RISE Peer Responder Basic Training Module 2: The Value of Intervention

Continue Continue Continue Continue Continue powerpoint.jpg powerpoint.jpg powerpoint.jpg Continue Continue Course © The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System Specifically prepared for Siemens Healthineers ARMSTRONG INSTITUTE FOR PATIENT SAFETY AND QUALITY This training may not be commercially available in all countries. Please contact the Armstrong Institute for Patient Safety and Quality and The Johns Hopkins University, Hospital, and Health System for more information. Siemens Healthineers are neither the provider nor legal manufacturer of this training. Any claims and statements made in this training and any content shown in the training are under the sole responsibility of the Armstrong Institute for Patient Safety and Quality and The Johns Hopkins University, Hospital, and Health System. Disclaimer Jingle Peer Support for Caregivers in Distress: Peer Responder Basic Training Specifically prepared for Siemens Healthineers © The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System Resilience In Stressful Events- RISE Module 2: The Value of Intervention ? Peer Responder Training: Module 2 Welcome to Module 2 of Peer Responder Basic Training. Module 2 will serve as your introduction to the value of RISE intervention. For assistance navigating the course, select the question mark at the bottom right of the screen. Throughout the course, select the Resources tab in the top right corner of your screen to access the RISE Peer Responder Toolkit. It is highly recommended to have the RISE Toolkit nearby while taking this online training. At the end of this module you will have the opportunity to print all typed responses from the course. We highly recommend that you print your responses to have on hand at your RISE team meetings. Interacting with your team is the best way to establish your skills as a responder and contribute to an effective RISE program. ? RISE Peer Responder Roadmap Keeping within the Scope of RISE Module 5 Application of Skills & Principles Module 4 The RISE Intervention Module 3 Value of RISE Intervention Module 2 Introduction to RISE Module 1 Peer Responder Training Roadmap We’re at our second marker along the RISE peer responder roadmap. Module 1 was our introduction to the program and now we dive into the value of RISE intervention. In modules three (3) and four (4), we will begin learning intervention skills and, in module five (5) we will outline keeping within the scope of the RISE program. Hover your mouse over each marker along the bottom of the screen to view the steps of the program. ? RISE Peer Responder Training Module 2: The Value of Intervention Module 2 demonstrates the value and importance of intervention for caregivers in distress. 1 2 3 Outline stages of recovery following traumatic event Describe the RISE intervention workflow Identify three forms of empathetic response Define components of compassionate action 4 Module 2 Objectives In this module we'll focus on the value of the RISE intervention. We'll discuss the stages of recovery following a traumatic event, outline the RISE intervention workflow and discuss the three types of empathetic response. Finally, we define compassionate action and its importance for peer responders. ? Introduction to RISE Intervention Introduction to RISE Intervention ? Role Play Role Play ? Role Play: Debrief Role Play Example_ Debrief Example: After a difficult relationship a friend….. Type your responses into the text box. In the past, have you received emotional support from someone when you felt distress? Reflection: Emotional Support Note: This activity is required for course completion. Reflection: Emotional Support Let’s take a moment for reflection. In the past, have you received emotional support from someone when you felt distress? Was it helpful? What did they say that was helpful or harmful? Please type your response into the text box and then select Submit. Thank You You will have an opportunity to print all typed responses at the end of this course. ? Stages of Recovery Table with 2 columns and 1 rows Stage of Recovery Clinician Experience Scott, S. D., Hirschinger, L. E., Cox, K. R., McCoig, M., Brandt, J., & Hall, L. W. (2009). The natural history of recovery for the healthcare provider ‘‘second victim’’ after adverse, patient events. Qual Saf Health Care, 18, 325-330. Table with 2 columns and 1 rows Chaos & Accident Response Internal & external turmoil Distracted: needs others to lead Table with 2 columns and 1 rows Intrusive Reflections Inadequacy Self-doubt/ loss of confidence Table with 2 columns and 1 rows Restoring Personal Integrity Unsupportive colleagues may intensify self-doubt Table with 2 columns and 1 rows Enduring the Inquisition Worries about job security/ licensure Possible litigation Table with 2 columns and 1 rows Obtaining Emotional First Aid Unsure whom is safe to confide in/ privacy concerns Don't want to expose others to pain Table with 2 columns and 1 rows Moving On Dropping out: change job/ leave profession Surviving Thriving Stages of Recovery Sue Scott and colleagues at the University of Missouri conducted research on the stages of recovery following a traumatic event. In their article, published in 2009, 6 steps are outlined that I would like to introduce you to. These steps of recovery may not happen in this sequence and vary per person. The most common first step is chaos and accident response in which the person feels both internal and external turmoil and is distracted in daily activities. Following the initial response, intrusive reflections begin. During this stage, one will feel a sense of self-doubt and inadequacy. During the stage of restoring personal integrity, one may feel increased self-doubt in response to unsupportive colleagues. The 4th stage outlined is enduring the inquisition. At this point, one worries about job security and potential litigation associated with the event. The final stages of recovery include emotional first aid and moving on. When seeking emotional first aid, one may feel unsure who to confide in and if privacy will be maintained. Finally, in the last stage, moving on, there are three possible paths; dropping out of the job or the profession, surviving, showing up to do the job but isn't happy or engaged, or thriving, recovering from the experience, learning and growing from it. ? Stages of Recovery Carr, S. (2009). Disclosure and apology: What's missing? advancing programs that support clinicians. Medically Induced Trauma Support Services. Published literature & anecdotal reports indicate peer support is CRUCIAL when things go wrong Maybe also went things go right RISE Resilience In Stressful Events Stages of Recovery Both anecdotal and published literature indicate the importance of peer support when something goes wrong in healthcare. In fact, there is support for such intervention even when the outcome is positive. Healthcare experiences can be intense, intimate and scary; peer support improves our caregivers resilient zone. ? RISE Intervention Workflow Request for Support Make Plan to Meet RISE Intervention Debrief RISE Intervention Workflow Next, let’s look at a typical workflow for the RISE program. When a peer makes the call requesting support our workflow begins. Select each step of the workflow on your screen beginning with request for support. Notes: Request for support When we receive the call for help, a timely response is important. We want to make a connection with the caller and validate their effort in reaching out. Notes: Make a Plan During the initial call, make a plan to meet. This includes determining if the meeting will be in-person, which is ideal, or on the phone. Will the meeting be with an individual or a group of colleagues? Finally, establish a meeting place that is on business property and a time. Notes: Intervention: At the meeting, emotional first aid is provided. We will introduce specific intervention skills in module 3 of peer responder training. Notes: Debrief: The final step of the workflow is the debrief for the RISE responder. The RISE program includes support and learning opportunities for the responder to maintain their emotional health and well-being. Timely response Provide appropriate support In person vs. phone call Individual vs. group Time & place Support Learn Select X to return to the course. Timely response Provide appropriate support In person vs. phone call Individual vs. group Time & place Select X to return to the course. Timely response In person vs. phone call Individual vs. group Time & place Select X to return to the course. Timely response Select X to return to the course. Extra-therapeutic Change Common Factors Expectancy Techniques ? Intervention & Listening Lambert, K.J. Psychotherapy outcome research: Implications for integrative and eclectic therapists. Handbook of psychotherapy integration, 1992. Intervention & Listening You may wonder if there is value in only listening. Yes there is, and we are also doing many other things that help people feel better. This chart describes the results of a study investigating why people get better when they go to therapy with a mental health professional. Even though this is beyond the scope of what we’re doing as peer supporters, it can give us some insight into the important value of listening. Select each area of the chart to learn more Notes: Techniques: When attending therapy with a mental health professional, 15% of the intervention outcome is associated with the skills the trained professional uses during the intervention. Notes: Expectancy: 15 % of the intervention outcome is placebo effect. The caller expects to feel better and thus they do. Notes: Common factors: 30% of the RISE intervention outcome is associated with common factors the caller feels with the peer responder. Giving full attention, being kind, not judging, and offering caring compassion. These are all things we can do as peer responders. Notes: Extra- therapeutic: Interestingly, 40% of the outcome is outside our control. People often get better because of some other life change. Maybe they start exercising or eating a better diet, maybe they start a new relationship, or maybe they change jobs and they feel better about their lives. ? 40%: Factors outside control Select X to return to the course. ? 30%: Factors in common with responder Select X to return to the course. ? 15%: Placebo Effect Select X to return to the course. ? 15%: Skill Contribution Select X to return to the course. ? Empathic Response Empathetic Distress Self-focused Empathy with no action Share in the suffering Over-identifying with one’s own story Creates negative feelings Singer, T. et al. Empathy and Compassion. Current Biology. Volume 24, Issue 18, 2014, pg. R875-78. Sinclair S. et al. Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understanding, experiences and preferences. Palliat. Med. 2017 May; 31(5): 437-47. Sympathy Other focused Acknowledging suffering Pity Distant Self protective Compassion Other focused Motivated to reduce suffering Responds from place health Creates positive feelings Empathy: Empathetic impulse is activated when we see suffering As human beings we connect to another person suffering Empathetic Response In addition to what we have discussed in the literature, it's important to discuss empathy. When we see a distressed person that is suffering, our empathetic impulse is activated. As a human we connect to the other person suffering. Empathy can show up in several different ways. One way it can present is empathetic distress. With this response the responder remains self-focused and shows empathy without specific action. Often the responder is over identifying with their own experiences and ultimately the person in distress feels negatively about the interaction. Another way empathy can present is with sympathy. In this case the responder is focused on the person in distress and acknowledges their suffering. The responders response is self protective and thus maybe perceived as a more distant reaction and is received by the person in distress as a feeling of pity. The final way empathy can present is empathetic compassion. This response is also focused on the person in distress and is characterized by the responders motivation to reduce suffering and comes from a healthy place in the responder. This response is received positively by the person in distress. ? Empathic Response Empathetic Distress Responder begins to cry and shares a personal experience Overly involved in the person’s story Responder incorporates their distress into the situation Sympathy Responder states feeling sorry for her Doesn’t engage feelings Keeps distance Compassion Responder is a strong presence allowing nurse to express feelings Validates feelings Allows processing feelings out loud Nurse experiences death of beloved patient and is feeling remorseful that they couldn’t do more. Peer responder is called to provide support. Empathetic Response Let’s look at an example to help makes sense of these empathetic responses. Imagine a nurse experiences the death of a beloved patient. No mistakes were made, but it was a surprise. When the nurse talks with a peer responder, he describes feeling sad and remorseful because he wishes he could have done more for the patient. The peer responder has a few options of how they will respond. If they respond with sympathy they might say something like “That sounds like a hard situation, I hope it gets better for you.” That response acknowledges that the nurse is suffering, but does not really engage the feelings. If they respond with too much empathy or empathic distress they might begin crying themselves and say something like, “That sounds horrible. You must be devastated. It reminds me of when my favorite patient died.” Empathic distress gets over-involved in the person’s story and makes it also about the peer responder’s distress. If they respond with an empathic compassionate response they might say something like, “I am so sorry your favorite patient died. Can you tell me what you liked about her? Was there anything you did when taking care of her that you feel really good about?” This response acknowledges the feelings that are present and then invites the nurse to further process their feelings out loud. Remember, this intervention is intended to help reduce the suffering of the person in distress. ? Empathic Response Empathetic Response Dr. Tania Singer further explains the neural response associated with empathetic distress. This is an image of the f-MRI scan of someone feeling distress and pain. And this next image is the f-MRI scan of the person witnessing the pain with an empathetic distress response. The responders brain is illuminating the pain as if it's their own. This highlights the self focus and over identification responses associated with empathic distress. Clearly, empathic distress isn't the ideal response for the person in distress or the peer responder. ? Empathic Response Empathy + intention to help lead to: Empathetic Compassion Compassion ACTION results in compassionate satisfaction Improves self worth Feels meaningful Intrinsic award Empathetic Response As a RISE peer responder we encourage compassionate action. Showing up with empathy and an intention to help, will result in a response of empathetic compassion. Your intervention will be positive for the person in distress and, equally important, for you. Our responders regularly report that they continue working with RISE because of the positive intrinsic award. In fact, one of our responders at Johns Hopkins Hospital said, “ RISE has taught me more about being a human being than anything else in my life.” Empathic Action: Drop Here Physical Action: Drop Here Validation Remaining Calm Pain Reduction Safety Feeding Confidentiality Empathic Actions Physical Actions Think about physical and empathic actions. Drag each of the items below into the corresponding column. Empathic Response ? DRAG-AND-DROP Think about physical and empathic actions. Drag each of the physical actions and empathic actions to the corresponding columns and then select submit. One or more of the answers is incorrect. Incorrect Correct ? Examples Peer Support Examples of Peer Support Now let’s watch a brief example of a successful peer support encounter. There will be more examples coming in the following modules. Notice some physical changes indicating that our distressed colleague shifted back into her resilient zone. She took a breath. Her shoulders dropped, and she exhibited a soft smile. ? Examples Peer Support Examples of Peer Support ? Course Review Congratulations. You have completed the RISE Peer Responder Training: Module 2 course. Select the numbered buttons below to review the material before proceeding to the final assessment. Identify three forms of empathetic response Describe the RISE intervention workflow Outline stages of recovery following traumatic event 1 1 1 3 3 3 2 2 2 Define components of compassionate action 4 4 4 Course Review Congratulations! You have completed the 2nd module in RISE peer responder training. Select each of the numbered buttons on your screen to review the objectives before proceeding to the final assessment. Notes: Stages of Recovery Trauma research outlines six stages of recovery following a traumatic event. The order of stage presentation can vary person to person. As a RISE peer responder it’s important to be aware of these stages to help guide your intervention. Notes: RISE intervention The RISE intervention workflow begins with the initial phone call. The next steps include making the meeting plan and performing the intervention. The workflow concludes with a peer responder debriefing. Notes: Empathetic response There are three primary forms of empathetic response; empathetic distress, sympathy and compassion. One may not intentionally choose to respond a certain way. Understanding the differences between the types of response allows us to identify the benefits of a compassionate response. This form of response is best for both the person in distress and the responder. Notes: Compassionate action Compassionate action includes both physical and empathic actions. Physical actions focus on meeting one’s basic needs; warmth, safety etc. Empathic actions include showing up with kindness, listening, validating and respecting the person in distress. Select X to return to the course. Components of Compassionate Action Empathetic Response Select X to return to the course. Empathetic Distress Self-focused Empathy with no action Share in the suffering Over-identifying with one’s own story Creates negative feelings Sympathy Other focused Acknowledging suffering Pity Distant Self protective Compassion Other focused Motivated to reduce suffering Responds from place health Creates positive feelings Select X to return to the course. RISE Intervention Workflow Timely response In person vs. phone call Individual vs. group Time & place Provide appropriate support Support Learn Request for Support Make Plan to Meet RISE Intervention Debrief Stages of Recovery Select X to return to the course. Table with 2 columns and 1 rows Stage of Recovery Clinician Experience Table with 2 columns and 1 rows Chaos & Accident Response Internal & external turmoil Distracted: needs others to lead Table with 2 columns and 1 rows Intrusive Reflections Inadequacy Self-doubt/ loss of confidence Table with 2 columns and 1 rows Restoring Personal Integrity Unsupportive colleagues may intensify self-doubt Table with 2 columns and 1 rows Enduring the Inquisition Worries about job security/ licensure Possible litigation Table with 2 columns and 1 rows Obtaining Emotional First Aid Unsure whom is safe to confide in/ privacy concerns Don't want to expose others to pain Table with 2 columns and 1 rows Moving On Dropping out: change job/ leave profession Surviving Thriving Assessment This assessment will test your retention of the presented content. A passing score of 80% or higher is required to complete the course and earn your certificate . Assessment questions must be answered completely to receive full credit. Partial credit will not be given for assessment questions that require multiple answers. You may repeat the assessment as many times as needed. Start ? Assessment No Audio Select three (3) answers. Question 1 of 5 Which of the following are possible responses during the moving on stage of recovery? Dropping out Surviving Empathy Thriving ? ? Multiple Answer No Audio Incorrect One or more of the answers is incorrect. Correct First Request for support Second Make plan to meet Third Intervention Fourth Debrief Drag each response from the right column to its corresponding item in the left column. What is the correct order of steps for the RISE Workflow? ? ? Question 2 of 5 Matching Incorrect One or more answers are incorrect. Correct Select the best answer to complete the statement. ? self inner inner inner outer outer outer Question 3 of 5 Empathetic distress is a ________ focused response. other other other Fill in Blank Incorrect Outer focused response focuses outward. Incorrect Inner focused response focuses inward. Incorrect Other focused response targets someone else. Correct Select the best answer. ? ? Compassion Compassion Compassion Advice Sympathy Sympathy Sympathy Distress Distress Distress Question 4 of 5 Which empathetic response provides the most support for the person in distress and the peer responder? Multiple Choice Incorrect Advice is offering an opinion. Incorrect Incorrect Empathetic distress is self-focused. Incorrect Empathetic sympathy is self-protective. Select the best answer to complete the statement. ? ? validating feelings validating feelings validating feelings judging judging judging showing pity showing pity showing pity Question 5 of 5 Empathic compassionate actions include paying attention, ________, and maintaining confidentiality. reducing pain reducing pain reducing pain Fill in Blank Incorrect Pity is a feeling of sorrow. Incorrect Judging another can be harmful emotionally. Incorrect Reducing pain helps one feel better. Correct YOUR SCORE: PASSING SCORE: Review Review Review Retry Retry Retry Continue Continue Continue Continue %Quiz2.ScorePercent%% %Quiz2.PassPercent%% Assessment Results Select Print to print a copy of all of your typed answers throughout this course. Exiting the course will not save your responses. Select Continue to complete the course. Print Assessment Results Please select Print on your screen to print a copy of all typed answers throughout this module. Typed responses are not saved after exiting the course. After passing the assessment, select Continue to complete the module and access your certificate of completion. You did not pass the course. Take time to Review the assessment then select Retry to continue. Congratulations! You passed the course. Exit To access your Certificate of Completion, select the Certificates tab from the learning activity overview page. You can also access the certificate from your PEPconnect transcript. ? You have completed the RISE Peer Responder Training: Module 2 Online Training Completion No Audio Navigation Help Select the icon above to open the table of contents. Click Next to continue. Next Welcome Slide The timeline displays the slide progression. Slide the orange bar backwards to rewind the timeline. Click Next to continue. Next Tmeline Select the CC icon to display closed captioning (subtitles). Click Next to continue. Next Caption Icon Select the buttons to learn more about a topic. 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Assessment Slide Question Bank 1 HOOD05162003355572 | Effective Date: 21 May 2023 RISE Peer Resonder Toolkit 1.1 Disclaimer 1.2 Peer Responder Training: Module 2 1.3 Peer Responder Training Roadmap 1.4 Module 2 Objectives 1.5 Introduction to RISE Intervention 1.6 Role Play 1.8 Reflection: Emotional Support 1.9 Stages of Recovery 1.11 RISE Intervention Workflow 1.12 Intervention & Listening 1.13 Empathetic Response 1.18 Examples of Peer Support 1.20 Course Review 1.21 Assessment