EXTINGUISHING THE FLAMES OF BURNOUT THROUGH PATHOPLASTICITY Susan

EXTINGUISHING THE FLAMES OF BURNOUT THROUGH PATHOPLASTICITY Susan G. Klappa PT, Ph. D Professor Briar Cliff University Sioux City, IA USA Scott P. Klappa MS POR LLC Emotional Wellness Mental Health Clinic Golden Valley, MN USA

OBJECTIVES At the end of this presentation, participants will be able to: 1. Define burnout as a social phenomenon and its constructs. 2. Describe the principle of pathoplasticity in behavior change. 3. Compare constructs of burnout among physical therapists in various clinical and leadership positions. 4. Explain strategies for diminishing burnout among physical therapists using the ICF model. 5. Develop a personal plan for behavior change to mitigate aspects of burnout in clinical practice.

BURNOUT DEFINED 1 -12 § Burnout (BO): Emotional exhaustion, depersonalization, & low feelings of personal accomplishment 10 § Secondary Trauma Stress (STS): Residual stress of working with traumatized individuals 10 § Compassion Fatigue (CF): Reduction in capacity to bear sufferings of others 10 § Compassion Satisfaction (CS): Pleasure derived from doing work well & helping others 10 (Stamm, 2010)

PATHOPLASTICITY DEFINED 13 -17 • Pathoplasticity utilizes the influence of interpersonal traits of dominance, submissiveness, agreeableness, and quarrelsomeness in the treatment of various mental health disorders in order to develop social treatment methods complimenting the interpersonal style of those seeking assistance with mental health challenges.

PERSONALITY THEORY 1, 17, 19, 20 • Since the infancy of personality research there has been a great emphasis on individual personality traits until recently. 1, 17 • The introduction of Pathoplasticity turns the focus from traditional traits like the “Big Five” and sheds new light on personality traits that are exercised in social settings from dyadic relationships, group interactions, and beyond. 19 • The traits of greatest interest on two orthogonal axes, the first being the Power Axis and the second being the Affiliation Axis. 20

PATHOPLASTICITY & BEHAVIOR CHANGE 13 -20 • Pathoplasticity starts by focusing on the influence of interpersonal style in relation to presenting mental health disorders such as depression, anxiety disorders, and traumatic experiences in order to develop successful treatment strategies for those dealing with mental health challenges. • Principles of pathoplasticity suggest that a tailored treatment strategy may better influence treatment outcomes. • Treatment is often focused in a social setting consisting of at least two people, thus, it is imperative to know the style of communication and interaction that is best received by all individuals involved.

BURNOUT 21 -25 IN PHYSICAL THERAPISTS

BURNOUT & PHYSICAL THERAPISTS 23 -25 § Phase 1: Professional Quality of Life (Pro. QOL) Survey • Participants: 304 surveys o DRW: n=90 (63 females, 27 males) o NG: n=151 (112 females, 38 males) o WPT: n=63 (39 females, 24 males) § Phase 2: Phenomenological interviews • Participants: 34 interviews o DRW: n=15 (12 females, 3 males) o NG: n=12 (12 females, 0 males) o WPT: n=7 (4 females, 3 males) (Stamm & Hundall, 2010)

ENVIRONMENTAL FACTORS 21 -25 § PTs, like other health care professionals, lacked an awareness of CF and its influence on care § Preventative Factors = Better Patient Care 0 Healthy life-work balance 0 Mentors 0 Colleague support

PERSONAL FACTORS 21 -25 § Personal Factors contributing to CF in PTs 0 Lack of adequate coping mechanisms 0 Busy work schedules 0 Productivity

ICF MODEL: STRATEGIES TO DIMINISH BURNOUT 26

MITIGATING EFFECTS OF BURNOUT IN CLINICAL PRACTICE 21 -25 • The Good • Journaling • Social Networking • Creative Writing/Song Writing/Dance • Giving Presentations • Exercise, Mindfulness, Yoga • The Bad • Feeling bullied at work • Feeling not valued at work or home • Not eating or over eating • The Ugly • Drinking excessively • Smoking • Illegal drugs • Unprotected sex outside committed relationships

STRATEGIES FROM AROUND THE WORLD 21 -28 • Rigidity or chaos: Where are healthy strategies located? • Hardiness or resilience? • Strategies to transform oneself and the environment

PERSONALITY TRAITS & BEHAVIOR CHANGE 21 -28 • Looking inward: Personality assessment • SCOT Analysis: Strengths, Challenges, Opportunities, and Threats • Scanning the environment: Cultural and work challenges • • • Mentors Spiritual counselors Peers who understand challenges Paid time off of work Benefits for difficult challenges

CONCLUSION § By understanding the experience of PTs, we can better anticipate the support needed for these individuals as they engage in their caregiving careers. § The importance of having social support at work and home cannot be underestimated. § Pathoplasticity and the ICF Model provide a way to develop strategies for successful coping.

WHAT IS YOUR PERSONALITY TYPE? Some ideas for learning more about your personality style: • DISC Training: http: //www. everythingdisc. com/everythingdiscpartners/Everything. Di. SCAssessment. Partnership-Bing. aspx • Strength Finders: http: //www. strengthsfinder. com/home. aspx • True Colors: https: //truecolorsintl. com/ How will you cope?

THANK YOU! Questions may be addressed to: Susan. klappa@briarcliff. edu

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REFERENCES 21. Klappa SG, Crocker R. Interprofessional collaborative practice during disaster relief work in Haiti: An ethnographic study. HPA PTJ PAL. 2013; 13(4); J 1 -11. 22. Klappa SG, Audette J, Do S. The role of physical and occupational therapists in disaster relief post-earthquake Haiti 2010. Disability and Rehabilitation. Early Online, May 2013. 35: 1 -9. ISSN 0963 -8288. Print: 2014; 36(4): 330– 338. ISSN 0963 -8288 print/ISSN 14645165 online. 23. Klappa SG, Howayek R, Reed K, Scherbarth B, Klappa SP (2015). Compassion fatigue among new graduate physical therapists. Global Journal of Medicine, Physical and Health Education. September 2015; 3(4): 100 -111.

REFERENCES 24. Klappa SG, Crocker R, Hughes L, Thompson J, Klappa SP. Predicting compassion fatigue: A model for disaster relief workers. HPA PTJ PAL. January 2016; 15(4): J 1 -J 18. 25. Klappa SG, Fulton LE, Cerier L, Peña A, Sibenaller A, Klappa SP. Compassion fatigue among physiotherapist and physical therapists around the world. Global Journal of Medical, Physical and Health Education. October 2015; 3(5): 124 -137. 26. World Health Organization. International Classification of Functioning, Disability, and Health (ICF). http: //www. who. int/classifications/icf/en/ Published July 22, 2016. Accessed October 20, 2016.

REFERENCES 27. Klappa SG, Fulton LE, Gregg J, Tollefson A, Van Praag E, Klappa SP. Physical therapist leaders: How gritty are they? Global Journal of Medical, Physical and Health Education. November 2015; 3(6): 138 -151. 28. Weidlich C, Ugarriza D. A pilot study examining the impact of care provider support program on resiliency, coping, and compassion fatigue in military care providers. Military Medicine. 2015; 180(3): 290 -295.