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290 APRIL 2023
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Addressing Compassion Fatigue and Compassion Satisfaction in Supervision

Patricia Kostouros and Shannon Kearney

The purpose of this study was to understand how supervisors might use the sub-scales of the Professional Quality of Life (ProQOL) Scale-5 (Stamm, 2010) to purposefully target secondary traumatic stress, compassion satisfaction, and burnout to make a difference in staff wellness at a Western Canadian young male adult addiction treatment facility. For six months the program implemented supervision guided by the ProQOL-5. After six months, twelve participants who were either program staff, supervisors and managers, completed qualitative interviews with researchers and expanded on their experience. Participants reported that regular supervision increased their satisfaction and helped them feel valued. It also helped mitigate the impacts of compassion fatigue. This study showed that relatively healthy people benefited from regular and consistent supervision, focusing on the ProQOL-5 themes. Other agencies and organizations may benefit from implementing a similar supervision routine, adjusting it to suit the needs and personality of their staff group.

Keywords

Compassion Fatigue, Compassion Satisfaction, Addiction, Supervision, Wilderness

 

Over several years, addiction programs have seen an increase in deaths that occur due to the use of more dangerous drugs such as fentanyl, as well as other opioids, which has been reported by Peterson et al., (2015) for the centre for disease control and prevention (CDC). This increase may cause staff who work at addiction facilities, or in addiction practice, to experience more symptoms of secondary traumatic stress (STS) and burnout (Beitel, et al., 2018). The link between compassion fatigue (CF) and addiction work has been considered in the past (Fahy, 2007) and continues to be a concern today given the opioid crisis taking place (Winstanley, 2020).

Bride and Walls (2008) suggested that those who struggle with addiction misuse are more likely to experience trauma and therefore, would bring this traumatic material into their work with an addition counsellor. In addition, Bride, and Kintzle (2011) noted that STS influenced job satisfaction and commitment to staying in the field of addiction counselling. In particular, survey results from their study showed that those with higher levels of STS had lower job satisfaction. Lower job satisfaction, STS and higher turnover was also demonstrated in the Ewer, et al. (2015) study.

Frontline staff may leave the work when it becomes too taxing and the cost of caring (Figley 2002) becomes too high. While larger facilities that are government run or have funds that are continuous may find ways to replenish frontline staff, in smaller agencies with less stable funding this could be a concern. In a needs assessment focused on medical professionals (McEachern, et al., 2016) it was established that trained professionals are lacking. Therefore, finding ways to keep staff feeling well and motivated to stay in this work is necessary and ethical.

Wilderness Addiction Programs

While limited, there is some research surfacing related to stress and wilderness programs in particular. For the most part, these studies investigated and discussed work related stressors such as schedules or organizing wilderness trips (Marchand, et al., 2009) versus CF or compassion satisfaction (CS). One study (Oser, et al, 2013) investigated the differences between urban and rural settings and the impact of drug and alcohol treatment. However, this study was related to burnout and stressors in general and not specific to CF or CS. In the Oser et al. (2013) study counsellors from both urban and rural regions agreed that they experienced burnout and recognized that to prevent burnout there needs to be co-worker support, clinical supervision, and self-care. How CF and CS are addressed in clinical supervision may make a difference in staff wellness.

Purpose of the Study

The purpose of this study was to understand how supervisors might use the sub-scale areas of the Professional Quality of Life (ProQOL) Scale-5 (Stamm, 2010) to purposefully target secondary traumatic stress, compassion satisfaction, and burnout to make a difference in staff wellness at a Western Canadian young male adult addiction treatment facility. The overall purposeful research question was: Does intentionally targeting the CF constructs of STS, CS and burnout in supervision raise awareness and does discussion about these areas in supervision make a difference in staff wellness.

The program in this study is unique in many ways as it is a wilderness program and staff live on site for days or weeks at a time. In addition, although the program in this study is part of a larger agency with several other programs, this specific program is a satellite program (away from the city and administration) allowing them to be more removed from some of more typical agency policies and practices. Therefore, while being a satellite program has its drawbacks, it also has its positives.

ProQOL-5

The ProQOL-5 (Stamm, 2010) is an empirically valid measure that reviews positive and negative effects of helping others who experience suffering and trauma. It is comprised of three separate scales, measuring Compassion Satisfaction, Burnout and Secondary Trauma (Stamm. 2010). Recognizing that helpers can be negatively affected by their work is important as is realizing that the work might also bring satisfaction both personally and professionally. While the negative effects of helping should not be minimized, explicitly linking to the enjoyment from one’s work could add to a supportive supervisory relationship. Building a level of awareness, understanding, and resiliency provides an environment for supervisors to address compassion fatigue directly and to successfully adapt amid challenging and often complex situations in order to develop resiliency and build, or increase, compassion satisfaction.

Prior to beginning the study, the primary researcher met with the administrative team of the program and described the purpose of the research. Recognizing the uniqueness of this program, the primary researcher was aware that the language in the ProQOL-5 (Stamm, 2010) would not likely fit their program culture. Therefore, the primary researcher worked with the administrative team to distill the ProQOL-5 questions into theme areas and used language appropriate for the program staff and supervisor personality. Examples of what was presented to the supervisors for potential ways they could approach staff are as follows:

Compassion Satisfaction: Is about the pleasure you derive from being able to do your work well, helping others, enjoying your colleagues or your ability to contribute to the work setting. Potential questions during supervision could be:

  1. Tell me about an encounter that made you feel satisfied or proud.
  2. Tell me about the successes you have had recently.
  3. What sort of thoughts and/or feelings do you have about these successes?

Secondary Traumatic Stress: Is about your work-related secondary exposure to traumatically stressful events. For example, you may repeatedly hear stories about the traumatic things that happen to those you work with or other people. Potential questions during supervision could be:

  1. What are the stories about your work that you tend to carry with you?
  2. In what ways is this work affecting your personal life or health?
  3. What is it like for you after you engage with a difficult story/event?
  4. What do you do to let go of work stories or events?

Burnout: Is associated with feelings of hopelessness and difficulties in dealing with work or in doing your job effectively. Burnout is related to systemic issues related to your work. Burnout can reflect the feeling that your efforts make no difference and can be associated with a very high workload or a non-supportive work environment. Potential questions during supervision could be:

  1. What are the roadblocks you are encountering working here?
  2. In what ways does the system here (or agency policy) get in the way of your work?
  3. How does your work philosophy/ beliefs align with our work here?

Once the research began, supervisors purposefully addressed these three areas in regularly scheduled supervision meetings, however, they may have adjusted the questions to match their style more authentically for example one supervisor often said, “tell me what floats your boat in your work,” or “describe your low level sufferings.” By making changes to the language we were able to match supervisor way of being which made the staff-supervisor interactions more authentic. 

Methodology

We were asking participants about their experiences in relation to a particular phenomenon, therefore, we conducted a qualitative study that is interpretative (Creswell & Creswell, 2018). We were seeking to understand the experience of staff and supervisors in relation to the phenomenon under study which was addressing STS, CS and burnout in supervision. According to Merriam (2002), asking about one’s perspectives and collecting this data via interviews matches an interpretive-phenomenological methodology.

Design

To understand the experience of targeting secondary traumatic stress, compassion satisfaction and burnout in relation to supervision, a decision was made to design a supervisory format, as described above, and glean information about that experience through individual interviews. It was necessary to have enough time for both supervisors and supervisees to become comfortable with the format and begin to see it as part of the supervisory culture. Therefore, in collaboration with program management a decision was made to allow a six-month period to pass before interviews would begin.

Recruitment

At a staff retreat, the study was described, and potential participants were provided a consent form and a demographics questionnaire which, once completed, was put into a sealed envelope. Potential participants were asked yes or no if they were interested in being interviewed, and if yes to provide contact information. Agreement to participate or not was confidential to researchers only. All staff would encounter the new supervisory format whether participating in the research or not.

A general demographic questionnaire was used in this study. Previous studies have found that age, and years in service could have an impact on one’s CS, STS and burnout (Craig & Sprang, 2010; Sacco, et al., 2015). The questions in the demographic questionnaire used for this study focused on the role at the agency, years in human service, education level and age of the participant.

Data Collection

Demographic data was collected the day of the retreat and the data related to live experience was collected through interviews over a one-month period after the new supervisory format was implemented for a period of six months. Demographics was a pencil paper survey and interviews were audio recorded then transcribed. All participants who agreed to be interviewed were interviewed. Of the 12 participants that were interviewed two were held over the phone, due to travel distance and the rest were face-to-face.

Analysis

Using open ended questions, the researchers collected responses from participants that provided opportunity to share their lived experience of the phenomena of secondary traumatic stress, compassion satisfaction and burnout. For the purpose of qualitative analysis these researchers read the transcripts for themes on their own then met to determine our findings. By working on our own then comparing and contracting our findings, there is a certain amount of inter-rater reliability that increases the validity of the themes and general findings.

As an attempt to glean some understanding into the interpretive approach, evaluating methodology and examining how this particular inquiry method unfolded is necessary. In qualitative methods, research can follow a particular structure; however, in an interpretive approach the presentation of the content and the structure may vary (Cohen, et al., 2000). Regardless, there is certain rigour that should be present. According to Fleming et al, (2002), there are ways in which to establish reliability and thus, we have employed their particular format as a basis for our methodology. Additionally, we have gathered information from other sources that endorsed Fleming, et al., (2002) claims about establishing rigour (Creswell & Creswell, 2018).

Joining the participant in dialogue and conversation is the starting point of understanding. Through language, the researcher is able to connect to the participant and then the dance of understanding becomes fluid. In the interpretive process, the purpose in dialogue, according to Fleming, et al. (2002), is to reach a shared meaning, and that is when the researcher and participant co-create understanding about the phenomenon under question.

Participant Demographics

Of a possible 22 members of the staff team in this program 15 completed the demographic questionnaire. In addition, 12 of the 15 that completed the demographic questionnaire agreed to an interview. Of the 15 participants that completed the demographic questionnaire, eleven identified as male and four identified as female. In terms of education, eight had a bachelor’s degree, four had some college or vocational training and three had master’s degrees. The majority, seven, were between 25-34 years of age, five were between 35-44, and three were over 45 years of age.

Seven participants had worked in this field for less than one year, two participants had one-to-two years of experience, two participants had three-to-five years of experience, one participant had five-to-seven years of experience, two participants had seven-ten years of experience and one participant had more than ten years in this field. Three of the participants were supervisors, who themselves received supervision from the management team. Because of the small number of participants in this study, identifying specific roles makes it easy to identify participants, therefore, roles will not be discussed in this demographic section.

Qualitative Findings

Themes that arose from the interviews took two directions. One direction was program related and the other was more personal in nature, although still related to the work. The program concerns that participants discussed in interviews related to the fact that there is a “constant vigilance” when working in a wilderness program with “rough guys.” Participants also disclosed that personally it was difficult to work in a wilderness program because it felt like “life in a duffle bag” and the “24/7 isolation” challenged their stamina.

Personal Concerns

As noted above, working in a wilderness program means having to take time away from friends and family for days or weeks at a time. Numerous staff in this study noted the difficulty with maintaining friendships and one participant described the challenge of trying to keep in touch with friends when they are only at home ten to 12 days a month. This person also noted their priority being on their primary partnership when at home, “if I have any time in the evening I’m going to talk with her as opposed to talking with somebody else.” Participants also recognized there was limits to pursue personal interests, “people just feel like they can’t really like get into the community.” They noted challenges such as trying to join weekly course or program but then missing every other class. The challenges inherent in working in a wilderness program was noted by Reyes, et al., (2019) who suggested that working in a wilderness program means one’s lifestyle will be adjusted and there are impacts of burnout. For example, individuals stated that what they are doing is rewarding and aligns with their personal values, but it can also be extremely draining and impacts work life balance. In this present research one participant left the program shortly after the six-month supervision period associated with the research ended but asked to be interviewed and explained the reason for leaving, “I absolutely loved working out there, I really did. But I love my family more.” Everyone we spoke to said they loved the program but also recognized the cost of addiction work in the wilderness.

While the wilderness work can be draining many staff in our study personally appreciated many things about their work. For example, one participant described how the program encouraged participants to, “bring your gifts, bring what you’re passionate about,” and found ways to include that in their work. Many noted the long drive home gave them time to process the events of the program, “even though it’s like burdensome, it’s also great because stuff gets to like be processed,” and arrive home being able to be more present. For some there was a ritual to leaving work that included leaving the program property and “[calling] my soul back.” Having to call one’s soul back speak to the difficult work and the need for supervision that is responsive to compassion fatigue.

Supervision

Apparently before this research began, supervision in this program was less structured. Almost all staff said something like, “I didn’t have a lot of supervision” prior to this research. Often staff had to approach their supervisor if they wanted to talk about any concerns, “it would be like me sort of requesting to debrief something with somebody senior.” This meant that supervision was typically focused on negative aspects of the work. We used the interview as an opportunity to understand how the change to regularly scheduled supervision made a difference for those being supervised and those supervising. Themes that emerged related to supervision were: opportunity to address and mitigate CF, no longer having to ask for supervision, feeling valued, supervision became purposeful, and consistency in supervision lead to increased awareness. One participant who provided supervision described the change due to the research as,

I’ve really appreciated just being able to have like those frameworks [STS, CS and Burnout], like those words as frameworks for them to share their own experience. Um, so instead of me asking directly about [a conflict], I can just ask about like how are you experiencing compassion fatigue. And what I’ve found is often there’s things that I’m not aware of that are like past experiences that will arise. Like we’ve had a fair amount of death in our community in the last year. And so like that stuff will kind of come up. Um, which is invisible unless, unless there’s that platform given for them to talk about it.

Having regular supervision assisted one participant in realizing that they were using the language of being traumatized by the work but came to understand that in most circumstances “it’s just draining not traumatic.” Being able to tease apart the concepts related to STS, CS and burnout helped in many ways for both staff and supervisors. For example, one supervisor talked about having more control over self and system because of understanding the different concepts related to CF. This individual was “able to differentiate between the burnout and the fatigue,” and recognized that burnout is “related to systemic issues.” Once the issue is identified the program has “more agency to change.” In addition, including these concepts in supervision allows supervisors to change what they can and support when needed.

Besides supervision, the staff start their day with a morning check-in. This check-in allows staff to share how they are feeling, discuss any conflicts they might be having with clients, share any impacts of their work or general concerns. For example, someone might share that they are not in the mood to cook and that staff is on kitchen duty. By sharing these concerns leaders and supervisors as well as team members can potentially shift the duties of the day or the client work. Many study participants talked about how these morning check-ins seemed to make a difference for them. As one participant noted, “we spend three minutes or four minutes in mindful meditation and then we share what’s cropping up for us. Before we even get into what’s going on with the guys.” This check-in helped communicate what was going on personally for each individual and created openness to “speak a need that we might have.” The morning check-in also brings the staff team closer. One participant mentioned that those morning check-ins “helped contribute to like building trust and building knowing each other.” When the team can support one another, then the client work could potentially go smoother. According to Landrum, Knight and Flynn (2012), “adverse effects of burnout on staff can extend to client engagement” (p. 223). Therefore, organizational environments that decrease stress and increase satisfaction can make a difference to staff wellness and potentially client wellness outcomes as well.

Secondary Traumatic Stress Themes

When asked to consider the main concerns in relation to the work with young adults with addiction issues and the secondary trauma experienced, the main themes that emerged were: worry and fear, client resistance, emotional commitment, and the environment. In terms of the environment and the link to secondary traumatic stress, participants shared that the clients can be “intimidating and scary.” While clients come to the program having already detoxed, there are still challenges with behaviours that come from being street entrenched.

Those young people that arrived at the program with more challenges and sometimes are not doing the work can be frustrating for staff who said things like the following when clients were not taking the program seriously, “we’re not doing the work, get them out.” In addition, when the clients have not done well, the staff then worry more about their future, “we know they’re going to walk out that door, they’re going to use and possibly die. And so, we live with that fear every day.” The staff and supervisors in this program care deeply about the young people in their care and want them to do well.

At times, that deep emotional commitment that staff and supervisors have for the clients can take a toll on them. One participant described, “when you’re living at work, it can be, it’s hard to step out,” or another participant that discussed the emotional unpredictability,

so like there’s only been times that I can remember leaving work and like crying about what a client has like disclosed on my way home, like things like that were really impacting me. I keep wondering whether it’s going to sort of sneak up on me a bit, but I’ll be fine, I’ll be fine, and then one day somebody will tell me something and I’ll really not be fine.

Usually, frontline workers work eight-hour shifts, giving them the ability to go home and distance themselves physically and emotionally from their work. The staff and supervisors at this program must actively carve out time for themselves, which can be difficult when you are living at work. However, many identified their unique workspace as what they enjoyed about their job, including being able to spend time with clients on the wilderness trail.

Compassion Satisfaction Themes

The participants in this study spoke in depth about the work that happens on the wilderness trail. For those that went with clients on trail it was highlighted as one of the compassion satisfaction themes. Other themes that emerged as a result of asking about what satisfied the participants in their work were: client wellness, roving leadership, using gifts and talents, flexibility and colleagues.

In terms of being on the trail a participant stated that, “being outside and in nature is really restorative for us.” Many of the staff and supervisors at this program find peace when outside but also recognize the healing that their clients experience while being on trail. A participant shared an experience describing an evening on trail, “they start talking about their addiction history, and their experiences, and feelings of shame. And, and they start sharing all these stories, and so it’s like, moments like that, you feel like, oh, okay, it’s all worth it.” Being on trail is also an opportunity for staff to engage in their passions. As one participant shared, “they talk with the guys, and get all these really cool connections, and see some really awesome places in the world, and do some really cool stuff.” Engaging in what staff enjoy allows them to feel an increased sense of compassion satisfaction. Experiencing satisfaction is important in frontline work as it decreases the influence of STS as well as increases occupational commitment, both of which lowers the amount of staff turnover that a program experience (Bride & Kintzle, 2011).

Another factor that contributed to compassion satisfaction was the flexibility that the staff and supervisors provide for one another. One participant stated how supportive their supervisor is, “if I need two months, he’s like great have it.” That type of flexibility allowed staff to feel an increased sense of support, knowing that adjustments would be made with them in mind. One of the supervisors labelled the team as “my most critical resource.” The supervisors in this program put a conscious effort in attending to the team and increasing their potential for satisfaction.

Burnout Themes

Participants shared about the factors that lead to them feeling less excited about their work in relation to systemic issues or the workplace environment. Themes that came from the participants in relation to burnout were: wilderness logistics, lack of benefits and shift work, minimal supervision (prior to the research), agency bureaucracy, and team members not following existing system structures or lack of structure.

The issue related to lack of structure was most often brought up by newer staff or those used to a program that was more hierarchical. This program tends to be more fluid and less dependant on procedures, but this can be frustrating for some,

like little things could be more streamlined at [program] instead of figuring everything out on the fly. That was my, and still is my frustration. Just like, we have systems in place, and it’s just a matter of using them. And I find that some people just don’t use them, even just like keeping track of like, we have a client board in the office of like who’s who. And where are they at and what are their needs, and sometimes that gets missed. And just like that’s like a simple example of I think that like, what’s the term, burnout.

It is not unusual for novice treatment providers to need and want more direction initially (Gersten et al., 2013) as this can provide an anchor from which one can gain confidence. Fortunately, given the flexibility of the program, this particular staff was given the go ahead to create the structures that were helpful.

Program Specific Themes

The wilderness program involved in this study is unique in many ways. The program leader has been in the field for many years and is open to staff needs. Two of the leaders are also able to shield staff from some of the agency politics and systemic complications. One supervisor described how they reworked some staffing positions to create a new position that would “[take] off the low level suffering from the other staff.” Another supervisor explained that, “the low level sufferings that I encounter are at that higher macro level. So I’ve spent ten years buffering the low level sufferings, in order for the program to thrive and do what it needs to do.” This is one example of the unique environment that the supervisors create at this program.

There is a specific culture to this program that allowed for them to be open to participating in this research. The staff team members care about one another and are open to being flexible and willing to change, if it means betterment for those around them and the program. The leader of the program believes in a philosophy related to right use of power and the shared journey. In addition, the leader of this program described that pay is not enough, Um, so I just feel that as long as they have a pay that keeps them just above survival, then that kind of incentive isn’t going to keep them at a program where they have to work half their life. The program leader seemed to understand that staff need to have an incentive other than the work with clients, “so what will drive them and keep them there is the sense of autonomy and that their creativity has a purpose. And so, the only way to do that is to give them real power to, to make changes.” He explained, “if someone comes to me, it means they’ve got a vision for something, and here’s the resources they need to carry it out.” When asked how this approach might lead to CS the leader responded, “well, I think huge.” The leader also talked about the importance of the shared journey and how that too can lead to job satisfaction.

Shared Journey

Sometimes referred to in counselling literature as the parallel process the shared journey comes up when client content triggers counsellor’s own history (St-Armaud, 2017). Often, this concept is brought up during the student-supervisor relationships (Barnes-Holmes, 2018) to help novice practitioners understand how to explore their own wounds when they surface. In this program the shared journey is a concept,

If you’re asking these clients to be on some cosmic journey of self-discovery, to see what’s driving them, you better be on one yourself. And it may not be an addiction journey, but at the human level, that’s what we’re really looking at, is how to be better humans. And not um, classifying, oh, they’re addicts, and I’ve learned this about addiction, so I’m the expert. There’s no experts, no um, receivers of wisdom. In fact, what we can get from the clients will help in our journey.

Clearly the leader who promotes this concept believes it is important, but we also heard about this concept from most staff and supervisors as positive, “that shared journey piece, gives deep permission for staff to be where they are.” Other staff described the ability to share their own histories with clients as connectors and learning opportunities. Others said it allowed them to be honest. For example, when on the trail the staff can share how they are doing which can lead to the client using their power in support of staff.

Right Use of Power

Essential to the program culture is the discussion about the right use of power. One participant explained, “what we try to do is be aware of our use of power and know that we’re above.” The same participant further expanded on how this approach influences the way they interact with clients stating, “we treat them like they have rights, and we walk with them in that. Knowing that we are 150 percent responsible for the relationship. And the clients, we, we are walking beside but also guiding the way.” The right use of power is something that is modelled by management and supervisors and is regularly discussed in the staff team. According to Egan, Maidment and Connolly (2017), a supervisory relationship can be seen in the workplace, “the dynamics occurring between the supervisor and supervisee illuminate the impact of organisational culture and structure” (p. 309). In the case of this program, supervisors know they have more power than those they supervise, and the staff know they have more power than the clients. However, what they discussed was how to use that power rightly, “it empowers staff to be like okay, show up as you feel, like you can be human. Because we’re working with humans and we want them to learn.” The way the participants and the supervisory team described the right use of power helped us understand their philosophy that helpers also need to keep learning.

Of interest, Egan, et al., (2017) noted that trust breeds safety and when a supervisee feels safe, they are more likely to allow for discussion of mistake making. In their study they noted that in some cases an external supervisor may be better able to create an honest trusting relationship. At this particular program, staff stated that they felt safe and trusted their supervisors and management team, however, they also had access to external support. In one case a participant stated that their ability to access an external clinical supervisor helped with recognizing the potential for work impacts, “having, my clinical supervisor…he’ll reflect back things that I’m saying and go like, I’m wondering if that’s impacting you.” Regardless of a supervisor using the right use of power, it still might be beneficial to have an external perspective to see the impacts of this work.

Discussion

The findings of this research provide a potential direction for supervision in human service programs. There are likely some overarching ideas that could be taken up by other agencies in relation to supervision to increase staff wellness. One such potential is the use of the ProQOL-5 (Stamm, 2010) sub-scale areas as a tool for supervision, as we did similarly in this research, as discussion points during supervision. Staff who engaged in this research overwhelmingly agreed that targeting the areas of the ProQOL-5 made a positive difference to their supervision experience.

Teasing apart the CF constructs and targeting these specifically, allowed staff to feel valued and lessened their need to approach a supervisor if having a concern. As Kapoulitsas and Corcoran (2015) noted, supervision can play a role in reducing CF and according to Miller and Sprang (2017) supervisors can use a number of strategies to assist staff to recover from the impact of CF or build resilience to these effects. Miller and Sprang (2017) suggested five strategies that can assist with reducing CF which are: experiential engagement, managing rumination, intentional narrative, reducing emotional labor, and parasympathetic recovery strategies. If CF constructs are purposefully targeted in supervision, staff could share their experiences and supervisors could suggest these strategies. Unless CF constructs are targeted, staff may not be aware that there are strategies for reduction of effects.

The modification of the ProQOL-5 (Stamm, 2010) to fit the program culture, as noted in the ProQOL-5 section, may have some implications related to these results. For example, the positive implication of making language changes allowed for a more authentic fit with both the program and the individuals using these areas for supervision. A potential negative impact could be related to inconsistent messaging or less co-construction of understanding about the areas under discussion during supervision. A supervisor or administrator who wants to modify the ProQOL-5 sub-scales would need to have an understanding of the language used by staff and supervisors in a program. Once that language is understood then appropriate changes could more authentically fit these sub-scale areas into supervision.

It is important to note that this staff team were already a close-knit group who often expressed care for one another; we believe we had a pool of participants that were a team of fairly healthy individuals. Had we been discussing these issues with a team of disgruntled employees, who lacked trust and safety, we may have yielded different understanding of how using the ProQOL-5 (Stamm, 2010) sub-scale areas as a supervision tool could be useful.

This program had leaders and supervisors that helped contribute to a supportive and open working environment. Many participants credited their supervisors as individuals that helped mitigate their burnout and CF. The flexibility provided to staff from supervisors allowed for wellness to be a priority for all staff working at the program. Other settings may not have the same supportive supervisory relationships and as noted by Kapoulitsas and Corcoran (2015) the supervisor matters.

Another important note related to this research is that by engaging in this study, the research itself influenced the supervisory relationship. The program took on a change in the way that supervision was being implemented, it became more regular. Therefore, this change may have contributed to the staffs’ comments about feeling valued and expressing the increase in CS. However, if a change to more regular supervision had remained focused on the more difficult aspects of the work, the CF components, rather than an increase discussion related to CS or burnout, it may not have made a difference in staff wellness.

This research likely needs to be replicated in a variety of settings in order to know if targeting these areas of CF does indeed make a difference to staff wellness. This particular program was situated in the wilderness and away from agency bureaucracy, a different setting nearing the policy makers might find it harder to combat burnout concerns. In addition, more could be done to discover the how supervision unfolds prior to research in a pre-post design. Finally, future research could consider staff wellness strategies and consider how supervision that targets CF specifically might change or enhance those strategies.

Conclusion

We appreciate the participants willingness to share their experiences and engage in this research. This research suggests that supervision has an important role to play in mitigating compassion fatigue and increasing compassion satisfaction. Specifically, supervision that is regularly scheduled and addresses compassion fatigue, and compassion satisfaction may also increase staff wellness. In this research we noted that staff appreciated not having to be the pursuer of supervision as this led to supervision typically being about the negative aspects or conflictual concerns about the job or workplace. Increasing discussions about compassion satisfaction reminded people about what they enjoyed and why the do this difficult work in the first place.

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Republished from: Relational Child and Youth Care Practice, Vol 33, No.4 pp34-54

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