Self-Care & Resilience for Direct Service Workers

Melissa Matheney (she/her)

Capacity Building & Training Development Manager

matheney@harmreduction.org

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DOPE PROJECT | 2025

National Harm Reduction Coalition creates spaces

for dialogue and action that help heal the harms caused

by racialized drug policies.

Policy & Advocacy

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National & Regional

Conferences

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Trainings &

Technical

Assistance

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Overdose

Prevention

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Resources &

Publications

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TABLE OF CONTENTS a

Workshop Overview�Introductions and Agenda�Housing Keeping

Understanding Stress�Types of Stress�Stress Responses

Burnout & Compassion Fatigue�Vicarious Trauma�Responsibility to Self

Practicing Care�Prevention

Care Tips

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Advocacy & Community Care�Advocacy and Care

Closing, Q&A

GROUP AGREEMENTS

Step Up, Step Back

Apply Non-Judgment

Use “I” Statements

Agree to Disagree

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Say it rough! ( But intent ≠ Impact)

Tech issues happen, just roll with them

We agree to learn from each other

Equal Opportunity to Learn!

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Any other Ground Rules you want to discuss?

ACTIVITY!

.STRESS SCALES.

STRESS SCALE

• Indicate your Stress Level on a scale from 0 ⇒ 10, where 0 is not STRESSED out at all and 10 is extremely STRESSED out:

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Where are you now?

What is contributing to this?

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SOCIAL SUPPORT SCALE

• Indicate your Social Support Level on a scale from 0 ⇒ 10, where 0 is not NOT SUPPORTED at all and 10 is extremely SUPPORTED.

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Where are you now?

What does your ideal social support look like? (i.e. peer support groups, PTO to create more time, childcare help, etc)

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SELF-CARE SCALE

• Indicate your Self Care Level on a scale from 0 ⇒ 10, where 0 is not practicing SELF CARE at all and 10 is incredibly SELF CARED:

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Where are you now?

What types of self care do you desire? (i.e. walks, hobbies, faith & spirituality)

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Understanding Stress

THE IMPACT OF STRESS ON

“HELPING PROFESSIONALS”

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STRESS

LONG TERM (CHRONIC)

RESILIENCE

SHORT TERM

COMPASSION FATIGUE

BURNOUT

COMPASSION SATISFACTION

STRESSORS FOR DIRECT SERVICE WORKERS

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Lived experience IS the job description

Re-exposure to trauma, loss & grief

“Tokenism”: Diversity without inclusion

Workplace safety

Cultures of scarcity (Never enough of anything)

Poor and unfair Pay

Lack of transparency around policies

Turnover and lack of training

What else?

Hidden Stressors in Harm Reduction

• Bearing witness to mass loss of life
• Institutional restrictions and injustices
• Personal morals/ethics/values vs. Professional
• For peers: The job IS the life lived, professional guardrails don’t always apply
• “Thrivers Guilt”: Having access to resources and knowing other peers and colleagues may be facing incredibly hostile conditions doing the same work

What are YOUR Stress Responses?

• How do YOU typically respond to stress?
• Fight/Flight, physical, mental, emotional impacts

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• Do you notice a difference in your stress response at work vs. home?

Burnout & Compassion Fatigue

WHAT ARE SOME WAYS CARING ABOUT YOUR CLIENTS AND WORK CAN IMPACT YOU?

Burnout

exhaustion resulting from the combination of mental, emotional, and physical stress.

the stress you experience from seeing people suffering, from seeing the failures of the system, and potentially from being retraumatized at work.

Compassion Fatigue

BURNOUT

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COMPASSION FATIGUE

More Gradual

Affects view of workplace

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Can be related to all aspects of life, not just work

Related to systems and institutions

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Isolation

from others

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Mental, physical, emotional exhaustion

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Reduced sense of meaning or accomplishment in work setting

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Burnout and CF can occur together, or separately

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Quicker Onset

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Feelings of meaningless, hopelessness

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Reduced ability to feel sympathy and empathy

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Shares aspects of PTSD

Warning Signs

• Every day is a bad day.
• You’re starting to feel that some folks are not “deserving” or “earning” care or services.
• Client interactions are impacting your self-worth and esteem.
• Caring about your work or home life seems like a total waste of energy.
• You’re exhausted all the time.
• The majority of your day is spent on tasks you find either mind-numbingly dull or overwhelming.
• You feel like nothing you do makes a difference or is appreciated.
• You’re having new troubles sleeping, or an increase in health issues.

Workplace Symptoms of Burnout & Secondary Trauma

Be on Look Out for…

Behavioral

Interpersonal

Personal Values/Beliefs

Job Performance

• Staff conflict
• Blaming others
• Impatience
• Lack of collaboration
• Change in staff relationships

• Tardiness/absence
• Irritability
• Exhaustion
• Reactivity

• Dissatisfaction
• Apathy
• Hopelessness
• Detachment
• Lack of appreciation

• Low motivation
• Increased errors
• Decreased quality
• Avoidance of responsibilities
• Avoidance of participants

Personal Symptoms of Burnout & Secondary Trauma (What others won’t see)

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Behavioral

Physical

Cognitive

Emotional

• Panic
• Aches and pains
• Weakened immune system
• GI issues

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• Sleep disturbance
• Nightmares
• Hypervigilance
• Self-harm behaviors

• Minimizing VT
• Lowered self-esteem
• Perfectionism
• Racing thoughts
• Thoughts of harming self or others

• Helplessness
• Survivor’s guilt
• Numbness
• Fear
• Anxiety
• Apathy
• Anger

Emotional

• Withdrawn and isolation
• Loneliness
• Distrust
• Projection of shame/blame
• Decreased interest in relationships

Prevention Strategies

• Take time to think about your relationship with work- what are some things you already do to soothe work related stress? Can you make intentional time for those things?
• Set boundaries: on how much and when you will work, on what work you will say no to, on how accessible you are
• Recognize your support systems and rely on them!
• Does your workplace have available support beyond supervision?

Practicing Care

Self Regulation: Self Control/Discipline/Willpower

• Emotions: Ability to calm yourself down, cheer yourself up
• What feelings are you aware of?

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• Behavior: Ability to act in your best interest, consistent with your values
• Self awareness of values, boundaries, understanding of risk/consequences to actions

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• Know your emotions = know your motivation for behavior
• “I need to, I have to, I should….” vs “I want to”

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Self Care is NOT:

• Something that serves as a reward or has to be “earned”
• Self care isn’t JUST for the difficult days

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• An act of selfishness or over-indulgence

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• Something that causes harm to another person

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• Something that comes naturally to all people
• It may feel forced at first or uncomfortable

WHAT ARE SOME TECHNIQUES YOU USE TO MANAGE STRESS AND TAKE CARE OF YOURSELF?

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Care to Treat/Prevent Burnout

Evidence-Based Approaches

• Assess your self-care resources
• Professional supports and training, work/life balance, mental health strategies

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• Change the way you think about work
• Reflect on successes, know strengths/weaknesses, consistent self check-ins & have an accountability buddy (someone you trust)
• Know when to pivot- maybe another population, location or type of work for a period of time

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• Physical activity
• Cardiovascular and resistance strength training is effective

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Preventing and Treating Burnout

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• Social support
• Frequent check-ins with mentors, colleagues, family, friends, etc.
• Organize
• Advocacy work, “move beyond outrage to constructive action”
• Consider unplugging
• Reduce time on phones, social media, computer, etc.
• Mindfulness (meditation, breathwork, walking, etc.)

Care Tips

• Take that extra few minutes for yourself

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• Hydrate and nourish your body regularly- stop working through your work/lunch breaks!

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• Re-engage in rituals or practices that may have brought you comfort in the past

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• Learn a new skill, or engage in a new hobby that is NOT related to your work

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• Post-its or phone reminders to “press pause” or take a walk

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On Rest and Self Care…

• It is NOT resting if you are ruminating about all the things you “should” be doing
• Remember you can start the day over at any time

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• Resting is NOT quitting. It IS: Refueling, Restoring, Regrouping, Redirecting, ReWiring

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• Glorifying pushing past our actual bandwidth is a toxic societal trait we need to evolve out of

Dr. Jen Wolkin, neuropsychologist

Advocacy and Community Care

ADVOCATING FOR OURSELVES & OTHERS

• Organizing with coworkers to advocate for safer staffing numbers
• Collaborating with clients to advocate for client needs
• Organizing across departments for agency-wide changes
• I.e: more paid time off, training, etc.
• Organizing across agencies to advocate for systemic change
• Creating spaces for peer supports amongst staff
• I.e: case managers being able to meet without upper management to be able to discuss unique needs and issues to their roles
• Feeling empowered to voice personal needs and accommodations
• I.e: not feeling guilty when requesting time off
• Self-advocacy is not selfish!
• Centering care for the self and one another to increase resilience

HOW ARE SELF CARE AND COMMUNITY CARE CONNECTED?

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Care Network Mapping

Think through who is in your network of care- who can you rely on for emotional support and who can rely on you for emotional support?

In a professional setting?- supervisors, colleagues. Do you have clinical supervision and/or group supervision?

Interpersonally? - family, friends, partners. Do you see a counselor or therapist?

Care Network Mapping

YOU

Where can you look for outside support if this Isn't enough?

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Examples: accountability peer group, coaching, support groups, etc.

Individual people in your support network

4 Steps to Low-Impact Debriefs

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• Increase self awareness:
• What details do I need to share? What am I looking for?
• Fair warning
• What would I say to someone if I was sharing bad news? Can we speak somewhere private? I’ve got some bad news…
• Consent
• I need to debrief with you. Is now a good time?
• Limited disclosure - Headlines not details (initially)
• Start with the outer circle of your story and as you move in, decide how much of the graphic details you need to include.
• Tell people upfront what happened (i.e: is this person ok?)

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Low Impact Debriefing Toolkit

TAKE HOME MESSAGE

Self-care doesn’t come natural for everyone

Know/develop your boundaries surrounding work

Taking care of ourselves = taking care of eachother

Self-care takes practice

THANK YOU FOR ATTENDING THIS WORKSHOP

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Copyright 2025 National Harm Reduction Coalition