Hi Emily,

Thanks for reading my post and your thoughtful comment. I agree with you that reflective supervision (RS) should be one of a number of strategies that need to be integrated in to the structure and fiber of organizations in order to address secondary traumatic stress.  I do continue to think it's an excellent model that is not available to most care providers that need it, and an imperative.

I also advocate that movement/body based activities  be available to staff as part of staff wellness and resiliency organizational plans.  However, just as you say RS should not necessarily be the "standard" I would argue that suggesting that, for everyone, trauma healing  REQUIRES work with the body is not true.  I believe, and have seen good evidence,  that there are many paths to prevention and healing from primary and secondary traumatic stress.  This is why, in response to secondary traumatic stress, organizations need to make a variety of strategies available.  I've highlighted many in my blog and they are:

• Educate all staff about the signs and symptoms of secondary traumatic stress.
• Provide meaningful and creative opportunities for professional development (e.g., brown bag lunches on topics of interest to staff, book club discussion groups, etc.)
• Provide opportunities for staff to safely explore their own trauma histories.
• Provide reflective supervision, a model which gives staff an opportunity to meet regularly and collaboratively with their supervisors to reflect on how their work affects them and deepens their understanding of parallel process.
• Offer on-site opportunities for employee self-care and social connection such as physical activity, birthday celebrations, knitting circles, yoga, meditation, etc.
• Make the creation of individual safety and self-care plans an organizational practice for all staff.
• Share power with employees; provide opportunities for employees  to contribute  ideas to organizational improvement, staff wellness, and resilience.
• Ensure that the physical environment where staff works is safe.
• Ensure that staff have psychological safety at work (e.g., have and enforce strong policies condemning bullying, harassment, discrimination, racism, sexism, etc. in the workplace)
• Provide health and mental health care benefits and access to employee assistance programs.
• Provide paid sick and family leave.
• Provide a living wage.

Leslie

Leslie,

Thank you for the article and highlighting a very important topic.  My primary concern with reflective supervision being held as the "standard" of high quality supervision is that it is still very much a "cognitive-based" approach to supporting care providers.    

Secondary traumatic stress, vicarious trauma, compassion fatigue are neurophysiological conditions that emerge as a result  "overwhelm" in the body's nervous system.  Therefore, repairing and/or preventing such conditions REQUIRES work with the body - movement, rhythm, breath, touch, quieting the mind.  Connection and talking have a place but they are by no means the "end all be all" stress repair.  There is still a great need within much of the clinical community to recognize there is more to trauma than just what's happening in the mind and/or cognitive processes.  

If you are interested in incorporating more "bottom-up" approaches to overwhelm repair, let me know.  Would love to talk...

Thank you, again, for bringing up a very important subject matter.  

Best, Emily Read Daniels

Leslie, I am so grateful for your work on this very important topic area.  Bringing this information and competencies (plus all the related aspects) to conferences that are primarily attended by nurses - could reach an important target group.  I'd be interested in learning more about how this information is being rolled out!  Many thanks for your leadership.  Karen