We recently sat down with Dr Cathy Kezelman AM, President of the Blue Knot Foundation, as she looks into the key issues that the Government needs to be aware of to ensure the wellbeing of their staff. She will be presenting at the upcoming 6th Annual Government Law Conference 2020 on Wednesday 11 March, where she will delving into how Government lawyers can safeguard their wellbeing in challenging times.
What are some of the key issues for Government to ensure the wellbeing of staff?
These are challenging times politically not just in Australia but also globally. It is a time of escalating stress as the pace of daily life speeds up and technology arguably offers as many challenges as it does opportunities. It can also be a time of uncertainty with job changes and restructures as government seeks to respond to the rapid pace of change externally, and tight fiscal times.
Change is challenging for us all and the uncertainty which accompanies change can impact the health and wellbeing of staff within government. The environment of uncertainty together with that of time pressure and budget demands is one of escalating stress. While work/life balance has always been somewhat elusive in many work roles, in the current day, despite flexible work practices, many people find balance difficult to sustain. The ability to achieve it depends on not only the individual and their attention to their own self-care but also to team and organisational culture. With changing environments and constantly changing teams and culture it can be hard for staff to know where to turn if they find their sense of wellbeing is waning.
What is not being understood about stress and trauma and its impacts on government staff if left unmanaged?
Research (neuroscience) helps us understand how stress affects our body and brain. When we are in danger or think we are, our body switches to automatic. Our thinking brain switches off and our stress response takes over. Our stress response is a survival response. It is part of our biology. It helps us survive danger. It is innate – biologically ‘built in’ and happens outside of our conscious awareness.
When responses are innate, we do not intend them. They simply ‘cannot be helped’. We survive in one of three main ways. We fight, we run away (flee) or we freeze (shut down). When we are in fight or flight, we become agitated (on high alert). We call this hyperarousal. When we freeze, we shut down, go numb or dissociate (i.e. we disconnect from our current experience – this is not conscious). We call this hypoarousal. When the danger passes, our thinking brain turns back on. Our body becomes calm. We return to a resting state. In the resting state we can repair. This happens with everyday stress.
Trauma is different. For people with trauma histories, or when are in danger, (or think we are), the stress response stays turned on. Our body and brain are flooded with stress hormones e.g. adrenaline and cortisol. When this happens, we stay in survival mode. It means that we can’t readily return to a calm state of repair. What’s more we can be triggered into this response – by cues in the environment. These can be sensory cues i.e. stimuli which activate one of our 5 senses – smell, touch, sight, hearing, taste or something which reminds us of prior trauma. Often the trigger is not obvious.
In uncertain times, and times of change and challenge there are lots of triggers for many of us, including a felt sense of danger, threat and powerlessness. This can mean we are anxious and on edge or shut down at other times. It can be hard for us to manage often strong emotions and the effects they have on our equilibrium and relationships.
What are the growing risks and trends for government with staff burnout and increase incidents of vicarious trauma?
Vicarious trauma is a risk for anyone who is exposed to trauma material or with people with trauma experiences. It is not a matter of personal weakness. It is to be expected. The effects of vicarious trauma are similar to those of Post-traumatic stress disorder (PTSD). This can include intrusive symptoms e.g. flashbacks, nightmares; constrictive symptoms e.g. numbing and dissociation and avoidance (of people or prior trauma). It also can include changes in thoughts (cognitions) as well as a disruption of core beliefs and a person’s world view. Vicarious trauma can also affect a person’s feelings of safety, trust, self-esteem, meaning and hope as well as their relationships.
Vicarious trauma develops as a result of exposure to traumatic material over time. While it develops only because of exposure to traumatic material, it can be affected by other factors. These include a person’s work context and workload, their existing coping strategies and different factors in the service or system in which they work. The main challenge with vicarious trauma is recognising and managing it. It is progressively being seen as a Work Health and Safety issue.
Workers who have supported traumatised people can grow beyond the trauma and develop a renewed identity, world view and priorities. Acknowledging and embracing the impact of VT or other impacts can become a source of resilience.
Burnout is different. It can be experienced by any worker in any workplace. It is not about working with trauma material. Rather it reflects the general stressors in the workplace (Brown, 2009). Burnout presents as physical and emotional exhaustion. Compassion fatigue is the emotional impact of helping others. This can happen without trauma exposure e.g. aged care workers. This used to be called secondary traumatic stress.
It is hard to know whether there is an increase in burnout and vicarious trauma in the workplace or whether it is about greater recognition. In respect to both burnout and vicarious trauma the important thing is to be aware of the issues, recognise them early and implement strategies to mitigate them. They both don’t only affect worker wellbeing but also productivity and job satisfaction and longevity.
Are there any specific strategies that can be implemented by government departments to counteract the impacts in the workplace?
All government departments need to invest in the health and wellbeing of their staff. This means that there needs to be clarity of roles and responsibilities, open and transparent communication around change and reasonable expectations around workload. It is also important to vary work tasks especially for people who are dealing with trauma material. Variety as well as scheduled breaks are important. So too are robust feedback mechanisms in the spirit of open collaboration and team cohesion.
The culture is important too. This means a culture in which there is an openness to hearing of staff members who might be struggling with their workload or the nature of their work. It means having teams which invest in wellbeing practices and provide support to those who are feeling impacted. It is important for government departments to invest in ongoing trauma-informed and vicarious trauma training. Workshopping the strategies needed, putting wellbeing plans in place and building in support structures, including formal and informal debriefing, mentoring and supervision are critical. These are OH& S issues and emotional and physical health and wellbeing are no longer just the responsibility of the worker and their daily self-care plan. It is about systems change and a culture of flexible receptive work practices for all.
Dr Cathy Kezelman, AM, is a medical practitioner, President of the Blue Knot Foundation – National Centre of Excellence for Complex Trauma; prior member of Independent Advisory Council on Redress; member of the Mental Health Community Advisory Council (NSW), member of NSW Standing Committee of Child Safety. Cathy worked in medical practice for 20 years, mostly as a GP. Under her stewardship over 15 years, Blue Knot Foundation has grown from a peer support organisation to a leading national organisation combining a prominent consumer voice with that of researchers, academics and clinicians advocating for socio-political change and informed responsiveness to complex trauma. She is a prominent voice in the media and at conferences, as well as author of a memoir chronicling her journey of recovery from child sexual abuse: Innocence Revisited- a tale in parts. She is co-author of multiple publications including the seminal Blue Knot Foundation document – Practice Guidelines for Treatment of Complex trauma and Trauma Informed Care and Service Delivery and Trauma and the Law – Applying Trauma-informed Practice to Legal and Judicial Contexts. On Australia Day 2015 Cathy was awarded an AM “for significant service to community health as a supporter and advocate for survivors of child abuse”. Contact Cathy at ckezelman@blueknot.org.au or connect via LinkedIn 
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You can also connect with the Blue Knot Foundation via Facebook 
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