MODULE

DEVELOPING SELF AWARENESS

& SELF CARE
10

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 MODULE 10 DEVELOPING SELF AWARENESS & SELF CARE

Introduction
In this module, case managers will examine their own attitudes and perceptions to explore ways in
which they can bring helping attitudes to their work, and ways to motivate and encourage clients. Case
managers will have an opportunity to further develop self-awareness and skills needed to work effectively
and appropriately with a diverse group of people, from different cultures, professions, religions, and
nationalities.

Learning Objectives
The learning objectives for this module are:
• Learn ways to motivate and encourage clients
• Emphasize the importance of cultural competence
• Develop further skills in working with a diverse group of people, from different cultures, professions,
religions, and nationalities
• Know how to recognize physical, emotions, cognitive, and behavioral signs of experiencing stress
• Understand ways for managing stress, self-help techniques, supervision, and support

Expected competencies
By the end of this module participants will:
• Reflect on the attitudes, biases, and perceptions they bring to their work
• Have developed skills in being non-judgmental, motivating, and encouraging
• Have developed further skills in working with, and communicating with, a diverse group of people
Insert Observation Check List Here

Module Timings
Estimated preparation time for trainer: 0.5 hour
Estimated Module Session time: 3 hours (1.5hr core content, 1.5 hr exercises)

Module Assessment
The following competencies will be assessed in module tests:
• Reflecting on the attitudes, biases, and perceptions they bring to their work
• Have developed skills in being non-judgmental, motivating, and encouraging
• Have developed further skills in working with, and communicating with, a diverse group of people,
from different cultural groups
• Be able to identify signs of stress
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MODULE 10 DEVELOPING SELF AWARENESS & SELF CARE

Helping attitudes
Being non-judgmental
Motivating and encouraging clients
Understand cultural competency
Culturally-sensitive communication
Challenges of Case Management work and Sources of Workplace Stress

Attitudes and Helping Relationships

Attitudes are extremely important. The feelings that you have about other people can be communicated
through your attitude, without you explicitly expressing them. Often we have own personal barriers related
to working with “difficult” groups. It is important to think about what it is that we as professionals find
hard, rather than blaming the client’s behaviors. Negative attitudes may stem from such issues as fear of
violence, a previous negative experience, lack of knowledge, aversion to a client's appearance or behavior,
or our own weaknesses 1. Therefore, it is essential to learn about yourself, your fears, sensitivities, and
judgments. Some basic “helping attitudes,” or attitudes that will have a positive influence, which you will
need to bring to your work are: warmth, genuineness, and empathy.
Through an attitude of warmth, you communicate to your client that you will work with them to understand
their needs. Warmth helps you demonstrate that you respect the client’s right to make their own decisions
and that you will respect the decisions they make. And, through the rapport that is built when you express
an attitude of warmth, you may have the opportunity to work with the client to make better decisions than
the ones they might have made alone.
Genuineness is vital to case management work. Having an attitude of genuineness means that you “be
yourself” and are authentic. It means that you correct clients’ assumptions and impressions of you when
they are not helpful (e.g., if the client refers to you as “doctor”). In order to enforce your genuineness, use
normal, conversational language: don’t use big or technical words the client does not understand and
don’t use slang to try to sound more authentic. Finally, if you do not know something, say so.
Empathy is the ability to “put yourself in another person’s shoes” or see things from their perspective.
Empathy is a way of working, an approach or strategy which is reflected in your actions

2 1 Alberti, R., & Emmons, M.L. (1986). Your perfect right. San Luis Obispo, CA: Impact.
and your words 2. It is a means of supporting people through difficult times. Empathy is not sympathy—
sympathy is a common feeling we have for others in pain. Empathy includes the ability to communicate
to a person that you understand their underlying emotions. It is assessing where the client is at any given
moment and being able to express that and support it.

Group Discussion
What other helping attitudes can you name which you feel are valuable in your role as case manager?

Helping Relationships

Activity#1. Helping relationships: Small Group Exercise

Helping relationships are important in case management because they form the main tool in the practice of
social work. It is the relationship that social workers have with clients that helps the clients to help themselves.
One of the things that social workers do is to help clients feel comfortable receiving help from them.
There are many factors that influence the helping relationship. Have the participants gather in pairs or
small groups and then ask the following questions and record on a flipchart:
• When you have a problem that you cannot manage on your own, what do you do? Who do you go
to? Where do you go?
• When would you seek help from a case manager? What are the types of things that stop people from
seeking professional help?
Earlier we explored the ethics and principles of our relationships with, and responsibilities to, our clients.
As professionals, we must reflect on our own attitudes and behaviors in order to explore what it means to
help a client as a case manager, how helping a client differs from helping a family member or friend, and
to clarify what a helping relationship looks like. As case managers, we have no control over changing a
client’s behavior but we can look at the things that we do and how we can change our thinking and work
practices to make things easier.

Activity#2. Understanding challenging clients

Group Exercise
Divide participants into groups and have them work together to organize the cards in the order they
consider to be the most difficult person(s) to work with to the least difficult. This may be difficult because
not everyone in the group may agree on the difficulty level of each client.
Discussion:
What can we do as case managers to overcome these personal barriers?
Prompt: work hard on developing a non-judgmental attitude. The aim of this activity is building confidence
and thinking through strategies to help cope better with demands both personally and professionally.

2 Maslach,C. (1978). Job burnout: How people cope. Public Welfare, 36, 56-58.
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Place the below descriptions on separate note cards ready to hand out to participants.
Elderly person with dementia Elderly person with incontinence Male survivor of rape
Orphan Child abuser Drug abuser
Person with schizophrenia Young offender Teenage pregnant girl
Abused child Terminally ill child Murder
Rapist Homeless person Female survivor of rape
Person with depression Single mother Suicidal person
Sex worker Person living with HIV Autistic child

Being Non-Judgmental
The nature case managers’ work means that many of the people they see may be feeling discouraged at
the time in their lives when they need case management services the most. People may feel discouraged
because they are overwhelmed, or unable to take responsibility for their situations, or find it difficult to
discuss their problems or focus on solutions. They may have low regard for their own capabilities and
strength to cope and solve their problems 3.
It is important that you, their case manager, are non-judgmental and encouraging, and that these attitudes
are genuine. These attitudes should be reflected in the language you use with clients and the relationship
you build to plan and manage their care with them.

Activity#3. Being non-judgemental

Exercise
Amal refuses to work with the mother of one of her child clients. She claims that she is disgusted by the
condition that the child is kept in and expresses her concerns to her supervisor and colleauges she works
with in the clinic stating that the mom is “dirty” and “her house is dirty”. She is seen talking to the mom in
a sharp tone and seems annoyed when mom is running late for appointments.

1) What are some different ways this situation can be approached?

2) Think of at least three things that may help mom, and the case manager, feel more supported.

Activity#4. Discrimination
Exercise
This exercise looks at the discrimination that some client groups often face in society. If we understand
the oppression they face we can start to understand better how we need to work with them. Split the
participants into three groups:
Group 1 – Will look at unmarried mothers
Group 2 – Will look at people with physical and/or mental disabilities
Group 3 – Will look at people who use drugs

4 3 Maslach,C. (1978). Job burnout: How people cope. Public Welfare, 36, 56-58.
 Distribute flip chart paper to each group and ask the participants to write down as many things as
possible about how general society perceives this group of people. Make sure the groups fill their flip chart
paper. Give 10 minutes. If necessary prompt the groups:
• How does society perceive this group’s behavior?
• What kind of outcomes in terms of work or education does society think these people should have/
do have?
• Are they seen as victims or aggressors?
• What kind of relationships/ families/ children are they perceived as having?
• Are they seen as having a positive or negative influence on society?
Groups may not want to write down the negative way that these groups are thought of in society but
it is crucial for the whole exercise that these negative things are recorded. Remind them it is not what
they personally think but how marginalized groups are thought about and treated by society in general. If
people are not writing down negative perceptions to give groups examples:
• Unmarried mothers are disowned by their own families, seen as immoral; labeled as deviants
• Drug users are labeled as deviants or failures; people are frightened and label them as criminals, take
up valuable medical resources.
• Disabled people are excluded from society and put in institutions, are unemployed, pitied, take up
valuable medical resources, and discouraged from sexual relationships and having children.
Once the groups have filled their flipcharts, bring them back together as a whole group and ask them to
feedback their ideas.

Motivating and Encouraging Clients

These are some ways in which case managers can motivate and encourage clients, and each of
these issues has been covered in depth in earlier modules of this training. The better you understand
these, and the better you are at practicing them in your work, the more effective you can be as a
case manager.
Begin where the client is: As a case manager, you may be the first person to really listen to the clients
entering the system. Use this opportunity to bring acceptance and understanding to the way things
are now. Accept your clients exactly as they are at the moment they first see you, without judgment.
To provide useful assistance to clients and encourage them to grow into their true potential, you must
start where they are, not where you think they should be.
Use effective communication skills: Attending behavior and active listening are the acts of placing
our full attention with the other person to not only listen, but to also show that we are listening.
This behavior allows others to “see your empathy”, as you are present with others physically and
psychologically. Attending behavior can help encourage someone to speak with you, and allows the
person to feel that you are listening 4.

4 Anderson, D.G. (2000). Coping strategies and burnout among veteran child protection workers. Child Abuse and Neglect, 24(6), 8390848.
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Collaborate: When we encourage people to try something or move away from a difficult or unhealthy
situation, we need to work with them in collaboration to find the best way for the client to do this. Where
case managers collaborate with clients to determine their priority needs. Talk to the client about what “we”
can do or how “we” can look at this differently. Ask the client if they would be willing to consider certain
approaches or solutions and ask what solutions they may have thought of.
Applying a strengths-based approach: Using a strengths-based approach, case managers identify not
only issues and concerns that need attention first, but also the strengths, support and other resources
clients have in themselves and in the community. By understanding both components, case managers are
more likely to know where clients will do well, what interests them most, and how they can best achieve
their goals. As emphasized throughout this course, a strengths-based approach is fundamental to the IMC
case management model of health and protection. In this wide spectrum of abilities and needs, a good
case manager will see the strengths of each individual client and work hard to help the client maximize
and take pride in those strengths. Case managers should focus on the attitudes they bring to your work
by asking themselves:
Do I view people as capable?
• Do I approach clients people in a way that demonstrates that I ultimately want them to, and believe
they can, take responsibility for their lives?
• Can I accept that some clients can grow into full independence and others will always need some
degree of help?
Understand protective factors, existing resources, and support systems: It is important to emphasize
the informal resources and natural support systems for a client; that is, the supports offered by their
communities, such as extended families or community centers. Case managers need to know what
resources are there for common problems we all have. Clients’ wellbeing is generally enhanced through
remaining close to the people and communities where they have established relationships and where
natural support systems are in place 5.
Remain hopeful and encouraging: Be accepting and empathetic. Work at your client’s pace, and appreciate
the significance of all their efforts. Verbally recognize the client’s strengths using positive feedback and
show confidence in them. Keep your sense of humor. Focus on the efforts not the results by showing your
client that the attempt to grow and change is more important to you than whether or not it worked. Point
out that the attempt gave valuable experience or information and that it creates a basis for improving.
Celebrate success.
Motivational Interviewing: Motivational Interviewing is a client-centered technique that is directive at the
same time. It does not attempt to force people to change, but it helps to draw out the internal motivation the
person already has. It is concerned with the person’s own perspective, but does not just involve following
the person, it moves them along in the direction of change. While conducting this type of intervention, it is
important to remember to be respectful of the person’s thoughts and opinions.

6 5 Rapp, A. Charles (1998). The Strenghts Model. Case Management with People Suffering from Severe and Persistent Mental Illness, 76-81.
Accurately assess the client’s reluctance: A client may not follow through on projects or goals the two of
you set together. The reason may have more to do with the projects/goals than with the client. It may be
that the two of you set a goal that is too complicated for now. Perhaps the goal looked safe when the
client sat with you in the office, but now it looks terrifying. Explore this with your client. Do not assume
clients who do not follow through are being obstinate or uncooperative. Seek to understand how real the
obstacles are for clients.
Never lose sight of potential: Focus on clients’ potential. You know about their deficits, so do they. Clients
have less confidence in their potential for change and growth. Look at a clients’ history of strengths, their
past experiences, and their accomplishments, however small 6.

Figure#1. Encouraging and discouraging attitudes and behaviors

A PERSON WHO IS ENCOURAGING A PERSON WHO IS DISCOURAGING

• Says you can • Says you can’t

• Helps clients to do their best • Wants clients to compete
• Helps clients look for the best in life • Tells clients life is unfair
• Believes others are capable • Believes he or she is more capable than the person he
• Talks directly to people or she is helping
• Is supportive of others • Talks down to people
• Is enthusiastic about others • Is critical of others
• Is interested in the smallest accomplishments • Is reluctant and wary of others
• Helps clients set realistic expectations • Is interested in the smallest mistakes
• Sees resources and strengths in clients • Has unrealistic expectations for clients and gives up
• Let clients develop their own personal standards • Sees mainly weaknesses and incompetence in clients
• Believes people can improve • Believes people never change

Cultural Competency
Cultural diversity
As case managers, we think of culture in a broad sense, focusing not only on race or ethnicity, but also
on gender, history, sexuality, social-economic status, religion, and many other areas that people typically
don’t consider. We will be framing culture in these broad terms.

6 Anderson, D.G. (2000). Coping strategies and burnout among veteran child protection workers. Child Abuse and Neglect, 24(6), 8390848. 7
Activity#5. What does cultural diversity mean?
Group Discussion
Ask the group if they can think of words that best describe or define cultural diversity.
List answers on flipchart.
Suggested that a simple way of thinking of “culture” or “diversity” is to think: ”People Differences”. Taking
the People Differences view helps us to remember that culture is an important issue with everyone we
work with: families, co-workers, and other professionals.
Group Exercise
Draw two columns on a flip chart. Label one side “Groups by Birth,” the other side, “Groups by Choice.”
Have participants name groups that people belong to by birth and then groups people belong to by
choice.
List these on the board as people call them out.
Belonging to these groups, and your experiences in these groups, contributes to the formation of your
culture.
Just because we belong to the same family or the same race or ethnic background doesn’t mean we
have everything in common with everyone else in that culture.
Ask participants to think back to when they were teens themselves.
Did they always value the same things as the other members of their family?
Did they share all of the same traits and experiences?
Even members of the same family have different cultures.

Cultural Competency
Cultural Competency is the ability to understand the client within their own cultural context, yet at the same
time, see them as individuals that may or may not operate within that cultural context. One must consider the
individual, the family, the community, and the society when thinking of culture. Cultural Competency is the
essence of best practice.
This broad manner of looking at culture recognizes that each individual / family / community / society has its
own unique experience of culture. While this concept sounds logical and appears easy, it is often overlooked in
assessment and intervention planning.
Our natural tendency is to do what’s comfortable for us and to operate based on what we would do in our own culture.
There are two generally accepted definitions of prejudice:

The common, narrow definition: Irrational suspicion or hatred of a particular group, race, or religion. It generally
implies inferiority of the group and leads to misunderstanding and miscommunication.
A more broad definition: A bias or preference.
The primary reason for using this broad definition is that it opens the door for discussion. We all have biases,
and using the broader definition makes it easier to admit. Taking this approach moves the discussion away from

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“No, I am not prejudiced; I treat everyone the same.” Once people can admit they do have biases, it makes
it easier for them to be aware of when they are letting their biases affect their behaviors 7.
What are stereotypes? Exaggerated beliefs about a person or group that are held and sustained by selective
perception and selective forgetting.

Where do stereotypes come from?

• Incomplete or distorted information
• Limited personal experiences
• Outside sources such as others’ interpretations of behavior
Stereotyping is common, but often destructive because it is often unfair, does not allow for individuality, and
interferes with communication.
Addressing the thoughts in our heads about bias, prejudice, and stereotypes is crucial because a thought
precedes a feeling, which precedes a behavior. Until we become aware of the thoughts in our heads, we will be
unable to alter the behaviors that occur because of the stereotypes that exist in our heads.

Discussion
Do you need to be expert on a culture before you can work with someone of that culture?

Personal Culture and Cultural Difference

The best way to become comfortable about cultural differences is to begin by thinking about personal culture.
By being proud of your culture and being comfortable enough to educate others about your culture, you open
yourself up to be receptive of the same from others. The purpose of the next activity is to get us comfortable
with sharing and learning about each other’s cultures.

It is an opportunity to teach one another about our personal cultures. However, be mindful that the information
is not to be taken and generalized to everyone else that happens to share that attribute, since situations vary
from person to person – “people differences”. Generalizing the information to everyone else they encounter
who has that attribute is still stereotyping: failing to value and recognize differences.

We rarely discuss issues of prejudice and difference because it’s uncomfortable. We tiptoe around the issues,
we make false assumptions, we stereotype, and we have cultural clashes because we are operating from
erroneous or false information. The goal is to make this discussion about differences a comfortable one,
something that people can feel safe in talking about.

This exercise allows us to see that just as we are bothered when others stereotype us or make false assumptions
about us because of a group we belong to; the clients we work with will have similar feelings when they are
stereotyped. The only way to know about another person’s culture is to ask and for them to tell you.

7 Alberti, R., & Emmons, M.L. (1986). Your perfect right. San Luis Obispo, CA: Impact. 9
Culturally Sensitive Communication
Accepted communication strategies and behaviors can vary from culture to culture. For example, e.g.
touching (hand-shaking), eye contact, sitting position.

It is important for case managers to be aware of what is acceptable and appropriate for the clients and
families and communities we work with. Often we will need to adapt the ways in which we relate and
communicate with people of different cultures, to show respect, and to create a comfortable environment
in which we can listen and work with the issues and challenges our clients have brought to us.

Activity#6. Group Discussion

What are some practical ways in which we might need to adapt the ways in which we relate and
communication with clients, families, and communities?
Flipchart:
Encourage participants to share their knowledge and experiences of what works well and what to
avoid.
Dress:
• Do I need to dress a certain way to be respectful?
• Will impacted people be in need of certain clothing items to keep their dignity and customs?
Language: What is the customary way of greeting people in this culture?
• What language impacts people to speak?
Gender, Age, and Power: Should women only be approached by women helpers?
• Who may I approach (e.g. head of family, head of community)
Touching and Behavior: What are the usual customs around touching people?
• Is it acceptable to hold someone’s hand or touch their shoulder?
• Are there special considerations for behavior with the elderly, children, women, or others?
Beliefs and Religion: What are the different ethnic and religious groups among affected people?
• What beliefs or practices are important to the impacted people?
• How might they understand or explain what has happened?

Challenges of Case Management work and Sources of Workplace Stress 8

This section is drawn heavily from the Terre des Hommes and can be located at http://www.tdh.ch/en.
Many thanks to the team who assisted us in completing this project.

10 8 adapted from tdH p97 & Romania p75

Recognizing stress and burnout
Stress can be broadly defined as a “set of biological and psychic disturbances caused by any aggression
on an organism.” But it is a complex phenomenon, with many different definitions; its symptoms vary from
one individual to another, as do perceptions of stressful situations. Some people can get more stressed
than others, and we can not judge people who get more stressed than others – the important thing is for
each person to find his or her own efficient and appropriate response in order to cope with stress.
Stress management is different for everyone, and by exploring what case managers find difficult about
their work and encouraging them to find solutions to stress, we are helping them to be happy in their work
and to be more effective.

Activity#7. Recognizing stress

Group Exercise
Show slides and read to group:
For the past month, Tareq’s manager has forced him to come into work every day, including
weekends. Tareq is overwhelmed with tasks and is making up for the shortcomings of others in his
office. When he comes home, his children want to spend time with him, but he is too exhausted and
is easily irritated by them. He has trouble sleeping and often wakes up in the middle of the night,
thinking about what needs to be accomplished the next day.
Show question and ask:
What kinds of problems does Tareq have?
Expect answers to include:
1
2
3

Activity#8. Identifying own stresses in case manager role

Small Group Exercise
In groups of three to five participants, discuss:
What are sources of stress that people in your role may experience?
What makes your work difficult?
Choose one person to report back to the group.
Identifying Signs of Experiencing Stress

Activity#9. What are your own signs of experiencing stress?

Individual Exercise
Ask participants to note their own signs of experiencing stress and show table below.
Ask participants: How do you know you are stressed? What are the signs that let you know you are
experiencing stress? Think of physical, emotional, cognitive, and behavioral indicators.

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Figure#2. Stress reactions
PHYSICAL EMOTIONAL
• Sleep disturbances • Mood swings
• Changes in appetite • Feeling "over emotional"
• Stomach upsets • Irritability
• Rapid heart rate • Anger
• Fatigue • Depression
• Muscle tremors and tension
• Anxiety
• Back and neck pain
• Emotional numbness
• Headaches
• Discouragement and loss of hope
• Inability to relax and rest
• Being easily startled • Alienation and loss of sense of connection

COGNITIVE BEHAVIORAL
• Poor concentration • Risk taking (such as driving recklessly)
• Over-eating or under-eating
• Confustion and disorganized thoughts • Increased smoking
• Forgetfulness • Listlessness
• Hyper-alertness
• Difficulty making decisions
• Aggression and verbal outbursts
• Dreams or nightmares • Alcohol and/or drug use
• Intrusive thoughts • Compulsive behavior (e.g., nervous tics and pacing)
• Withdrawl/isolation
• Cynicism
• Promiscuity

Workers who are burned out are likely to be unsafe and ineffective in their professional roles. They may
have become cynical, for example they may have lost their belief that people are basically good, and begun
to feel they can have little impact on changing the world. They may lose hope in the system and in the
effectiveness of the caring and the interventions they advocate and manage. They may experience such
discomfort and anxiety that they feel incompetent. They may dread hearing about client’s needs, problems,
and the graphic details of awful events. They may protect themselves by avoiding listening to clients and
resort to changing the subject and minimizing clients’ stories and feelings to protect themselves. The
effects of burnout will likely extend beyond job performance, to interpersonal relationships and emotional
wellbeing.
Managing stress and avoiding burnout
The reality is that case management work is sometimes unenjoyable. You have many cases, short time
frames, and clients with difficult challenges and who have had upsetting and harmful experiences which
they need you to listen to and help them cope with. Therefore it is important to be honest with yourself
and your supervisors about what you can cope with, what you find stressful, and ways you can help one
another to keep you strong and effective and safe in the workplace.
Self care is important in preparing us to care for others. If we can recognize the stressors in our workplaces
and know when we are beginning to experience stress, we can help ourselves and support our colleagues
and communities more effectively. This, in turn, helps us to respect and support our clients.

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Activity#10. Identify own ways for relieving stress
Exercise
Option 1: Ask participants to spend a few moments to write down five things that help them relieve
stress and feel calmer. Ask them to share these methods with the rest of the group.
Option 2: Art activity. Participants draw themselves doing something they find useful to relieve stress.
When drawings are completed, put them on the wall and allow participants to walk around and see
what others have drawn.
Compile group list on flipchart: Ways to Relieve Stress
Suggest others from the list below and add them to the group list if the participants agree they are
helpful.

Suggestions for relieving stress:

• Think about what has helped you cope in the past
• Take time to eat, rest, and relax, even for short periods of time
• Keep reasonable working hours so you do not become too exhausted
• Remember that you are not responsible to solve all of people’s problems. Do what you can to help
people help themselves
• Minimize use of alcohol, caffeine, or nicotine
• Check in with fellow workers to see how they are doing and have them check in with you
• Find ways to support each other
• Talk to friends, loved ones or other trusted persons for support

Managing Stress
Your sense of yourself serves as the reference point for who you want to become and what you want to
do with your life. Some of the questions in this exercise difficult or impossible to answer. Self-awareness is
a skill case managers must practice and work at to maintain, and you may need to look to others to help
you.
The following exercise is designed to help you look at what you know about your own core self, your basic
identity, and whether that self is healthy, partially healthy, or unhealthy.
Answer the following questions and complete the following statements to help get a sense of yourself:
What about me gives me a positive sense of who I am?
What facts describe me?
I feel competent about (or in control of):
I have worth because:
I am able to be intimate with:
My basic values are:
I have a positive sense of humanity and the meaning of life because:

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I make the following appropriate, reasonable demands on myself:
The following “shoulds” govern my life and are inflexible:
I should ____________________________________
I should ____________________________________
I should ____________________________________
Which of these “shoulds” would you be able to discard or throw in a trashcan?

Mark with an “X” where you lie on the following continua:

___Rigid ___Flexible
___Harsh ___Gentle
___Critical ___Accepting
___Inappropriate ___Appropriate
___Overcontrolling ___Undercontrolling

What did you learn about yourself by doing this exercise?

Now that you have done this exercise, how would you describe your core self?

Role of supervisors and creating a supportive and environment

Acknowledge that this work is stressful by its nature. It is important even for those who excel at avoiding
or managing stress to be honest about the effects of stress, learn how to recognize the symptoms in
themselves, and to take responsibility to help themselves. This will contribute to creating a supportive and
healthy environment for themselves and their co-workers. This means being aware, assertive, and may
mean asking for help at times.

It’s a fact that they will ‘feel’ for the people they work with and the issues they deal with. This is a strength,
and what makes them good at what they do; compassion, empathy, care. It also means that they are at
risk of feeling stressed by it at times, or overwhelmed (or any emotional or physical response), and so self
awareness is important.
And, it is why organizations put safeguards in place:
• Guidance and support from managers and peers
• Open and sharing organizational culture
• Respect for confidentiality
• Allow sufficient time for breaks (e.g. during work)
• Allow time away to see family
• Have fun together (e.g. events organized by co-workers)
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Techniques for relieving the symptoms of stress: Physiological
Time Management: Plan your time as best you can. Minimize distractions when you are concentrating
and identify personal time wasters. Keep your work and you case files organized in a systematic manner.
Stay on top of your documentation of case files and identify when is the best time for you to complete
these and stick to that. Learn to say no.
Sleep: Sleep is essential for good physical and mental health.
Meditation: This is a technique in which the mind concentrates on one thing instead of many things.
Often it involves focusing on breathing, repeating a word, or staring at a particular thing. We have all had
the experience of staring at something and thinking of nothing. Most people can do it easily with a little
practice and there are lots of free courses on the internet to help you in the beginning.
Visualization: This technique involves developing a scene in your mind. The focus is on imagining all the
sensations in the scene. How does it smell, sound, taste, and feel? This can be practiced independently
or with the help of an audiotape.
Deep Breathing: Deep breathing involves inhaling deeply, feeling your stomach expand, holding the
breath for a few seconds, and then slowly exhaling while visualizing the tension leaving your body. As
babies we breathe deeply naturally. As we grow, we forget how to breathe properly. We begin to breathe
more shallowly. When we breathe from our stomachs, we cleanse our bodies and expel our tension.
Relaxation: This relaxation technique involves tensing and relaxing each muscle or muscle group, one at
a time. Special awareness is given to the noticeable difference in how the muscle feels when it is tense as
opposed to relaxed. One region of the body is completely relaxed before moving to another region of the body.
Healthy Diet: Avoid excesses; use moderate amounts of alcohol (less than 2 oz. per day), decrease use
of caffeine, tobacco, salt, and fatty foods. There are 76 illnesses associated with alcohol abuse and many
associated with obesity.
Exercise: Exercise is important in minimizing the effects of stress. Physical activity “uses up” the excess
of chemicals produced by the fight or flight response. A well-rounded exercise program should include
activities for flexibility, muscular development, and endurance. We should exercise a minimum of three
times per week for at least 20 minutes.
Stretching: Stretching helps work the tension out of the body. There are some simple exercises that can
be done at work while sitting in a chair.

Techniques for relieving the symptoms of stress: Psychological

Be as organized and efficient as you can: Organize your day. Organize your time. Have a system for your
case files. Keep on top of paperwork. File everything so that they are easily located.
Be assertive: Stand up for your rights and communicate clearly and politely to people around you what
is important to you.
Take breaks: When you can, schedule breaks into the workday. Intermittent rest will make you more
productive and help to minimize stress.

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Review your day: When you finish work, spend 10 minutes reviewing your day. Once you get work off
your mind, you can make room to enjoy being home. Try to make a deliberate mental transition from work
and home, and leave aside work worries while you enjoy your personal and family time.
Invest in Relationships: Relationships take time and commitment. Much of the research shows that
people who have social support manage stress far better than people without social support systems. If
you put off time with friends and family because you are busy, they may not be there when you eventually
find time.
Take vacations: You need time off to rest and re-energize.
Stay positive: Make a list of all the things in your life that bring you joy, the things for which you are
thankful, and the things you are grateful for. Read over the list and add to it on a regular basis. Learn
cognitive behavioral techniques for changing your thoughts. Replace learned helplessness with learned
optimism.
Ask for help when you need it. Sometimes people in the helping professions can be slow to realize they
need help themselves, and reluctant to ask for it. Be honest with yourself and seek help when you need it.
Make use of the resources around you: colleagues, counselors, family, and friends

References
Alberti, R., & Emmons, M.L. (1986). Your perfect right. San Luis Obispo, CA: Impact.

Anderson, D.G. (2000). Coping strategies and burnout among veteran child protection workers. Child
Abuse and Neglect, 24(6), 8390848.

Cassell,J., & Mulkey, W. (1985). Rehabilitation caseload management. Austin, TX: PRO-ED.

Lee, S., & Crokett, M.S. (1994). Effect of assertiveness training on levels of stress and assertiviesness
experiences by nurses in Taiwan, Republic of China. Mental Health Nurseing. 15(4), 419-432.

Maslach,C. (1978). Job burnout: How people cope. Public Welfare, 36, 56-58.

Rapp, A. Charles (1998). The Strenghts Model. Case Management with People Suffering from Severe and
Persistent Mental Illness.

Weinfeld, R.S., & Donohue, E.M. (1989). Communicating like a manager. Baltimore: Williams & Wilkins.

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