“This project was supported by Grant #2017-MC-FX-K051 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect those of the Department of Justice.” 

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"Shining Light on the Commercial Sexual Exploitation of Children: A Toolkit to Build Understanding" is a toolkit designed to be a resource for multidisciplinary professionals, policy makers, volunteers, faith communities, and others involved in anti-trafficking work. While the information provided on each topic is in no way exhaustive, you will find additional resources to facilitate further study. Each topic is addressed in three sections: First, the “what?”– what we know about the topic which includes a review of what we know from both research and the field. “So what?” addresses what this means – the reason this information is important to understand and how it will enhance our response to trafficking. “Now what?” considers the implications of this information in practice - how the information can be used to enhance our response to human trafficking. This includes specific implications for mentoring relationships, when applicable.  

What?

Why is the practice of self-care so critical for professionals and mentors in this work?

• Stress. A unique combination of stressors accompanies our work.
• The consequences of these stressors on professionals, mentors, and organizations is significant, and this also has an impact on the youth we serve.

Stress is a natural component of everyday life. However, there are a number of reasons why those who work in direct service professions (either as volunteers or career professionals) will likely encounter additional stress.

• The nature of the work and work responsibilities.¹³

These individuals walk alongside and support people who are navigating various stages of their healing journey. They are exposed to stories about past and current trauma, and such exposure can have a significant impact.^1,2,3 Staff and mentors working with young people who have been commercially sexually exploited can experience what is referred to as vicarious trauma, secondary trauma, or secondary traumatic stress. This occurs when a staff or mentor goes beyond hearing about trauma to re-experiencing it along with the person.^2,3,4 The continual exposure to traumatic material can result in both physical and psychological symptoms.⁵ Additionally, professionals in this field often face large caseloads with extremely complex issues, enormous amounts of paperwork, on-call duties, funding gaps, lack of support resources, and a shortage of trained staff. The accumulation of this stress over a period of time increases the risk for compassion fatigue and burnout. 

• The personal experience that draws many into this work. Entrance into this field is often driven by childhood experiences of adversity.¹³

A high number of child welfare professionals report choosing their work, in part, due to their own adverse childhood experiences. While the “lived experience” of childhood adversity brings numerous benefits to the work, it is not without it’s costs, including: higher work stress, increased negative coping skills and responding negatively to secondary traumatic stress.¹³

 Self-care, including positive coping skill development and mindfulness can be effective ways for staff and mentors to manage stress in their personal and professional lives as they navigate the additional stressors of supporting victims/survivors.

• Self-care is the way a person tends to their emotional, psychological, physical, and spiritual well-being. It is foundational to maintaining health and wellness.⁶  Self-care has also been described as “a process, ability, or engagement in behaviors that would promote certain positive outcomes such as a positive lifestyle or stress relief”.^{(Lee & Miller, 2013)} 
• Positive coping skills allow a person to tolerate, adapt or deal with stressful situations and manage painful or difficult circumstances in a healthy manner. A person’s choice of coping strategies are directly related to burnout rates. Examples of positive coping skills include:
  • Accessing external social and emotional resources such as family, friends, organized support groups, faith-based resources, etc.
  • Actively planning or developing specific strategies to respond to stressors. 
  • Putting aside other activities to concentrate on addressing the stressor.¹³
• Mindfulness is being purposefully aware and present to experiences moment by moment.⁷
  • Mindful individuals tend to perceive difficult situations as less stressful and use more adaptive coping strategies in response to stress.⁸
  • Individuals who engage consistently with mindfulness techniques and self-care often experience greater emotional stability, more adaptive responses to negative events, and more adaptive regulation of stress.⁸

So What?

Prolonged exposure to stress results in negative outcomes.¹³ Including:

• Personal cost to individuals and their families.
• Professional disruption and sabotage to individual careers.
• Diminished quality of care for the young people we serve.
• The cost to agencies including turnover, training, strain on existing staff, loss of expertise, decreased programming quality, loss of volunteers/mentors and more.

When left unattended, a culmination of these stressors can result in unmanageable work and volunteer situations. Often used interchangeably, compassion fatigue and burnout are two distinct constructs that often affect those providing direct services.⁴  It is not uncommon for these two issues to overlap in the lives of staff and mentors.^4,9 If left unaddressed, compassion fatigue and burnout can have significant consequences for both the individual and the organization. Compassion fatigue is a state of tension and preoccupation with the traumatized individual, and is characterized by re-experiencing the person’s traumatic events, avoidance of or numbing of reminders, and persistent arousal (e.g., anxiety) associated with the individual.⁴ Compassion fatigue focuses on the effects of working closely with those who have experienced trauma.^4,5,10 Compassion fatigue may cause staff or mentors who are survivors of sexual exploitation or other abuse to re-experience or “flashback” to their own trauma. In contrast, burnout “reflects an uneasy relationship between people and their work”.¹⁰ Burnout is a multifaceted condition consisting of exhaustion, cynicism, detachment from work, and feelings of inefficacy that ultimately result in apathy and general dislike for one’s work.^5,10 With burnout, there is no specific exposure to trauma; it can affect those in all types of professions and is the result of continued exposure to a demanding or high stress work environment.¹⁰ In order to be the most effective volunteer, mentor or helping professional, it is extremely important to take care of yourself.

• Self-care is about prioritizing and taking care of your own physical, emotional, and mental health needs.¹¹
• Positive coping skills help professionals to cope with work stress, enjoy a higher level of job satisfaction and can assist agencies in decreasing the rate of turnover in their programs.¹³ 
• Mindfulness and self-care can prevent and/or treat burnout.⁷
• Mindfulness is positively associated with life satisfaction, self-esteem, and positive affect.⁸    
• To properly care for others biological, psychological, social, and spiritual health needs, you must first attend to your own needs.¹¹

Now What?

General Practice Implications

• Take intentional steps to ensure you have balance between your personal life and other commitments (work, volunteer time, etc.).
  • Small steps go a long way. Eat well, exercise, make sleep a priority, get outside, attend to your relationships, make time for a hobby, drink plenty of water, etc.
  • Create a self-care plan.¹¹
  • Identify ways to practice self-care that attend to your biological, psychological, social, and spiritual health.
  • Commit to practicing at least one self-care activity each week (i.e. yoga, meditation, journaling).
• Be aware of your own risk factors and predisposition to developing burnout.⁷
  • Adverse childhood experiences increase the chances of higher work stress and the use of negative coping skills, which result in increased stress in personal and professional lives.¹³
• Develop your ability to set boundaries professionally and personally.
• Learn and integrate positive coping skills as a way of coping with personal and work stress.¹³
• Avoid negative coping skills as they increase levels of work stress (i.e.. denial of stress, emotional and social disengagement, alcohol and drug disengagement).¹³ 
• Consider practicing mindfulness to mitigate burnout in the following ways:⁷
  • Read mindfulness books and websites.
  • Watch or listen to guided mindfulness and tutorials.
  • Attend a local mindfulness group (i.e. meet-up groups, spiritual groups).
  • Enroll in a mindfulness course (i.e., college or continuing education offerings).

General Practice Implications for Providers

• Include the practice of employee self-care in your agency's list of best practice models.
• Provide self-care education and planning as a part of new employee training, including the identification of research based positive coping skills.¹³
• Train supervisors to create a trauma-informed work environment, recognize work-related stress and intervene early to mitigate potential burnout.
• It is important to create a healthy and responsive organizational culture where systemic stress factors are addressed.⁶
  • Encourage staff to take vacation time/mental health days.
  • Promote wellness in the workplace (i.e. make healthy snacks available, hold a fitness competition, try a yoga lunch break).
  • Engage in a monthly social activity.
  • Allow for some flexibility in the work schedule. (i.e. work one day a month from home, come in later and stay later, etc.).
  • Encourage employees to take short breaks (1-5 minutes) every 90 to 120 minutes. Remind them to mindfully stretch, breathe, or walk during those breaks.¹²
  • Schedule additional individual and/or group debriefs when challenging or stressful situations occur. Establish and require regularly scheduled supervision sessions for staff and mentors.
  • Implement effective safety engagement protocols to ensure that staff and mentors feel safe.
  • Create a crisis response plan. Ensure that staff and mentors know how to respond in crisis and are properly cared for afterward.
• Make sure the staff or volunteer workload is not overly burdensome and that they are using their talents in a manner that is meaningful.⁵
• Foster a sense of community. People do their best work when they feel connected to their colleagues and have no unresolved issues.⁵
  • Offer regular opportunities for staff and mentors to celebrate successes, talk through challenges, and debrief challenging situations.

General Practice Implications for Communities

• Offer free events to engage the community in self-care activities (i.e. yoga, mindfulness, healthy cooking classes, etc.).
• Recognize the contributions of volunteers and professionals who work to support youth impacted by trauma.  
• Host healing-centered and collective care spaces/events to respond to traumatic events that occur in the community.

Mentoring Practice Implications

• Ensure you are building self-care into your routine. Mentoring, particularly for youth who have experienced commercial sexual exploitation, can take an emotional toll.
• Establish and maintain proper boundaries with your mentee to prevent burnout. Check in with program staff for support and self-care resources.
• Consider adding self-care practices, such as, utilizing positive coping skills into mentor/mentee activities. Modeling these practices for youth can help them develop healthy strategies to cope with stress.
• Offer support for mentors. Ensure that program staff check in often to ask about successes and challenges, as well as to debrief difficult situations.
• Integrate self-care into your mentor training so they understand its importance in the context of their role as a mentor. Provide practical suggestions and let me know that you will check in with them periodically to see how their self-care plan is working.
• Plan volunteer appreciation nights to honor the hard work and the many hours that mentors contribute to our organization. Rewards, even small ones, can help prevent burnout.⁵
• Create a culture where self-care is discussed and prioritized.

Resources

• University of Buffalo School of Social Work Self-Care Starter Kit
• Idealist Careers: Burnout and Balance
• Strategies for Self-Care for Mentors
• Quick Relaxation Techniques
• Guided Meditations
• Stanford Social Innovation Review: A Culture of Care, Without Compromise
• Addressing Grief and Growth Community 
• Rethinking Self-Care for Youth and Allies

References

1. Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1), 63-70.
2. Killian, K. D. (2008). Helping till it hurts? A multimethod study of compassion fatigue, burnout, and self-care in clinicians working with trauma survivors. Traumatology, 14(2), 32.
3. Showalter, S. E. (2010). Compassion fatigue: What is it? Why does it matter? Recognizing the symptoms, acknowledging the impact, developing the tools to prevent compassion fatigue, and strengthen the professional already suffering from the effects. American Journal of Hospice and Palliative Medicine, 27(4). 239-242.
4. Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion fatigue and psychological distress among social workers: a validation study. American Journal of Orthopsychiatry, 76(1), 103.
5. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52(1), 397-422.
6. Monk, L. (2011, January). Self-care: An ethical imperative. Perspectives, 33(1), 4-7.
7. Luken, M., & Sammons, A. (2016). Systematic review of mindfulness practice for reducing job burnout. American Journal of Occupational Therapy, 70(2), p1-p10. doi:10.5014/ajot.2016.016956
8. Friese, M., & Hofmann, W. (2016). State mindfulness, self-regulation, and emotional experience in everyday life. Motivation Science, 2(1), 1-14. doi:10.1037/mot0000027
9. Jenkins, S. R., & Baird, S. (2002). Secondary traumatic stress and vicarious trauma: A validation study. Journal of Traumatic Stress, 15(5), 423-432.
10. Maslach, C, Leiter, M. (2005). Reversing burnout: How to rekindle your passion for your work. Stanford Social Innovation Review, 3(4). 42-49.
11. Butler, L. (n.d.). Developing your self-care plan. Retrieved from https://socialwork.buffalo.edu/resources/self-care-starter-kit/developi…
12. Overholt, M. & Vickers, M. (2014). Stress Management and Mindfulness in the Workplace. American Management Association International.
13. Lee, Kyuho & Pang, Yuk & Lee, Jo Ann & Melby, Janet. (2017). A Study of Adverse Childhood Experiences, Coping Strategies, Work Stress, and Self-Care in the Child Welfare Profession. Human Service Organizations: Management, Leadership & Governance. 41. 10.1080/23303131.2017.1302898.

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