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.     

The Use of Peer Support for Parents and Youth Living with the Trauma of Child Sexual Abuse: An Innovative Approach

ABSTRACT

This article describes and reports on an innovative intervention program for parents of sexually abused children and youth. Peer support provided by non-professional staff and volunteers, who have been personally affected by the trauma of child sexual abuse, is an approach with unique advantages. Many of these consumers have not been able to benefit from traditional service delivery approaches. Goals and objectives of the Peer Support Program (PSP) have been developed through inter-agency collaboration initiatives comprised of a coalition of existing social service agencies. This report examines characteristics of service delivery and level of consumer satisfaction of parents and youth who have participated in the peer support program. Implications for interventions with sexually abused youth and parents of sexually abused children are discussed.     

After the Assault: Cognitive Trauma Therapy with a Single Event Trauma Survivor

This article explores the specific context of a single event criminal assault, (i.e., a stranger non-sexual assault that occurred during a robbery) and shares the theoretical framework that successfully guided the clinician’s assessment, treatment planning, and interventions. Based on a literature review and employing a case study, this article presents the potential norms of trauma aftermath following a single event non-sexual criminal assault. It provides an overview of those theoretical frameworks that have consistently proven effective with this population; this article shares the rationale for selecting cognitive trauma therapy and illustrates its application to an assault survivor.

Predictors of Secondary Traumatic Stress among Children's Advocacy Center Forensic Interviewers

This study examined various predictor variables that were hypothesized to impact secondary traumatic stress in forensic interviewers (n = 257) from children's advocacy centers across the United States. Data were examined to investigate the relationship between organizational satisfaction, organizational buffers, and job support with secondary traumatic stress using the Secondary Traumatic Stress Scale. The most salient significant result was an inverse relationship between three indicators of job support and secondary traumatic stress. Also significant to secondary traumatic stress were the age of interviewer and whether the forensic interviewer had experienced at least one significant loss in the previous 12 months. Implications for future research, training, program practice, and policy are discussed.     

Trauma: Conscious and Unconscious Meaning

Developmental, constructivist theory is applied to increase understanding of conscious and unconscious dynamics of trauma experience. DSM-IV criteria provide the accepted standard guiding research and practice for trauma. Concern is raised that rigid adherence to diagnostic categories is problematic for trauma survivors. Trauma survivors are unique in both conscious and unconscious experience. Saari's (2002) levels of cognitive integration of experience based on Nelson's (1985) tripartite theory of meaning are employed as an investigative tool. Understanding the individual's cognitive integration of the traumatic event is central to facilitating reintegration and healing post-trauma. The therapeutic dyad co-constructs a narrative that allows reintegration and healing. A case study of a childhood sexual abuse survivor demonstrates how relationship dynamics facilitate co-creation of a healing narrative.     

Financial Abuse of Elders and Dependent Adults: The FAST (Financial Abuse Specialist Team) Approach

ABSTRACT

The Financial Abuse Specialist Team, a partnership of professionals from diverse disciplines, volunteer their time to review cases of financial elder abuse and facilitate comprehensive service delivery. The team also advocates for legislative reform, educates the community about the problem, and trains professionals in how to recognize, prevent, and resolve financial elder abuse.     

Barriers to Integrated Treatment of Substance Abuse and Trauma Among Women

Despite increasing empirical support for an integrated approach to treating trauma and substance abuse, many substance abuse treatment programs have been slow to embrace integrated models of practice. Using an embedded case study design, the purpose of this study was to understand barriers that prevented a substance abuse treatment provider and 20 professionals and staff from adopting an integrated approach to treating substance abuse and trauma. Data analysis revealed 2 kinds of barriers that prevented substance abuse treatment professionals from fully integrating substance abuse and trauma: systemic and professional barriers. These barriers have to be taken into account when trying to move providers and professionals toward integrated approaches to treating substance abuse and trauma.     

Implementing Single Session Family Consultation: A Reflective Team Approach

Setting up and implementing a single session family consultation in a specialist child and adolescent mental health setting, which for a long time has been an organisation and culture that has undertaken a traditional detailed child and family assessment and treatment, brings with it challenges. This paper will look at the history of single session consultation within the field of child and family services and, in particular, child and family services in mental health. It will also look at the development and implementation of a single session therapy program, and associated research on the effectiveness of the program, at the Alfred Child and Youth Mental Health Service. Clinical examples will assist in illustrating the program and its model and structures. Lastly, it will review the research data and compare this with other research data in the field.     

Complementing SBIRT for Alcohol Misuse with SBIRT for Trauma: A Feasibility Study

Reducing alcohol misuse is a priority for U.S. health officials considering that misuse of alcohol is a leading preventable cause of morbidity and mortality. Consequently, health centers are integrating Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol misuse within usual care. Although SBIRT is well validated among general patient samples, results have not generalized to drinkers with probable alcohol use disorder; moreover, little is known about the efficacy of SBIRT with patients who are of low-income or ethnic or racial minority status. Members of these groups are of particular concern because they are at risk to experience trauma, potentially in concert with alcohol misuse. Therefore, translational approaches to delivering SBIRT particularly with these groups of interest might be needed to meet the Grand Challenge of reducing alcohol misuse. Accordingly, this study combined SBIRT with a model designed to address psychological trauma: T-SBIRT. With a sample of 112 adults, most of whom were African American or Latino/a, authors analyzed multiple indicators of feasibility. Results indicated that T-SBIRT is suitable for and acceptable to patients accessing community-based health services, and T-SBIRT can promote high referral acceptance rates to specialty treatment, particularly among patients with probable alcohol use disorder.     

Integrating a Trauma Lens into a Family Therapy Framework: Ten Principles for Family Therapists

This paper aims to show how a trauma lens can be incorporated into existing family therapy practices, changing how therapists perceive presenting problems and therefore the issues and sites of intervention. After reviewing the family therapy literature concerning trauma and defining different types of trauma, the paper discusses how traumatic memories differ from ordinary memories. Ten principles for practice are described to guide therapists in integrating the trauma lens into their family therapy practice. Three case studies are used to illustrate these principles.     

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.     

Nursing-Home Resident Quality of Life: A Longitudinal Case Study Approach

Longitudinal quality-of-life (QOL) research incorporating multiple perspectives can add to knowledge about how nursing home residents experience QOL, but these methods are seldom used. This study employed interviews and participant observation to conduct multiple-perspective, longitudinal case studies of six residents. Close, reciprocal relationships with staff members, staff knowledge of residents, and autonomy were fundamental to QOL. Autonomy was experienced through choice and self-advocacy. Changes in QOL over time related to changes in resident health status, acclimation to the setting and family member availability. Study results may have implications for staffing and staff training.     

Attachment Quality and Post-treatment Functioning Following Sexual Trauma in Young Adolescents: A Case Series Presentation

Children and adolescents who suffer sexual abuse evidence symptoms that may persist into adulthood. Attachment theory may lend some insight into the psychological sequelae following sexual trauma. A clinical case series presents four sexually abused young adolescents from the first author's clinical caseload. Each case is rated regarding the quality of attachment, the severity of trauma, and the child's functioning at the time of follow-up. Ratings are made by the first author and qualified by a second clinician who is familiar with each case. Findings suggest that those youngsters who had the benefit of a strong and secure attachment evidence more positive outcome at follow-up.     

The Trauma Outcome Process Assessment Model: A Structural Equation Model Examination of Adjustment

This investigation sought to operationalize a comprehensive theoretical model, the Trauma Outcome Process Assessment, and test it empirically with structural equation modeling. The Trauma Outcome Process Assessment reflects a robust body of research and incorporates known ecological factors (e.g., family dynamics, social support) to explain internalizing distress (e.g., anxiety, depression), externalizing distress (e.g., aggression), and recovery outcomes following traumatic events. Results revealed that expected relationships among the variables were significantly related in the expected direction, and the measures mapped well onto the expected latent constructs. Following optimal specification of the relationships within the Trauma Outcome Process Assessment, structural equation modeling revealed strong support for the Trauma Outcome Process Assessment as a comprehensive identification and treatment model to explain the differential outcomes of those exposed to traumatic stressors.     

Stress, Trauma, and Coping Strategies: Cross-Cultural Variations

This article examines three major issues. First, it considers the nature of trauma, its cognitive and emotional appraisal, and the cultural variations in its appraisal. In this context, it also distinguishes between universal traumas and culture-specific traumas with pertinent examples. In addition, the conceptual, epistemological, and methodological problems of investigating trauma across cultures are highlighted. Second, the article critically examines the controversies surrounding the nature, theoretical formulations, and methodologies currently adopted in stress research both in Western and non-Western cultures, with special emphasis being placed on the situation prevailing in Indian stress research. Third, it focuses on therapeutic issues and highlights some of the culture-specific healing techniques used by some people in Indian cultures to cope with stress and trauma. Finally, it suggests ways by which one might achieve a rapprochement between Western approaches and non-Western approaches to the study of stress and trauma.     

American Indian Grand-Families: Trauma and Services

Since the United States Census Bureau began collecting data regarding grandparents raising their grandchildren, the American Indian and Alaska Native (AI/AN) population has had the highest proportion of families led by grandparents as the primary caregivers of their grandchildren. Despite this, research into AI/AN grand-families is limited. To begin to fill this gap, this qualitative study of 49 AI/AN grandparents raising grand-families (GFs) was conducted in an urban area with one of the highest AI/AN populations in the United States. Results indicated that loss and trauma within the middle generation is a central theme for GF formation. Such GFs also reported using a variety of services spanning state, tribal, and urban AI/AN programs, with educational support as a primary need articulated for their grandchildren. Surprisingly, enculturation was not mentioned as a primary driver of GF formulation. The study suggests a need for further exploration of the needs of urban-based AI/AN GFs, and that service providers must be aware of such issues when working with AI/AN GFs.     

Trauma and the Clinician: Therapeutic Implications in Clinical Work with Clients

This article explores clinical issues related to self-disclosure to clients following a traumatic event in clinicians' lives. In particular, special attention is paid to the role of self-disclosure in clinical work when clinicians are conflicted about whether or not to share personal information or how to communicate it to clients due to the nature of the trauma. Therapeutic implications, both short and long term, associated with such self-disclosure are discussed.