Watch this !
• https://www.youtube.com/watch?v=felNf2R
CZKc
• https://www.youtube.com/watch?v=NzrNM
BAkhcE
• https://www.youtube.com/watch?v=lqTlLeU
Dhb8
Resilience
Based on Jane Chalmers work
ST1.
2016
Resilience.
• https://www.youtube.com/watch?v=WnH45
nKEEgU
Aims of today’s session
Position resilience as a skill that can be developed
To introduce some of the evidence base for developing resilience
Undertake some simple exercises that demonstrate how to develop
resilience
Take away some learning points to share with trainees/colleagues
Definitions
•
Resiliency is something you do. It’s active and something you can develop
•
“The ability to bounce back or recover from stress”(1)
•
The ability to bounce back from tough times, or even triumph in the face of
adversity: to develop tenacity, but not at the expense of reason (5)
•
Highly resilient people are flexible, adapt to new circumstances quickly and
thrive in constant change. They expect to bounce back and feel confident
they will.
•
Resilient people embrace change and problem solve quickly in unexpected
circumstances (2)
Emotional Resilience – adaptive coping skills, understanding
and managing one’s emotions (emotional intelligence) and
seeking social support to enable the ability to “bounce
back” or even experience post adversity growth after a
stressful event. (Alys Cole-King, ref 10)
Evidence for developing resilience
• Richard Duggin – “Avoiding the performance cliff”
• “Sharpening the saw” – Richard Covey’s 7th habit
• Stress-vulnerability model of mental illness (Zubin and Spring)
Performance cliff – not this
Avoiding the performance cliff
• Helping doctors to develop skills to avoid the performance cliff in the
first pace.
• We are a hard to reach group that makes us high risk
• So we should develop awareness and skills earlier on our training to
cope better with whatever life throws at us.
Richard Covey – 7 habits of highly
effective people.
•
•
•
•
•
•
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1. be proactive
2. begin with the end in mind
3. put first things first
4 think win/ win
5. seek first to understand, then to be understood
6. synergise.
7. sharpen the saw – the habit of renewal.
Zubin et al (1977)
Further evidence
• Socially connected people are happier and more resilient (Diener and
Seligman 2002)
• Tregoning – NW Deanery provided training in resilience skills and evaluated
the outcomes immediately after the session and later
• Resilience Quotient questionnaire.
• How useful was the tool?
• What did you get out of using it?
• Would you repeat it? Reasons
• How could it be used with colleagues/trainees?
• PROQOL and Compassion fatigue self-test
• Any unexpected findings ?
• Anybody with self-care issues ??
What is burnout
• Physical and Emotional Exhaustion:
– You are emotionally drained, depleted and worn out by work and
not able to recover in your non-working hours
• Depersonalization:
– The Development of a negative, callous and cynical attitude
toward patients and their concerns (“my patients are so #%*&!”)
– The cardinal sign here is cynicism, sarcasm and feeling put upon
by your patients.
• Reduced Sense of Personal Accomplishment:
– The tendency to see your work negatively, without value or
meaningless (“what’s the use?”) and see ourselves as
incompetent.
Why is resilience important in
GP and GP trainees?
• ePortfolio/appraisal
• Lifelong learning
• Ever changing NHS
• Dealing with uncertainty in GP
• Health and well being
Differences between:
•
Highly resilient and less resilient people
Identification of areas to develop
5 areas to develop
(Al Siebert)
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Health and well being
•
Problem solving skills
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Self esteem, self confidence and positive self concept based on moral
values
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Curiosity, self managed learning, optimism and positive thinking
•
Accept new realities quickly (changes) and influence things so they turn out
well (Ref 2)
• Emotional Intelligence - Emotional intelligence is the
capacity of individuals to recognize their own, and other people's
emotions, to discriminate between different feelings and label them
appropriately, and to use emotional information to guide thinking and
behaviour.
• Social networks
Break !
• https://www.youtube.com/watch?v=zV1zK8
zRCPo
Exercises
based upon previous list
Becoming more positive
• Think of a difficult experience and write down a limit of 3 negative aspects
• Write down 3 positive points for EACH negative
Aim to build on the positives and
problem solve with the negatives
Other ways to increase positivity
List your positive experiences:
Ask the following questions:
1. What do I have fun doing? What am I enthusiastic
2. What would I like to do that I keep putting off?
3. Who do I enjoy sharing good experiences with?
4. When do I sleep best at night?
5. What positive aspects of my life am I ignoring?
about?
Circle of Influence
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Identify a problem
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Write a list of concerns associated with the problem
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Draw 2 circles, one inside the other
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In the inner circle put all the concerns you have that you CAN influence
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In the outer circle all those you can’t influence
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Problem solve with the ones you CAN influence
Goal Setting
• Relates to problem solving skills and influencing what you can change so they
turn out well
• Do this specifically wrt circle of influence exercise ( be SMART if we can)
Steps to improve resilience
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Become more positive - when something happens look for a positive/s
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Learn from your experiences. Problem solve. What is useful? What are my
choices? Circle of Influence can be helpful
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Be kind to others
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Keep socially connected
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Keep a note of things you’re grateful for, each day
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Look after yourself - physically and mentally
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Smile, laugh - it reduces tension
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(Ref 4)
What are you thankful for from today's session
References 1
•
1. Carver CS. Resilience and thriving: issues, models and linkages. J Soc Issues
1998;54:245-66
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2. Al Siebert. The Resiliency Advantage. Berrett-Koehler, 2005
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3. Tregoning C. Facing change: developing resilience for staff, associate specialist, and
specialty doctors. BMJ 22.1.14
•
4. The 5 best ways to Build Resiliency: Experience life
http://experiencelife.com/article/the-5-best-ways-to-build-resiliency (8.4.14)
•
5. Jane Clarke and John Nicholson. Resilience - bounce back from whatever life throws
at you, 2010
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6. Stephen Covey. The 7 Habits of Highly Effective People. 1992
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7. Resilience Training workbook from HENE Resilience Training session
References 2
• 8. Diener E, Seligman ME. Very happy people. Psychol Sci 2002 Jan;13(1):81
• 9. Zubin J, Spring B. Vulnerability; a new view of schizophrenia. Journal of
abnormal psychology 1977; 86;103-126
• 10. Alys Cole-King blog 15.7.15 Doctors under pressure need resilience, not
mental toughness
“Let’s be careful out there”