Tools to Help Caregivers

Tools to Help Caregivers

Community members, clients and congregants, colleagues may look to you for support with various types of trauma, loss and suffering. Listening to difficult stories and helping others overcome hardships can affect you in unexpected ways. It can also be enriching and rewarding. In watching community members develop resilience, you will witness both the strength of the individual and of the greater community. This section discusses the positive and negative aspects of finding yourself in this role, and offers tips for self-reflection and self-care.

You Can’t Pour from an Empty Cup

Helping Unintended Impacts
The word caregiver refers to any individual who provides direct care to another person.1 This type of care includes personal, familial, spiritual, professional and communal caregiving responsibilities. Community leaders often take on caregiving responsibilities when they engage with people seeking spiritual guidance or social support. This work is beneficial to the greater community and can be personally fulfilling for you as a community caregiver. However, helping work can also be overwhelming and lead to burnout.

These responsibilities that can negatively impact your mental health include:
  • Listening to the difficulties and traumatic experiences of others
  • Working closely with people in need of support
  • Empathetically engaging in others’ distress
  • Hearing about others’ grief, fear and/or anxiety
  • Learning about community members’ unmet basic needs
  • Hearing personal accounts of traumatic experiences involving loss, violence,exploitation, discrimination and hate
To listen and respond in a supportive way, you must open yourself up and establish trust with the people you help. As a result, you may feel emotionally impacted by others’ stories and troubles. Helping work exposes you to a variety of overwhelming emotions, which may change your perceptions and cause both negative and positive reactions.

The personal responsibility you feel to help those in need can also be a source of stress. You may feel pressured to succeed every time you try to help a community member. Becoming invested in your work is honorable, and often results in positive outcomes. But this stress can become overwhelming if a community members’ needs cannot be met.

When helping someone cope with trauma, loss or other types of stress, you may feel:
  • Overwhelmed by the intensity of the person's feelings
  • Discouraged by your inability to help
  • Depressed or intensely disturbed by the person’s situation
  • Angry at the injustices the person faces, and the perpetrators that have caused them
  • Overinvolved in the person's situation
  • Detached or distanced
Although this work can be stressful, it can also benefit you as a community caregiver. Seeing the perseverance, resourcefulness and resiliency of community members can be a source of inspiration for you. It can help you develop your own systems of strength and lead to personal growth.

The Effects of Listening and Engaging with Others
Be aware of your emotions and recognize when your work is becoming overwhelming or distressing. It is your responsibility to protect the fragile state of the people you serve. This includes  maintaining an appropriate and supportive response during your interactions with them.

Tuning into your emotions allows you to:
  • Identify what you are feeling
  • Empower yourself to take action
  • Practice self-care
Before you are able to engage with others, you must first learn how to engage with yourself. You bring your own experiences to your work. This includes past life challenges; personal histories of trauma, loss or disruption; and your unique strengths and weaknesses. Working with community members encourages you to reflect on the inner resources, strengths and efforts that helped you meet challenges in the past. By developing this self-awareness, you can control your reactions and prevent negative, unhealthy responses in your current work.

Working with People Experiencing Trauma, Loss or Other Life Disruptions

You will learn about a variety of challenging experiences when working with people who have experienced, or are currently going through, trauma, loss or other life disruptions.

Some examples include:
  • Witnessing community violence
  • Losing a child
  • Living through a natural disaster or violent attack
  • Serving in combat
  • Surviving sexual assault, domestic violence and/or human trafficking
  • Escaping conditions of war, civil unrest, social instability and/or genocide
Over time, you will notice the impact of working with survivors of these experiences. Some accounts of trauma may affect you more deeply, and in different ways, than others. Negative reactions can include vicarious trauma or compassion fatigue. Positive reactions can include vicarious transformation, vicarious resilience or compassion satisfaction.

Vicarious Trauma2
Vicarious trauma is the negative change to a caregiver’s inner experience as a result of hearing survivors’ accounts of trauma. Vicarious trauma can affect the caregiver’s identity, worldview and spirituality, as well as their sense of hope, meaning and safety in the world. Vicarious trauma is extremely common among caregivers, and is not a sign of weakness or inability to provide proper care.

  • Example: A faith-based leader avoids taking the subway home one night after speaking privately with a congregant who was sexually assaulted. The community leader recalls that many of the women she has worked with over the years have also survived sexualassault. She begins to feel hopeless about the nature of the world, and experiencesintense loneliness.
It is important to seek professional or spiritual guidance if you think you are experiencing vicarious trauma. Use this tool to self-assess for vicarious trauma

Vicarious Transformation
Vicarious transformation is a possible byproduct of vicarious trauma, but unlike vicarious trauma, it positively changes one’s perceptions. This change can include experiencing a deeper sense of compassion or connection to humanity, or discovering a new sense of meaning, purpose and hope.

Example: The faith-based community leader mentioned above meets a young woman in search of spiritual guidance. The young woman is another survivor of sexual assault. She expresses the desire to harm herself after losing a court case against the man who attacked her. The community leader immediately connects her to help possibly saving the young woman’s life. The community leader develops a renewed commitment to supporting survivors.

Vicarious Resilience3
Vicarious resilience describes a caregiver’s improved ability to overcome challenges as a result of seeing a survivor face their own traumatic experience.
  • Example: The community caregiver mentioned above helps the young woman reach a full recovery after her sexual assault. The caregiver is inspired by the young woman’s perseverance and determination to overcome this experience. As a result, the caregiver feels more hopeful about her work and the world around her.
Compassion Fatigue4
Compassion fatigue, also known as the outcome of caring, is a state of exhaustion caused by the stress of helping, or wishing to help, trauma survivors. Compassion fatigue can include avoidance, emotional numbing, hyperarousal, anxiety and depression. Some caregivers even experience mirrored reactions that parallel the survivors’ own experiences.
  • Example: An adolescent boy who is being violently bullied by his peers seeks help from a community center leader. The community leader begins to notice that he grows anxious each time he confronts the bullies. Eventually, the leader finds himself avoiding talkingto them altogether. He begins to feel exhausted and depressed by his inability to stop the bullies and protect the victim.
Compassion Satisfaction5
Compassion satisfaction is the fulfillment you feel when helping others.
  • Example: After working with the young boy mentioned above every day after school fortwo months, the community center leader begins to notice improvements in the boy’s self-esteem. This confidence helps the young boy defend himself against the group of bullies. The community caregiver realizes the positive impact he has had on the boy’s life. He finds a new sense of appreciation for his community and satisfaction in his ability to improve it.

The Impact of Workplace Stress on Caregiver Performance

Constant exposure to intense work conditions can lead to stress, burnout and restricted job performance. Unlike the stress listed in the previous section, it is not a result of working directly with individuals dealing with trauma, loss or other life disruptions. This kind of stress is only influenced by one's working environment.

Stressors in the Work Environment

Caring for community members can be demanding, and you may find yourself working with very few resources or for little compensation.

Common workplace stressors include:
  • Large number of people in need
  • Long work days or unreasonable hours
  • Working alone or with little support
  • Receiving little to no recognition for your efforts
  • Working with too few resources
  • Little to no time for lunch or breaks
  • Low spirits among coworkers and supervisors
Burnout is the physical, mental or emotional exhaustion you feel as a result of stress in the workplace. Burnout can occur in any occupation.

Burnout for caregivers can include:
  • Feeling discouraged, depressed or unfulfilled
  • Losing compassion for people in need
  • Feeling negative about others and the world in general
  • Doubting your ability to help others
  • Falling short of your expectations
Addressing Burnout and Other Problems in the Workplace
There are many ways to establish and maintain a respectful, enjoyable work environment: 
  • Ensure all staff members' and volunteers' voices are heard, and that communication is respectful
  • Express gratitude for staff members’ and volunteers' efforts
  • Celebrate the positive impact of working closely with community members
  • Create a supportive community among coworkers
  • Work with staff and other professionals in the field to identify common challenges
  • Ensure work conditions are fair and include job security, vacation time, benefits andreasonable expectations for working hours
  • Manage the number of community members that staff and volunteers work with
  • Offer specialized trainings and professional development opportunities
  • Provide supervision that is supportive
  • Offer constructive feedback on staff and volunteers’ work challenges and accomplishments
To make sure community members receive the highest quality care, you must recognize when you are experiencing burnout. Complete this work-life experience assessment to assess your level of burnout 

Ensuring the Highest Quality of Care for Community Members

Enhancing Self-Care
To maintain good mental health and general well-being, you must practice self-care. This includes the basics of self-care, like eating healthy and getting enough sleep, as well as additional practices, like yoga, meditation or prayer. Self-care is different for everyone, and developing a self-care practice takes time. For an in-depth look at self-care tips and strategies, please see Part 2 of this toolkit.

When engaging with those in need of support, it is important to observe your own emotions and reactions. This can help you decide what self-care practices will meet your emotional needs.  Enhancing your social support network and developing a strong sense of meaning, purpose and/or spirituality can be especially useful for those at risk of vicarious trauma.

Other useful practices include:
  • Self-awareness and self-nurturance
  • Strong social connections and support at home and at work
  • Healthy work-life balance
  • Empathetic management from supervisors
  • Social justice advocacy and engagement 
Considering the Need for Additional Support
Deciding when you need additional support can be difficult, but a strong and reliable social support network can help. These individuals can help you recognize the signs of stress and make sure you maintain an appropriate response when engaging with community members. You also have a responsibility to support your coworkers by watching for signs of stress and offering help when needed. It is important for community caregivers to remain self-aware, and to seek professional help when they need it. Reaching out to anyone in your social network — whether it be family, friends or even your doctor — is better than ignoring your mental health concerns.

Moving Our Work Forward with Meaning and Hope

Maintaining good mental health is critical to any community caregiver’s work. Social connections at home, at work and/or through faith- or community-based organizations are an important part of this. Incorporating peer support, supervisory consultation and interpersonal communication in the workplace can reduce the risk of job-related stress and caregiver burnout. By actively engaging in these practices every day, you can make a more positive impact on the communities you serve, and can set an example for future community caregivers.

1 Definition of "Caregiver" by Merriam Webster dictionary.
2 Saakvitne, K., & Pearlman, L. (1996). Transforming the pain: A workbook on vicarious traumatization. For helping professionals who work with traumatized clients.NY: Norton.
3 Hernandez, P., Gangsei, D., & Engstrom, D. (2007). Vicarious resilience: A qualitative investigation into a description of a new concept. Family Process, 46, 229-241.
4 Stamm, B. H. (2002). Measuring compassion satisfaction as well as fatigue: Developmental history of the compassion satisfaction and fatigue test. Figley, Charles R (ed.). Treating compassion fatigue, (pp 107-119) New York: New York: BrunnerRoutledge.
5 Figley, C. (1995). Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in those who treat the traumatized. NY: Routledge.