Compassion

Background: African Americans are at increased risk for stress-related disparities. Mindfulness-based interven-tions are effective in reducing adverse outcomes; yet, racial/ethnic minorities are underrepresented in theseinterventions. Also, the development of culturally-responsive interventions has been mostly non-existent.

Materials and methods: Focus group and interview data were acquired following a four-week mindfulness in-tervention with African American women.

Results: Using Brigg's (2011) mental health utilization model to guide analysis, several recommended culturally-responsive modifications emerged. Recommended modifications internal to the intervention included usingAfrican American facilitators, incorporating cultural values, using culturally-familiar terminology, and providingcultural resources. Suggested modifications to the intervention's external factors included offering the inter-vention within culturally-familiar settings. Individual-level factors to address were religious concerns, perceivedbenefits, and holistic health goals.

Conclusions: Themes were used to propose a model toward the creation of a culturally-responsive mindfulness-based interventions to guide culturally-relevant treatment modifications and improve underserved communities’engagement in these interventions

Context. Compassion is frequently referenced as a hallmark of quality care by patients, health care providers, health care administrators, and policy makers. Despite its putative centrality, including its institution in recent health care reform, an empirical understanding based on the perspectives of patients, the recipients of compassion, is lackingdmaking compassion one of the most referenced yet poorly understood elements of quality care. Objectives. The objective of this study was to investigate palliative cancer patients' understanding and experiences of compassion to provide a critical perspective on the nature and importance of compassion. Methods. This grounded theory study used semi-structured interviews to investigate how patients understand and experience compassion in clinical care. Using convenience and theoretical sampling, 53 advanced cancer inpatients were recruited over a seven-month period from a specialized palliative care unit and hospital-wide palliative care service within a Canadian urban setting. Data were analyzed by four members of the research team through the three stages of Straussian grounded theory. Results. Qualitative analysis yielded seven categories, each containing distinct themes and subthemes. Together, they constitute components of the compassion modeldthe first empirically based clinical model of compassion. The model defines compassion as a virtuous response that seeks to address the suffering and needs of a person through relational understanding and action. Conclusion. The components of the compassion model provide insight into how patients understand and experience compassion, providing the necessary empirical foundation to develop future research, measures, training, and clinical care based on this vital feature of quality care. J Pain Symptom Manage 2016;51:193e203.

Background Self-criticism is a ubiquitous feature of psychopathology and can be combatted by increasing levels of self-compassion. However, some patients are resistant to self-compassion.

Aims To investigate whether the effects of self-identification with virtual bodies within immersive virtual reality could be exploited to increase self-compassion in patients with depression.

Method We developed an 8-minute scenario in which 15 patients practised delivering compassion in one virtual body and then experienced receiving it from themselves in another virtual body.

Results In an open trial, three repetitions of this scenario led to significant reductions in depression severity and self-criticism, as well as to a significant increase in self-compassion, from baseline to 4-week follow-up. Four patients showed clinically significant improvement.

Conclusions The results indicate that interventions using immersive virtual reality may have considerable clinical potential and that further development of these methods preparatory to a controlled trial is now warranted.

Leaders and employees agree on the need for empathy in the workplace, yet crucial gaps remain between intentions and implementation. To bridge this gap, empathy practice in organisations needs to be understood, implemented and studied. In this booklet we introduce Empathic Intervision, a structured peer-to-peer method to apply empathy in organisation routines. We introduce intervision, an organised conversation between people combining work and learning, to handle situations, questions and problems with an intent to learn from each other, improve expertise and co-evolve insights and outcomes. We describe how Empathic Intervision supplements the advantages of intervision with five layered empathic capacities: self-empathy, kinesthetic, reflective, imaginative and creative empathy, to aid deeper hearing and understanding of each other and consideration of each other’s perspectives. We contextualize this method within the emergence of practices such as human-centric design, agile self-organizing teams and co-creation with the aim to bridge silos, cross barriers and engage a broader range of knowledge.

L’urgence sociale a fait l’objet de nombreuses analyses depuis le début des années 1990, mais elles ont le plus souvent versé soit dans la critique, soit dans l’éloge. Elle a ainsi été très présente dans l’espace public, sans faire l’objet d’enquêtes empiriques systématiques. C’est le point de départ des auteurs : adopter une perspective compréhensive, et s’engager résolument dans la description des actions qui font le quotidien de l’urgence sociale. Le terrain choisi est celui du Samusocial de Paris, institution fondée par le French doctor Xavier Emmanuelli, qui a donné sa forme au cours des années 1990 à l’assistance des personnes sans-abri en France, articulant des accueils de jour, des centres d’hébergement ou de soins infirmiers, une régulation téléphonique (le « 115 ») et des équipes mobiles professionnelles. C’est l’ensemble de ces dispositifs que les auteurs donnent à voir et à comprendre, mais leur attention s’est particulièrement focalisée sur les « maraudes », équipes qui vont à la rencontre des personnes sans-abri dans les espaces publics. Les auteurs produisent une grande quantité d’analyses de situations, en plongeant dans la tessiture corporelle et émotionnelle de l’intervention d’urgence, en explorant la texture morale de la relation d’aide, en suivant le fil ténu qui conduit de l’aide humanitaire au droit social. Chemin faisant, ils pointent aussi les dilemmes qui se jouent en termes de justice distributive (comment allouer des biens d’urgence à certaines personnes en détresse et pas à d’autres, comment concilier les impératifs d’inconditionnalité et d’équité dans un contexte de rareté des ressources) et explicitent les tensions dont font l’épreuve les intervenants sociaux quand ils cherchent à assister les personnes sans-abri (comment articuler présent de l’urgence et avenir de l’insertion, comment trouver l’équilibre entre autonomie et dépendance, comment s’ajuster à la singularité de la personne tout en faisant preuve de professionnalisme, comment appréhender la souffrance et les récits de malheur présentés par les personnes sans tomber dans la froide défiance ou la crédulité compatissante).

Cette enquête ethnographique, pour minutieuse soit-elle, se raccroche à quatre types d’enjeux généraux. 1. Elle ne réduit pas les descriptions du travail de rue à des micro-interactions, mais les adosse à une enquête sur les modalités de coopération, d’évaluation et d’intervention de l’ensemble du dispositif du Samusocial de Paris. 2. Elle revient sur la généalogie de l’urgence sociale et ouvre sur les controverses qui traversent l’arène publique des politiques d’assistance des personnes sans-abri depuis les mobilisations associatives de Médecins du monde (2005) et des Enfants de Don Quichotte (2006). 3. Elle recadre l’urgence sociale dans le moyen terme des évolutions des politiques sociales, en mettant en regard les manières de faire du travail social et infirmier avec des travaux plus généraux sur les mutations de l’action sociale. 4. Enfin, elle met en regard les résultats de cette enquête ethnographique avec un certain nombre de théories politiques et morales qui se sont développées depuis les années 1970, qui portent sur le care, la reconnaissance, le don ou la proximité. C’est ainsi qu’elle montre, à la différence d’autres travaux, que l’urgence sociale n’est pas réductible à sa dimension humanitaire, interprétée comme une « politique de la pitié » ou de la « compassion », mais qu’elle est orientée pratiquement par une pluralité de sentiments moraux – le respect, la reconnaissance et la sollicitude.

This article places social work clinicians' compassion fatigue, burnout, and other negative consequences in a broader context of positive social work. We argue for a paradigm shift towards identifying the factors that lead clinical social workers toward human flourishing in their field. We introduce a model for creating ''compassion satisfaction'' or feelings of fulfillment with clients, rooted in positive psychology and expanded to incorporate the social work perspective. The model suggests that affect, work resources, and self-care influence clinicians' positivity-negativity ratio, which in turn can result in compassion satisfaction. To maximize compassion satisfaction, research, education, and training should consider how classroom instruction and workplace policies can promote the most success among clinical social workers.