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.     

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.     

The Unbearable Fatigue of Compassion: Notes from a Substance Abuse Counselor Who Dreams of Working at Starbuck’s

Current research has determined that a larger percent of social workers and other counselors are affected by PTSD types of symptoms when working with traumatized clients than the general population. While much of this research addresses workers in specific trauma areas like sexual assault centers or child welfare agencies, little specific thought has been given towards the special stress that working with Substance Abuse Disorders (SA) and trauma may present. This paper takes a brief look at the issues of vicarious trauma and compassion fatigue with SA practice and describes future investigation pathways toward this goal.

Sifting Through Trauma: Compassion Fatigue and HIV/AIDS

This article explores the compassion fatigue of the author and the graduate students he supervised while conducting psychotherapy with persons living with HIV/AIDS at a counseling center in Atlanta, Georgia. The metaphor of a sifter is suggested to represent the self-care strategies that providers employ to avoid and manage compassion fatigue. Several vignettes are presented and discussed from the perspective of the provider. The vignettes facilitate an examination of the contribution of trauma experienced by persons living with HIV/AIDS to the compassion fatigue of social service providers. The author recommends a renewal of research in the area of compassion fatigue among social service providers working with these clients.     

The Fatigue of Compassionate Social Workers: An Introduction to the Special Issue on Compassion Fatigue

The paper introduces the special issue by first discussing its purpose for the reader and the field of social work. Each article, in the order it appears, is discussed in terms of its contribution to the special issue and the field and linking conceptually each with others in the collection. These articles discuss the special challenges of social workers working with clients who live with the traumatic effects of disasters—both natural and human-caused or human-contributed, war combat, HIV/AIDS, and substance abuse. It is noted that far more research, education, and practice innovation should be devoted to compassion fatigue. The article ends with a final plea not only for such attention but also standards of self-care in addition to standards of professional practice.     

Do Secondary Trauma Symptoms in Spouses of Combat-Exposed National Guard Soldiers Mediate Impacts of Soldiers’ Trauma Exposure on Their Children?

This exploratory study examines the associated effects of combat exposure on Soldiers assigned to a Midwestern Army National Guard unit. It also explores the secondary and mediating effects of combat exposure on Soldier’s spouses and children. The correlations of combat exposure with trauma symptoms, substance abuse, domestic violence and secondary trauma symptoms among family members are identified. Survey results suggest that immediate family members of combat-exposed Soldiers with high levels of post traumatic stress disorder (PTSD) are at risk for developing secondary traumatic stress. Secondary trauma symptoms in these spouses are a risk-increasing mediating variable between trauma symptoms in combat-exposed Soldiers and secondary trauma symptoms in their children. Results from this investigation emphasize the need for further inquiry into this topic. They further highlight the need for preventive and treatment efforts targeted toward all family members and relationships in order to lessen the effects of combat exposure.     

The role of self-care on compassion satisfaction,burnout and secondary trauma among child welfare workers

Child welfare workers are routinely exposed to multiple traumatic events when working with children and families, and are at an increased risk of experiencing burnout and secondary trauma. Self-care is often recommended as a restorative or protective activity against the negative effects of working with traumatized individuals, although few studies have examined the benefit of self-care empirically. Trauma-informed self-care (TISC) includes being aware of one's own emotional experience in response to exposure to traumatized clients and planning/engaging in positive coping strategies, such as seeking supervision, attending trainings on secondary trauma, working within a team, balancing caseloads, and work–life balance. Compared with generic personal care activities, TISC is likely to be especially relevant for child welfare workers. This study examined the role of TISC on compassion satisfaction, burnout and secondary trauma which was assessed by administering surveys to a sample of 104 child welfare case managers and supervisors. Almost one third of the sample reported high levels of burnout (29.8%) and secondary trauma (28.8%), and low levels of compassion satisfaction (31.7%). Results suggested that workers who engaged in higher levels of TISC experienced higher levels of compassion satisfaction and lower levels of burnout, although there was no relationship with secondary trauma. Findings provide preliminary evidence that TISC may be a beneficial practice to reduce risk of burnout and preserve workers' positive experience of their job, however workers experiencing secondary trauma are likely to need additional specialized intervention to assist them with their recovery.     

Sociological conceptualizations of compassion fatigue: Expanding our understanding

Compassion fatigue has been primarily studied at the micro level and framed as a psychological “personal trouble” that results from one's personality traits, demographic characteristics, or life and work stressors. In addition, compassion fatigue is used to predict other psychological outcomes such as burnout, depersonalization, and stress. This literature on compassion fatigue has been reviewed, in order to illustrate areas where sociologists can contribute to a more nuanced understanding of the phenomenon. In this article we conceptualize compassion fatigue as a sociological concept and overview the potential ways that sociological approaches can enhance our understanding. We draw on the literatures of emotion work, social exchange theory, and macrolevel sociological theories to facilitate the use of compassion fatigue from a sociological perspective. For example, we use concepts such as social integration and anomie to stimulate thinking about rates of compassion fatigue.     

Therapists' Collusion with the Resistance of Rape Survivors

Based mostly upon a qualitative study of nine rape survivors, but also upon intensive review of the literature devoted to countertransference, vicarious traumatization, compassion fatigue, and burnout, this article examines collusive resistance, a process whereby therapists join clients to avoid confronting painful issues. It offers guidelines for the therapist to follow in the therapeutic dance to avert such collusion, and thereby to intervene more effectively especially with traumatized clients to facilitate their recovery actively, and, ultimately, to contribute to their true survivorship.     

Self-Care Practices and the Professional Self

ABSTRACT

Consistently and actively engaging in self-care has been shown to improve the performance of mental health practitioners by reducing burnout, vicarious trauma, compassion fatigue, and other stress-related psychological problems. Not only is this important to the individual practitioner’s well-being, but ethical standards also mandate the recognition and remediation of any physical, mental, or emotional self-impairment to maintain high standards of care for clients. Professionals in small communities, like the Deaf community, however, confront unique challenges in attending to their self-care. This article investigates these challenges—as well as the rewards—experienced by Deaf and hearing counselors working in mental health care with deaf clients.     

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.     

Childhood abuse history,secondary traumatic stress,and child welfare workers

Social workers are exposed to trauma vicariously through the trauma of their clients. This phenomenon, called secondary traumatic stress, vicarious traumatization, or compassion fatigue, presents a risk of negative personal psychological consequences. Based on a sample of 166 child welfare workers and using standardized measures, the study findings document the link between a personal history of primary trauma, childhood abuse or neglect, and the heightened risk for secondary traumatic stress in child welfare workers.     

A fractured journey of growth: making meaning of a ‘Broken’ childhood and parental mental ill-health

The psychopathological impact of parental mental ill-health on children is well known. However, little research explores positive and negative interpretations of such exposure in childhood, from the adult child's perspective. Using interpretative phenomenological Analysis this study sought subjective interpretations of the ‘lived’ experiences of growing up in a family with parental mental ill-health. A purposive sample of seven adult children provided data for analysis through semi-structured interviews. One superordinate theme: A fractured journey of growth to adulthood, overarched six subordinate themes. Four themes captured stigma, shame, social isolation and betrayal. Juxtaposed with this, two themes captured purposeful redefinition of self and psychological growth. This study captures the chronicity of traumatic distress and sense of betrayal experienced by these participants in childhood through unrelenting exposure to parental mental ill-health. However, despite unpredictability, fear, and neglect in childhood, they identified the emergence of inner strengths in adult life: unexpected growth in empathy and compassion, high resourcefulness, and personal authenticity through higher education. Findings highlight that positively redefining ‘self’ in adult life is possible in the aftermath of childhood trauma associated with parental mental ill-health. Implications for therapy include: (a) moving forward from childhood trauma and (b) managing ongoing family dynamics in adult-life.     

Secondary Trauma: How Working with Trauma Survivors Affects Therapists

Secondary trauma, a relatively recent topic that has emerged in the field of social work, includes the emotional and psychological effects that working with traumatized clients has on therapists. Secondary trauma can seriously impact therapists' personal and professional well-being. Trauma therapists face major ethical dilemmas if their reactions to being traumatized enter into the therapeutic relationship, exposing clients to psychological harm or possibly re-traumatization. As many graduate programs in social work and social service agencies are still unaware of this phenomenon, recommendations are made for how to introduce the topic as priority and how to cope with and prevent secondary trauma.     

Editorial

Undergoing a traumatic experience can be a life-changing event, having a significant impact on individuals, families, communities, workplaces and societies. Traumatology is therefore a complex field of study demanding a sophisticated level of understanding to serve as a theory base. This article explores the potential for existentialist philosophy to make an important contribution to our understanding of trauma and its effects. It presents trauma as an existential injury and explores the psychosocial basis of traumatic experience — that is, conceptualising trauma as having both psychological and sociological dimensions, the combination of which has profound existential resonances. While the theoretical ideas discussed can be applied to trauma at any stage in the life course, this paper focuses in particular on childhood trauma. Consequently, child abuse is used as an example of how trauma can have a significant (and detrimental) effect on identity development, invoking a need for a commitment to trauma recovery.     

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.     

See no evil,hear no evil,speak no evil: assessing complex trauma in young children

Complex trauma generally refers to a child's exposure to multiple traumatic events often within the context of an interpersonal relationship. Childhood traumatic events are commonplace and can have significant implications for physical and mental health. However, traumatic events are often not assessed by clinicians involved in their care. This paper outlines an approach to assessing complex trauma in young children in clinical settings. This approach involves an initial interview, an assessment of traumatic events and trauma symptoms in the child, an assessment of the parent–child interaction, an understanding of the child's functioning in multiple settings, and an assessment of parental trauma where relevant. Complex trauma takes time to assess and is dependent on the parent's ability to recognise and acknowledge the effect trauma has had. The paper concludes with some of the challenges when assessing complex trauma in young children in clinical settings.     

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.