30 minute depression session

May 2, 2019 1:29 AM

I volunteer for a national charity that supports people with severe mental health issues, feelings of despair and suicidal ideation. I have been given the opportunity to design and facilitate a session on mental health for the volunteers. The catch is I only have 30 minutes. What should I cover?

New volunteers go through a rigorous training programme so they can provide emotional support for people in all sorts of states of distress, with every problem imaginable.

As you can imagine, this can be both incredibly rewarding and hugely disturbing, and it could exacerbate or trigger mental health issues in our volunteers (it happened to me).

While there is a support system, it's pretty informal and mostly comprises of debriefing to another volunteer after a shift, and being encouraged to reach out if you had a particularly distressing interaction.

I feel strongly we can and should be doing more to support our volunteers, and after some lobbying I've managed to get some time in the training schedule to cover this.

Unfortunately I only have 30 minutes for a pilot in June, but it's a start, and I really want to use the time as effectively as possible, both for the benefit of this particular cohort of volunteers, and to make a case for a wider rollout.

What should I cover?

My draft agenda:
- Mental health statistics (it could happen to anyone, and there's no shame if it happens to you)
- Recognising your limits, triggers, and warning signs for depression and anxiety (maybe a hand out to save time)
- Discussion on what you can do (self-care, how to arrange leave from volunteering)
- Shorted guided mediation focussed on self compassion (in an ideal world I'd love to spend a good amount of time on self-compassion as I think it maps really well to the work we do, but I don't think I have time to do it justice. Meditation is pretty mainstream these days, but tell me if you think this will make people uncomfortable)

Is this too much, too little? Totally wrong? What key messages should I include? What resources should I point them to? Any books, podcasts, Youtube videos I should look at in preparation?

I'm planning to focus on depression and anxiety as they are so common, we don't have much time, and I don't know a huge amount about other mental health issues, but what can I do to be inclusive of all mental health issues?

Context: My fellow trainers are bought into the importance of this, but are wary about scaring off the new volunteers, so I need to strike a balance between transparency about the potential impact on the volunteers' wellbeing, while remaining positive.

This might sound like a bit of a wash, but I actually find volunteering helps me manage my own depression- it really helps me feel connected to humanity and like I'm doing something worthwhile with my time (both things I struggle with when depressed). However, there was a time I found it completely unmanageable, and the organisation was no help at all.

Last thing: this will be included in the final session of 6 weekly sessions, each of about 6 hours, so the volunteers will have bonded somewhat, and already talked about very challenging and potentially triggering topics as part of the training. I will be meeting them and doing some training in the first session.

posted by Dwardles to Education (17 answers total)

This article from the Guardian is about a scheme in Zimbabwe that I think might have really useful insights that can help you.
posted by london explorer girl at 2:38 AM on May 2, 2019

Searching for "secondary trauma" and "vicarious traumatization" will turn up a lot of programs meant to help caretakers like this for burning out. The model they work on is "this burnout is like PTSD" rather than "this burnout is like depression" — but you may either end up finding that model describes your situation well, or at least learn things from their situation that are applicable to yours.
posted by nebulawindphone at 3:43 AM on May 2, 2019

I work with at-risk teenagers and recently did a one-day course on vicarious trauma. Amongst other things, we spent time on "burnout is like PTSD"; on meditation and relaxation apps, and some time on self-care / acceptance of our limitations / triggers / etc. Our course was presented by a registered psychologist who included anecdotes from clients, and her response to their situations.

Thirty minutes is nothing. I wouldn't waste any time on statistics but I think your three remaining agenda items could be really useful. Don't include anything that is 'administrative' like how to take leave. Just mention that taking leave before burnout is a good thing.

wary about scaring off the new volunteers
You have a duty of care toward your volunteers to adequately prepare them for the risks of the role.
posted by Thella at 3:57 AM on May 2, 2019

Assuming your org has volunteers on site during their shifts, another thing to cover would be recognizing signs of mental stress in others and how to be supportive to colleagues. Volunteers aren't necessarily going to reach out the way your client group does so your people may need to take a watchful approach for each other.
posted by jacquilynne at 4:04 AM on May 2, 2019

I personally do not want to participate in group guided meditation, thank you, but a list of apps volunteers might find helpful like Calm and Head Space would be appreciated.

I agree on not wasting time on statistics, but opening with the message that "it can happen to anyone, it happened to me, and there's no shame if it happens to you" would be valuable.
posted by DarlingBri at 4:09 AM on May 2, 2019

I’m reading Trauma Stewardship and find it illuminating for unpacking how to navigate headspace, with the wear-and-tear that the work can bring. Providing resources and information for a deeper dive can help, and providing it electronically in a place they routinely access can help them connect when they are seeking support, which might be well past a training & orientation phase.
posted by childofTethys at 4:36 AM on May 2, 2019

Yes, please pass on the mandatory group guided meditation. Very awkward. Maybe at the end say you'll be leading a small meditation session at later time/date and if anyone wants to join they'll be welcome to.
posted by seanmpuckett at 5:01 AM on May 2, 2019

My standpoint is that really debriefing needs to be built into the work schedule. Someone needs to check in with these people of the regular .
How will they do that? How can you talk about making that happen?

Information on what they can do is so important. Who can they talk to at the organization, outside the organization. What are the steps if something is too much for them? This information is hard to come by when you're in that space.

I'd skip the mediation especially with that time frame and focus on tools and strategies for working in a place like that long term.

I'd hope that statistics have already been covered in other parts of the training, i think maybe some emphasis that anyone can be on ther other side of that hotline, even them would be more effective.
posted by AlexiaSky at 7:44 AM on May 2, 2019

I'd also be wary about emphasising how any particular volunteer is essential and if no one can take the shift it doesn't get covered. These people aren't getting paid to do this, they really need to be able to advocate for themselves when they can't. I've seen it where the originzation adds SO much guilt for the mental health time people really need that someone else is hurting, when in reality the volunteers are really hurting too.
posted by AlexiaSky at 7:48 AM on May 2, 2019

In similar situations, I have found that facilitating a group discussion is often more helpful, and creates longer-lasting change, than doing a presentation. Five to ten minutes of "This work is stressful, it will affect everyone in different ways, here's how it affected me [staying as vague as you want]" followed by 20 minutes of "What do you all do to help manage your own wellbeing?", then five minutes of summarizing and maybe adding suggestions/best practices if the sharing skipped over anything essential.

Otherwise, I'm finding that a lot of self-care trainings end up, intentionally or not, shaming the people they're supposed to help, or adding one more checklist item to their already overburdened To Do list. Additionally, by letting volunteers share, you/they may uncover some structural changes the organization could make to better support them, which would be more valuable and farther reaching then just one person doing five minutes of meditation a day.

I think self-care has been co-opted by neoliberalism as an individual responsibility to one's employer, rather than a community responsibility that often requires system change to make employers responsible for their employees' (or volunteers') health and wellbeing. You obviously don't need to get into a Marxist critique in your presentation, but I think helping empower the volunteers to speak up and to support each other would be valuable.

[I work as a therapist in county mental healthcare and have previously worked in hospice and sexual-assault-treatment agencies, and I have both led and been led in various self-care workshops/presentations, so that's my context for the above.]
posted by lazuli at 8:14 AM on May 2, 2019

Oh please don't make them do a mandatory (which it sounds like from your description) guided meditation. I would absolutely walk out. I find things like that actually make me feel worse, and I know I'm not alone in that. I like the idea of referring people to apps and/or websites where they can find resources. As I understand it, meditation is a very personal thing. I would not like (actually hate) being made to do something like that. In addition, people who do meditate have their own way of doing it (mantras? imagery?) and I wouldn't like (if I were a person who did meditate) to be made to practice something I find I didn't like.
posted by kathrynm at 9:15 AM on May 2, 2019

I do this kind of work for healthcare professionals. There is a strong move in our field to move from "burnout" to "moral injury" as better reflective of the systemic oppression that prevents physicians, nurses, social workers, therapists, for doing right by their patients. I don't know if that exactly applies in your situation, but it's something worth mulling over. The PTSD framework is probably closer, as is the concept of reflected trauma.

One of the drivers of this is a feeling of isolation, so I agree that normalizing is important. If you do want to do a group activity, you might look into expressive writing, which improves resiliency in a number of ways. Like meditation, it's a quick (2-5 min) self-debrief that can help people externalize and vocalize trauma in a structured way. MeMail me if you'd like more info.
posted by basalganglia at 9:26 AM on May 2, 2019

Shorted guided mediation focussed on self compassion

I would offer resources for this and if you do any group thing, maybe just helping people do some relaxing breathing techniques. Then people can participate or not. I agree with others especially DarlingBri that personalizing this may be very useful for people to hear.

we can and should be doing more to support our volunteers

Likewise if this training can be a bit of a beginning to a conversation about what volunteers think they need to do their roles better or with more support, that might be excellent. Just hearing someone saying "No seriously we are listening and care about how you are doing" can make timid people more bold to speak up if something is hard or not working for them.
posted by jessamyn at 9:27 AM on May 2, 2019

I am guessing this is in the US? I only ask because any advice I would find useful would be very dependant on the health services in my country (UK). This kind of points the way to types of material I think would be useful in such a short session: i.e. as many frameworks you can provide for the attendees to continue getting the help and support they need after the session. Mental health provisions in this country - in my experience - are very sketchy, and usually geared towards people who are considered to be a danger to themselves and other.s People with less acute forms of depression are pushed towards websites, or workshop sessions where you are handed piles of paper with more websites on them. Finding the direct support YOU need is not as easy as it should be, and any information you can provide to navigate the system better, and avoid the long waits and setbacks, would be extremely valuable.
posted by 0bvious at 9:31 AM on May 2, 2019

As someone who suffers with chronic depression, I wish I had known earlier what “self care” means to me. I hear that term and automatically think, taking bubble baths and taking as much off my plate as possible. And I’ve done that and I get worse. For me self care is not being at home, having a schedule/plan for my days - even days off, and being productive in a tangible way (there is physical evidence of my productivity). So, perhaps acknowledging that self care takes on many many forms and it’s not a one-size fits all concept. Encourage others to find what self care means for them individually.
posted by Sassyfras at 11:22 AM on May 2, 2019

Look up Mental Health First Aid and see if there's something there you can adapt. It's not very social-model oriented and not free from problems but it could be a good starting point.
posted by divabat at 4:23 AM on May 3, 2019

Bravo to you for pushing to get this on the agenda! It is rare to see staff/volunteer care taken seriously: this new class of volunteers will benefit greatly from you taking up the cause on their behalf.

I am a psychotherapist and over the past five years I have given a number of trainings in Psychological First Aid and other psychosocial support skills to front-line humanitarian aid workers in various countries. Over time, my approach to the self-care portion of training has evolved. I echo lazuli above that discussion is a million times more powerful than presentation, particularly on this topic. If I had only 30 minutes I would:

1) Help volunteers practice (role play) setting boundaries with clients and, if your co-facilitators will allow it, with the organization. Sounds hokey, and it can even be a bit funny when you do it, but the volunteers will remember that role play. They'll remember how you pretended to pressure Sue into taking a shift she wasn't up for, and how even in role play mode she struggled to say no to you, but at the end you congratulated her for putting on her own oxygen mask first. [12 minutes]
2) Give a three-sentence summary of the research on secondary traumatic stress and burnout, emphasizing that the only source of social support proven to protect against all three components of burnout is support from colleagues (fellow-volunteers who know what it's like).* [1 minute]
3) Give the floor to the participants for them to talk about what they expect they will need to do to monitor and maintain boundaries and their own well-being, and what types of support they might need to ask for from the others in their cohort. [16 minutes]
4) Hand out a piece of paper (also send by email) containing resources for self-care tools, the procedures for taking leave, etc. - all the things in your draft agenda. The paper can also have a dedicated section at the bottom for writing down contact info of training buddies they can reach out to for support, as well as pre-filled contact info of anyone on the organization's staff whose role includes care for volunteers. [1 minute]

Also, this:
I actually find volunteering helps me manage my own depression- it really helps me feel connected to humanity and like I'm doing something worthwhile with my time (both things I struggle with when depressed). However, there was a time I found it completely unmanageable, and the organisation was no help at all.

If you feel comfortable sharing that with the volunteers (maybe softening up the last phrase to "I had trouble getting the support I needed from the organization alone"), that could be a beautiful, courageous way to open the discussion. it moves you from being a person giving them instructions about the correct way to do self-care, to a person who is on this journey with them and wants to shine a bit of light on the path.

*Maslach, C., Shaufeli, W.B., & Leiter, M.P. (2001). Job burnout. Annual Review of Psychology, 52, 397-422
posted by philotes at 4:59 AM on May 3, 2019