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Hazmat Suit for the Soul—Part 1 of 3

September 10th, 2015

A prior version of this article was printed on Corrections.com January 03, 2011. It has been updated and reprinted with permission from Correctional Oasis: Volume 12, Issue 9.

The other day I heard someone state that, as firefighters expect to see charred bodies on the job, correctional workers should expect to encounter violence, injury or death at work. Consequently, that person proceeded to say, they should be prepared to deal with such incidents, and not be negatively affected by them.

The speaker made two points here about corrections personnel: (1) that staff should be prepared to deal with workplace traumatic incidents; and (2) that they should not be adversely affected by such exposure—that they should be practically immune to its effects, even when these keep happening over and over.

These are two separate issues that need to be addressed separately.

(Before proceeding with this subject, however, I would like to add that there is an underlying assumption in the above statement about firefighters that does not hold true when scrutinized further. That assumption is that firefighters are not psychologically harmed by their exposure to trauma on the job. The fact is that in several studies firefighters have been found to suffer from high rates of PTSD, depression, and alcohol abuse disorder [1,2]. This indicates that regardless of their degree of preparation, on the average, firefighters may not be getting through traumatic exposure unscathed.)

Let us now go back to the two issues of corrections staff’s preparation for what they may encounter on the job, and the degree to which they may be affected by traumatic exposure.

Corrections agencies diligently train their staff to respond to incidents of violence, injury or death. They train them to intervene and take charge of situations to minimize harm to both offenders and staff. Staff are trained to save lives in the case of offender self-injury or suicidal behaviors, offender medical events or accidents. They are trained to deescalate conflict, to quell disturbances of various sizes as safely as possible, and to respond to arson. Staff are also trained to prevent such incidents through wise use of intelligence, their own observations, and their communication skills. Corrections personnel are usually very well trained to take control of their external environment.

However, how well are they trained to manage their internal environments—that is, themselves, their thoughts, emo-tions, and physical reactions right before, during and after such events?

Historically, the psychological effects of corrections staff’s routine exposure to traumatic incidents has not received a lot of attention. The traditional perspective has been that there is no need to address this issue because corrections staff (officers, in particular) on the whole are unaffected, due to their “toughness.” But how valid or realistic is that perspective, particularly after staff’s repeated and often intense exposure to such events?

The fact is that exposure to trauma, especially when it happens intensely and repeatedly, can have a multitude of ad-verse consequences, regardless of preparation. The military has recognized that during the last few decades.

(Let us now introduce a new term here. Repeated exposure to traumatic incidents is also called “complex trauma.” We shall use this term in the rest of this article, as corrections professionals are rarely if ever exposed to only one traumatic event in the course of their careers.) [3,4]

Complex trauma can result in psychological symptoms and even diagnosable psychiatric disorders, with their associat-ed functioning impairments in one’s personal and professional life. Conditions such as PTSD (full-blown or partial), different types of depression, various anxiety disorders, and substance use disorders, such as Alcohol Use Disorder, frequently follow complex trauma. Moreover, these disorders may be comorbid—that is, a person may suffer from more than one of these disorders at the same time. One common such combination in the corrections workforce (as well as in military personnel and veterans) is the comorbidity of PTSD and depression, which can have devastating outcomes, such as suicide. [5]

As if that was not enough suffering, complex trauma can also result in physical illnesses, such as cardiovascular disease, gastro-intestinal diseases, and sleep disorders, also with their associated functioning impairments. The Adverse Childhood Experiences (ACE) study [6] showed that clearly in the general population. According to Bessel van der Kolk, “(a)s the ACE study has shown, child abuse and neglect is the single most preventable cause of mental illness, the single most common cause of drug and alcohol abuse, and a significant contributor to leading causes of death such as diabetes, heart disease, cancer, stroke, and suicide.” (p. 351) [7]

Both the psychological and physical consequences of complex trauma affect the workplace adversely. Job performance is hampered by, for example: (a) absenteeism—“calling in sick” and necessitating that other staff work doubles (increasing overtime costs) or posts remain vacant (increasing the risk of something dangerous happening, or of something important remaining undone); (b) policy violations (due to errors of omission, such as due to forgetfulness or fatigue, or errors of commission, such as due to staff irritability or anger outbursts), or even (c) “presenteeism”—staff reporting to work while ill, injured, depressed or anxious, thus saving on overtime for their agencies but performing at levels lower than their usual productivity.

This could include substantial errors of omission (one of the most frequent causes of security violations), while masking and failing to deal with any potentially relevant underlying issues, thereby perhaps prolonging them, and possibly, as a result, spreading negativity to co-workers.

The cost of these consequences to administrators is enormous. For example, a recent study reports that the economic burden of individuals with Major Depressive Disorder in 2010 in the U.S. was $210.5 billion dollars, of which 48% were attributable to workplace costs of absenteeism and presenteeism. [8]

And, perhaps most ominously, complex trauma can result in biochemical and even structural neurobiological changes. These brain changes then manifest in a variety of physical, psychological, and spiritual symptoms. (For a fascinating, though technical read of the neurobiology of psychological trauma, read “Healing the Traumatized Self: Consciousness, Neuroscience, Treatment” by Paul Frewen and Ruth Lanius. Another excellent and less technical book is “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma” by Bessel van der Kolk.)

What do we know about corrections personnel? What happens to those exposed to traumatic incidents on the job? In a nutshell, malfunctioning—be it underperforming at work, absenteeism, physical illnesses, psychological distress symptoms, and even full-blown psychiatric disorders. Data exist on the prevalence of PTSD, depression, anxiety, and the most toxic combination of co-occurring PTSD and depression in corrections staff. Data exists on the relationship between such disorders and consequences on physical health, sick leave, and dissatisfaction with life. Data exist on the prevalence of Corrections Fatigue and the low implementation of resilience-promoting behaviors among corrections staff. Data also exist on the extremely high suicide risk of corrections officers. And HR departments have the data on staff policy violations on the job, and malfunctioning off the job—including DWAIs, DUIs, family violence, and other types of violent incidents in the community.

So, repeated exposure to traumatic incidents—complex trauma—wields a formidable weapon against staff’s psychological and physical well-being. To use another metaphor, complex trauma is toxic, hazardous to staff’s health. But if traumatic toxicity is an expected part of the profession, how are the staff being prepared to protect themselves?

Professionals trained to clean up toxic materials don their hazmat suits before going to clean up a liquid chlorine spill on the highway. Workers in nuclear settings wear contamination suits as well. And soldiers carry equipment to counter different types of environmental eventualities. Yet correctional workers are oftentimes thrust into situations that make war zones pale by comparison in terms of unspeakable gruesomeness, mayhem, and danger that can follow them home. How are they being psychologically prepared beforehand to handle such “hazardous materials,” and how do they “decontaminate” themselves afterwards? What kind of hazmat suit are they given to wear while exposed to such incidents and conditions? They—YOU—train themselves/yourselves physically to respond, but do they—you—train to de-contaminate emotionally ? Is it even realized or acknowledged that an incident may have had hazmat-type consequences? And how frequently is that realization a part of correctional training and preparation?

To be continued in the October 2015 issue of the Correctional Oasis.

REFERENCES

[1] Perrin, M.A., DiGrande, L., Wheeler, K., Thorpe, L., Farfel, M. & Brackbill, R. (2007). Differences in PTSD prevalence and associat-ed risk factors among World Trade Center disaster rescue and recovery workers. American Journal of Psychiatry, 164, 1385-1394.

[2] Wagner, D., Heinrichs, M., & Ehlert, U. (1998). Prevalence of Symptoms of Posttraumatic Stress Disorder in German Professional Firefighters. American Journal of Psychiatry, 155, 1727-1732.

[3] Herman J.L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress.;5(3):377-391.

[4] International Society for Traumatic Stress Studies. The ISTSS Expert Consensus Treatment Guidelines for Complex PTSD in Adults. Available at http://www.istss.org/ISTSS_Main/media/Documents/ComplexPTSD.pdf.

[5] Connera, K.R., Bossartea, R.M., Hea, H., Aroraa, J., Lua, N., Tua, X.M., Katz, I.R. (2014). Posttraumatic stress disorder and suicide in 5.9 million individuals receiving care in the veterans health administration health system. Journal of Affective Disor-ders, 166-1-5.

[6] The ACE Study. http://acestudy.org/

[7] van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: VIKING, Pen-guin Group

[8] Greenberg, P.E., Fournier, A.-A., Sisitsky, T., Pike, C.T., and Kessler, R.C. (2015). Journal of Clinical Psychiatry, 76, 155-162.

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Administrators’ Immediate Action Steps Following a Critical Incident

August 14th, 2015

Q: I wanted to check in with you to ask if you have any ideas on where I can find some basic beginning steps on how administrators can act the first moments after a critical incident. Not about the debriefing, not the referrals to EAP. Rather what steps should be taken in the first 1-30 minutes of an event?

After talking with someone who was recently assaulted by a client, it really hit me that so many administrators just don’t know what to do. So they avoid the situation – they freeze rather than act. I don’t think this is done on purpose; it’s like a reflex, automatic. I feel if we can begin sharing ideas with all department heads on how to even respond to the incident just after it occurred (for example, don’t have them continue to see more clients on that day!! Duh! But so many do to make sure the job is getting done), we can begin to help show the importance of administration being involved in the addressing of the problems.

A: Thank you for your commitment as an administrator to keep moving the corrections profession forward by looking for effective ways to respond to potentially traumatized staff. Appropriate supportive responses can reduce the toxic effects of occupational hazards in corrections work, such as a staff assault.

Please note that this response only addresses ways to respond to the assaulted staff member, not the need to lock down units, arrest clients, take offenders to segregation, etc.

In a nutshell, the focus immediately after the incident needs to be on ensuring staff safety, tending to staff’s urgent needs, and beginning the process of staff re-stabilization.

The first step is a medical examination to assess the employee’s condition, and to provide them with immediate medical care as needed. This is to be followed by access to higher-level emergency medical treatment as their condition requires, which may include transportation to a hospital by ambulance. In that case, administrators should visit the staff member at the hospital as soon as their condition allows, to offer them emotional and moral support.

After a medical checkup, and if no further medical care is recommended or is deemed to be warranted, the next step consists of the removal of the assaulted employee from the area of the incident. This is done in order to secure their physical safety, to reduce the likelihood of their exposure to possible ongoing threat, and to reduce the risk of them being re-victimized. That may mean getting them away from all offenders/clients, and also from trauma reminders (such as the location, certain items, or individuals.) There will be time to “get back on the horse” again later. Immedi-ately after the event, the person needs to be able to begin calming down. Distancing themselves from threats and reminders—the perception of danger—is one way to do that.

Make it possible for the assaulted staff member to change clothes, and get cleaned up ASAP, if they have been soiled (such as by having body fluids thrown on them), or if their clothes have been torn. That will reduce their exposure to triggers (incident reminders) and get them to feel like they are regaining their dignity. Indeed, some facilities stock care packages for staff that have been assaulted. These may include a pair of sweats, socks, a shirt, a towel, shampoo, toothpaste, and a token for a snack or beverage from a vending machine.

Have the assaulted staff member come to your office or go where they are and spend some time with them one-on-one. Offer them water to drink. Sit down with them in an area where you can close the door. If they come to your office, get around from behind your desk and sit in a chair next to them. Make eye contact. Express to them your caring about what they just went through, and your concern about their welfare. Absolutely do not drill them about details of the incident. Just listen. Listen empathically—that is, listen with a frame of mind of putting yourself in their shoes, trying to understand what the experience was like for them. If they froze, remind them that this is an involuntary and unpredictable brain-based reaction. Absolutely do not reprimand them for it. Point out what they did well, and what went well overall.

The employee, pumped full of adrenaline, may be angry at this point, perhaps blaming themselves and/or others, including administrators. Give them space to vent. Listen, acknowledge, and validate the horror of what they’ve just experienced. Suggest that they most likely did the best they could at the time, under the circumstances, and that, like in every situation, lessons will be learned from this incident as well. Reassure them that their immediate reactions are understandable and to be expected/normal.

Absolutely refrain from arguing with the employee, or threatening them with discipline for being disrespectful. Do not tell them to correct their attitude or watch what they are saying if they want to keep their job. The general stance of administrators needs to be supportive—not judgmental, critical, angry or blaming. At this point self-control needs to be exercised by administrators if their own buttons are getting pushed by the assaulted staff’s angry reactions.

I personally know of one such a situation that was handled in an exemplary fashion. The assaulted CO went “off” on his warden who met with him after the medical check. The latter, having come up through the ranks, and having experienced being assaulted himself, remained calm and quiet during the employee’s tirade. When the CO finally ran out of words, the warden gently expressed to him his understanding of the CO’s state of mind, and verbalized to him his sincere compassion for what he’d just been through. In turn, the CO took it all in, waited for a few moments, and then apologized for coming unhinged.

The next step of “being there” for the assaulted employee is tapping into their support network by having their friends at the facility be relieved of their duties so they can come to express their support to the staff member. In some cases, staff may not be comfortable talking extensively to an administrator, but they will talk to a friend. If you have trained peer supporters, call on them to come by as well and talk to the employee.

Ask the assaulted staff member if they want to make a phone call to family members and/or significant others in their community, and make it possible for them to do so privately.
If the assaulted staff member wants to make a round of the office or unit to show the clients/offenders that they “are keeping it together” and have their head up in spite of the assault, honor them by accompanying them in doing so.

Additionally, as part of the support you offer, have the assaulted staff member be checked confidentially by a mental health provider at the facility, or allow them access to a room where they can shut the door and call your EAP hotline. These professionals can check for safety concerns, assess the employee’s current functioning level and frame of mind, remind the staff member that acute reactions after an incident are normal, and tell them what signs might indicate that additional care/treatment is needed. They can give/email/fax them handouts with relaxation exercises and other coping strategies, and remind them to avoid using substances to cope, as these can destabilize their mood further.

Relieve the assaulted staff member of their duties for that day. Ask them if they’d like to take a day off of work. If they decline that, allow them to spend time as needed with peer supporters and/or mental health providers. If they insist on working, assign them to an area where they are likely to have minimal client/offender contact. When they come back to work, do another round of the unit/office with them, to visibly express your support of them.

If they are asked to write up their incident report immediately after it happens, keep in mind that the reported order of events may be jumbled or unclear. (Remembering details of a traumatic incident is a subject that will be addressed in one of the webinars to be offered through Desert Waters’ Resilience Academy.) Therefore, this initial report should be regarded as part 1 or incomplete, with the understanding that material may be added a few days later. This may be controversial to some, primarily for legal reasons, yet we are dealing with realities of the neurobiology of human memory following exposure to a traumatic event. The brain is not a video camera.

When it is time for the assaulted staff member to leave the office/facility, arrange for someone to drive them home, and for another employee to drive their vehicle to their house.

And remember, it may not only be the assaulted staff member who needs your immediate attention. Those who witnessed the incident and those who responded are also likely to require your expressions of caring, consideration, validation, and support.

Note: Dr. Susan Jones was consulted on this piece, and she offered several comments and suggestions which helped shape this article.

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Higher Highs and Lower Lows: Working with Justice-involved Youth – Part 2

June 18th, 2015

Continued from the May 2015 issue of the Correctional Oasis.

How Staff Are Affected

If, on average, staff working with youth try harder to help their charges, attach more, and care more regarding outcomes than staff working with adult offenders, then they are also more likely to both be elated when youth make progress, and also more disappointed—even crushed—when something goes seriously wrong with the youth.

In a nutshell, when working with justice-involved juveniles, the highs tend to be higher and the lows lower than when working with older, adult offenders.

And even in the absence of current adverse incidents, just reading the youth’s files and hearing their stories is enough to stir up in staff grief, anger at perpetrators, and a sense of powerlessness to stem the tide of child abuse or neglect.

So staff who deal with young offenders have the dual task of needing to stay afloat emotionally themselves—managing their emotional reactions effectively, while also keeping the youth’s heads above water. And this must be accomplished in the context of experiencing acting-out incidents and other crises on a not infrequent basis, on top of other regular stressors of corrections work.

As they continue to deal with such incidents, may staff become progressively more negatively impacted—unless they learn effective ways to process the fallout of these events.

Think of how a staff member may feel when a youth (whom they have been helping diligently and consistently) for no apparent reason, suddenly assaults them or makes unfounded yet serious allegations against them.

Up to that point, that staff member may had come to believe that they had earned the youth’s trust and respect. They may have even thought that the youth might be grateful toward them for their sincere efforts to help them and for their obvious caring.

Assaults or unfounded accusations can, understandably, shatter the interpersonal bridges staff have so painstakingly been building to reach the youth. Because of the deeper emotional investment in their charges (compared with adult offenders), staff may feel personally betrayed by the youth, “stabbed in the back.” Staff may (most often inaccurately) conclude that no progress was made and that their efforts were all in vain.

Coming to believe that their hard work was to no avail would likely lead to staff building high psychological walls around themselves, becoming reluctant to care and invest emotionally in youth again. And on top of trying to work through the sense of betrayal, they now have to deal with the traumatic aftermath of the assault experienced and/or the stress of being under investigation.

Even though staff’s negative reactions are understandable—as none of us like to receive harm in return for good—if they become entrenched (not worked through), they will render staff much less effective at their work, and they will also drastically diminish the positive meaning and satisfaction they derive from their work.

Similarly, when youth attempt suicide or die by suicide—in spite of staff’s incessant efforts to help them work through their struggles—that is a crushing blow for staff. Staff may be also become deeply distressed when a tragedy strikes youth in the community, such as them being murdered or dying due to a drug overdose.

When youth commit new crimes, staff who have been working tirelessly with them may start doubting their ability to influence youth for the better. Their confidence in their professional skill sets and in their ability to facilitate pro-social change, and their sense of meaning and value of their work may be seriously undermined. They may ask themselves, “What’s the point of trying to help these kids? Either they get back in the system or they die.”

Additionally, compared to dealing with adult offenders, staff may take on more responsibility for youth treatment and intervention outcomes than is realistic or warranted. As a result, they may be more likely to experience false, un-founded guilt when justice-involved youth make another poor choice, thinking that they should have done more to help them.

It is difficult to allow oneself to care deeply over and over again, only to have one’s expectations fail to materialize, or only to be “paid back” with a verbal or physical attack. To protect themselves from disappointment and to be able to continue working with this population, some staff may take an all-or-nothing approach. They may “harden their hearts,” shut down emotionally, do the bare minimum, and lose the vision and idealism that initially propelled them to serve youth offenders. Others may also occasionally react by becoming verbally abusive in return to the more chal-lenging youth. Eventually some will quit, as the investment may seem to them to be too high for the meager returns. Others may be let go due to misconduct. And the not-often mentioned reality is that a number of staff may develop PTSD, depression and anxiety symptoms and even full-fledged disorders as a result of what they witness and what they experience in the course of working with justice-involved youth.

Solutions for Youth Workers

Effective functioning as youth workers depends on three main components: (a) finding and maintaining positive meaning and purpose in the work; (b) pursuing their own wellness; and (c) experiencing support and understanding by their administration.

Finding Positive Meaning and Purpose

Youth workers need to maintain the belief that it is indeed possible for justice-involved juveniles to improve and to have a better future. The fact that areas of the juvenile brain are still developing means that there are very real op-portunities and possibilities that at least some of them will acquire prosocial behaviors to some degree through posi-tive interactions as well as through experiencing consequences for their actions. Reminding themselves of these en-couraging facts can help staff remain open and willing to invest in youth in appropriate ways even after struggles and relapses.

Staff may also need to modify their expectations and their definition of success. Celebrating every tiny bit of pro-gress, while also factoring in setbacks as part of the norm, is a necessity. Reminding themselves to distinguish be-tween what they CAN influence and what they cannot change will help keep their expectations realistic and more likely to be attainable. It also helps for staff to re-main cognizant of the fact that they are not responsible for other people’s choices and that they cannot control others’ actions.

Staff need to remember that their calling involves doing their best (the level of which may vary from day to day), to sow good seed and continue to water it, and then let go of expectations regarding the outcomes. That means ac-cepting that some seed may sprout immediately, but not endure under harsh conditions; some may sprout and con-tinue to grow steadily; some may sprout much later; and some may not sprout at all. The good seed that sprouts—whether sooner or later, and to whatever degree—can make the effort worthwhile, as one person does matter, and one person can have a tremendous impact in their world, even for generations to come.

Staff need to balance their emotional engagement and investment in the youth with a degree of professional detach-ment based on understanding the process of a youth’s maturation and change, and given the context of neurological, psychological and spiritual damage that the youth may have already sustained.

Given the harsh reality of juveniles’ acting-out behaviors, some of which involve aggression against other youth and also against staff, to be able to continue working effectively in this field, staff have to have a way of letting go of grudges. They have to be able to forgive to some degree at least, so they can go back the next day and engage the youth as human beings under their care—not as monsters to avoid, hate or punish. That is a tall order, but it can be done, and it is being done across the country.

In addition to re-evaluating their understanding of what constitutes success, staff would benefit from adopting a strengths-based framework when dealing with youth. This involves identifying youth’s abilities and skillsets, acknowl-edging these strengths to themselves and to the youth, and working with identified strengths as starting points to encourage and empower the youth and to promote change.

The predominant way in which the youth is perceived by the staff is also critical, as it determines how staff will deal with them. In line with the work of Gordon Bazemore, are they viewed as helpless victims, villains who deserve to be punished, or as valuable resources that can be developed and redeemed, at least to some degree? Are they worth investing in and helping, or should they be simply warehoused and written off? This perception of youth is of course is shaped by staff’s exposure to trauma, as trauma can change the worldview of those affected by it. So staff need to be continually countering the tendency to overgeneralize from one youth (or a few) to all, and the tendency to draw sweeping, negative conclusions about the youth while overlooking, minimizing or dismissing positives.

Staff need to remember that we live in an imperfect yet beautiful world, where injustice but also goodness happen, and where some degree of recovery and healing is possible for most, if not for all. And, most importantly, that every amount of healing matters. Sometimes the steps forward that youth take may be so small that they are hardly notice-able. In that case they are what I call “ant steps.” But, as staff and youth persevere and keep moving forward in spite of stumbling and falling down at times, these ant steps add up, and ants can get to go to far away places!

I have spoken with staff who have experienced the betrayal of an assault by youth they had been helping, and worked through it successfully. After the dust settled, they chose to examine the situation objectively. If they took the attack personally at first, they stopped doing that. “Why did he do this to me after all I’ve done for him?” became “I know that this was not about me, and I think I understand where he came from.” That is, they were able to frame the inci-dent as it being due to what they represented (adult authority) to the youth; and/or due to the youth being torn about letting anyone get close to them emotionally. (Disruptions in the development of secure attachment may mean that youth become anxious and agitated when someone gets close to them emotionally, as they expect that to be the prelude to more pain. And so they react, violently at times, and push whoever they consider to be a threat away. They may do so in a flash, impulsively, and without thinking through the context of the relationship.) By reframing assault incidents in this manner, staff were able to let go of grudges, forgive the youth, and even analyze the situation with them. In all cases of assaulted staff I am aware of, the youth later expressed regret and apologized for their conduct.

Pursuing Their Own Wellness

As their career progresses, staff need to develop and maintain effective resilience-boosting strategies, so that they can deal with repeated letdowns and other high-stress experiences at work. Ideally, this parallels the staff’s efforts to teach youth to develop life skills for coping with adversity.

Staff need to aggressively pursue their well-being in every area—from getting enough positive social interactions in their lives outside of work to eating well to working out to sleeping enough to cultivating a healthy spirituality to getting enough time away from work to rest and play.

Wellness also involves balancing giving to others with taking care of themselves—to “refuel,” to process what they have experienced, and to remind themselves of basic truths. That is, staff need to ensure that they are regulating their own thought process and emotions in healthy ways, and that they “detoxify” sufficiently following difficult en-counters. And effective supervisors remind their subordinates of these truths, while also practicing them themselves.

Experiencing Administrators’ Support and Understanding

It is vital for line staff to be confident that their administrators understand the pressures of the job, and that they support them and look out for their well-being. Little could destroy morale more than coming to believe that the youth’s well-being is regarded as more important than theirs, or that youth are not held appropriately accountable for their actions.

Administrators’ support needs to be both verbal and action-based—both in word and deed, particularly regarding issues of staff’s physical safety. If youth workers have previously worked with adult offenders, they may struggle with the differences in how physi-cally violent behavior of these two populations is handled.

In summary, dealing with justice-involved youth may “tug at staff’s heart strings” more than when dealing with adult offenders. This leaves youth workers more vulnerable to disappointment and discouragement, even while providing them with more opportunities for satisfaction due to breakthroughs witnessed in the youth’s lives. To use another analogy, youth workers walk on an emotional tightrope more so than staff working with older offenders.

To maintain their effectiveness, they need to be making vigorous efforts at engaging wisely at the emotional level with the youth while maintaining professional boundaries—not too much and not too little, and depending on each individual case. They need to also redefine what professional success means in this line of work, seek ways to contin-ue deriving fulfillment in spite of challenges, and take deliberate, intentional steps at maintaining their own resilience and well-being.

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Higher Highs and Lower Lows: Working with Justice-involved Youth — Part 1

May 18th, 2015

During the past few years I have had the privilege of training corrections staff who manage, educate or treat justice-involved youth in facilities/campuses or in the community. As a result, I have noticed that there seem to be some distinct differences in the professional experiences of staff who work with youth compared to the experiences of corrections staff who work with older, adult offenders.

These notable differences are most likely related to specific conditions that are inherent to working with justice-involved youth, and they may affect staff’s interactions with youth in both positive and negative ways.

Overall, especially in locked facilities, justice-involved youth tend to be more unpredictable, more likely to suffer from psychological disorders, more violent, and more likely to exhibit extreme behaviors than adult offenders are, on the average [1].

These youth tend to suffer from mood, anxiety, traumatic and substance abuse disorders, often with two or more conditions occurring at the same time — more so than adult offenders [1, 2, 3]. And they may be more at risk for attempted or completed suicides, self-injury, and other types of self-harm. Youth who suffer from PTSD, for example, due to their repeated exposure to trauma, may expect to die young. Therefore, their actions might reflect what to us is a shocking disregard for their welfare, their future, and even their very lives.

That is, compared to adult offenders, justice-involved youth may be less apt or able to “apply the brakes” on their impulses, or to think through potential consequences of their behavior, thus opting for reckless and destructive choices—including “throwing their lives away.”

The youths’ emotional volatility and higher impulsivity render them more dangerous to themselves and to others (staff included) than is the case with adult offenders.

The following are some of my observations regarding the professionals who work with justice-involved youth:

  1. On the whole, youth workers tend to (at least initially) invest emotionally more in the youth than corrections staff invest in adult offenders.
  2. Staff working with juveniles tend to derive deep satisfaction, and a sense of purpose and meaning, from progress made by the youth. In that regard they may enjoy more fulfillment than staff working with adult offenders. This satisfaction, though, can be offset by staff’s disappointment when youth lose ground. Disappointment negatively affects staff’s self-perception as effective helpers, with the ensuing disillusionment undermining the degree of their motivation and engagement in the work, and ultimately possibly reducing staff retention.

    So the highs tend to be higher and the lows lower for staff working with juvenile offenders, compared to those working with adults, due to the greater emotional investment in and greater hope for progress by the youth.

  3. Due to high assault rates in juvenile facilities both of other youth and of employees, staff end up exposed to more potentially traumatic events and physical injuries than may be the case in adult correctional settings (perhaps with the exception of maximum/high security facilities). And this occurs in a context where youth—because of their age—are managed differently than adult offenders, both physically and in terms of the overall philosophy of care, with the emphasis being on treatment.

Let us now examine issues affecting staff working with justice-involved youth in some detail.

Some Reasons for Staff’s Greater Emotional Investment

Youth workers, at least early on in their careers, are often characterized by enthusiasm and zeal. They are on a mission, sincerely wanting to help justice-involved youth heal from their all-too-often tormenting pasts and improve their lives. This usually leads staff to be persistent, teachable and engaged when dealing with the youth.

There are many reasons for the greater, on the average, emotional and relational investment of youth workers in their charges than that of corrections staff who work with older offenders. (Of course, there are always exceptions for staff working with either population.)

  1. The emphasis and approach regarding young offender management differ significantly from adult offender management. The approach with justice-involved youth tends to be more therapeutic than with adults, more heavily weighted toward treatment, mentoring and relationship building. Staff is trained and encouraged to build supportive relationships with the youth, to interact, to discuss issues, to offer guidance, comfort and encouragement, and to help them problem solve rationally and pro-socially—and within policy. That is, staff is trained to act as advisers, counselors and positive role models for the youth, as well as disciplinarians who administer consequences for poor choices.

    The underlying assumption is that younger offenders are still relatively “wet cement,” less “hardened” or set in their thinking and behaviors than adult offenders, since they are still growing and maturing. Consequently, there is an ex-pectation that services designed to teach pro-social behavior and bring about healing are more likely to succeed with youth than with older offenders. As a result, staff may be more hopeful of positive outcomes with youth and try hard-er to bring about enduring improvements than when working with older offenders.

  2. Due to their specialized youth-focused training, youth workers may also be aware, more so than with adults, of neurological issues affecting youth, such as fetal alcohol syndrome and/or other drug exposure in the womb, traumatic brain injuries, and consequences of their own drug abuse. Youth files may include details of their psychological abuse, neglect, abandonment, and physical injuries. And, perhaps most importantly, they are educated about the fact that regions of the brain (specifically, the prefrontal cortex) are not fully mature in adolescence. Rather, they continue to mature over the course of adolescence and into young adulthood [4,5]. These parts of the brain govern self-regulation, including decision making, planning for the future, foresight of consequences, risk-assessment, and judgment—capacities that typically associated with criminal culpability.

    Similar details regarding neurological problems may well be true of adult offenders, but they may not appear in their files, simply because they were not diagnosed; or no one asked the relevant questions; or offenders did not provide that information. Or, even if documented, some staff may not have access to adult offender files.

    Consequently, as they deal with each individual case, it may be easier for youth workers to “connect the dots” from a juvenile’s immature brain development (and also perhaps early childhood adverse experiences and neurological dam-age) to destructive choices and criminal behaviors. So, staff might empathize with the youth’s predicament and circumstances, “understanding” (without excusing) why they may have acted on impulse, violated others’ rights, and/or acted destructively and aggressively. And this awareness and empathy may increase their resolve to help youth less-en, if not overcome, negative aftereffects of adversity.

    Adult offenders, on the other hand, may be held to a higher standard in the minds of staff—as knowing right from wrong, and as being responsible for their choices (with the exception of the severely mentally ill).

  3. Another factor that contributes to staff’s greater investment is that youth may not be as able to hide behind a mask of toughness as well as older offenders. Rather, the youth may display their vulnerabilities more. They may express distress more, ask for help more, and break down openly more. That is, youth may tend to be more transparent, and so staff may be more likely to see their frailty, their emotional pain, and their very real need for help. This can lead (on average) to a desire to understand, to offer support, and to problem-solve instead of exhibiting indifference or being punitive. So youth workers may feel more compassion and a stronger urge to help than staff working with older offenders.
  4. Another subject that typically youth workers are trained on is that justice-involved youth are in the midst of negotiating “normal” social, emotional and physiological (hormonal) adolescent developmental stages 5. These developmental changes and milestones are occurring while the youth are also dealing with the inescapable realities of a still-maturing brain, and while also likely experiencing effects of past adverse experiences on body, soul, and spirit. Knowing these facts may prompt staff, once again, to be more understanding of certain behaviors, more caring, and perhaps more patient with youth than they would be with adult offenders.
  5. Staff may also identify with the youth more than with adults, for example, by remembering their own childhood emotional struggles and hardships, or the struggles of friends or siblings. Or, when dealing with the youth, they may reflect on their own children, and so form deeper emotional bonds to young offenders and be more impacted by their struggles, compared to staff working with adult offenders.

These factors contribute to youth workers’ more complex relationships with juveniles on the whole than corrections staff who work with adult offenders, including the building of attachments that evoke strong emotional responses in staff in relation to youths’ behaviors and outcomes of their involvement in the justice system.

To be continued in the June 2015 issue of the Correctional Oasis.

REFERENCES

[1] Abram, K.M., Choe, J.Y., Washburn, J.J., Teplin, L.A., King, D.C., Dulcan M.K., and Bassett E.D. Suicidal Thoughts and Behaviors Among Detained Youth. Juvenile Justice Bulletin, July 2014.
[2] Dierkhising, C.B., Ko, J., Woods-Jaeger, B., Briggs, E.C., Lee, R., & Pynoos, R.S. (2013). Trauma histories among justice-involved youth: Findings from the National Child Traumatic Stress Network. European Journal of Psychotraumatology, 4, 20274.
[3] Kerig, P. K., and Julian D. Ford, J. D. (2014). Trauma among Girls in the Juvenile Justice System. National Child Traumatic Stress Network.
[4] Fagan, Jeffrey. Adolescents, Maturity, and the Law. The American Prospect. August, 2005.
[5] Adams, G. R., Montemayor, R., and Gullota, Thomas P. (Eds.) (1996). Psychosocial Development during Adolescence. Sage Publi-cations: Thousand Oaks, CA.

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Sleep Difficulties of Corrections Professionals: Nothing to Yawn At

November 7th, 2014

“I sleep a lot and have had bouts with insomnia and did not sleep for days.”

“Too much mandatory overtime has affected my sleep patterns.”

These are quotes from anonymous corrections officers. Their comments are not at all unusual. We have also heard many a time of staff bringing six “high-energy” (that is, high-caffeine) drinks to work, to consume during their shift—to force their brain to stay awake and alert while on duty, when in fact it is trying to shut down and go to sleep.

Of DWCO’s national 2011 sample of N=3599 corrections professionals of multiple job types and agency types, 43.3% indicated that they were experiencing sleep problems, with 45.8% of the men reporting sleep problems, and 40.2% of the women. Of those who reported having been exposed to one or more incident of violence, injury or death, 45.7% reported sleep problems, as opposed to 26.8% of those who did not report exposure to such incidents. Of those comorbid-positive (that is, meeting criteria for PTSD and also scoring as moderate or higher on depression symptom severity) 72.1% reported sleep problems, as opposed to 37.3% those who were not comorbid-positive.

Sleep disturbances include difficulty falling asleep, difficulty staying asleep, nightmares, obstructive sleep apnea, and Restless Leg Syndrome.

What are some of the consequences of sleep deprivation/insufficient sleep? According to the Centers for Disease Con-trol and Prevention (CDC), 23.2% of US adults 20 years and older reported difficulty concentrating on things in relation to sleep insufficiency (less than 7 hours of sleep in a 24-hour period), and 18.2% reported difficulty remembering things in relation to sleep insufficiency. In corrections work environments, difficulty concentrating or remembering can have life-threatening consequences.

Also according to CDC, insufficient sleep is associated with high-risk behaviors such nodding off or falling asleep while driving, and unintentionally falling asleep during the day. And insufficient sleep is associated with low energy and feel-ing tired during the day.

Sleep insufficiency undermines health by increasing the risk of chronic illnesses such as hypertension, diabetes, depression, and obesity, as well as cancer, increased mortality, and reduced quality of life and productivity [1].

Moreover, a study of employees in the transport industry and in the army found that even moderate sleep depriva-tion produced impairments in processing and motor performance. These impairments were be equivalent to those of alcohol intoxication [2]. After 17-19 hours without sleep, speed and accuracy on some tests were equivalent to or worse than speed and accuracy at a Blood Alcohol Content (BAC) of 0.05%. After longer periods without sleep (up to 28 hours), performance reached levels equivalent to performance following the maximum alcohol dose given to subjects (BAC of 0.1%). In the US, drivers with BAC of .08% or higher are considered to be legally intoxicated—Driving Under the Influence (DUI).

Given the inescapable consequences of sleep deprivation on health and functioning, it seems safe to conclude that every effort must be made to ensure that corrections professionals, and in particular shift workers, are presented with work conditions that allow them to get on at least 7 hours of sleep per 24-hour period.

Here are some tips from the National Sleep Foundation that may help promote sufficient and good quality sleep.

  • Establish and adhere to a regular routine regarding what time you go to bed to sleep and what time you wake up. This helps regulate your body’s biological clock which controls your circadian rhythms to help you go to sleep and to stay awake. Of course, working over-time throws your biological clock off. And changing shift schedule confuses your body even further as to when is should be secreting chemicals to help you go sleep and when it should be working on helping you wake up and stay awake. Whenever shift schedules change, staff experience the equivalent of jet lag.
  • Avoid exposure to bright lights, loud sounds, activities or information that may cause you to get “wound up,” excited or otherwise stressed just before bedtime. Avoid watching the news on television, playing video games, or working on your laptop in bed before going to sleep.
  • Instead, help your brain wind down and shift from wakefulness to sleep mode. If your mind is on things you have to do the next day, write them down and tell yourself that you are going to sleep now and you will be dealing with these matters the next day.
  • Make sure that the room where you sleep is dark and quiet, and that your mattress and pillow are comfortable.
  • Routinely engage in a relaxing ritual just before bedtime. That could involve drinking a warm non-alcoholic and non-caffeinated beverage, reading, stretching, taking a shower or engaging in sexual activity with your partner.
  • If napping during your day interferes with sleeping at your regular bedtime, avoid taking naps, especially later in your day.
  • Get physical exercise, daily if possible, to help yourself unwind.
  • Avoid consuming alcoholic drinks, tobacco products, caffeine, or heavy or spicy meals prior to going to sleep.
  • If you find yourself unable to sleep, get up and do something relaxing, such as reading, until you feel tired and ready to go to sleep.
  • If you continue having difficulty sleeping in spite of your efforts to do so, consult with your physician about it.
  • Like needing water, oxygen and food, our body, including our brain, NEEDS sleep. Sufficient and good quality sleep is a non-negotiable prerequisite for our health and functioning, and even for our very survival.

References

[1] Institute of Medicine. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press; 2006.
[2] Williamson, A. & Feyer, A. (2000). Moderate sleep deprivation produces impairments in cognitive and motor performance equiv-alent to legally prescribed levels of alcohol intoxication. Occupational Environmental Medicine, 57, 649–655.

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A Marathon, not a Sprint: Systematic Action Is Essential to Reduce the High Costs of Corrections Fatigue

September 8th, 2014

Corrections employees of all ranks and disciplines are repeatedly exposed to a multitude of occupational stressors throughout the course of their careers, including operational stressors, organizational stressors and traumatic stressors. The large number of stressors corrections workers face are formidable and their effects dire for individuals and groups immersed in unhealthy corrections workplace cultures. Well-documented consequences include pervasive and contagious negativity, hostile work environments, abusive behavior among staff and toward offenders, high sick leave and health benefits use, high turnover, and off-duty law-breaking behaviors. In addition, corrections staff often suffer serious physical and psychological health issues, and potentially shortened life expectancy.

During the past few days we were informed of two more corrections officer suicides that occurred. We also recently read news reports of expensive lawsuit settlements—into the millions—due to physical abuse or neglect of offenders by corrections personnel. Results of nationwide research conducted by Desert Waters Correctional Outreach estimate that 27% of corrections professionals meet criteria for Post-traumatic Stress Disorder, and 26% demonstrate moderate to severe depression symptom severity. Using a data-driven and research-supported assessment tool, the Corrections Fatigue Status Assessment (CFSA-v5), it has been estimated that 20% of corrections staff typically demonstrate a high level of Corrections Fatigue, accounting for 36% of reported sick days. These figures, together with other corrections research, consistently indicate that corrections workers’ health and functioning is seriously affected by occupational stressors, with significant negative outcomes.

Desert Waters’ research-supported Corrections Fatigue Model illustrates the causal factors, process, and consequences defining Corrections Fatigue. The model helps us understand the mix of circum-stances that tend to produce dysfunction in corrections workplace cultures, and sometimes severe health and functioning consequences for individuals.

Countering the trajectory of Corrections Fatigue’s development is a difficult yet critically needed undertaking. Effective interventions require a customized, comprehensive and data-driven approach that addresses the needs of each agency while considering its specific issues and characteristics. One size does not fit all. Taking into account the unique nature of Corrections Fatigue and corrections workplace environments, a six-stage approach for addressing Corrections Fatigue systemically was recently published.

The recommended six-stage approach to improving corrections workplace health and functioning includes the following component stages: (1) Inform (i.e., educate on the nature of Corrections Fatigue, (2) Assess (i.e., measure the extent that Corrections Fatigue permeates the workplace culture using validated workplace health assessment tools), (3) Evaluate (i.e., compare identified problem areas to the content of existing programs, structures, and resources for promoting staff health and functioning), (4) Plan (i.e., prepare for implementation of new or modified programs, structures, and resources), (5) Implement (i.e., roll out planned changes or improvements), and (6) Re-Assess (i.e., periodically and systemically re-assess workplace health and functioning using validated assessment tools).

Desert Waters Correctional Outreach offers a variety of data-driven and research-supported assessment tools designed specifically for addressing Corrections Fatigue (i.e., the CFSA-v5) and additional critical areas such as corrections staff suicide risk (i.e., the DDS), and average exposure to life-threatening events or critical incidents (i.e., the VIDES). A Corrections Staff Resilience Inventory (CSR-I), currently in beta, allows for identification of resilience-promoting behaviors that staff are effectively using (or not using sufficiently). Results from the CSR-I provide highly specific and concrete recommendations of behaviors to be increased through workplace culture improvement efforts for the purpose of raising the resilience of the workforce against Corrections Fatigue.

The aim of interventions for staff health and functioning is to educate staff of all ranks and disciplines on healthy adaptations to work-related challenges, ways to increase resilience to stress, and ways to reduce preventable and avoidable stressors, such as staff conflicts or staff-offender clashes.

It cannot be emphasized enough that enduring change of ingrained negative or dysfunctional patterns requires systematic, ongoing, culture-wide efforts within organizations. Over the decades, dysfunctional behaviors become self-sustaining and self-reinforcing patterns in corrections environments, where new recruits are vulnerable to “contamination” through unhealthy indoctrination as they assimilate into the affected workplace culture. Interventions involve gradually “deprogramming” and “reprogramming” staff’s thinking, beliefs, and behaviors in response to challenging corrections workplace experiences, situations, and circumstances, and learning to adapt successfully to occupational stressors. Culture improvement is a slow, laborious, but deeply critical process. It is a marathon, not a sprint.

While a good program offered once can help to temporarily modify individual responses to occupational stressors, unless other resources are applied as well, and repeatedly over time, that one-time program is unlikely to produce sustained cultural changes. The continuous stressors impinging on corrections staff, if not offset by continuous countermeasures, will most likely wash away the effects of sparsely offered positive countermeasures, and fairly quickly.

Desert Waters’ signature course, From Corrections Fatigue to Fulfillment™ (CF2F), represents an ideal starting point for initiating a program of sustainable change and deterrence of Corrections Fatigue. It helps increase staff awareness of how and why occupational stressors can shape staff’s emotions, thoughts, and behaviors, while also validating staff’s struggles. The course provides participants with information about self-care skills, cognitive repairs to damaged core beliefs, and strategies to impact the work environment constructively. The programming also helps staff identify ways in which THEY can make a positive difference in areas where they have influence.

In seeking organizational culture improvement, staff’s habitual ways of responding—both en masse and one staff member at a time, must be constrained to health-promoting parameters through targeted skill-building and repetition, repetition, repetition. To use a couple of analogies, one does not become a sharp shooter by firing their gun once in a while. Nor does a body-builder achieve and maintain success by working out only a few times. Corrections staff also require ongoing instruction and role modeling from higher-level staff in order to continue honing their self-management, interpersonal, and resilience-boosting skills. Continual reminders of effective strategies and structured opportunities to practice them are needed. Corrections organizations as a whole need to be genuinely invested in this pursuit for improvement to take root and grow.
Several questions can be asked about motivations that drive improvement efforts. “Is it to simply check a box to confirm or substantiate that a certain training has been provided?” “Is it to maintain the status quo while biding one’s time to retire?” Or, “Is the goal to breathe new life into staff by bringing enduring and sustainable solutions to corrections workplace problems?”

It is helpful to bear in mind that improving workplace culture health and functioning also requires defining goals that reach to the heart of problems, which is critical in the formulation of effective solutions. At times, what may be perceived as a problem may actually be a consequence of a cause that is more deeply rooted or embedded in a broader context. For example, high sick leave use may be the outcome of a hostile work environment or of staff’s fears for their physical safety. For this reason, effective and validated assessment tools, such as the CFSA-v5, can be seen as particularly advantageous. The CFSA-v5 results allow organizations to objectively pinpoint critical areas of need and facilitate optimal and efficient channeling of improvement efforts.

Other useful questions for corrections administrators to consider include: “How big will a problem become if systematic steps are not taken to counter the negative effects of ongoing occupational stressors?” and “What is it costing an agency in the long term to ignore Corrections Fatigue within their organization?” What is the actual price of turnover, sick leave days, overtime, substandard job performance due to low morale, and lawsuits for staff misconduct—to name a few of the consequences of corrections work malaise? What is the impact on the workforce of another staff suicide?

Given tight budgets, administrators may hesitate to embrace the idea of investing in staff well-being in a focused, systematic and long-term fashion. Yet the actual price tag of avoidance may be extremely high. In fact, empirical evidence is in hand that supports the high costs. Click here to obtain a no-charge estimate of the costs of just one component of Corrections Fatigue—use of sick leave, using Desert Waters’ online Corrections Fatigue Annual Costs Calculator.

In summary, significant and enduring positive improvements in the quality of corrections workplace culture require serious, long-term and ongoing commitment to change, including routine and periodic scientific assessments, monitoring of scores, and programming and training adjustments.

A road map that is in-depth and solutions-oriented needs to be drawn up and permanently installed, becoming “the way we do corrections” from now on, while also incorporating data-driven, evidence-supported modifications over time. This includes planning ahead for ways to deal with obstacles and bumps on the road that inevitably crop up during the journey toward healthier staff and healthier workplace cultures.
An approach that emphasizes prevention steps and proactive game-planning is invaluable, as it reduces risk, loss and liability, and it increases the likelihood of safety and security.

We at Desert Waters bring a data-driven, comprehensive umbrella approach to counter corrections agencies’ personnel problems and address their legitimate needs. We desire to take the journey with you and your agency, and to design the best-fitting road maps for you, and with customized solutions to match the unique needs of your particular organization—while also engaging the unique strengths of your organization.

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Communicating Safely in the Midst of Disagreement

July 23rd, 2014

Working in corrections takes a toll on staff’s personal relationships. Relationships with significant others are difficult enough under the best circumstances, let alone when people repeatedly come home after work seriously stressed. This article examines ways to communicate and problem-solve when tension builds due to a disagreement.

In healthy relationships, the purpose of communicating regarding a disagreement has several facets: (1) to understand each other’s perspective, needs and wants about the subject of concern; (2) to brainstorm for possible solutions to deal with the current differences; and (3) to agree to a mutually acceptable and viable solution to the problem at hand.

Ideally, before any such major disagreement emerges, a couple needs to spell out and agree to certain ground rules for managing their differences. Effective ways to communicate safely and constructively on such occasions need to be identified and agreed upon ahead of time. No one would think of playing sports or any other game before first presenting and agreeing upon how the players are to conduct themselves throughout the event. If we do that for a game, how much more should we do something similar for activities that may affect the safety and future of what may well be our most important relationship? (I remember in the 1990’s hearing John Bradshaw say that we get more training for driving a car than we do for being married and for raising a child.) Often-times, however, we do not know what safe and effective communication looks like. We may have not seen it take place or experienced it directly. That is where a few premarital counseling sessions (or even a good book on the subject) may prove to be a very wise investment.

Here are some thoughts on the matter, in a nutshell, to help you communicate safely and sanely with your partner when you have to discuss an area of disagreement:

  1. Agree to limit your discussion to one issue at a time– and exercise the self-control required to honor that.
  2. Listen attentively to what your partner is saying.
  3. Repeat back what you hear them saying so they know that you are listening and they have the opportunity to correct you if you misunderstood them.
  4. Ask for clarification when not sure about the meaning of something your partner said.
  5. Ask open-ended questions to try to gather more information that will help you improve your understanding of your partner’s perspective. Open ended questions do not have Yes or No answers. They start with How, What, When, Where.
  6. Do not interrupt while your partner is talking.
  7. Maintain an open and respectful body posture and facial expression. That is, monitor your body language. No glaring, frowning, rolling of the eyes. No folded arms. No torso or face turned away from your partner. Maintain eye contact while keeping your arms at your sides or resting in front of you. Remember to smile every once in a while in a friendly way.
  8. When it is your turn to speak, talk about your own perspective and your own experience using “I” messages (“I feel __,” “I think __,” “I want __,” “I need __”).
  9. Avoid mind-reading— that is, assuming that you know what your partner thinks, feels or intends to do, or what their motives are.
  10. Avoid verbally attacking your partner through “You” messages (such as through expressions of contempt, disrespect, sarcasm, ridicule, accusation, criticism or blame).
  11. Avoid “I” messages that are in reality critical “You” messages, such as, “I feel that you are being unfair” or “I think that you are all wrong.”
  12. Avoid all-inclusive critical or accusatory generalizations (e.g., “You always __,” “You never __.”)
  13. Let your partner know when you think that they have made a good point, or when you agree with what they said.
  14. Avoid power-plays (blackmail, intimidation or manipulation) through threats of escalation or revenge.
  15. If your partner begins to violate the ground rules, point that out to them and ask them to regroup and respect the rules.
  16. Absolutely avoid aggressive physical contact with your partner when angry.
  17. Remind each other periodically that you are on the same team, that you are not each other’s enemy, that you love, cherish and appreciate one another.
  18. Dialogue until both parties have said all they want to say about the issue.

Stop the discussion and agree to revisit the matter at a future time if:

  1. At least one party is consistently violating the communication ground rules and tempers are escalating, that is, when at least one party has become too emotional to be capable of calm and logical. Aim to agree to meet again at a later time when “cooler” minds prevail.
  2. Either party fears they may lose control physically or verbally— doing or saying something destructive.
  3. Either party needs more time to think things through.
  4. There is a significant number of interruptions and you cannot stay focused on the topic.
  5. The timing for the discussion turns out to be inappropriate for any other reason.

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P.A.V.E. Your Road to Wellness

July 23rd, 2014

Revised and reprinted from the March 2009 issue of the Correctional Oasis.

There are four areas that are pillars of wellness for corrections staff. These include:

  • (a) Processing the emotional impact of the job;
  • (b) Identifying and using Antidotes to neutralize negative consequences of work-related stressors;
  • (c) Having a positive Vision for their professionals and personal life; and
  • (d) Offering words of Encouragement to oneself and also to others.

(a) Processing: Emotional processing refers to the “digesting” of the fallout of stressful life events in order to be able to continue to move past them and to even grow as a result of them. Like milk is processed into cheese and peanuts to peanut butter, processing converts the emotional impact of events to constructive lessons learned and distressing memories that get “filed” so they are no longer acutely disturbing. Such processing can reduce negative mood and thoughts, and related acting out behaviors (such as going on a drinking binge or an overeating binge).

Processing requires willingness and determination to examine our inner life, to become aware of our thoughts, emotions, intentions and urges. Processing is not for the faint of heart, as being honest with ourselves requires courage. (Someone once said, “The truth will set you free, but first it will make you miserable.”) It is much easier to try to escape emotional discomfort through addictive behaviors or through attempts to take our frustrations out on others, instead of facing our inner reality and taking responsibility for our well-being.

Common methods of processing involve talking to trusted others about the issue, writing, or pursuing specialized psychological treatment.

(b) Antidotes: An antidote is a counter-dose, a chemical that negates the effects of a poison. If bitten by a rattle snake, you need the antidote of rattle snake anti-venom to neutralize the venom in your body. At work, you may have some emotionally painful interactions and experiences. These negative experiences need to be countered, and their “venom” neutralized, in order for you to regain your peace of mind. Telling yourself the truth is fundamental. Having someone you can confide in is also essential. Getting enough sleep and having a meaningful and love-filled life outside of work are key basic antidotes for corrections workers. Being outdoors in the beauty of nature refreshes your spirit. Working out on a regular basis de-stresses your body. Engaging in enjoyable hobbies and other activities, such as volunteering, refuels your soul. Make a list of the antidotes that work for you. Then put them to practice.

(c) Vision: Research shows that having a vision to pursue—a purpose to get out of bed every day—boosts health. Vision guides how you invest your life, what you do to impact others, and what legacy you want to leave behind. Vision helps you see yourself as part of something bigger than yourself. It propels you beyond your solitary existence as an individual to a person who sees and embraces the big picture, a person who invests in the welfare of others, both now and in the future.

How do you come up with a vision for your life? Start by asking yourself what principles you value dearly, what causes you are passionate about—what makes you feel the most alive, what you sense your natural talents are, and what brings you joy. Then start thinking of ways to uphold these principles and to promote those causes through the use of your talents and by doing what brings you joy.

(d) Encouragement: This practice is about “speaking words of life” to yourself and to others. The word “encouragement” is composed of two words: “in” and “courage.” So encouraging someone is like injecting a dose of courage into them! Think about that!! It’s no wonder that encouragement can be so energizing and empowering.

In order to encourage yourself to persevere or to do the right thing, treat yourself like a good parent or a good coach would treat you. Identify your abilities and strong points. Acknowledge any progress you make. Point out to yourself a job well done. Remind yourself that mistakes are learning opportunities. Figure out ways to work on areas where you need to improve. Speak similar words of life to others as well. Identify their abilities and strong points. Acknowledge any progress they make. Point out to them a job well done. Remind them that mistakes are learning opportunities. Support them as they figure out ways to work on areas that need improvement.

Encouragement can bring out the best in us—both for the recipients and the givers of courage “injections.” An added bonus is that as you encourage others you tend to attract to yourself positive people. So you end up enjoying the supportive community that gets built up around you. This of course contributes both to your well-being and to theirs.

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New DWCO Data Collection Initiative

December 31st, 2013

We are inviting willing corrections professionals to complete assessment questions to help with an initiative to collect and analyze important information on the occupation-specific challenges and impact of corrections work.  Assessment completion is voluntary and it is to be done on staff’s own time and from their personal computers. Data are ultimately used to promote the health, well-being, functioning, and fulfillment of corrections professionals.

Read more…

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Research

Another Pink Elephant?

December 20th, 2013

Some subjects are very hard to talk about. These are usually topics that involve addressing painful emotions, struggles and failures, or our personal fragile mortality. These matters are particularly hard to talk about by people who make a living out of projecting an aura of invincibility, power and control. Fragile is the last thing they want to be or appear to be. Of all these difficult subjects perhaps the hardest to address is that of suicide by “one of us.” And of all the professions that may have a difficult time talking about the suicide of “one of us,” corrections professionals are close to the top of the list—especially the security/custody staff.

After all, aren’t corrections professionals the ones who keep everybody in their care safe? Aren’t they the ones who have life and death duties, every day of the week, 24/7? Aren’t they the ones who often intervene in the case of inmate suicide attempts and save offender lives? Aren’t they the ones who keep whole communities safe through their supervision and management of society’s most dangerous?

In the 1980’s, when the literature seemed to explode on the subject of alcohol abuse and other types of family “dysfunctions,” helping professionals fervently highlighted the fact that the substance abusing individual and their family members often denied the issue or tried to rationalize it away. Helping professionals likened this minimizing or denying to having a pink elephant sprawled in the middle of the living room floor, with no one in the family acknowledging the presence of the beast. Instead of exclaiming, “What’s going on here? There’s this huge pink elephant in our living room!!!” they would figuratively continue to gingerly step around the animal, perhaps for years, acting like it did not exist. Not mentioning it, not commenting on it, not confronting it.

In some correctional settings a similar situation seems to be happening. In this case the pink elephant is staff suicide. The numbers indicate that there is truly an epidemic of suicides among corrections professionals, but very, very few are talking about this, and even fewer are doing something to proactively address the issue.

There are probably many reasons for this silence. It is hard for this tough group of “in control” individuals to admit that they have limits and that they too can break when pressures get bad enough. Many of them may also not know how to even begin to fix the problem, and so they opt to avoid it altogether. (It is easier to attribute the staff suicide to “weakness,” and move on, without exploring possible underlying issues.) And some may think that staff suicide has been going on for so long, that there is nothing that can be done about it anyway. For all these reasons, and probably many more, we continue to silently step around the pink elephant in the corrections living room.

Addressing the subject of corrections staff suicide involves facing and acknowledging some hard realities regarding corrections work. This requires tremendous integrity and courage.

In the general population the average suicide rate for the year 2010—the latest year for which national statistics are available—was 12.4 completed suicides per 100,000 persons (American Society of Suicidology, 2012). (Suicide rates are reported in terms of number of occurrences per 100,000, as—thankfully—suicide is a very rare event.) When examined by State, the highest reported rate was 23.2 per 100,000, for the State of Wyoming, and this is considered to be alarmingly high—almost twice the national rate.

A New Jersey study of active duty law enforcement professionals found that for male police officers the suicide rate was 15.1 per 100,000, and for adult males of the same age range (25 to 64 years old) in the general population the suicide rate was 14.0 per 100,000. For male Corrections Officers, however, the suicide rate was 34.8 per 100,000, more than twice that of the police officers and two-and-a-half times higher than that of the general population!

When an agency reports that they have a certain number of staff suicides per year, that number may appear small and negligible, as it is usually less than 5 staff suicides annually (unless the agency’s workforce is very large.) However, when the proportion is considered—the number of completed staff suicides com-pared to the total number of employees of that agency—the real impact and risk for suicide for that population becomes apparent.

For example, when a Department of Corrections with a workforce of 5,200 employees has five suicides in one year (which is an actual case), this translates to 96.2 suicides per 100,000. Yes, 96.2 per 100,000, compared to the average of 12.4 per 100,000 for the U.S. general population. This is the stuff of nightmares for behavioral scientists and behavioral health providers. Even three corrections staff suicides in one year out of 5,200 corrections employees translates to 57.7 suicides per 100,000—again frighteningly high compared to the general population.

Moreover, these numbers do not reflect suicide rates of retired staff for that agency. It has been our experience over the years that these rates are high as well, as we periodically receive information about retiree suicides.

What might contribute to these horrific suicide rates in the corrections profession? Could it be that corrections agencies inadvertently or selectively hire individuals predisposed to mental health struggles that may culminate in suicide? Upon reflection, this possibility does not seem very logical or likely.

Or might it be that the corrections work environment causes or contributes to a gradual erosion of staff’s well-being to the point that suicide becomes an acceptable option to them?

The latter seems to be a much more probable alternative, and there is substantial research evidence that supports this notion.

One recent study (Bierie, 2012) reported that a prison work environment of noise, clutter, dilapidation, lack of inmate privacy and lack of cleanliness contributed to increased substance use, increased sick days, and physical symptoms (e.g., recurring headaches, poor sleep, digestive problems) and psychological symptoms (e.g., feelings of anger, depression, worry) in corrections staff.

In an Australian study, corrections officers serving in high-stress and social-isolation posts were found to have increased negative emotions and outlook the longer they worked at these posts (Dollard and Winefield, 1998).

A Canadian study reported a 26% Post-traumatic Stress Disorder (PTSD) rate for corrections officers (Stadnyk, 2003).

A French study (David et al., 1996) determined that 24.0% of corrections staff of several disciplines met criteria for depression.

DWCO’s 2011 Initiative found that, for a nationwide U.S. sample of corrections professionals, 27% met criteria for PTSD (Spinaris, Denhof & Kellaway, 2012), and 26% met criteria for Depression (Denhof & Spinaris, 2013)—both of which are very high compared to other high-risk professions and the general population (Perrin, et al., 2007; US Centers for Disease Control and Prevention, 2010). Occurrence of both of these conditions increased with workplace exposure to incidents of violence, injury or death. Even more disturbingly, 17% of the DWCO Initiative sample was found to suffer from both PTSD and Depression at the same time. This is a highly significant finding in relation to staff suicide concerns, because the co-occurrence of PTSD and Depression has been repeatedly found to significantly increase suicide risk (Pietzrack, et al., 2011; Sareen, et al., 2007).

Could it be, therefore, that the high suicide rate among corrections professionals is fueled by undiagnosed and untreated occupationally-related PTSD and Depression, often coupled with substance abuse? These, and perhaps other disorders as well, may arise for the first time as a result of employment or they may have existed prior to corrections work and made worse due to high-trauma and other high-stress work conditions.

The evidence suggests that this is a likely explanation of the suicide epidemic among corrections staff.

So what should our response be to these realities?

As with every tough occupational subject, we need to start by acknowledging the problem at the highest executive levels. This must be followed with long-term committed conversations and studies that seek to explore causes and solutions for the issue. Engaging in this endeavor requires inspired leadership vision for the future of corrections as a profession. It takes courage and the tenacity to go against the status quo (a resigned stance that says, “This is the way it’s always been in corrections, and we can’t change it”). It also takes the courage, caring and tenacity to go against the system-wide denial that oftentimes characterizes corrections professionals of all ranks. In other words, it takes no longer tolerating or ignoring realities and conditions that would be deemed intolerable to most other professions and populations.

Courageous leaders acknowledge, without judgment, that the challenges they themselves and their executive colleagues may have faced (and apparently overcome) during the course of their careers are still present in the work environment for others.

Leaders are taught to believe that the health of the working environment is their duty to maintain, as it’s “on their watch,” as the saying goes. Therefore, when evidence indicates that the environment still contains chal-lenges which prove to be too much for some to overcome, some leaders might take this as a criticism of their lead-ership effectiveness, when in fact it is not.

The reality is that the profession’s numerous challenges constitute inescapable occupational hazards. It is the unsuccessful or unhealthy individual and collective adaptation to those unavoidable and recurring challenges that create corrections staff’s funerals and memorial services. Acknowledging the inherent difficulties, without pointing fingers, by noting that they are real and impactful and “the nature of the beast,” helps leadership to validate and maintain the committed conversations that follow: “It’s not just you. It’s not just our agency, office or facility. It’s the job. And we’re all in it together. So let’s do our best to try to make it better and safer for us all.” Those conversations can then focus on training on, instituting and providing for healthy adaptations to these challenges at both the individual and the organizational levels. In other words, the aim needs to become one of identifying and making possible the implementation of healthy tools for overcoming the challenges in a way that keeps body, mind, spirit, work teams and families together.

Appearances can be deceiving, and the appearance by “macho” corrections professionals of adapting successfully to difficult work environments may be the most deceiving of all. Corrections staff make their living by convincing others that they are in control at all times, which is a necessary part of the job if those around them are to remain safe. Corrections staff also know that their employers have their retirement and their family’s finances in their hands. And so the last thing they would want to show to their supervisors or administrators is the depth of the difficulty they may be experiencing adapting well to the challenges of the job. Appearing to be in control at all times allows them to continue to come to work day after day without drawing negative attention to themselves. In actuality though, they may be one of the walking wounded.

They may be grinding along on the power of unhealthy and even toxic coping strategies until, for whatever reason, they sadly decide that life just got to be too much and they opt to end it suddenly (hopefully without harming someone else first).

We at Desert Waters believe that the corrections profession now has enough information and tools on hand to begin implementing changes and providing training and relevant resources to corrections employees regarding the maintenance of their well-being and the health of the organization.

In the case of an actual staff suicide, the subject needs to be addressed with the surviving coworkers respectfully, compassionately and non-judgmentally—but also head-on, without being vague or indirect. We need to acknowledge the fact that even the toughest of the tough can break when their load gets heavy enough and/or when a staff member’s constitution gets undermined to the point where even a relatively light load causes their knees to buckle. The proverbial last straw that breaks the camel’s back accurately illustrates this concept. It has been our experience over the years that corrections staff relate to that metaphor only too well—hence our proposed term “Corrections Fatigue” and its analogy to the phenomenon of metal fatigue.

Regarding corrections staff suicide, we need to start somewhere and we need to start NOW. We need to continue designing data-driven methods to “vaccinate” staff against the suicide “virus” and whatever feeds it through the teaching of effective coping strategies and through effective workplace climate interventions— coupled with the provision of ample and affordable resources. More specifically, the impact of repeated exposure of corrections staff to psychological trauma on the job, whether directly or indirectly, must be at the forefront of discussions and interventions, as we know that it contributes to staff’s psychological undoing (Denhof & Spinaris, 2013).

We also need to train staff to handle and intervene safely and compassionately in the case of distraught coworkers. And we need to have appropriate protocols in place regarding postvention—handling the issue of a completed staff suicide and communicating to staff about it. Doing so effectively can provide healing closure to coworkers as well as an opportunity for a powerful pitch for the importance of staff wellness and the promotion of mental health. Staff are usually listening at that point. A coworker’s suicide allows for a breach in their walls of denial, even if briefly, as staff’s defenses go temporarily down when they are faced with the undeniable reality of the frailty of one of their own.

Not doing anything significant to target staff wellness from an occupational standpoint, in spite of the mounting evidence of the dire need for such interventions, could be perceived as deliberate indifference—which is certainly not the intent.

So let’s acknowledge the pink elephant in the corrections living room and begin to take the necessary steps to get it safely transported out of the house.

As C.P. Sennett has said, “If nothing changes, then nothing changes.”

And we are in desperate need for POSITIVE and PROACTIVE CHANGE regarding corrections staff wellness, including suicide prevention.

References

American Society of Suicidology (2012). U.S.A. Suicide: Official Final 2010 Data. Available at: http://www.suicidology.org/c/document_library/get_file?folderId=262&name=DLFE-636.pdf.

David, S., Landre, M.F., Goldberg, M., Dassa, S., & Fuhrer, R. (1996). Work Conditions and Mental Health among Prison Staff in France. Scandinavian Journal of Work Environmental Health, 22, 45-54.

Denhof, M.D., & Spinaris, C.G. (2013a). Depression, PTSD, and Comorbidity in United States Corrections Professionals: Impact on Health and Functioning. Available at: http://desertwaters.com/wp-content/uploads/2013/06/Comorbidity_Study_6-18-13.pdf

Dollard, M.F. & Winefield, A. H. (1998). A test of the demand-control/support model of work stress in corrections officers. Journal of Occupational Health Psychology, 3, 243-264.

New Jersey Police Suicide Task Force Report. (2009). Available at: http://www.state.nj.us/lps/library/NJPoliceSuicideTaskForceReport-January-30-2009-Final(r2.3.09).pdf.

Perrin, M.A., DiGrande, L., Wheeler, K., Thorpe, L., Farfel, M. & Brackbill, R. (2007). Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. American Journal of Psychiatry, 164, 1385-1394.

Pietrzak, R.H., Goldstein, R.B., Southwick, S.M., & Grant, B.F. (2011). Prevalence and Axis I Comorbidity of Full and Partial Posttraumatic Stress Disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Re-lated Conditions. Journal of Anxiety Disorders, 25, 456-465.

Sareen, J., Cox, B. J., Stein, M. B., Afifi, T .O, Fleet, C., & Asmundson, G. J. G. (2007). Physical and Mental Comorbidity, Disability, and Suicidal Behavior Associated with Posttraumatic Stress Disorder in a Large Community Sample. Psychosomatic Medicine, 69, 242–248.

Spinaris, C.G., Denhof, M.D., & Kellaway, J.A. (2012). Posttraumatic Stress Disorder in United States Corrections Professionals: Prevalence and Impact on Health and Functioning. Available at: http://desertwaters.com/wp-content/uploads/2013/09/PTSD_Prev_in_Corrections_09-03-131.pdf.

Stadnyk, B.L. (2003). PTSD in corrections employees in Saskatchewan. Available at: http://rpnascom.jumpstartdev.com/sites/default/files/PTSDInCorrections.pdf.

United States Centers for Disease Control and Prevention (US-CDC). (2010). Current Depression Among Adults—United States, 2006 and 2008 Morbidity and Mortality Weekly Report, October 1, 2010 Erratum. Available at: http://www.cdc.gov/features/dsdepression/revised_table_estimates_for_depression_mmwr_erratum_feb-2011.pdf.

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