ethical responsibility for staff to ensure
that they are grounded and healthy so that they can provide the best care
possible to clients.
u Focus on 4 core areas that all employees need:
1. Physical: safety at the workplace, opportunities to recharge at work
2. Emotional: safety in workplace relationships, feeling valued and appreciated
3. Mental: space to focus to get tasks done, autonomy of when and where to get the
work done
4. Spiritual: doing more of what they are good at and what they enjoy doing
Compassion Fatigue Defined
Characterized by a deep physical and emotional exhaustion and a
marked change in the ability to feel empathy for clients, loved ones, and
colleagues. It occurs when you are overexposed to pain and suffering
without proper use of or availability of resources.
Stages of CF: Arousal -> Avoidance -> Zombie
Combatting CF:
• Radical Acceptance: “The need will always be greater than the resources.”
• Accept your limitations, and lean on your team. Reduce responsibilities, if
necessary.
• Practice conscious empathy.
• Honor the use of breaks and actually rest.
• Creative, humorous, and playful outlets.
• Seek consultation or supervision.
• Be intentional with social interactions: spend time with those you enjoy,
reduce work-related connections, reduce toxicity.
Secondary Traumatic Stress Defined Adapted from the Southern Regional Child Advocacy Center
Cognitive Emotional Behavioral Physical Interpersonal Spiritual

Diminished Powerlessness Impatient Exhaustion Withdrawn Questioning the

concentration meaning of life

Confusion Anxiousness/Worry Irritable Lethargy Isolation from Loss of purpose

friends
Loss of meaning Exhaustion Hypervigilant Headaches or other Decreased interest Loss of hope
pain in sex
Perfectionism Guilt or Survivor Guilt Increased use of Insomnia or Mistrust Lack of self-
alcohol/drugs Hypersomnia satisfaction
Preoccupation with Anger/Rage Other addictions Anxiety Impact on Anger at God
trauma parenting
Trauma images Hypersensitivity Appetite changes GI distress Projection of anger Questioning prior
or blame faith-based beliefs

Apathy Numbness Nightmares Autoimmune flare ups Intolerance Decreased spiritual

practices
Minimization Fear Attrition Weight gain or weight Loneliness
loss
Racing thoughts Helplessness Absenteeism Somatization/ Hypersensitivity
hypochondria

Cynicism Sadness Impaired decision- Increased illness Resentment

making
Diminished Hopelessness Hyper sense of
enjoyment of career responsibility

Reduced ability to feel Avoidance of clients

sympathy or empathy
Burnout Defined

u Burnout describes anyone whose health is suffering or who has a negative

perspective because of their work.
u Provider burnout occurs when CF and STS go unaddressed.
u Burnout can also exist separately of these experiences.
u Burnout can happen as a result of personal, professional, and/or clinical
relationships.
u Burnout can also be a symptom of the work environment (caseload,
expectations, leadership, supervision, toxicity, etc.).
Maslach Burnout Inventory (MBI)

Are you:
HIGH in Burnout (depressive anxiety syndrome)?
HIGH in Depersonalization (loss of empathy)?
LOW in Personal Achievement (self-critical and unable to
move forward)?
Burnout Management
The Parallel between Burnout and PTSD
Dr. Geri Puleo

The descent into burnout is rapid, but the recovery process is

slow (expect 2 years for agency leaders).
Symptoms:
u presence of a major stressor(s)
u Respond with fear, hopelessness, horror, emotional numbing
u Sleep disturbance
u Depression and withdrawal
u Mood lability and irritability
u Avoiding activities that remind you of what’s stressful

Maintaining Factors:
u Poor leadership
u Lack of organizational caring
u Toxic culture
u Overwhelming workload
u Overachieving personality (Type A, “Star” employee)
u Chronic fatigue and illness
Consider…

The ADA and ADAA maintain that PTSD is a physical disability

requiring reasonable accommodations with no mitigating
factors (like: additional time, flexibility with punctuality,
removal from triggers). Ponder: How would the workplace
change if workers had to be reasonably accommodated for
burnout? For example: mandate vacations, down time, paid
or unpaid time off, recognition of efforts. This might
increase creativity (ideas), job satisfaction, employee
retention, and overall productivity. This might decrease the
risk of employment-based litigation.
- Dr. Geri Puleo
Life/Work Balance Self-test: What’s Draining You?

Add score from each category:

RELATIONSHIPS: _____
ENVIRONMENT: _____
BODY MIND SPIRIT: _____
WORK: _____
MONEY: _____

Are there areas that drain more energy from you than others?

Let’s create an action plan for 1 item on this assessment.

Provider Self-Care is NOT the Sole
Solution
u Bober and Regehr (2006) found that when therapists did take better care of
themselves, symptoms of STS did not improve. The most effective solutions
to reduce STS symptoms are correlated with workload, reduced exposure to
trauma, social support, staff competency, and service delivery.
u The economic system directly impacts provider services: availability of
resources and the needs of consumers.
u Barkin (2011) suggests that agencies hold high responsibility in provider VT/CF
due to focusing on the business of the organization rather than quality of care
(productivity, service reimbursement, documentation). She also maintains
that the lack of peer supervision and lack of emphasis on safety (for staff and
consumers) directly impacts VT/CF.
u Killian (2008) confirmed that social support is vital to a healthy workplace and
that this leads to greater compassion satisfaction.
 Incivility can fracture a team,
destroying collaboration, splintering
members’ sense of psychological
safety, and hampering team
effectiveness. Belittling and
Christine Porath demeaning comments, insults, and
other rude behavior can deflate
confidence, sink trust, and erode
helpfulness – even for those who
aren’t the target of these
behaviors.
Workplace Culture Pitfalls

u Lack of congruency
u Unclear values
u Goodness of fit
u Poor communication, lack of feedback, withholding information
u The leaders’ leader
u Profit over people
u “This is the way we’ve always done things”
u Limited space for calm
u Rewarding perfectionism
Workplace Culture Pitfalls

u Overwhelming workload
u Low connection
u Lack of belonging
u Leaders not leading
u Using shame and humiliation
u Low self-awareness and self-compassion
u Poor boundaries
u Conspiracy Theory: limited data and lots of imagination
Common Enemy Intimacy

A counterfeit connection with others rooted in dislike for the same people or
having contempt for the same ideas, “You’re either with us or against us.” It is
an intense, immediately gratifying experience to discharge outrage and pain.
- Brene Brown’s Braving the Wilderness

Avoid this in the workplace.

What am I contributing to my work environment?
What would you say?
What would your co-workers/employees say?
And, what would your community partners say?

Gossip My Best Self Clear communication

Competitiveness Fun Reliability
Ethical practice Humor Armor
Judgements Empathy Encouragement
Assumptions Kindness Trust
Honesty Creativity Consistency
Drama Openness Vulnerability
Compassion Transparency Courage
Stress Grace Intentional
Isolation Cooperation Ego
Punitive attitude Flexibility My Story
Cliquey Gratitude Fatigue
Difficult People Scale
A - OR - B C - OR - D
More animated More passive More flamboyant More restrained
take charge go along spontaneous deliberate
assertive hesitant responsive detached
demanding accepting impulsive methodical
demonstrative thoughtful sociable aloof
confronting supportive sentimental analytical
talkative quiet people-oriented task-oriented
bold timid outgoing reserved
intense subdued dramatic self-controlled
direct indirect friendly unfriendly
TOTAL A: (horizontal line) TOTAL D: (vertical line)
 Task-focused (D)
What kind of
Difficult Person 9

are you? 8

Get it 7 Get it
right done
6
Passive (A) 1 2 3 4 5 6 7 8 9 Aggressive
4
Get Get
along 3 appreciated
2

People-focused
 Get It Right, “The Know It All”: Tend to focus on tasks, intend to get it
right, detail-oriented, systematic thinking, need to be correct,
communicate indirectly and detailed fashion. When under pressure,
become silent, flee/withdraw, exhibit negative behavior (stubborn,
change stifler). Effective interaction with this person: Know your stuff,
schedule time to talk, be efficient.

Get It Done, “The Bully”: Tend to focus on tasks, intend to get it done,

Difficult
focused, direct, blunt, high need for control, communicate directly and to
the point. When under pressure, may raise their voice, bully and jab or
become demanding, behave arrogantly, withdraw. Effective interaction
with this person: Be brief, be right, be gone.

People Get Appreciated, ”The Diva”: Tend to focus on people, intend to get

Defined appreciated, creative, warm, charisma, high energy, need to be

recognized and applauded, communicate directly and elaborately. When
under pressure, may talk more loudly and quickly, throw tantrums,
exaggerate. Effective interaction with this person: Be flexible,
enthusiastic, let them talk, provide demonstrations.

Get Along, “The Cryer”: Tend to focus on people, intend to get along,
behave in an agreeable/helpful manner, need to be liked, communicate
indirectly and considerately. When under pressure, may submit,
accommodate, exhibit passive-aggressive behavior. Effective interaction
with this person: Be casual and sincere, slow down and listen, make
honesty safe, set goals, build them up.
The Polyvagal Theory
The biology of safety and danger is rooted in the interplay between the
visceral reactions of our own body and the voices and faces of people
around us. Our vagus nerve stems from our brain to our colon, directly
influencing the somatic experiences we have from our head to our gut,
and this nerve system directly responds to perceived threat and
perceived social support in a top-down process. This theory explains why
a kind face or soothing tone can dramatically alter how we feel, and why
feeling heard and understood by important people in our lives can make
us feel calm, and why being ignored or dismissed can trigger feelings of
rage or withdrawal. Our mammalian brains are designed to help us
function as members of a tribe, as most of our energy is devoted to
connecting with others.
-Excerpt taken from The Body Keeps the Score by Bessel Van Der Kolk
Creating Safety and Reciprocity
"Being able to feel safe with other people is probably the single most important
aspect of mental health. Numerous studies of disaster response around the world
show that social support is the most powerful protection against becoming
overwhelmed by stress/trauma. The critical issue is reciprocity: the experience
of being truly heard and seen by the people around us, feeling that we are held
in someone else’s mind and heart.”
When we feel threatened, we respond in this systematic way:
1- First, we turn to social engagement.
2- If no one comes to our aid, we revert to a more primitive way, fight or flight
(autonomic, sympathetic nervous system ramps up).
3- If this fails, and we can’t get away, we then move into a state of freeze or
mental collapse (autonomic, parasympathetic nervous system slows down).
The Body Keeps the Score by Bessel Van Der Kolk
 If leaders really want
people to show up, speak
out, take chances, and
innovate, we have to
create cultures where
people feel safe – where
their belonging is not
Brené Brown threatened by speaking
out and they are
supported when they
make a decision to brave
the wilderness, stand
alone, and speak truth to
bullshit.
Exploration of That which matters most to you, that
which gives your life meaning, a compass
Values that provides direction to your life and
helps you make choices.
Values Worksheet. Identify the values that are most important to you and
rank the top 5 in order of importance.

Acceptance Creativity Helpfulness Nature Self-acceptance

Accuracy Dependability Humility Nurturance Self-esteem
Achievement Duty Honesty Openness Self-control
Adventure Ecology Hope Open-mindedness Self-knowledge
Art Education Honor Order Service
Attractiveness Equality Humor Passion Sexuality
Authenticity Excitement Independence Patience Security
Authority Faith Industry Patriotism Simplicity
Autonomy Faithfulness Inner Peace Pleasure Solitude
Beauty Fame Intimacy Popularity Speed
Caring Fitness Justice Power Spirituality
Challenge Flexibility Law Privacy Stability
Change Forgiveness Leadership Prosperity Status
Comfort Freedom Leisure Purity Strength
Commitment Friendship Loved Purpose Success
Community Fun Loving Rationality Teamwork
Compassion Generosity Loyalty Realism Tolerance
Competence Genuineness Knowledge Resilience Tradition
Competition God’s Will Mastery Respect Unity
Contribution Gratitude Mindfulness Responsibility Virtue
Cooperation Growth Moderation Risk Wealth
Courage Harmony Monogamy Romance Wisdom
Courtesy Health Non-conformity Safety World Peace
Values
Identify the governing principles for you and your agency.

Do you know what your organization’s values are?

Are they clear and understood by everyone?
How are they being communicated within the organization?
Does the workplace culture appear to be aligned with these core values?
What would hold people accountable specific to these values?

Action Steps
Ø Post the organization’s values.
Ø Routinely evaluate employees’ perception of value congruence.
Ø Elicit employee ideas for valued action within the organization.
Ø Increase the opportunity for feedback about this in staff meetings.
 My Top 3 Personal Top 3 Values reflected
Values in my agency:
1. 1.
2. 2.
3. 3.

Are my values showing up Is there a disconnect

in my work? between our agency’s

Values
values and the way our
Are my values showing up employees engage at
in my personal life? work?

What’s getting in the Do our leaders embody

Worksheet
way? our agency’s values?

Are my personal values What would our

congruent with my community partners say?
agency’s values?

Where are we strong?

How can we address any challenges?

How do we promote professional growth and development?

How do we provide feedback?

How do we encourage work/life balance?

What TIC practices are implemented to promote safety, connection, and choice?
 PART II
Exploring the Stages of
Change & the Power of
Congruence
Change is always possible!
Virginia Satir

Stage I: Status Quo

Awareness of the need for change but the familiar is preferred. 99% anxiety, 1% comfort.
Stage II: Foreign Element… Resistance
The established system becomes unbalanced when something new enters.
Stage III: Chaos
Old ways are no longer working and people feel out of control, anxious, or ill. Revert back or take
the risk of something new.
Stage IV: New Integration & Transformation
Taking in new ideas and new ways of engaging.
Stage V: Practice… New Status Quo/New Balance
Support and reinforce the new ways till this becomes the new Status Quo. 75% anxiety, 25%
comfort.
Satir’s Change Model
The Lies I Tell Myself
u I am fine.
u I love my job.
u I am happy to take on more.
u I am just tired.
u You don’t understand, no one else can do this.
u People are depending on me.
u I will be fine once this is done.
u I’ll take a vacation and be okay.
u If people just let me do my job, I would be fine.
u It’s not me, it is everyone and everything else.

www.workplacestrategiesformentalhealth.com
Coping Stance GRID Results
The Placater

u Goes along to get along and does not speak their truth, even accepting blame
when unnecessary.
u The peace-keeper, the mediator, the nice guy, the doormat, the martyr.
u Conflict avoidant and uncomfortable saying “No.”
u Low Self-esteem: I need you to value me.
u Growth: genuinely cares.

SELF OTHER

CONTEXT
The Super Reasonable

u Utilizes logic, ideas, and the facts to maintain

accuracy and a greater sense of control.
u “Cool, calm, and collected,” the intellectual, non-
feeling, sometimes cold or aloof.
u May avoid direct contact with others.
u Good at giving advice or taking control of a situation
and often holds power. SELF OTHER

u Low self-esteem: I need you to think I’m ok.

u Growth: exercises good judgment CONTEXT
The Irrelevant

u Distracts, can’t stay focused, pretends not to understand,

deflects topics, may act inappropriately.
u The manipulator, the attention-seeker.
u Needs structure and support, but doesn’t know how to ask
for it.
u Low self-esteem: I feel helpless.
SELF OTHER
u Growth: creative energy.

CONTEXT
The Blamer

u If something goes wrong, the blamer lets others know

their fault and takes little responsibility themselves.
u The complainer, the bully, the boss, and the dictator.
u Often feels lonely and powerless.
u Low Self-esteem: I am vulnerable.
u Growth: Can utilize assertiveness. SELF OTHER

CONTEXT
The Congruent

u Words spoken match internal experience and

outside expression.
u Will take responsibility for their individual self by
standing on their own and challenging the status
quo when necessary.
u Real energy and authenticity.
u High Self-esteem: “I feel valued and cared for.”
SELF OTHER
u Growth: Maintain center and
takes risks in order to grow.
CONTEXT
 PART III
Digging Deep: The Body
& Parts of the Self
 Using a pen or picture, you are going to
draw a picture of yourself on a blank sheet
Blind Body of paper. Place the point of your pen in
the middle of the space. Close your eyes.
Drawing Now, begin drawing a picture of yourself.
There are no rules. You may stop when you
have finished or when I tell you the time is
up.
 PART IV
Self-Sovereignty:
Self-care Redefined
 At its core, self-care is not something you do. It is an
Self-Sovereignty incomparable way of existing in this world that conveys, “I
am here, I am engaged in my life, I have a voice, and I
have choices. I am worthy of my own love and respect.”
“the loving regard and Self-sovereignty is not bound by perfection, judgement,
governance of one’s rejection, or the perceptions of others. It is the rebellious
truest self” choice to see yourself exactly as you are, to take a deep
breath and give thanks for every moment of your journey.
 The Wisdom Box: Inner Truth & Guidance
The Detective Hat: Ability to Analyze
The Wishing Wand: Hopes & Desires
Satir’s Self- The Courage Stick: Going Forward with Fear
Esteem Toolkit The Golden Key: New Possibilities
The Yes/No Medallion: Setting Boundaries
The Heart: Giving & Receiving Love
 The Wisdom Box

INNER TRUTH & GUIDANCE

u Place your hand over the center of your body, perhaps just over your stomach
and below your left rib.
u Let your eyes close and breathe into the center of your body.
u Your inner wisdom has always been with you. You do not have to make
anything happen. Your inner wisdom will surface when it’s ready.
u Just stay open to it and let it come into your awareness.
u What does it have to say to you?
 The Detective Hat

ABILITY TO ANALYZE
u Everybody has the ability to know things in a unique way.
u How have you used questions in the past to help you find out the facts or
truth of something?
u Can you think of three questions you might ask to help uncover more
information and give richer meaning to your situation?
u Give yourself time to think and reflect before you respond
 The Wishing Wand

HOPES & DESIRES

u If you could have, do, be anything you wanted at this moment in time, what
would that be?
u If you could change the situation you are in with the wave of a wand, how
would the situation be different?
u When did you last ask yourself what you wanted for yourself?
u What do you most long for?
 The Courage Stick

GOING FORWARD EVEN WITH FEAR

u Can you imagine moving forward even if you are afraid?
u Close your eyes, recall a time when you used your courage. Let your body
remember the experience of courage within you. What part of you hold and
activates your courage? Does your body know the connection between fear
and excitement?
 The Golden Key

NEW POSSIBILITIES
u Let’s hold that idea, feeling or conviction for a moment. What else could your
experiences mean?
u Can you come up with two or more possibilities for what might have been
intended?
u Let’s brainstorm the possible ways you might respond?
u Can you give your unconscious permission to inform you of things you might
choose to do that are beyond what is familiar to you?
 The Yes/No Medallion

SETTING BOUNDARIES
u Do you know what it feels like in your body when you want to say, ‘Yes’ but
find yourself saying ‘No’?
u Do you know what it feels like in your body when you want to say ‘No’ but
find yourself saying ‘Yes’?
u What is the cost for you to not express your true feelings or ideas?
u Imagine caring for yourself enough to tell your truth and caring enough for
the other person to share what is real for you at a moment in time.
 The Heart

GIVING & RECEIVING LOVE

u Does your heart speak to you? Do you remember a recent time when it spoke
to you? What was that like?
u Given that it is impossible to really love someone and not get disappointed or
hurt sometimes, how is your heart at healing? What do you do to help your
heart when it is hurt?
u Can you trust your heart’s feelings?
 SELF-ESTEEM TOOLKIT HANDOUT

The Wisdom Box The Detective Hat

What does your inner truth and guidance tell you about your What facts or truths do you know about this situation?
situation?

The Wishing Wand The Courage Stick

If you could change this situation, how would you make it How can you move forward even with fear (the hard truths
better or different? And, what do you want for yourself? and conversations)?

The Golden Key The Yes/No Medallion

What might have been intended by you or the other contexts What is the cost to you of not expressing your true feelings
in this situation (what might I be missing?)? or ideas?

The Heart Other?

What do you do to help your heart when it is hurting? Any other strategies you can use to cope with this situation?
References
u Barbara, E. F. (2014). The keys to reducing turnover in long-term care. McKnight’s.
Retrieved 6/13/19 from http://www.mcknights.com/the-world-according-to-dr-
el/the-keys-to-reducing-turnover-in-long-term-care/article/333071/
u Barrett, K. & Greene, R. (2016). Where are all the social workers going. Retrieved
6/13/19 from:
http://www.governing.com/columns/smart-mgmt/gov-social-workers-
turnover.html
u Brickels, S. (2018). Prevalence of secondary traumatic stress at New Hanover
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