Kristin DeVall:
Hello and welcome back to the Justice to Healing Podcast. I'm Kristin DeVall, one of the co-directors of the National Drug Court Resource Center. And today I'm joined by the other co-director Christina Lanier.

Christina Lanier:
Hi everyone.

Kristin DeVall:
We are very excited to have Dr. Jacquelyn Lee with us today. She is a licensed clinical social worker and associate professor of social work at the University of North Carolina, Wilmington. Welcome, Dr. Lee.

Dr. Jacquelyn Lee:
Thanks so much for having me.

Kristin DeVall:
Today's episode of justice to healing focuses on the issue of self-care and mindfulness. Dr. Lee, can you talk briefly about how you became interested in the topics of mindfulness and self-care?

Dr. Jacquelyn Lee:
Sure. Well, really my interest actually was born out of my practice experience. So when I was in practice, there direct practice, I should say, I worked with kids that had emotion regulation issues, and sort of behavioral issues. And I really left that practice experience with more questions than answers. And I was also struck during that time by how emotionally exhausted I was by the work that I was doing. Work that I really loved doing. So that felt a bit confusing. So when I decided to pursue my doctorate, I had a longstanding interest in trauma and secondary trauma. And for anybody who's not familiar with the term secondary trauma, essentially, this is when folks can develop symptoms of PTSD by way of secondary exposure. So like in a workplace kind of scenario. And so I was interested in looking at risk and protective factors for secondary trauma.

And I began looking into the literature thinking about the concept of self-care and certainly maybe that was a protective factor, it was my hypothesis. And that's where I really kind of discovered that there was a real dearth of literature around self-care. And that really surprised me, but upon reflection, it made a lot of sense thinking about my own educational experiences and my own stumbles and practice and my questions I had about practice. So, that was how my interest in self-care evolved.

And then when it came to learning about mindfulness, when I first completed formal training around mindfulness, it was in-learning mindfulness based therapy models. And what really struck me about this training was that it really felt so clear to me that the practice of mindfulness was actually foundational to the practice of social work. So beyond a particular clinical model, it just seemed like what was necessary to do this work well. And when I thought back to the work that I did in practice, it was clear to me that what really worked was when I was engaging with mindful best practices. So, when I was slowing people down. And so that's how my interest in both of those topics sort of began.

Christina Lanier:
Well, thanks so much. That's really fascinating to see how those two intertwined as well. So thinking about self-care in that term, how do we define, or how do you define self-care?

Dr. Jacquelyn Lee:
Sure. So Dr. Sherry Miller and I in 2013, published a framework around self-care and we offered in that framework definitions for both personal self-care and professional self-care, so separating them out. So in terms of defining personal self-care, we define it as a process of purposeful engagement and practices that promote holistic health and wellbeing of the self. And so if I could just tease out a few pieces there, the first being important that it's a process, that there's some intention and there's this focus on the holistic nature of it. And that really calls upon us to take into account both the mind and the body. When it comes to professional self-care we understand that similarly as a process of purposeful engagement and practices that promote effective and appropriate use of the self in one's professional role within the context of sustaining holistic health and wellbeing.

So here we're really emphasizing effectiveness at work, but also within the context of wellbeing. And so for us, we really think about self-care as being foundational for effective ethical practice. I'm an ethics in social work. We have a code of ethics, so that's particularly important. We also see personal and professional self-care as being dynamic. We see them as being implicitly interconnected, and we also see self-care as being a means of empowerment for practitioners and organizations. And lastly self-care is a potentially really powerful vehicle for changing the professional culture of a field of practice as well.

Christina Lanier:
Thanks so much for giving us that definition of self-care. I think that really leas itself to understanding exactly what we mean when we talk about that term.

Kristin DeVall:
Can you say a little bit more about the difference between personal and professional self-care?

Dr. Jacquelyn Lee:
Sure. So personal and professional self-care can be build and sustained by what we call structures of support, which are basically organizing domains that are strengthened by particular self-care strategies. So when we think about personal self-care, we've identified five structures of support, and these are physical, psychological, and emotional, social, leisure, and spiritual, if that feels relevant to a particular person. So within these structures of support, these domains invite us to think about strategies that might support us in this particular area. So when we think about self-care in general, we tend to think about things like movement, exercise, thinking about nutrition, we might think about engaging socially with people. So the things that typically come to mind, I think, fit into this more personal area of self-care. And so I think the greater contribution of this framework, hopefully for folks is that it invites us to think a bit more critically about idea of professional self-care.

And so professional self-care, we offer six structures of support here, which can sort of drive our thinking about particular strategies. So the first structure of support for professional self-care is workload and time management. So inviting us to think about how we negotiate our workloads. So strategies here might include taking breaks throughout the work day, reserving work tasks for during particular work hours, thinking about how we organize and prioritize our work tasks. The second structure of support is attention to our professional role. And this invites us to really take stock of the meaning of our roles and whatever those are for a particular discipline, as well as the particular job that we're in, that job description, the particular setting we're in and the particular goals that our work might have. So some examples related to this structure of support might relate to when we're working in multidisciplinary teams, for example. Strategies here might help us to see where our area of expertise lies versus where someone else's expertise lies.

So that can help us to sort of parse out responsibility and not maybe take over responsibility where we don't need to. It can also help us to maybe refer when needed. It can also help us to increase our focus on our particular goals. So the third structure of support related to professional self-care is attention to reactions to work. And this is where we devise strategies that help us to notice, honor, and respond to the thoughts, feelings, and physiological sensations that can come along with doing the work that we're doing. So strategies that might fit in this category are things like potentially going to therapy, mindfulness exercises, journaling, targeted supervision, debriefing with colleagues and things of that nature. The fourth structure of support related to professional self-care is professional social support, and self-advocacy. And this area helps us think about strategies that can solicit encouragement, constructive feedback, guidance, and education from peers and colleagues, as well as invites us to think about what do we need in the workplace and advocate for that.

So this can involve certainly developing a network of colleagues that we might meet at formal trainings or conferences and things of that nature. The fifth structure of support is professional development. So this invites us to devise strategies that help us to increase our knowledge and our skills related to the work that we're doing. So this could include strategies such as reading journal articles, going to trainings, being observed by colleagues and getting feedback or participating in other kinds of consultation.

And lastly, the sixth structure of support around self-care is revitalization and generation of energy. And these are practices that we devise in this area are really meant to help us sustain energy, encouragement, and hopefulness about the work that we're doing. Examples for this structure of support could include strategies such as creating a pleasant workspace, revisiting reminders of positive outcomes achieved with clients with whom we have worked, reminiscing with colleagues about formative experiences that we've had as well as trying out new and creative approaches to the work that we're doing.

Kristin DeVall:
Jacquelyn, that's really helpful to distinguish between sort of what we think about in terms of personal self-care and then this other aspect of professional self-care. And two things really stood out that you talked about. One, in terms of having very clearly articulated roles and responsibilities. That's actually part of the best practice standards for treatment courts is having clear roles and responsibilities for each team member. And then the second piece is the importance of ongoing professional development and recognizing the importance of ongoing training in whatever capacity you're serving on a team. So I think that's very helpful in terms of connecting this idea of professional self-care with the work that we're doing. So distinguishing between personal and professional self-care, and then the accompanying strategies really has me thinking about self-care being something that both individuals and organizations should be attending to. And I'd not thought about that before.

Dr. Jacquelyn Lee:
Absolutely. And in thinking about at the individual level, I like to say that we are our first client. So our capacity to connect with our clients, which we know is really important in those working relationships is influenced by our capacity to connect with ourselves. Our own wellbeing influences how available we are to others and how well positioned we are to use the knowledge and skills that we have as well as to embody our professional values. And then secondly, in thinking about the organizational piece, we know that workers don't practice in a vacuum. They are in the context of their workplaces, which heavily influence and dictate the landscape of their work. So organizational attention to self-care is critical to creating a culture where the worker wellbeing and subsequently the capacity of workers to be effective in their work is prioritized.

Christina Lanier:
Yeah, Kristin, that is a really interesting connection between this work and treatment courts. And, Dr. Lee, the idea of self-care seems to be really a topic that is garnering great interest across various fields of practice. Why do you think that is? Why do you think now we hear so much about this across various fields?

Dr. Jacquelyn Lee:
That's a really good question. And I'm not sure I'm certain about the answer, but I do have a few ideas. And the first is service provision trends. So I can say certainly for social work, we've got some data that suggests that social workers are reporting an increase in paperwork, severity of client problems, caseload size, increase waiting list for services simultaneously while experiencing a decline in the levels of reimbursement, availability of supervision and staffing opportunities, as well as the accessibility of services for clients being an issue. And so it may be that these increasing demands are really taxing workers in such a way that wellbeing has honored a greater focus. A second reason why we might be seeing increased interest is because of this fitting with the trajectory of the literature related to self-care. So we see as early on is the '30s.

We begin to see conversation about stress in the literature. We move into thinking about occupational stress and burnout in the '70s. We then begin to see language around resilience. In the '80s to 2000 is when we really see a wellness movement began. And this is where an academic and medical and in corporate settings, we see a much more increased focus here. So there really seems to be a bend towards wellness and resilience now. We're also seeing more science around the connection between the mind and the body. So with the Western study of mindfulness being prominent now within the last 20 years or so. So I think that the interest is also reflected in the science.

And in third, I would highlight just some cultural and social factors. So I think just more attention to wellbeing is being paid just in our world culturally. So thinking about perhaps the connection between that and the increasing demands, that result from the changes in how we work such as the increase in technology, we've also seen healthcare costs drive a shift toward wellness, and we've seen an increase in interest in complimentary and integrative approaches. So those are three areas that come to mind when I think about this increase in focus on self-care.

Christina Lanier:
It's interesting how you talk about the increase within some fields around these issues of self-care. I think that there's very little discussion of self-care within the context of the criminal justice system. But what's fascinating is that some of the challenges that you mentioned could apply also to criminal justice professionals. So I think that could be very helpful as well in that field.

Dr. Jacquelyn Lee:
And that really makes a lot of sense. When we think about the different areas of practice or fields of practice and the different contexts that social workers are in, they are in very multidisciplinary settings. And so while that research was about the perspective of social workers, it does give us insight into human services in general.

Christina Lanier:
Absolutely. Absolutely.

Kristin DeVall:
Yeah. And thinking about the work that judges and attorneys and treatment providers, probation and parole agents, very similar, the folks and the challenges that people are facing, all of those entities play a role in addressing those challenges. So definitely relevant. Could be a topic for future research within the criminal justice system. You know, how does self-care play a role and what does that look like?

Dr. Jacquelyn Lee:
Absolutely.

Kristin DeVall:
So we've talked about self-care conceptually. Can you talk a little bit about the how of self-care? How do we put this into practice?

Dr. Jacquelyn Lee:
Sure. Well, a concept that I like to use is this concept of mindful self-care, and it's got three pieces to it. And the first is just our experience, which is made up of the thoughts, feelings, and sensations that we just objectively experience. And then the second piece is about how we relate to those experiences in the mind and the body. And this is really where mindfulness comes into play. And mindfulness is a way of relating to those thoughts, feelings and sensations.

Mindfulness invites us to pay attention to the present moment intentionally and invites us to allow and make space for whatever is here and the mind and the body. It invites us to accept the truth of what is really happening for us in the mind and the body. And that doesn't mean that we necessarily like it or prefer it, or we're resigning to it, but we're really just telling the truth to ourselves about what is really happening with us. And we do that with an attitude of curiosity of non-judgment and with kindness toward our inner experience. And that way of relating positions us to be able to act with awareness, which is connected to this third part of mindful self-care, which is about responding to our experience with self-care practices.

Kristin DeVall:
That's really interesting. I think connecting both the experience with an intentional focus on how do we relate to that, how do we feel, and then garnering a response to ourselves. That's helpful. I understand you have a backpack analogy that you use. Can you talk a little bit about that?

Dr. Jacquelyn Lee:
Sure. So I like to use this invisible backpack analogy to help us to give some strategies and to help us to ask some questions of ourselves related to how we work with the thoughts, feelings, and sensations that we carry around with us. So if we imagine, again, going back to that objective experience that we have going on, the thoughts, feelings, and sensations, we imagine that as in our backpack. So these are some strategies that we can use. And the first is to observe what we are carrying in that backpack. So what sort of thoughts are here right now? What sort of feelings are around? What sort of sensations might we be experiencing in the body? A second strategy is to try to carry this backpack with kindness. So asking ourselves, how can we honor our own experiences and asking ourselves, what do we need?

We also might need to set down the backpack. So what ways could we think of that might give us some space from the thoughts, feelings, and sensations that we might be experiencing related to work. Also, the idea of packing this backpack carefully can be helpful. So this comes along with the question, how can I intentionally generate thoughts, feelings, and physical concessions that are helpful to carry with me? So this is where we might focus on meaningful experiences at work. We might focus on hopefulness we feel. We might focus on thinking about positive interactions that we've had with clients or positive experiences where there have been outcomes that we are excited about. Another strategy here is about sharing the load of the backpack. So this invites us to think about who could help me with what I'm carrying? Could that be colleagues? Could that be consulting? Could that be a space like a therapy kind of space?

And then lastly a strategy is thinking about how to strengthen our lifting muscles to carry that backpack when it's really heavy. And so this invites us to think about, what can we do to build our mental, emotional, and physical strength to carry with us what we carry around related to work. And I should say too, that this doesn't... This, I think, focuses on the ways in which work can be heavy, but it's also important to remember that what's in our backpack can be things that really make us feel good about our work. There's so much joy and fulfillment and hopefulness about the world that we get through our work. And so all of those things go in our backpack as well.

Christina Lanier:
Dr. Lee, you've provided a wealth of information around self-care, including the mindfulness. So what would you encourage our listeners to do with this information? Can you talk about suggestions for how self-care and mindfulness could assist practitioners and even criminal justice practitioners with their work?

Dr. Jacquelyn Lee:
Absolutely. I think for individuals, I would encourage your audience to be courageous enough to be your first client and to do so gently. I think the greatest commodity we have is our attention. And in doing work with other people, we often put our attention on others, and it's really important to do that work and important for ourselves to recognize that we're deserving of our own attention. And for organizations, I would encourage organizations to be courageous enough to scrutinize the practices and policies governing the workplace environment in service of workforce wellbeing, and by extension, the quality of services provided. I used the word courage because focusing on self-care can be uncomfortable, it can be unfamiliar, and it can be different from the messages that we received growing up or just culturally.

Christina Lanier:
That's great. That really gives us something to work towards. Well, we'd like to thank our guest, Dr. Jacquelyn Lee for being with us today. We really appreciate your time and willingness to share your knowledge about self-care and mindfulness.

Kristin DeVall:
And to our listeners, thank you for joining us today. We hope this information regarding self-care is useful to you individually and with respect to your organizations. Please join us on the NDCRC.org, Justice to Healing Discussion Board to continue the dialogue regarding these important topics. Please join us next month for the next episode of Justice to Healing and always remember to do better.

Ben Yerby:
To our listeners. We thank you for listening and we hope you enjoyed the show. Be sure to hit subscribe to stay updated on the podcast. Follow us on Facebook, Twitter, and LinkedIn, to stay engaged with us and check out our website, NDCRC.org. Thanks again. Catch you next time on Justice to Healing.

The Justice to Healing podcast was presented by the National Drug Court Resource Center and was supported by Grant No. 2019-DC-BX-K002 awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the Department of Justice’s Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and the SMART Office. Points of views or opinions in this podcast are those of the author and do not necessarily represent the official position or policies of the United States Department of Justice.