Vicarious trauma: an exploratory study of the impact of providing sexual abuse treatment on clinicians' trust and intimacy

This study examined vicarious trauma effects in male and female clinicians who treat sexual abuse survivors (n = 111) and sexual offenders (n = 272). The national survey was conducted using a random sample of clinical members of two professional organizations. Analyses tested the relationships between demographic variables, maltreatment history, client population served, and cognitions about trust of and intimacy with others, using the Trauma Stress Institute Belief Scale (TSIBS-R-L, Pearlman 2003), the Childhood Trauma Questionnaire (CTQ, Bernstein & Fink, 1998), and author-generated questions. Respondents reported high rates of multiple forms of childhood maltreatment; however there was no relationship between history of child sexual abuse and vicarious trauma effects. Scores for self-reported disruption in cognitions about intimacy with others exceeded norms for mental health professionals. Sequential regression analyses were used to examine theoretically-derived variables. Implications for practice and research are detailed.     

Counselor happiness: Effects of therapy work with similar trauma

ABSTRACT

Many studies have researched burnout, compassion fatigue, secondary trauma, vicarious trauma, and shared trauma of practicing mental health professionals. Few have focused directly on the impact of personal trauma history on mental health professionals’ happiness. This exploratory study used an online survey to investigate the relationships among mental health professionals’ personal trauma history, happiness, and the effects of seeing clients with similar trauma. Personal trauma history was determined through a demographic survey and Posttraumatic Stress Disorder Checklist, and happiness was analyzed using the Oxford Happiness Questionnaire. The study examined several demographic variables to predict happiness. The study found that posttraumatic stress and number of client sessions were the most significant predictors of happiness.     

Vicarious trauma:predictors of clinicians' disrupted cognitions about self-esteem and self-intimacy

This study examined vicarious trauma in clinicians who provide sexual abuse treatment (N = 383). A random sample of clinical members from the Association for the Treatment of Sexual Abusers and American Professional Society on the Abuse of Children were surveyed. Vicarious trauma was measured using the Trauma Stress Institute Belief Scale (Pearlman, 2003). Maltreatment was measured using the Childhood Trauma Questionnaire (Bernstein & Fink, 1998). Respondents reported high rates of childhood maltreatment. Simultaneous multiple regression analyses were used to examine relationships between gender, age, maltreatment history, and vicarious trauma. Male gender predicted greater disrupted cognitions about self-esteem and self-intimacy. Clinician age and childhood emotional neglect predicted greater disrupted cognitions about self-intimacy. Implications for education, practice, and research are discussed.     

Burnout and Secondary Trauma Among Forensic Interviewers of Abused Children

This study examined factors associated with burnout and secondary trauma among forensic interviewers of abused children. Sixty-six forensic interviewers who are affiliated with advocacy centers across the United States completed an online survey. The Oldenburg Burnout Inventory and Secondary Traumatic Stress Scale were used to measure burnout and secondary trauma, respectively. Results indicate that organizational satisfaction has a moderate inverse relationship with burnout and a slight inverse relationship with secondary trauma. The number of forensic interviews conducted or length of employment in forensic interviewing did not have a strong relationship with either burnout or secondary trauma.     

Compassion Fatigue,Compassion Satisfaction,and Burnout

Summary

Over the past several decades the mental health field has become increasingly concerned about potential negative effects in professionals of providing crisis intervention and traumatic stress services to individuals and groups. The employee assistance (EA) field has not received adequate attention with regard to the study of these negative effects, such as compassion fatigue. This paper highlights results from a national research study of members of the Employee Assistance Professionals Association (EAPA) who were assessed for risk for compassion fatigue and burnout, as well as potential for compassion satisfaction. Additionally, coping methods for dealing with work-related stress resulting from the provision of workplace crisis intervention services were measured. Findings indicate that EA professionals who provide clinical services and/or crisis intervention services in the workplace are at low risk for burnout, moderate risk for compassion fatigue, and have high potential for compassion satisfaction. Implications for the EA field, in terms of training and practice, are discussed.     

Secondary traumatic stress and self-care inextricably linked

ABSTRACT

Increasingly trauma scholars are exploring the susceptibility of mental health providers to secondary trauma reactions. The current study explores the relationship between clinical social work practice with trauma-exposed clients and secondary traumatic stress among social workers. The intent of this study is to identify the role various factors play in the development of secondary trauma (also known as compassion fatigue). A simple random sample of National Association of Social Workers members were asked to participate. Participants completed an online survey that explored their exposure and responses to secondary traumatic stress. The online survey consisted of standardized measures including the Secondary Traumatic Stress Scale and The Coping Strategies Inventory which assesses secondary trauma and self-care strategies, respectively (Bober, Regehr, & Zhou, 2006; Bride, Robinson, Yegidis, & Figley, 2003). The magnitude of work (the extent and intensity of time working with trauma-exposed clients) is assessed by a non-standardized measure which consists of clinical caseloads composition questions. Job satisfaction is measured by items taken from the National Association of Social Workers’ workplace questionnaire (Whitaker & Arrington, 2008). 161 social workers completed the online survey. It required approximately 35 minutes to complete. This project empirically demonstrated that high-magnitude social work practice (providing therapeutic intervention to trauma survivors, i.e. military service members and veterans) is associated with higher levels of secondary trauma. There is also empirical evidence that self-care strategies can mitigate the impact of the secondary trauma. Educational and workforce implications for study findings are discussed.     

Vicarious traumatization,secondary traumatic stress,and burnout in sexual assault and domestic violence agency staff

This study investigated three occupational hazards of therapy with trauma victims: vicarious trauma and secondary traumatic stress (or "compassion fatigue"), which describe therapists' adverse reactions to clients' traumatic material, and burnout, a stress response experienced in many emotionally demanding "people work" jobs. Among 101 trauma counselors, client exposure workload and being paid as a staff member (vs. volunteer) were related to burnout sub-scales, but not as expected to overall burnout or vicarious trauma, secondary traumatic stress, or general distress. More educated counselors and those seeing more clients reported less vicarious trauma. Younger counselors and those with more trauma counseling experience reported more emotional exhaustion. Findings have implications for training, treatment, and agency support systems.     

Exhausted,Stressed, and Disengaged: Does Employment Create Burnout for Social Work Students?

Although burnout is a known risk for practitioners, some social work students may experience burnout in the classroom as a result of role conflict from balancing academics with employment. Higher rates of burnout occur in other disciplines in employed students, even higher than in professionals, because of the stress of shifting priorities between workplace and collegiate responsibilities. Employment can decrease collegiate engagement and academic competence and deter persistence to degree, all of which lead to the reduced competency associated with burnout. Additionally, physical and mental health factors are associated with role conflict, leading to a higher risk of burnout for employed students and resulting in burnout for social work students in the classroom even prior to becoming a practitioner.     

The Secondary Traumatic Stress Scale (STSS)

SUMMARY

The Secondary Traumatic Stress Scale (STSS; Bride, Robinson, Yegidis, & Figley, 2004) is an easy to administer 17-itemself-report measure of secondary trauma. Bride et al. (2004) reported a measure of three domains of traumatic stress specifically associated with secondary exposure to trauma: intrusion, avoidance, and arousal. The STSS was reported to have high levels of internal consistency reliability and indicated evidence of convergent, discriminant, and factorial validity. The purpose of this paper is to examine the reliability and validity of the STSS with a national, random sample of mental health social workers. To assess the fit of the data to the three-factor structure proposed by Bride et al., a confirmatory factor analysis was performed on data from 275 social workers who indicated exposure to client trauma. The model fit the data adequately although high factor intercorrelations strongly suggest a unidimensional scale. Subsequent confirmatory factor analysis of a unidimensional scale and a second order factor analysis yielded similar results. Findings indicate the need for further scale validation. Challenges remain for measuring and distinctly differentiating between secondary trauma symptoms of arousal, avoidance, and intrusion. Implications and suggestions for future research are discussed.     

Statewide dissemination of trauma-focused cognitive-behavioral therapy (TF-CBT)

Despite evidence linking childhood trauma to subsequent social, emotional, psychological, and cognitive problems, many children who have experienced trauma do not receive mental health treatment that has been proven to be effective. Large-scale dissemination of evidence-based practices (EBPs) is one possible solution to enhance the current negative state of mental health treatment for these children. This article describes a dissemination effort of an EBP (i.e., Trauma-Focused Cognitive-Behavioral Therapy [TF-CBT]) for childhood symptoms of post-traumatic stress disorder throughout Arkansas. The effort targeted mental health professionals within child advocacy centers and community mental health centers across the state. The article describes the process of dissemination and implementation. Lessons learned and recommendations for future dissemination efforts are highlighted.     

The limbic model of systemic trauma

Psychological symptoms, i.e. compassion fatigue, burnout and vicarious trauma, have been found to be associated with working with clients who are experiencing trauma. The literature on the brain and neuropsychological processes that accompany trauma indicate that physiological changes also arise in the person. This paper argues that psychological and physiological changes can be transferred from the traumatised clients to those working with the traumatised person. In an organisation where there is insufficient support and high case loads this can result in physiological changes occurring in the worker that lead to three main flawed decision-making processes. Clinical practice that supports reflective supervision can help workers to process their client's trauma and prevent a traumatised professional system arising.     

Building Resilience in Social Workers: An Exploratory Study on the Impacts of a Mindfulness-based Intervention

Burnout is a frequent and well-documented consequence of social work practice. The literature suggests that mindfulness-based interventions might help develop the mental states and emotional skills that are indicators of resilience. This mixed-methods, non-randomised controlled, exploratory study with 14 social workers in Canada investigated differences in social workers’ levels of stress, resilience, and burnout after a mindfulness-based intervention, compared to a waitlist group. The intervention group was also interviewed about changes in their relationships within the workplace, their perceived sense of mental health, and wellbeing. Results suggested that the mindfulness-based intervention significantly decreased the treatment group’s perceived stress compared to those on the waitlist and continued to decline for 26 weeks post-intervention. Intervention participants reported positive changes in attitudes, perspectives, behaviours, and energy in relation to their workplace relationships with peers and supervisors. Mindfulness-based interventions for reducing stress and building resilience to burnout in social workers and other helping professionals hold promise, and invite further research.     

Family Trauma and Dysfunction in Sexually Abused Female Adolescent Psychiatric and Control Groups

Differences in family trauma, stressors, and dysfunction among psychiatric inpatients grouped by sexual abuse self-reports were investigated. Group membership was determined by self-report of adolescents during a structured interview using a modification of the Traumatic Antecedents Scale (TAS). Family trauma/dysfunction was determined from a composite score derived from the TAS. The results indicated a significant difference for family trauma/dysfunction, with sexually abused adolescents reporting more family trauma/dysfunction than psychiatric controls. Also, those abused extrafamilally reported significantly more family trauma and dysfunction than psychiatric controls, while those abused intrafamilially did not report significant differences. Group differences in the endorsement of certain traumas stressors also were investigated. These findings indicated that among psychiatric inpatients, family dysfunction and trauma are present in those extrafamilially abused. Moreover, the extrafamilially abused were significantly different from controls, while incestuously abused were not significantly different. These results are discussed in the context of separation and abuse vulnerability.     

Beyond the prescription pad: psychosocial treatments for individuals with schizophrenia

Individuals with schizophrenia face multiple barriers to the achievement of optimal health, including apathy and poor concentration, sedative effects of medication, and poverty and lack of access to health education and treatment programs. In addition, the symptoms of the disease negatively affect their social functioning, which may result in isolation and lack of social support. In addition to providing psychiatric care and monitoring, both generalist nurses and advanced practice psychiatric nurses may assess physical and psychological risk factors, monitor medication responses, and provide health promotion to these individuals. Health promotion for individuals with schizophrenia includes psychosocial treatments to prevent relapse (e.g., education on the importance of treatment adherence) and to promote recovery (e.g., involving family members in treatment when possible). This article describes the key elements of recommended psychosocial treatments, briefly reviews the evidence for these treatments, and discusses clinical implications for all psychiatric nurses.     

The neurobiology of PTSD: implications for nurses

Posttraumatic stress disorder (PTSD) is a disabling and prevalent psychiatric disorder. Researchers and scientists have developed a neurobiological basis, which provides a framework for understanding the complexities of PTSD, for many symtoms of the disorder. The estimated lifetime prevalence of PTSD among adult Americans is 7.8%, with women twice as likely as men to have PTSD. Onset of symptoms can occur years after exposure to trauma, and the duration of the illness can last a lifetime. Patients with PTSD often encounter multiple psychosocial problems that result from the symptoms they experience, and their distorted perceptions can affect relationships within the family and the workplace. Nurses in various roles (e.g., educator, therapist, prescriber, case manager, staff nurse) may encounter individuals with PTSD. The nursing profession has traditionally sought to explain sophisticated language to patients in understandable terms, and nurses serve in encouraging, supporting, and evaluating roles, all of which will be increasingly important as science and technology discover more information about the neurobiological basis for mental illnesses.     

Self-Stigma of seeking help and job burnout in mental health care providers: the comparative study of Lithuanian and the USA samples

This study aimed to explore the correlation between job burnout and self-stigma of seeking help among nonmedical mental health care providers (psychologists, social workers, and counselors) in two countries – Lithuania and the US. The study included 234 professionals (111 social workers and 123 psychologists) from Lithuania and 93 professionals (33 counselors, 23 social workers, and 37 psychologists) from the US on a voluntary basis (93% females, mean age – 39.81?years). They completed a self-reported questionnaire with the Self-Stigma of Seeking Help Scale (SSOSH) and the Maslach Burnout Inventory-General Survey (MBI-GS). The results revealed a statistically significant positive correlation between self-stigmatization and burnout in the Lithuanian sample, but only weak positive correlation between depersonalization and self-stigma of seeking help in the US sample. The relationship between the self-stigma of seeking help and burnout was stronger in the Lithuanian sample of professionals when compared to their colleagues in the US.     

Stress,Depression, and Drug Use Among Aging Mexican American Men Living in the Barrio

Residing in Mexican American barrios might place individuals at heightened risk for chronic financial and acute stress, which are associated with adverse mental health outcomes. Stressors could be exacerbated for substance users. This research explores relations between chronic financial stress, acute stress, and depressive symptomatology among aging Mexican American heroin and other drug-using men. A prospective cohort study and field-intensive outreach methodology were used to recruit 227 men for in-depth interviews. Participants were categorized into depressed and nondepressed groups based on symptomatology measured by the Center for Epidemiological Studies Depression Scale. Chronic financial stress (i.e., poverty) and acute stress (i.e., Life Events Questionnaire) associated with depressive symptomatology were tested using logistic regression. Findings suggest scores of depressive symptoms among substance users are highly related to chronic financial stress. Community-level interventions targeting chronic stressors present in the barrio could be especially salient in improving the mental health of Latino drug users.     

Perception vs. Circumstances of the Child Sexual Abuse Event in Relation to Depression and Post-traumatic Stress Symptomatology

The study examined the impact of the circumstances of childhood sexual abuse on post-traumatic stress symptoms and depression among female adult survivors of childhood sexual abuse. The sample consisted of 225 Israeli women divided into two groups according to the identity of the perpetrator (nonfamily perpetrator versus a family member perpetrator). A self-report questionnaire was used consisting of the following scales: demographic variables, the Traumatic Events Questionnaire, Childhood Sexual Experiences Scale, Post-Traumatic Stress Disorder Symptom Scale, and Depression Scale. The findings indicated that the identity of the offender significantly differed between groups only if intercourse had occurred. Women who experienced coerced intercourse scored significantly higher on depression and post-traumatic stress compared to those who experienced other forms of childhood sexual abuse.     

Technostress: Implications for Adults in the Workforce

The use of technology can enhance workplace efficiency, productivity, and flexibility; yet, technological tools can have negative effects on individuals’ cognitive, psychological, and physical health, as well as on organizations (e.g., lowered employee satisfaction, decreased employee commitment). The use of information and communications technologies (ICT) adds to existing work stress. The authors reviewed recent literature to identify ICT trends, define key terms, and gain insights to improve awareness of ICT issues related to career development, health and wellness, and job security. The potential for inquiry as it relates to career exploration, development, and advancement is relevant to counselors and clients in today's workplace. Research is needed to examine the effects of technostress across different industries, to identify workers at greatest risk of adverse effects, to explore the impact on career decision making, to help clients develop personal coping resources, and to determine strategies for career professionals to collaborate with workplace managers.