Social Services Compassion Reader

An Interview with California Health and Human Services Secretary Diana Dooley | CHHS Agency
original source: https://www.calhr.ca.gov/Training/Pages/executive-perspectives-diana-dooley-curiosity-competence-and-compassion.aspx

Q: What are the key attributes of leadership?

A: Fundamentally, three things: curiosity, competence, and compassion.

A good leader has to be curious. If you aren't curious, you aren't engaging, you aren't encouraging people.
Competence leads to credibility. People look to you as a leader to know about their world, their organization, the details of their work. But it's your job to set big objectives in ways that translate into small details. Sometimes you have to translate for them. So there has to be a measure of subject matter competence to be a leader.

Compassion is important to me because it's another way of saying empathy. Compassion means putting on the shoes of other people: workers, colleagues, the people that we're serving. We have many programs in the Health and Human Services. The beneficiaries need nutrition assistance, temporary assistance because they're out of a job, health assistance, or community development work. They are the consumers and beneficiaries of our work, at the heart of what we do. If we didn't have compassion, it would be hard to connect the detailed, data-driven, sometimes ministerial functions to the lives of the beneficiaries.

Q: How do you handle the crunch caused by furloughs and the financial crisis?

A: When I came in two years ago, the system had already been stressed for years. We couldn't achieve the same objectives with fewer resources.

We first had to prove we were using all the resources well and wisely. We had to address whatever waste, fraud, and abuse there was.

Then we made reductions. These affected people's lives in very consequential ways. I think it's disrespectful to suggest otherwise.

I asked at every level: What could you set aside? What can't be done with the reduced resources?
To everybody who tells me how someone else could change what they were doing I say, "What can you change?" I don't want you to tell me that you're doing everything perfectly and someone else needs to change. If someone else changes, yes, it's an improvement. But every one of us can improve by doing something differently. I want to know what that is.

Q: How do you empower your team to make difficult decisions?

A: I worked very hard in the first six months to recruit the finest talent who had worked with the Health and Human Services Agency from the other side of the table. Many took reductions in pay and now work harder than before. They all have the components of curiosity, competence, and compassion.

We don't run programs or set policy at the agency. We have leaders in every one of the departments who understand and run the programs. They come to me when they need support, advice, guidance, or an interface with the broader public and legislature.

As an Agency Secretary, I articulate the vision for how we're going to achieve the Governor's goals. Sometimes I'm the adhesive and sometimes I'm the lubricant. I connect the abilities of the people who know more than I do about the programs to the Governor's goals.

Q: You've worked in both public and private sector jobs. How do the private and public sector compare in terms of strategy-setting?

A: In the private sector, a board of directors hires the CEO and they run the company. You say we want to achieve these goals. We want to increase market share, or we want to find a service that isn't otherwise provided. Then you have all of your horses pulling in the same direction.

Government is much more complex in setting its strategic agenda. The process for determining strategic goals is very diffused. And leadership changes more often. You have executive leadership that changes every four years. You have legislative leadership that changes every two years. The bureaucracy is slow to change because the people doing the work know that there will be these kinds of changes.

Governor Brown famously said in his first two terms of office that it takes about one term to begin to get people to speak the language of the new Governor and know where they're going and what they want to do. Then it takes another term to begin to move there. Then there's a new administration. And often it's an administration with a very different perspective and set of goals.

Q: Given the strategic challenges faced by government, what motivated you to return to public service?

A: I think that there are some things that we can only do together: educating our children, taking care of our most vulnerable, building our roads, protecting our environment. Those are things that make our democracy different than any other society in the history of the planet.

It does require us to honor and invest in and be committed to the people who do the people's business. I came back at the end of my career to where I started in order to serve as an advocate and champion of the people who do the people's business.

This interview with California Health and Human Services Secretary Diana Dooley was conducted on January 29, 2013 and has been edited and condensed.

Original Source: Discovering Growth - Providing Counseling for Families, Couples and Individuals (http://www.discoveringgrowth.com/wp/?page_id=171)

Compassion fatigue is a term used to describe a condition that occurs when clergy, mental health professionals, emergency care workers, human service workers, or advocate volunteers are overcome with providing care to others. Webster’s defines compassion fatigue as a “feeling of deep sympathy and sorrow for another who is stricken by suffering or misfortune, accompanied by a strong desire to alleviate the pain or remove its cause” (Webster, 1989, p. 229). According to the American Psychological Association, professionals who absorb a person’s pain and carry it with them, is experiencing compassion fatigue.

Although compassion fatigue is often interchanged with the term burnout, it is not the same. Burnout is characterized as cumulative events that are fueled by stress and highly demanding jobs. Conversely, compassion fatigue comes from dealing with others who are suffering from a trauma and are in great pain. In her article Compassion Fatigue: The Professional Liability for Caring Too Much, Rosemary Thompson states,

“Compassion fatigue develops over time – taking weeks, sometimes years to surface. Basically, it’s a low level, chronic clouding of caring and concern for others. Over time, the ability to feel and care for others becomes eroded through the overuse of skills expressing compassion. Compassion fatigue occurs when caregivers become emotionally drained from hearing about and being exposed to the pain and trauma of the people they are helping.”

Charles Figley, founder of the Florida State University Traumatology Institute lists the following as symptoms of compassion fatigue: low morale, reduced ability to concentrate, guilt, appetite changes, intolerance, depleted energy, insomnia, immune system impairment, apathy, depression, negativity, isolation, perfectionism, rigidity, regression, feeling of pervasive hopelessness, loss of purpose, questioning the meaning of life, shock, decreased interest in intimacy and sex, anger, and mood swings. A self-test to assess your susceptibility to compassion fatigue can be taken on the following website: http://www.ace-network.com/cfspotlight.htm.

It is crucial that the professionals who may be experiencing compassion fatigue pay attention to the symptoms and seek ways to deal with the fatigue. The best way to offer service and help to others when emotional, physical and spiritual resources become depleted is to be diligent about self care. Thompson’s article offers some wonderful reminders of ways to care for ourselves:

• Know your triggers and vulnerabilities.
• Resolve personal issues and monitor your reaction to pain.
• Allow yourself to be human and grieve.
• Have realistic expectations of yourself and recognize your limitations.
• Find opportunities to debrief. Debrief yourself, debrief with friends, and/or debrief with a professional.
• Delegate other life responsibilities.
• Take help from others.
• Develop a support system to protect yourself from further fatigue and emotional exhaustion.
• Remember that victims and helpers grow from their experiences.
• Eat nutritious food.
• Exercise
• Rest
• Set and keep healthy boundaries.
• Think about the idea that if you never say “no” what is your “yes” worth?
• Develop and reward a sense of humor.
• Spend quality time alone in prayer and meditation.
• Recharge your battery daily.

Knowing what to expect when crisis occurs is one of the best defenses against compassion fatigue. Other resources for dealing with compassion fatigue include:

Websites:
www.apa.org
www.riskinstitute.org
www.ace-network.com/cfspotlight.htm
www.vaonline.org/care.html

by Wendy Grace Evans
reposted from original source: http://homeless.samhsa.gov/resource/walking-through-the-river-restorative-self-care-for-human-services-workers-48850.aspx

Marc Potter is a social worker and a man in recovery who understands the essential nature of self-care when working in stressful environments. He dedicates much of his time to training human services professionals on the importance of renewing their capacity for compassion.

“As a social worker at a children’s hospital, I frequently receive the request: ‘Can you see the mom in room three? She is crying,’” shares Marc. He often wonders why it is difficult for a doctor or a nurse to go into room three, place a hand on the mother’s back, express compassion, and ask her to tell them why she is upset.

Recently Marc facilitated a training event for a team of nurses. He asked the team of nurses to reconnect with why they wanted to be nurses in the first place. What were their highest aspirations when they started? What sacrifices did they make to become nurses? He asked the nurses to share what inspired them to become nurses, and to identify the two traits that supported their highest aspirations. After sharing with the group, the nurses were asked to pair off and write down two positive traits describing their partners. Then, they exchanged the note cards identifying the traits they saw in each other.

“When you hand someone a gift, it is important to give and receive with two hands. This helps people to understand that the gift is being given and received with intention,” explains Marc. This exercise was combined with a guided meditation on renewing compassion as a practice to help the nurses be present for their patients at work while caring for themselves. He asked them to recall a time in their lives when someone had cared for them.

“Imagine all the things people have done for you. Visualize your mother, or caregiver. Someone fed you bottles and changed your diapers. Imagine love and care and extend this to teachers, mentors, partners, all the people who have helped us to be where we are today. Allow this to radiate out like a bright light.”

“Many meditation traditions have found that this particular imagery is incredibly powerful,” says Marc. When he does the meditation in the morning, he finds he is able to draw on the strength of the imagery when he is called on to be compassionate during his workday. His meditations are based on readings from The Lost Art of Compassion by Lorne Ladner, Ph.D.

As the nurses shared their stories, Marc circulated around the room, removing himself from the position of expert. “I understood that this group did not need an expert on vicarious trauma, but rather an experience of compassion, gratitude, and nurturing. I let go of being the expert,” says Marc. The result was that the group of nurses found renewed interest and strength in the power of being able to know and support each other.

In the human services field there is a longstanding focus on curing pathology. Marc believes this often adversely affects individual and organizational capacity for self-care. “If I don’t do the things I need to do to replenish my heart, then I walk around disconnected. I am less likely to be present for a patient’s suffering on a deeper level,” says Marc. He knows that he is not tending to himself when he realizes that he is not looking patients in the eye.

“In our culture we often look at self-care in terms of recreation, distraction, and pleasure.” says Marc. “I believe that self-care must be of central importance to workers in human services. You cannot walk through other people’s suffering without being affected, anymore than you can walk through a river without getting wet.”

by Marian L. Swindell, Ph.D.
from The New Social Worker - The Social Work Careers Magazine
original source: http://www.socialworker.com/feature-articles/practice/compassionate-competence-a-new-model-for-social-work-practi/

As a social work practitioner and educator, I have always felt something lacking in my practice philosophy. I encourage my undergraduate students to develop a practice “philosophy” or “mantra” that they will try to live up to every single day. Upon graduation from my MSW program, I embraced my practice “mantra” or philosophy as stemming from the Wesleyan Doctrines of Goodness. As I was raised within the church setting, I became very familiar with this doctrine, which encourages people to “do all the good you can, by all the means you can, in all the ways you can, in all the places you can, at all the times you can, to all the people you can, as long as ever you can"

As I graduated with MSW in hand, I was prepared to go out and “do good.” I was blessed with an amazing graduate program that encouraged MSWs to go out into the world and make a huge, positive difference. Thinking back upon that educational program, I realize that they were, in fact, giving me permission to go out, be brave and courageous, and really seriously change the 

During my education, one fundamental skill I was taught and worked to develop was the skill of cultural competence. A great definition of cultural competence is:

the process by which individuals and systems respond respectfully and effectively to people of all cultures, languages, classes, races, ethnic backgrounds, religions, and other diversity factors in a manner that recognizes, affirms, and values the worth of individuals, families, and communities and protects and preserves the dignity of each.... Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system or agency or among professionals and enable the system, agency, or professionals to work effectively in cross-cultural situations.... Operationally defined, cultural competence is the integration and transformation of knowledge about individuals and groups of people into specific standards, policies, practices, and attitudes used in appropriate cultural settings to increase the quality of services, thereby producing better outcomes (http://www.naswdc.org/practice/standards/naswculturalstandards.pdf).

The fundamental interpretation of culturally competent social work is different for each social worker. This difference in interpretation can make social work one of the most enriching, colorful, tactile, soul inspiring careers of all time. As a student, I fundamentally “got” exactly what cultural competence was. Being culturally competent meant that upon graduation, I would know how to ethically and effectively work with different types of people, from different towns, cities, regions, countries, with different dialects, speech patterns, belief systems, family systems, values, abilities, gifts, income, and educational backgrounds. Basically, I should be able to embrace the differences and similarities that each client would bring into my office and to remain open-minded and willing to learn new things about human beings when working with my clients. So, fundamentally, I was competent at being a culturally competent social 

After years of talking with clients, students, and colleagues, I knew my practice philosophy was changing—evolving—shifting. I was going deeper into doing what I was doing as a social worker. I was looking at a bigger picture, basically how I was changing the world, one person at a time. I was seeing that I was having universal impact, and that was 

I understood and fully comprehended that my actions with my clients had gone past being competent and had become compassionate. I understood cultural differences, and also that compassion included all cultures, all peoples, all walks of life. I understood that compassion was much bigger than culture. This understanding and the ultimate transformation took place solely because I yearned for a deeper connection to my

I struggled with not feeling like “I had been called.” So many people say that social work is a “calling.” My problem, however, was that I never felt or heard this “calling.” I sometimes felt that I was a fake social worker or that I was “faking it” because I didn’t get “called,” and I thought I was surrounded by all these great, and magical, mystical people who had gotten this miraculous call.

As the years passed and I began to authentically talk with my clients, my students, and colleagues, I understood that, yes, I needed to understand cultural competence, and I needed to be good at it. But that was just the beginning for me. I began to understand that cultural competence was a foundation upon which to enrich my career—a building block of sorts. Yes, yes. I knew I was competent. I was very technically efficient. But that wasn’t enough for me. In addition to being competent (the black/white side of social work), I also wanted to be compassionate (the colorful side of social work).

A great definition of compassion, defined by the Merriam-Wesbster dictionary, is:

a feeling of wanting to help someone who is sick, hungry, in trouble, etc.: a sympathetic consciousness of others’ distress together with a desire to alleviate it. (http://www.merriam-webster.com/dictionary/compassion)

I posit that we, as social workers, embrace a new philosophy about our profession. I no longer want to be merely culturally competent. I do not want to be seen as a technically efficient integrator and transformer of knowledge, skills, and policies to produce a better outcome. Yes, that technical, efficient, productive philosophy is about “answering a call.” That philosophy is very black or white.

Let’s consider a blending of these two ideas into one revolutionary practice goal—one that will change how social workers view our profession and how others view us, as well. Social workers should desire a career philosophy filled with black and white, and all the bright and beaming colors in between. We should embrace both competence and compassion. Thomas Merton states that “the whole idea of compassion is based on a keen awareness of the interdependence of all these living beings, which are all part of one another, and all involved in one another”
(http://www.fiercelight.org/resources). As social workers, we understand and embrace systems theory and ecological theory. Compassion embraces these theories as well.

The competent aspect of social work is crucial; we are worthless if we are incompetent. The compassionate aspect of social work is crucial, as well; without compassion, we are just automaton/robots going through the motions of our day. We need both competence and compassion, black/white and color. Based on the definitions explained above, I encourage social workers to embrace a new term with a new definition: Compassionate Competence. Building on the two previous definitions, I would loosely define “compassionate competence” as:

an ethically, successful integration and transformation of knowledge, skills, attitudes, behaviors, and policies to sympathetically and consciously alleviate suffering (Swindell, 2013).

The first section of the definition, “an ethically, successful integration and transformation of knowledge, skills, attitudes, behaviors, and policies” focuses on the technical and competent aspect of our social work—successfully completing a task and doing so correctly. The second section of the definition “sympathetically and consciously alleviating suffering” focuses on the humanitarian, unselfish aspect of our profession—helping those who are suffering—AND includes all people, all cultures, all religions, all socioeconomic classes, all human beings. The definition is written clearly, simply, and succinctly and reads “alleviate suffering.” This means all suffering, not just certain types of suffering. Suffering is suffering, regardless of how it is presented. All cultures suffer. People within all cultures experience suffering. The original language in the definition of compassion reads “alleviate suffering.” It does not matter what culture, gender, age, disability, poverty level, religious affiliation...all that matters is suffering and the alleviation of that suffering.

It is important to note that culture is indeed a significant aspect of a person’s life and that this article is in no way diminishing the importance of culture. The article is only suggesting that we focus more on compassion (which includes cultural awareness and knowledge) than just on culture itself.

In conclusion, I feel that I must explain that this article comes from my own personal and spiritual journey within myself from a social worker’s perspective. Many readers may completely agree or disagree with the notion of a new practice goal. Some may say that they have been practicing this way their entire career and that this notion of “compassion” in social work is nothing new. I agree. There are approximately 995 articles with the terms “social work” and “compassion,” according to a search of Academic Search Complete. The majority of these articles focus on self-compassion, compassion fatigue syndrome, and compassion satisfaction. So this relationship between compassion and social work is not new. The purpose of this article, however, is to formally introduce the term “compassionate competence” as a practice goal within our profession. Whether one chooses to embrace this practice goal and include it within the practice repertoire is purely personal.

The culturally competent social worker is a technically proficient, efficient, effective, successful worker. Once social workers become successful at this, they can complete tasks with their eyes closed. The difference is that compassionately competent social workers become successful ONLY AFTER they open their eyes.

Joel A. Barker affirms that “Vision without action is merely a dream. Action without vision just passes the time. Vision with action can change the world.” (http://www.brainyquote.com/quotes/quotes/j/joelabark158200.html)
The vision of compassion plus competent action can indeed change the world. The time is now for social work to shift into a higher calling, based on a higher vision, far reaching just culture, but embracing all of humanity.

References
BrainyQuote. (2013). Joel A. Barker quotes. Retrieved from http://www.brainyquote.com/quotes/quotes/j/joelabark158200.html.
Fiercelight. (2012). Fiercelight: Where spirit goes deeper. Retrieved from http://www.fiercelight.org/resources.
Compassionate. (n.d.). In Merriam-Webster’s online dictionary (11th ed.). Retrieved from http://www.merriam-webster.com/dictionary/compassion.
National Association of Social Workers. (2001). NASW standards of cultural competence. Retrieved from http://www.naswdc.org/practice/standards/NAswculturalstandards.pdf.
Swindell, M. (2013). Compassionate competence: A letter to MSU-Meridian social work students. Student Orientation, Fall, 2013.
Marian L. Swindell, Ph.D., is an associate professor of social work at Mississippi State University.