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Complex traumatic stress disorders: An evidence-based clinician’s guide
... Pearlman and Caringi (2009: 202) define VT as 'the negative transformation in the helper that results from empathic engagement with trauma survivors and their trauma material, combined with a commitment or responsibility to help them'. Similar to primary trauma, this transformation is often in the form of painful and distressing changes to a person's core systems of meaning, their relationships, their sense of hope and their measure of safety (Barrington and Shakespeare-Finch, 2013;Hunter and Schofield, 2006;Pack, 2013;Pearlman and Caringi, 2009). VT often manifests as intrusive thoughts and images, nightmares, overwhelming emotional responses and changes in belief systems and behaviour (Barrington and Shakespeare-Finch, 2013;Hunter and Schofield, 2006;Pack, 2013;Pearlman and Caringi, 2009). ...
... Similar to primary trauma, this transformation is often in the form of painful and distressing changes to a person's core systems of meaning, their relationships, their sense of hope and their measure of safety (Barrington and Shakespeare-Finch, 2013;Hunter and Schofield, 2006;Pack, 2013;Pearlman and Caringi, 2009). VT often manifests as intrusive thoughts and images, nightmares, overwhelming emotional responses and changes in belief systems and behaviour (Barrington and Shakespeare-Finch, 2013;Hunter and Schofield, 2006;Pack, 2013;Pearlman and Caringi, 2009). ...
... VT is considered by some to be an inevitable impact of exposure to trauma material and witnessing the suffering of trauma survivors (Barrington and Shakespeare-Finch, 2013;Pearlman and Caringi, 2009). While there is an overlap between VT, post-traumatic stress disorder, compassion fatigue and burnout, the distinction lies in the nature of the exposure to trauma material (Silver et al., 2015). ...
The psychological cost of exposure to traumatic events is receiving greater recognition in recent years, especially in terms of its impact in helping professions and emergency services. However, the costs to researchers remain relatively unexplored. In this article, we will discuss the nature and impact of vicarious trauma using two criminological research projects as case studies: one a qualitative project engaging with survivors of childhood sexual abuse, and the other, a quantitative analysis of police hate crime reports. In addition to considering the trauma elicited in fieldwork such as interviews, we interrogate the costs imposed on researchers during the coding and analysing processes. We suggest that the cost is potentially greater when the researcher has a personal connection with the issues being researched, but that this personal experience also provides the researcher with important skills for responding to new or compounded trauma. The costs of engagement with trauma may be compensated by the productive outputs and impact on policy and practice that this type of research may elicit. Understanding the impact and costs of engaging with close analyses of trauma is critical in developing more robust and ethical research processes to ensure that this trauma is appropriately managed so as to avert the long-term damage this work can inflict on researchers and participants.
... Framed as a vocational health issue, the mental well-being of social workers is critical in their ability to provide high quality services to recipients. Secondary traumatic stress, compassion fatigue, and burnout have been identified as among the workplace-based challenges facing those in helping professions (Figley, 1995;Pearlman & Caringi, 2009). Yet there remains a lack of understanding about the extent to which these issues impact social workers and in what ways. ...
... McCann and Pearlman (1990) introduced the concept of transference of beliefs and assumptions about the world related to the traumatic experience from the client to the therapist, calling this phenomenon "vicarious traumatization." Since then there has been a growing body of research introducing and identifying the effects and prevalence of Secondary Traumatic Stress (STS) among clinicians (Bride, 2007;Figley, 1995;Pearlman & Caringi, 2009;Pryce, Shackelford, & Pryce, 2007;Stamm, 1999). STS refers to behaviors and emotions resulting from helping a traumatized or suffering person (Figley, 1995). ...
... This population was selected because LCSWs are often exposed to high levels of stress, work with traumatized populations, and spend time listening to recollections of traumatic events. Exposure to stress and trauma can create burnout, compassion fatigue, or secondary trauma (Pearlman & Caringi, 2009). A list of social workers was obtained from the Montana Board of Licensure. ...
This study examines levels of secondary traumatic stress (STS), compassion fatigue, burnout, and compassion satisfaction in social workers in the State of Montana. It also seeks to explain how specific organizational factors or peer support can potentially reduce the impact of these phenomena. A mixed methodology was utilized. Respondents (N = 256, response rate = 56%) completed 4 short measures: (a) the Social Work Demographics/Workplace Questionnaire, (b) the Secondary Traumatic Stress Scale (STSS; Bride, Robinson, Yegidis, & Figley, 2004), (c) the Professional Quality of Life Scale (ProQOL) (Stamm, 2010), and (d) an original peer support survey. A smaller sample (N = 15) of follow-up interviews were conducted to collect qualitative data. A theory-based approach guided the qualitative data analysis, for which ATLAS-Ti software was used. Findings indicate that social workers in the sample experience significant levels of STS (M = 33.63, SD = 11.30), with 40.9% (n = 105) meeting the criteria for posttraumatic stress disorder, using the STSS (α = .92) as a proxy measure. ProQOL (α = .76) results confirm the presence of high levels of burnout and compassion fatigue on subscale scores, with t tests indicating that individuals performing case management reported lower levels than other groups. Age and time in current job were not found to be significant factors, whereas lower levels of job satisfaction and intent to look for other work were predictive of higher burnout and compassion fatigue scores. Qualitative data analysis revealed themes related to worker perceptions of factors that contributed to their levels of STS. Implications for policy and practice changes are offered.
... Figley (1995) introduced the concept of compassion fatigue (CF), Pearlman the concept of vicarious trauma (VT; McCann & Pearlman, 1990), and Stamm (1995Stamm ( /1999) who focused on secondary traumatic stress (STS). Both Stamm Stamm, 2002) and Pearlman (McCann & Pearlman, 1990;Pearlman & Caringi, 2009;Pearlman & Saakvitne, 1995) later recognized the positive, and transformative, aspects of caring. Stamm focused on compassion satisfaction, the positive aspects relating to providing care and Pearlman on the rewards of doing the work and the vicarious transformation that can occur (Pearlman & Caringi, 2009). ...
... Both Stamm Stamm, 2002) and Pearlman (McCann & Pearlman, 1990;Pearlman & Caringi, 2009;Pearlman & Saakvitne, 1995) later recognized the positive, and transformative, aspects of caring. Stamm focused on compassion satisfaction, the positive aspects relating to providing care and Pearlman on the rewards of doing the work and the vicarious transformation that can occur (Pearlman & Caringi, 2009). Other authors have conceptualized certain positive changes resulting from trauma work as vicarious posttraumatic growth (Arnold, Calhoun, Tedeschi, & Cann, 2005) or vicarious resilience (Hernandez, Gansei, & Engstrom, 2007). ...
... Both vicarious traumatization and vicarious transformation are change processes (McCann & Pearlman, 1990;Pearlman & Caringi, 2009). Vicarious traumatization and transformation are changes in psychological needs-based beliefs, self capacities, ego resources, and frame of reference that can occur across time when providing assistance in response to others' suffering and need. ...
... Although debate continues concerning the validity of the VT construct and its separateness from other similar concepts, there is some agreement that counselling trauma victims can negatively affect counsellors (Bride, 2004;McCann & Pearlman, 1990;Neumann & Gamble, 1995;Pearlman & Caringi, 2009;Pearlman & Saakvitne, 1995) and that this is similar for Australian counsellors (Dunkley & Whelan, 2006a;Iliffe & Steed, 2000;Steed & Bicknell, 2001;Steed & Downing, 1998). Negative counsellor functioning can range from distancing themselves from clients through to over-involved, intrusive client work (Astin, 1997;Gabriel, 1994;Neumann & Gamble, 1995) and feelings of being compromised due to the lack of non-verbal cues they receive in the digital environment (Bambling et al., 2008;Coman et al., 2001;. ...
... While empathic engagement is a necessary component of effective trauma counselling, counsellor traits of commitment and responsibility require close attention to ensure healthy boundaries are maintained in the working relationship (Astin, 1997;Hesse, 2002;McCann & Pearlman, 1990;Neumann & Gamble, 1995). Interestingly, there is some evidence to suggest that while unprocessed counsellor response to empathic engagement can result in VT when there is adequate, early intervention, positive growth can occur for both client and counsellor, (Pearlman & Caringi, 2009;Pearlman & Saakvitne, 1995). ...
... Possible causes of VT can be grouped as (1) aspects of the work (e.g., caseload, experience with the work) and (2) aspects of the counsellor (e.g., personal trauma history, attachment style, coping style and current life stressors; Pearlman & Caringi, 2009). Due to the potential of the many elements of each of these aspects to interact with each other in a variety of ways, a plethora of possible outcomes may be related to the development of VT, and conflicting outcomes are often found when individual factors are studied. ...
Literature with a focus on telephone and online counselling is reviewed as this form of counselling is becoming increasingly popular in Australia. The relevance and drawbacks of counselling in these two digital environments are detailed. Of the drawbacks, vicarious traumatisation (VT) is given a particular focus as its effects on counsellor functioning are seen to be profound. Possible causes of VT are outlined in light of the controversy surrounding the definition of the condition. Although positive supervisory effects on vicarious traumatisation was only partially supported from general studies on counselling, highlighting the need for focused research on the value of supervision for Australian telephone and online counsellors at risk for vicarious traumatisation, overall supervision was seen to be a legitimate part of VT management for counsellors working in telephone and online environments. In 2003, the Australian Department of Health and Ageing acknowledged the unique contribution provided by telephone and online counselling and highlighted the complementary and supplementary nature of these services to those provided by the mainstream health sector. The department also highlighted the value of alternate access pathways that telephone and online counselling had created for clients, especially those who were not able to access a face-to-face health service. The importance of telephone and online counselling has also been recognised by the Council of Australian Governments (COAG), who provided 56.9 million dollars of funding over a 5-year period, beginning in 2006. However, while the advantages of telephone and online counselling has been recognised by Australian government agencies, the drawbacks of this form of counselling is less well known. Indeed, online counselling may be more attractive
... feeling unable to relate to others), safety (e.g. to walk at night alone), and trust (e.g. in men, see Baird and Kracen, 2006;Morrison, 2007: 3). Typically, the shift in the individual's cognitive schema is correlative to the nature of the trauma to which the individual is vicariously exposed (Pearlman and Caringi, 2009). For example, the study of domestic abuse may lead one to doubt marriage to provide a safe and mutually loving union, and therefore, to perceive this relational outcome as something to be avoided. ...
... Following this inquiry in the press and visual reportage, I was distressed by the secrecy exercised by the Roman Catholic Church in relation to known instances of child sexual abuse. Like many scholars, I entered the field of child protection to contribute to reform in some way, a common causative risk-factor for vicarious trauma (Pearlman and Caringi, 2009;Waters, 2016). At the time, I did not readily comprehend what I was signing up for. ...
Criminology almost inevitably involves the study of sensitive and sorrowful research topics. Consequently, criminologists fall victim to the inherent risks of exposure to vicarious trauma, requiring many to practice emotional labour in the field, in the lecture hall, and perhaps, even along the corridors of the university campus itself. This article offers a reflective account of the experiences of vicarious trauma and the self-imposed, protective practice of emotional labour within doctoral research on child protection initiatives within a religious institution. It explores my experience of self-regulating my emotions in response to the reading of disturbing content, and of the active filtering of points of conversation when asked about my research within professional, familial and social settings, to prevent disturbing the emotions of others. The article encourages potential doctoral students to consider how they might prepare for themselves emotionally, socially and physically, for their inevitable encounter with difficult content, prior to the commencement of candidature, thereby increasing their resilience in facing the difficult components of a doctoral degree tasked with exploring content of a bleak and emotionally unnerving nature.
... A major focus of the literature of the field of trauma treatment (Pearlman & Caringi, 2009) has been the stressful effects of trauma work on service providers. Vicarious trauma, empathic stress, secondary traumatic stress, burnout, and compassion fatigue are concepts that identify the toxic processes experienced by trauma therapists and explain how these therapists may develop negative outcomes as a result of their work with trauma survivors. ...
... Another qualitative study found that therapists operating from a resilience-and strength-based clinical model seemed to experience VR across more dimensions than those using more traditional treatment models (Edelkott et al., 2016). Further, scholars in the trauma and resilience fields (Figley & Kiser, 2013;Pearlman & Caringi, 2009;Puvimanasinghe et al., 2015;Walsh, 2007) have noted the clinical, training, and supervisory relevance of VR, confirming that although working with trauma survivors may carry long term risks such as vicarious trauma and compassion fatigue, it may also bring the positive outcomes of improved skills to reframe and cope with negative events, and inspiration. ...
Objective: Attending to the potential impacts, both positive and negative, of clinical work with trauma survivors on professionals themselves is a crucial aspect of clinical training and supervision. Vicarious resilience refers to unique, positive effects that transform therapists in response to witnessing trauma survivors' resilience and recovery process. This study describes the development and exploratory factor analysis of the first instrument to assess vicarious resilience. Method: The Vicarious Resilience Scale (VRS) was developed and administered via electronic survey to 190 helping professionals from around the globe working with survivors of severe traumas, such as torture. Results: Exploratory factor analysis yielded 7 factors: Changes in life goals and perspective, client-inspired hope, increased recognition of clients' spirituality as a therapeutic resource, increased capacity for resourcefulness, increased self-awareness and self-care practices, increased consciousness about power and privilege relative to clients' social location, and increased capacity for remaining present while listening to trauma narratives. The Cronbach's alpha reliability of the VRS was .92 and, as hypothesized, the VRS was moderately and positively correlated with posttraumatic growth and compassion satisfaction, indicating convergent validity. The VRS was not significantly correlated with compassion fatigue (CF) or burnout, indicating discriminant validity and that vicarious resilience is a unique construct that is not merely "the opposite" of CF or burnout. Conclusion: The VRS possesses sound psychometric properties and can be utilized in supervision and training contexts and for self-assessment by professionals working with trauma survivors to aid the recognition and cultivation of vicarious resilience.
... Although thus far we have discussed the potential for interpersonal theory to be clinically useful with respect to the clinician's influence on the trauma survivor, it may also be useful for purposes of understanding and dealing with the trauma survivor's influence on the clinician. One particularly relevant kind of influence for clinicians conducting trauma-focused treatment is vicarious traumatization, the development of psychiatric symptoms (e.g., of PTSD) on the part of the clinician in response to her repeated exposure to narratives of and similar interactions with trauma survivors (Pearlman & Caringi, 2009). Detection of specific symptoms of vicarious traumatization and of disrupted patterns of interpersonal behavior more generally (e.g., the clinician's slow drift toward a submissive detached style in and outside of session, rather than her pulling the trauma survivor towards assertive attachment) is an important task for the trauma-focused clinician. ...
... It is also a task that is particularly amenable for interpersonally focused approaches to clinical supervision (e.g., Levendosky & Hopwood, 2017) in which disrupted interpersonal patterns such as those associated with trauma (vicarious and otherwise) are of primary interest. In such supervision, vicarious traumatization can not only be understood and managed for the sake of the clinician's own mental health, but potentially also leveraged in the clinical care of the trauma survivor (see Boulanger, 2018;Pearlman & Caringi, 2009). ...
Introduction
Symptom-focused theories of trauma and posttraumatic response have yielded many valuable clinical insights, ultimately leading to a number of empirically supported approaches to diagnosing and treating trauma survivors. Limitations observed in these approaches have led some trauma-focused researchers and clinicians to examine the role not only of symptoms, but of interpersonal factors on trauma and posttraumatic response. The study of such interpersonal factors is the mainstay of contemporary interpersonal theory, although at present research and clinical intervention concerning trauma has been largely detached from the insights of contemporary interpersonal theory.
Objective/method
In this paper, we review and integrate the disparate literatures on trauma and interpersonal theory.
Results/Conclusion
We conclude that synthesizing these two literatures is not only feasible, but may also generate useful clinical insights and provide directions for future research relevant to trauma.
... Examining outcomes of compassion satisfaction, STS and burnout provides a vehicle for appraising the professional quality of life of RMAs who work with trauma clients. Furthermore, protective factors were of interest with a view to mitigating potential risk factors that have been associated with more profound problems (Pearlman & Caringi, 2009;Salston & Figley, 2003). ...
... Symptoms resulting from direct contact with trauma clients include hyperarousal, avoidance, intrusions, trust and intimacy difficulties, depression, changed cognitions about safety, and increased use of substances (Levin & Greisberg, 2003;McCann & Pearlman, 1990). If left unchecked, STS has the potential to escalate into PTSD (Pearlman & Caringi, 2009). ...
Threats to professional quality of life such as compassion fatigue constitute a risk for those working with trauma-exposed individuals. Research has investigated professional quality of life in first responders, mental health practitioners, and medical personnel, but the impact on Registered Migration Agents (RMAs) who work with trauma-exposed refugee clients has not been evaluated.
This study examined the prevalence of secondary traumatic stress, burnout and compassion satisfaction in 188 RMAs, and the roles of empathy and coping strategies. More than one-third of the sample members were potentially at risk of compassion fatigue (under two-thirds indicated compassion satisfaction). Regression results suggested that compassion fatigue was significantly related both to lower empathy and to maladaptive coping; while adaptive coping and high empathy significantly predicted compassion satisfaction. Results indicate a potential occupational hazard for RMAs working with trauma clients; suggesting tailored interventions to reduce the risk of deleterious compassion fatigue on RMAs.
... A major focus of the literature of the field of trauma treatment (Pearlman & Caringi, 2009) has been the stressful effects of trauma work on service providers. Vicarious trauma, empathic stress, secondary traumatic stress, burnout, and compassion fatigue are concepts that identify the toxic processes experienced by trauma therapists and explain how these therapists may develop negative outcomes as a result of their work with trauma survivors. ...
... Another qualitative study found that therapists operating from a resilience-and strength-based clinical model seemed to experience VR across more dimensions than those using more traditional treatment models (Edelkott et al., 2016). Further, scholars in the trauma and resilience fields (Figley & Kiser, 2013;Pearlman & Caringi, 2009;Puvimanasinghe et al., 2015;Walsh, 2007) have noted the clinical, training, and supervisory relevance of VR, confirming that although working with trauma survivors may carry long term risks such as vicarious trauma and compassion fatigue, it may also bring the positive outcomes of improved skills to reframe and cope with negative events, and inspiration. ...
Objective: Attending to the potential impacts, both positive and negative, of clinical work with trauma survivors on professionals themselves is a crucial aspect of clinical training and supervision. Vicarious resilience refers to unique, positive effects that transform therapists in response to witnessing trauma survivors’ resilience and recovery process. This study describes the development and exploratory factor analysis of the first instrument to assess vicarious resilience. Method: The Vicarious Resilience Scale (VRS) was developed and administered via electronic survey to 190 helping professionals from around the globe working with survivors of severe traumas, such as torture. Results: Exploratory factor analysis yielded 7 factors: Changes in life goals and perspective, client-inspired hope, increased recognition of clients’ spirituality as a therapeutic resource, increased capacity for resourcefulness, increased self awareness and self-care practices, increased consciousness about power and privilege relative to clients’ social location, and increased capacity for remaining present while listening to trauma narratives. The Cronbach’s alpha reliability of the VRS was .92 and, as hypothesized, the VRS was moderately and positively correlated with posttraumatic growth and compassion satisfaction, indicating convergent validity. The VRS was not significantly correlated with compassion fatigue (CF) or burnout, indicating
discriminant validity and that vicarious resilience is a unique construct that is not merely “the opposite” of CF or burnout. Conclusion: The VRS possesses sound psychometric properties and can be utilized in supervision and training contexts and for self-assessment by professionals working with trauma survivors to aid the recognition and cultivation of vicarious resilience.
... Charles Murigande invited me and Laurie Anne Pearlman, a clinical psychologist (who has also been my life partner since 1992) specializing in research on and treatment of trauma (e.g., Pearlman & Caringi, 2009;Pearlman & Saakvitne, 1995), to come to Rwanda to help with healing and reconciliation. During the discussion in our small group, she and I committed ourselves to do so. ...
... Such connections also increase the likelihood that the work will fit the culture and be sustainable. Connections to both the people one works with and associates with also help inhibit or reduce vicarious trauma, the effect of substantial exposure to others' trauma (Pearlman & Caringi, 2009;Pearlman & Saakvitne, 1995). Moreover, in Rwanda, it is presumably because of relationships with some high-level officials that we have been allowed to broadcast programs that are at odds with both the authority orientation of the culture and an authority-oriented government. ...
In this article, I describe some of my research on caring, helping, active bystandership, and the origins of genocide and collective violence, as a background to interventions in real-world settings aimed to create positive change. They include working with teachers to create classrooms that promote caring and helping; training police to prevent or stop unnecessary harmful actions by fellow officers, and similarly students in schools to prevent harmful actions; promoting reconciliation, using trainings and workshops, and educational radio programs in Rwanda, Burundi, and the Congo; working to improve Dutch–Muslim relations in Amsterdam after violence; and a number of other projects. In these projects, information and participants’ experiences combined to create “experiential understanding.” Evaluation studies showed positive effects. These projects and their evaluation show that research- and theory-based interventions can be effective. An initial motivation for this work was my early childhood experience during the Holocaust in Hungary and receiving help from bystanders.
... Put differently, STS symptomatology is an everpresent risk in work with vulnerable children and families (Caringi, 2008;Caringi & Hardiman, 2012). Fortunately, STS specialists are developing specialized interventions (Bride, 2007;Pearlman & Caringi, 2009;Pryce, Shackelford, & Pryce, 2007). ...
... What is more, an emergent line of research documents STS in the adult workforce, reducing their ability to help affected children and families and contributing to turnover. Therefore, the designers of this intervention take the stance that it is an "ethical imperative" to provide STS training to those who implement evidence-based practices to children impacted by trauma (Pearlman & Caringi, 2009. Thus, a central element of the work of the NNCTC is the development of a trauma-informed system that entails evidence-based detection, treatment, and prevention mechanisms for children, families, and STS-affected social services professionals. ...
This analysis provides an emergent framework that emphasizes a neglected component of both direct practice with families and organizational development. Human emotions, both beneficial (positive emotional labor) and harmful (negative emotional labor), have received short shrift in leadership development, supervision, direct practice preparation and supports, and workforce stabilization, and professionalization.
Significantly, a key indicator of negative emotional labor—secondary traumatic stress (STS)—often has been ignored and neglected, despite the fact that it may be endemic in the workforce. STS typically results from traumatic events in practice, but it also stems from workplace violence. Often undetected and untreated, STS is at least a hidden correlate and perhaps a probable cause of myriad problems such as questionable practice with families, life-work conflicts, undesirable workforce turnover, and a sub-optimal organizational climate. Special interventions are needed.
At the same time, new organizational designs are needed to promote and reinforce positive emotional labor. Arguably, positive emotional labor and the positive organizational climates it facilitates are requisites for harmonious relations between jobs and personal lives, desirable workforce retention, and better outcomes for children and families. What’s more, specialized interventions for positive emotional labor constitute a key component in the prevention system for STS.
A dual design for positive emotional labor and STS (and other negative emotional labor) prevention/intervention is provided herewith. Early detection and rapid response systems for STS, with social work leadership, receive special attention. Guidelines for new organizational designs for emotional labor in child welfare are offered in conclusion.
... More recently research by Stamm (2002) and Pearlman and Caringi (2009) has described the positive and transformative aspects of caring. Stamm's original work gave rise to the development of the construct of compassion satisfaction, described as the positive aspects relating to providing care, and Pearlman's research identified the rewards of doing the work (Saakvitne & Pearlman, 1996) and the vicarious transformation that can occur (Pearlman & Caringi, 2009). ...
... More recently research by Stamm (2002) and Pearlman and Caringi (2009) has described the positive and transformative aspects of caring. Stamm's original work gave rise to the development of the construct of compassion satisfaction, described as the positive aspects relating to providing care, and Pearlman's research identified the rewards of doing the work (Saakvitne & Pearlman, 1996) and the vicarious transformation that can occur (Pearlman & Caringi, 2009). ...
Compassion fatigue, also referred to as secondary traumatic stress, is increasingly being acknowledged as a possible consequence of working in any helping and caring profession. Previous research has focused on examining this construct in a variety of health professionals - social workers, counsellors, psychologists and nurses; however, little attention has been paid to this experience in doctors. This research examined the presence of compassion fatigue in doctors. A self-selected sample of 253 doctors, working in four locations in New Zealand and training in a variety of specialty disciplines, participated in this research by completing an anonymous questionnaire which included the ProQOL (Professional Quality of Life) instrument. This instrument measures compassion fatigue, burnout and compassion satisfaction. Results indicated that 17.1% of the sample appeared to be at risk for compassion fatigue as indicated by a high score on that subscale of the ProQOL, and 19.5% at risk of burnout. These results are similar to those reported in studies of other health professionals and suggest a need for caution on the part of clinicians and employers as to the potentially emotionally demanding aspects of patient care.
... The impact of trauma stories on practitioners is conceptualised as vicarious traumatisation, which develops from empathically listening to or "witnessing" traumatic stories and symptoms (Pearlman & Caringi, 2009;Herman, 1992;McCann & Pearlman, 1990). Practitioners can suffer from secondary trauma symptoms such as intrusive thoughts of clients' stories, negative feelings of distress and outrage, raised anxiety and startle responses. ...
This article presents the participation of a client reference group in a qualitative research study which explored clients’ experiences of counselling and natural therapies services in a women’s health centre. The article focuses on the development of working relationships between the reference group and researchers using a capacity building approach which facilitated a two-way exchange of skills, knowledge and experience. This ensured that the views of clients and community members were represented in the research design, thereby increasing its rigour and accountability and fostering social inclusion. Members’ reflections on their journey and the changes they experienced as outcomes of the research process are presented. Ethical issues in working with the reference group are explored. Some members experienced vicarious traumatisation as a result of their exposure to data on domestic violence. This analysis of the use of a reference group and its beneficial impact on research outcomes will be of interest to other researchers looking to work with a client reference or advisory group.
... The review further includes vicarious trauma (VT) and vicarious resilience (VR), terms which are often used interchangeably with CF and CS within the literature (e.g., Meadors et al., 2010;Silveira & Boyer, 2015). VT is defined as the negative transformation in the helper that results from empathic engagement with trauma survivors and their trauma material, combined with a commitment or responsibility to help them (Pearlman & Caringi, 2009). In contrast, VR refers to the positive impact on and personal growth of therapists resulting from exposure to clients' resilience (Hernández et al., 2007). ...
Professionals employed within the field of domestic and sexual violence (DV/SV) are known to experience both positive and negative psychological impacts because of the nature of their work. This review aims to establish which factors influence the professional quality of life (ProQOL) of DV/SV advocates. This group is known to face challenges that are specific to their working practices including scarce resources and frequent exposure to traumatic material. The systematic review protocol was designed based upon Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidance. Following a mixed-methods convergent segregated approach, a systematic search for qualitative and quantitative research within PsycINFO, Academic Search Complete, CINAHL, MEDLINE, Sage, Taylor & Francis, Wiley Online Library, and BASE was undertaken. Peer-reviewed empirical research and relevant gray literature, published in English, were considered for inclusion. Thirty articles were identified (16 quantitative, 13 qualitative, and 1 mixed-methods study), and assessed for methodological quality and risk of bias using established quality appraisal tools. An array of risk and protective factors emerged including communication competence, support from co-workers, office resources, and occupational stigma. A gap in the current evidence base was identified regarding the role that personal strengths may play in the well-being of those employed within the DV/SV sector. The ProQOL of DV/SV advocates is complex and dependent upon a variety of factors specific to their situation at the time. However, the findings of this review provide an important evidence base for future research avenues as well as policies and procedures for this workforce specifically.
... Pearlman and Caringi (2009, p. 202) define vicarious trauma as 'the negative transformation in the helper that results from empathic engagement with trauma survivors and their trauma material, combined with a commitment or responsibility to help them'. Similar to primary trauma, vicarious trauma often manifests in the form of nightmares and intrusive thoughts, distressing changes to a person's core systems of meaning, their relationships, their sense of hope or their feelings of safety (Barrington & Shakespeare-Finch, 2013;Hunter & Schofield, 2006;Pack, 2013;Pearlman & Caringi, 2009). ...
Criminological research is a challenging field in many ways. The discipline criticizes the labeling carried out by the criminal justice system, which marks certain groups of people as “deviant,” “criminal,” or “dangerous.” Nevertheless, criminological studies often fall into the same trap. By relying on labels that the criminal justice system has applied when accessing the field through prisons, probation officers, or other kinds of support systems for offenders, sampling and labeling are intertwined. This article scrutinizes how qualitative reconstructive research supports and reproduces social inequality. It applies the concept of “doing social problems” and emphasizes a constructionist point of view. Furthermore, we review the sampling mechanisms of recent studies: What concepts of “social problems” do we see? What world does the criminological research at hand reconstruct? In our conclusion, we call for a sensitive approach and a broad discussion of possibilities and limitations. To us, qualitative reconstructive research – in fact – seems to offer some solutions for making the processes of labeling visible. We ask how social knowledge systems concerning crime and deviance are constituted and how we, as criminologists, contribute to them through our research practice.
... Pearlman and Caringi (2009, p. 202) define vicarious trauma as 'the negative transformation in the helper that results from empathic engagement with trauma survivors and their trauma material, combined with a commitment or responsibility to help them'. Similar to primary trauma, vicarious trauma often manifests in the form of nightmares and intrusive thoughts, distressing changes to a person's core systems of meaning, their relationships, their sense of hope or their feelings of safety (Barrington & Shakespeare-Finch, 2013;Hunter & Schofield, 2006;Pack, 2013;Pearlman & Caringi, 2009). ...
Many of us work in a dispiriting academic industry run by corporate philosophies which demand our time is increasingly spent towards marketing ourselves, writing grants, obtaining research funds and undertaking projects which generally tend to have less benefit for the people we study yet more for our academic kudos and that of our institutions. As university funding structures crumble and instead hone in on new student markets and the pursuit of big grants, the pressure on us increases and so, in turn, research calls become increasingly competitive. Many of us are continually rejected particularly if we try to do ethnographic research and even more so if it means that it is done ‘differently’, ‘unconventionally’ and ‘covertly’ with some of society’s most dangerous and hard-to-reach groups. Notwithstanding the time invested in writing proposals and even in the event they are successful, before commencement, projects must also secure ethical clearance – a means of research governance and control, which frowns on ethnography – thus reducing further time and resource away from the studying the fast-paced change of the twenty-first century. We subsequently believe that our academic worth thereafter translates to further investment in publishing in ‘high-impact-factor journals’ and producing a seemingly never-ending stream of social media updates and waiting for ‘likes’ about our ‘research excellence’ and academic activity. However, as I saw written on the wall of a building where thousands of Bosnians were executed in the 1990s genocide ‘a like doesn’t change the world’. In the same vein, we have to ask ourselves if what we are doing actually contributes to the positive social change we outline in our research proposals. If – because of restrictive funding calls and ethics committees – we cannot access the world’s most excluded groups, study between the nooks and crannies of democratic societies and propose unconventional research methods, how can we report on the real harms of the social structure? This paper offers a twofold reflection – firstly, how can one ‘break from the shackles’ of this academic capitalism, and secondly, it evidences what this liberation can produce by providing reflexive analysis of three ethnographic projects I have undertaken over the last 5 years: (1) a two-year study of Spain’s largest drug market, (2) a three-year study of the refugee crisis across Europe and (3) an 18-month undercover study of a luxury brothel.
... If reactive trauma-triggered behavior occurs, it may become a stressor for the caregivers, manifesting in them as anger over feeling insufficiently protected and overwhelmed by the overall presentation of consumers with tremendous trauma (Bride et al., 2009). Reactions can manifest as secondary traumatic stress, compassion fatigue, and PTSD (Figley, 1995;Huggard, 2003;Pearlman & Caringi, 2009). The lifetime PTSD rate for social service providers is three times that of the general population (Bride et al., 2009). ...
A growing body of evidence connects traumatic stress and homelessness, which illustrates the importance of trauma and-resiliency-informed care (TIC) to appropriately serve persons experiencing homelessness (PEH). This paper reviews the literature on traumatic stress, including the biology of trauma as well as psychosocial, environmental, and systemic factors. These areas of knowledge constitute necessary elements when designing systems of care for PEH in order to provide effective services, avoid re-traumatization, and create healing environments to foster resilience. The authors identify trauma-specific evidence-based therapies, and comprehensive programmatic approaches that stem from established trauma-informed core values. Practical applications of the reviewed literature are utilized to demonstrate how organizations can adopt a trauma and resiliency-informed approach, based on both the reviewed literature as well as the authors’ collective clinical experience. A key takeaway is an emerging consensus that service providers must consider trauma when designing and offering services to persons with a history of homelessness. The authors offer recommendations for future pathways to create outcome measurement tools for social service providers based on the theory of self-efficacy and using concrete, quantifiable variables.
... There has been a call for research on secondary traumatic stress given religious leaders' roles in supporting individuals in crisis (Hendron et al., 2012). Secondary traumatic stress, conceptually similar to compassion fatigue, describes the stress reaction of mental health workers who work with traumatized patients (Canfield, 2005;Pearlman & Caringi, 2009). They potentially experience symptoms similar to those of PTSD, such as avoidance, re-experiencing, and hyperarousal (Bride et al., 2007;Canfield, 2005). ...
Religious leaders face numerous mental health challenges, and prior research suggests that some experience symptoms of post-traumatic stress disorder (PTSD) due to work-related experiences. This study employed a diverse sample of 274 religious leaders to (a) qualitatively describe the types of work-related experiences they identify as particularly stressful or overwhelming, (b) assess the prevalence of PTSD symptoms associated with these experiences, and (c) test hypothesized associations between PTSD symptoms and narcissism. The study found that the stressful experiences reported typically involved relational conflict, having limited resources, or caring for people suffering. Over half of the sample endorsed symptoms that were above the cutoff for a clinical concern for PTSD, and PTSD symptoms were significantly associated with symptoms of both vulnerable narcissism and grandiose narcissism. Practical implications for the ongoing formation and support of religious leaders are discussed.
... Professional quality of life, the quality that a professional feels in relation to his or her work (Stamm, 2010, p. 8), is a key concept in occupational health. Conceptualised as a combination of both negative (compassion fatigue) and positive (compassion satisfaction) aspects (Figley & Roop, 2006;Pearlman & Caringi, 2009;Stamm & Figley, 2010), professional quality of life can be achieved as professionals in various fields such as healthcare, social services, education, law enforcement and the like help at the time of crises or need. ...
Background:
Compassion fatigue and compassion satisfaction are caring concepts that have been explored among nurses in specialized hospital units. However, there is paucity of studies exploring the occupational determinants among general medical-surgical Registered Nurses.
Aim:
To determine the prevalence and to identify the occupational determinants of compassion satisfaction and compassion fatigue among general medical-surgical Registered Nurses.
Design:
Cross-sectional.
Methods:
From August - November 2017, 121 consecutively-selected general medical-surgical Registered Nurses from 5 hospitals completed a 4-part survey packet composed of the participant information sheet, the Professional Quality of Life Version 5, the McCloskey-Mueller Satisfaction Scale, and the Eden Warmth Survey - Employee Questionnaire. Stepwise-forward multiple linear regression was employed to identify the occupational determinants of compassion fatigue and compassion satisfaction. The STROBE checklist was followed in reporting this study (See Supplementary File 1).
Results:
The prevalence of moderate to high levels of compassion satisfaction was 90.09% while burnout and secondary stress, the facets of compassion fatigue, had a prevalence of 74.38% and 83.47%, respectively. Among the identified occupational determinants, only job satisfaction and nurse colleague relationship positively influenced compassion satisfaction. In contrary, although higher monthly income positively influenced both dimensions of compassion fatigue, nurse colleague relationship had the strongest negative effect.
Conclusion:
Among the occupational determinants of compassion fatigue and compassion satisfaction, nurse colleague relationship had the strongest influence. This result highlights the importance of positive nurse colleague relationships and paves way for the development and initiation of appropriate strategies.
Relevance to clinical practice:
The findings of this study paves way for the development of institutional policies and individualized programs geared towards building rapport and communication among Registered Nurses assigned in general medical-surgical units. Likewise, the high prevalence of compassion fatigue needs further exploration to develop appropriate measures to mitigate its development among general medical-surgical nurses.
... Most social workers are at least familiar with, if not always great at, implementing traditional strategies for self-care such as boundary setting with service consumers and work responsibilities and making sure to take respite to avoid illnesses or to heal. Intentionally and consistently creating opportunities for rest; engaging in activities that offer distraction and personal growth; and developing and maintaining sustainable intimate, family, and interpersonal relationships are ethical imperatives for those in helping professions, such as social work (Pearlman & Caringi, 2009). As renowned environmental and political activist Audre Lorde decried, "Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare" (origin unknown). ...
Gradual environmental degradation, more extreme climate change events, and related environmental injustices affect individuals and communities every day. Social work entities around the world are increasingly highlighting professional responsibilities for addressing the global climate crisis. Often, social workers experience vicarious trauma from work with those immediately affected. Working within the context of the global climate crisis brings further risk. Social workers may be personally affected, or experiencing their own challenges, such as climate anxiety and eco-grief. Thus, radical self-care is a dire need as social workers promote sustainable communities and environments and seek ecological justice for all. This article discusses the health and mental health impacts of the compounding factors of the climate crisis, modern technology, and current political contexts. Activism for change and ecotherapeutic strategies are presented as radical self-care for social workers, in both academic and practice-based settings. These strategies are essential for recognizing, legitimizing, and addressing the need for radical self-care practices in the global climate crisis.
... This affects the way clinicians view themselves, their world view, beliefs and values, and therefore over time can change their cognitive schema in a negative way (Pearlman & Saakvitne, 1995). More recent research has explored vicarious traumatisation and identified it as a change process (Pearlman & Caringi, 2009) and has conceptualised certain positive changes resulting from trauma work such as vicarious posttraumatic growth (Arnold, Calhoun, Tedeschi & Cann, 2005) or as vicarious resilience (Hermandez, Gansei & Engstrom, 2007). One instrument designed to measure vicarious trauma is the Traumatic Stress Institute Belief Scale -Revision L (TSI-BSL) which measures and assesses cognitive disruptions in psychological areas of safety, trust, control, intimacy, and power (Jenkins & Baird, 2002). ...
The terms secondary traumatic stress, compassion fatigue and vicarious trauma are often used in literature to describe emotional consequences for health professionals working with traumatised clients. While research has paid some attention to social workers, care givers and other health professions in contact with traumatised clients, little specific attention has been paid to clinicians working in the alcohol and drug field. This article reports on a systematic review of literature that looked at what had been said about one or more of the three terms outlined above, for professionals that work within the alcohol and drug field. The aim of this review is twofold. Firstly, to increase awareness of an issue that appears to have gone unnoticed within this sector. Secondly, to highlight the importance of such awareness for clinicians and those involved in managing services within this sector. The current review found few published papers that investigated these terms with reference to alcohol and drug clinicians. However, the available literature reviewed did show that alcohol and drug clinicians are at risk of experiencing secondary traumatic stress and compassion fatigue. No literature was found that discussed vicarious trauma. The implications of this absence of literature are discussed, particularly with reference to the health and wellbeing of alcohol and drug clinicians. Recommendations for future research in this area are discussed.
... At the same time, therapists who work in treatment of complex trauma often experience vicarious traumatization, which may also include altered systems of meaning-making that threaten the therapist's belief systems and faith practices. Pearlman and Caringi (2009) state, "disrupted spirituality is a hallmark of both direct and indirect trauma, and rampant cynicism or despair in clients with complex trauma can challenge the helper's sense of meaning and hope" (p. 209). ...
Disrupted systems of meaning are a core domain in which adults with a complex trauma history are impacted, often leading to adversely affected belief systems. For adult survivors of childhood trauma, experiences related to shame, betrayal, meaning-making, and mourning often complicate their spiritual and/or religious beliefs. This article uses a clinical case example to introduce and illustrate the relevance of a particular complex trauma intervention framework in the context of spiritually-informed treatment with adult Christian clients. Component-Based Psychotherapy (CBP; Hopper, Grossman, Spinazzola, & Zucker, in press) consists of four principal components: (a) relationship, (b) regulation, (c) parts work, and (d) narrative, and is predicated upon the importance of clienttherapist parallel process to therapeutic movement and client change. Each treatment component is summarized and practically applied to case material, with particular focus on the ways in which client's faith beliefs and practices can serve as a potential resource and/or barrier in treatment. Particular integrative focus is given to the final treatment component (narrative), where issues of a client's lament, spiritual meaning making, and the therapist's potential vulnerabilities in working with this population are addressed.
... An incidental and interesting finding in this study relates to the drawings depicting a worrying professional meeting and can indicate the professional strain clinicians can experience during their daily routines. Problems such as high burnout rates (Maslach, 2003;Maslach, Jackson, & Leiter, 1996;Maslach & Leiter, 2005), and compassion fatigue in health professions has been well characterized (Fiagley, 1995(Fiagley, , 1997(Fiagley, , 2002Gerge, 2011a,b;Pearlman & Saakvitne, 1995a,b;Pearlman & Caringi, 2009;Wilson, 2004). Presumably arts-based self-experiencing methodology can provide possibilities in supervision to make explicit, and overt, implicit states and tacit knowing about overburdening tasks, and how we in our professions will be impacted of the suffering of other human beings. ...
In this paper we discuss the identification of defining characteristics in pictorial artefacts based upon a pre-understanding of traumatization, dissociation and recovery, metaphorical processing, and pictorial semiotics. Signs of reduced arousal, increased positive affect and states, self-efficacy, and self-esteem, are considered important parameters when assessing pictorial artefacts conducted in therapy. These signs, related to overcoming traumatization and a re-established experience of safety, as well as the concept of neuroception, should be easily identifiable via the use of appropriately designed assessment tools. We tested this hypothesis on a series of non-clinical material consisting of drawings produced by 122 experienced clinicians. Through the identification of defining concepts in artwork we developed a preliminary assessment tool with the aims of guiding clinicians in identifying perceptions of fright in relation to safety and in facilitating the nurturing of safe states in clients when conducting pictorial artefacts. This tool consists of plain observation and subjective appraisal combined with the identification of seven predefined perspectives; how is the picture made, colour utilization, depiction of states and body positions, which affects/emotions, symbols and secondary metaphors/symbols for the self can be recognised in relation to a neuroception of threat with respect to safety.
... Another qualitative study found that therapists operating from a resilience-and strength-based clinical model seemed to experience VR across more dimensions than those using more traditional treatment models (Edelkott et al., 2016). Further, scholars in the trauma and resilience fields (Figley & Kiser, 2013;Pearlman & Caringi, 2009;Puvimanasinghe et al., 2015;Walsh, 2007) have noted the clinical, training, and supervisory relevance of VR, confirming that although working with trauma survivors may carry long term risks such as vicarious trauma and compassion fatigue, it may also bring the positive outcomes of improved skills to reframe and cope with negative events, and inspiration. ...
Will be published online on OCT 16:
http://dx.doi.org/10.1037/tra0000199
Objective: Attending to the potential impacts, both positive and negative, of clinical work with trauma survivors on professionals themselves is a crucial aspect of clinical training and supervision. Vicarious resilience refers to unique, positive effects that transform therapists in response to witnessing trauma survivors’ resilience and recovery process. This study describes the development and exploratory factor analysis of the first instrument to assess vicarious resilience. Method: The Vicarious Resilience Scale (VRS) was developed and administered via electronic survey to 190 helping professionals from around the globe working with survivors of severe traumas, such as torture. Results: Exploratory factor analysis yielded seven factors: Changes in life goals and perspective, client-inspired hope, increased recognition of clients' spirituality as a therapeutic resource, increased capacity for resourcefulness, increased self-awareness and self-care practices, increased consciousness about power and privilege relative to clients' social location, and increased capacity for remaining present while listening to trauma narratives. The Cronbach’s alpha reliability of the VRS was .92 and, as hypothesized, the VRS was moderately and positively correlated with posttraumatic growth and compassion satisfaction, indicating convergent validity. The VRS was not significantly correlated with compassion fatigue (CF) or burnout, indicating discriminant validity and that vicarious resilience is a unique construct that is not merely “the opposite” of CF or burnout. Conclusion: The VRS possesses sound psychometric properties and can be utilized in supervision and training contexts and for self-assessment by professionals working with trauma survivors to aid the recognition and cultivation of vicarious resilience.
... The impact of trauma stories on practitioners is conceptualised as vicarious traumatisation, which develops from empathically listening to or "witnessing" traumatic stories and symptoms (Pearlman & Caringi, 2009;Herman, 1992;McCann & Pearlman, 1990). Practitioners can suffer from secondary trauma symptoms such as intrusive thoughts of clients' stories, negative feelings of distress and outrage, raised anxiety and startle responses. ...
This article presents the participation of a client reference group in a qualitative research study which explored clients’ experiences of counselling and natural therapies services in a women’s health centre. The article focuses on the development of working relationships between the reference group and researchers using a capacity building approach which facilitated a two-way exchange of skills, knowledge and experience. This ensured that the views of clients and community members were represented in the research design, thereby increasing its rigour and accountability and fostering social inclusion. Members’ reflections on their journey and the changes they experienced as outcomes of the research process are presented. Ethical issues in working with the reference group are explored. Some members experienced vicarious traumatisation as a result of their exposure to data on domestic violence. This analysis of the use of a reference group and its beneficial impact on research outcomes will be of interest to other researchers looking to work with a client reference or advisory group.
... At the same time, advocates may encounter clients who do not heed their advice, such as victims who return to abusive partners (Dunn & Powell-Williams, 2007), leaving advocates to cope with the clash of their professional values and victims' self-professed needs (Powell-Williams, White, & Powell-Williams, 2013;Ullman, 2005). These difficulties compound with advocates' risk of vicarious traumatization (McCann & Pearlman, 1990), an occupational hazard that can be aggravated if they receive inadequate emotional support from their organizations (Slattery & Goodman, 2009;Wasco, Campbell, & Clark, 2002), lack access to shared power in the workplace (Slattery & Goodman, 2009), or generally face barriers in aiding the clients in whom they have become emotionally invested (Pearlman & Caringi, 2009). ...
In contrast to works on victim advocacy in specific organizational contexts, this article introduces the term “victim work” to capture the vast array of victim-related roles and tasks that have proliferated in recent decades. Data are derived from in-depth interviews with 30 “victim workers” in public and private agencies in two Midwestern states. The interviews revealed diverse work experiences that spanned hotlines, crisis response, legal proceedings, and postconviction support. Three themes emerged that characterize “victim work”: flexibility, emotions, and the challenge of “fit”—the multifaceted difficulties of interacting with victims and agents of the justice system. Based on the findings, we offer a revised model of criminal justice vis-à-vis victims and implications for practice and future research.
... In the literature, this impact of working with trauma on professionals has been interchangeably termed vicarious trauma (McCann & Pearlman, 1990), compassion fatigue (Figley, 1999), secondary traumatic stress (Figley, 1995) and burnout (Maslach, 1982) . For the purposes of this paper, the conceptual framework of vicarious trauma (McCann & Pearlman, 1990;Pearlman & Caringi, 2009) is used as it was designed to capture the psychological consequences of working with trauma survivors . ...
Traumatic events are highly prevalent in South African society and psychologists who work with survivors of trauma have been identified as particularly at risk of being adversely affected by their work, and experiencing vicarious trauma. This study aimed to explore the experiences of a group of South African psychologists who work predominantly with trauma survivors. Individual semi-structured interviews were conducted with six psychologists (females = 67%). The predominant type of trauma encountered by participants in clinical practice was interpersonal trauma in the form of physical and sexual abuse (83%). Data were analysed using thematic analysis. All participants reported symptoms of vicarious trauma including disruption in cognitive schemas, symptoms characteristic of post-traumatic stress disorder, and somatic symptoms. Participants also reported vicarious post-traumatic growth including an enhanced sense of interpersonal connectedness and positive changes in their philosophy of life and self-perceptions. The findings serve to sensitise psychologists to the impact of working with trauma survivors so as to enhance the efficiency of psychological service delivery to traumatised populations.
... Seeing their reactions inspires similar ones in me. This process is sometimes called "vicarious transformation" (Saakvitne & Pearlman, 1996;Pearlman & Caringi, 2009) or "vicarious resilience" (Hernandez, Gangsei, & Engstrom, 2007;Engstrom, Hernandez, & Gangsei, 2008). In the spirit of this article, I call it "counterresilience." ...
Treating traumatized patients famously takes its toll on the treating therapist. This process has most often been called “vicarious traumatization,” although other terms have been used. The author proposes a more interpersonal term, “countertrauma.” Although countertrauma is a common occupational hazard when working with trauma victims, it is rarely discussed in depth from a personal perspective. Drawing from the author's experiences working with sexually abused men over almost three decades, he tracks his emerging conflicts and reactions to his work. These constitute his own countertraumatic as well as counterresilient reactions to engaging intimately with patients’ trauma experiences.
... Pearlman and saakvitne (1995) note that countertransference can occur in the context of trauma work. effective clinical work requires self-awareness on the part of the therapist (Pearlman & Caringi, 2009). the ability to reflect on practice promotes self-awareness (Pearman, 2012) but also, within counselling psychology training, trainees are encouraged to reflect on their practise. ...
Content & Focus
This paper will discuss the importance of professional and ethical guidelines for both Qualified Counselling Psychologists and Counselling Psychologists in Training when working in the field of trauma. It will also explore some of the challenges therapists may face when taking these guidelines into account. This paper will present a case vignette on how vicarious traumatisation may present, as well as how it may affect therapists before moving on to discussing how for some people trauma can lead to vicarious resilience. This paper questions if it should be compulsory to introduce trauma awareness courses prior to psychologists working with trauma survivors or within professional training programmes and concludes with suggestions of how therapists may prevent and/or manage vicarious trauma including the importance of self-care.
... Termed 'impression management', this behaviour is related to counsellors' perceived need to be regarded by their supervisor as a highly competent and effective mental health professional (Ladany et al., 1996). In contrast, counsellors who were less concerned with how they might be viewed within a supervisory context demonstrated that supervisory engagement enhanced their self-awareness and therapeutic ability, providing evidence for the utility of proactively addressing the negative effects of trauma work in an effective and timely way (Adams & Riggs, 2008;Courtois et al., 2009;Pearlman & Caringi, 2009;Wheeler & Richards, 2007). ...
The present study investigated the effects of supervision on the management of vicarious traumatisation among telephone and online counsellors on BoysTown Helplines. BoysTown Helplines include Kids Helpline, a 24-hour national counselling service for young people aged 5–25 years of age, and Parentline (PL), a counselling service for parents in Queensland and Northern Territory. The services provide telephone and email counselling services and Kids Helpline also provides web counselling. All counsellors (100%) worked as Kids Helpline counsellors (N = 38) and 42.1% (n = 16) as PL counsellors. The counsellors conducted 50,979 counselling sessions in 2008, of which 38,703 were completed over the telephone and 12,276 online. Of these, approximately 44% involved trauma clients, putting the counsellors at risk of suffering some level of vicarious trau-matisation. The findings from 38 supervised telephone and online counsellors showed that vicarious traumatisation fell within normal limits and positive coping strategies were above average. While correlations did not prove to be significant between supervision and vicarious traumatisation, the size of counsellors' trauma caseload proved to be strongly related to both vicarious traumatisation and negative coping style. Telephone and online networks are now recognised as increasingly important counselling mediums as they have a unique facility to create alternate access pathways for those who may not otherwise access a clinic-based counselling service, a fact acknowledged by a national review of telephone and online counselling services (Urbis Keys Young, 2003). Significantly, while both telephone and online
... X Feelings of intense rage and revenge following the murder of their loved one, or their loved one's death as a result of another person's negligence; X Feelings of disappointment and anger toward members of their support network who avoid them or make insensitive comments; X Feeling ashamed that because of memory and concentration problems, they are unable to perform as well at work as they did prior to the tragedy; X Feelings of guilt because they were unable to keep their loved one safe; X Feelings of inadequacy because they continue to experience intense pain when they encounter reminders of their loss. • Because of the demands this work places on the therapist, it is highly recommended that therapists seek consultation from their colleagues when difficult issues arise (Pearlman & Caringi, 2009). • Finally, it is important to recognize that clients benefit considerably if they are helped to understand that their reactions to such situations are typical and are not in-sobreviviente. ...
Duelo traumático: Investigación e implicaciones clínicas
Perder a alguien inesperadamente o de manera traumática deja a los sobrevivientes sintiéndose abrumados ya que sus vidas cambiarán repentinamente. Los sobrevivientes posiblemente sufrirán un fenómeno llamado luto traumático, que está asociado con síntomas de trauma, tal como pensamientos intrusivos sobre y relacionado al duelo, síntomas como anhelo por el ser que falleció. A través de la investigación, se ha encontrado que en la mayoría de los casos, los síntomas asociados con una pérdida traumática, son significativamente más intensos y prolongados que aquellos síntomas asociados con una pérdida de muerte natural. Estos síntomas también suelen ser más pentetrantes afectando todos los aspectos de la vida del sobreviviente. También se ha encontrado que a los sobrevivientes de una pérdida traumáticata tienen un tiempo difícil de aceptar lo que ha sucedido, les cuesta lidiar con sentimientos de responsabilidad y culpa, comienzan a cuestionar sus creencias religiosas, se preocupan al pensar que el fallecido haya sufrido al morir y viven en la preocupación que ellos, o alguno de sus seres queridos, vaya a morir. En este manuscrito se examina la literatura existente sobre las áreas de la vida que son afectadas por pérdidas traumáticas y los factores de riesgo que incrementan la posibidad de que el sobreviviente sufra de duelo traumático. También describimos de manera exhaustiva, un enfoque de tratamiendo que está basado en la literatura de duelo traumático, especificamente creado para sobrevivientes de duelo traumático. En tratamento contiene 3 partes críticas: recursos de construcción, procesar el trauma vivido, y facilitar el luto.
... So, caring can have a positive and rewarding outlook. According to Pearlman and Caringi (2009), helping others can be vicariously transforming. The positive side of caring according to Stamm (2005) is called 'compassion of Life of Mental Health Professionals at a Tertiary Psychiatric Facility in Nigeria satisfaction'. ...
The well-being of professionals in mental health settings has attracted considerable interest recently. Mental health professionals in the course of their professional duty report being either burdened or exhilarated. This study examined the factors influencing professional quality of life of professionals in a mental health facility in Nigeria. Using a cross-sectional design, 234 participants at the Federal Neuro-Psychiatric Hospital, Benin-City, Edo State, Nigeria responded to a set of questionnaires; professional quality of life and general health questionnaires. The results showed that the experience of violence in the workplace was significantly associated with secondary traumatic stress (t (231) = 2.141; P<0.05). Married participants reported better professional quality of life (t (218) =-2.220; P<0.05). Compassion satisfaction was significantly negatively correlated with psychological distress (r=-0.048; p<0.05). Conversely, burnout (r=0.241, p<0.05) and secondary traumatic stress (r=0.377, p<0.05) correlated positively with higher scores on the GHQ. Staff professional quality of life is influenced by work place characteristics.
Multicultural and feminist perspectives are characterized by a variety of similarities, and the integration of multicultural and feminist perspectives in counseling psychology has been a key aim of those in these fields for decades. However, the effective implementation this approach often has been proven challenging and elusive, with difficulties defining the complexity of feminist and multicultural factors in inclusive and meaningful ways. Integrating multicultural and feminist perspectives, The Oxford Handbook of Feminist Multicultural Counseling features the accumulated knowledge of approximately forty years of scholarship that flows out of feminist and multicultural efforts within counseling psychology. It brings a feminist multicultural perspective to core domains within counseling psychology such as ethical frameworks, lifespan development, identify formation and change, growth-oriented and ecological assessment, and career theory and practice. Emphasis is placed on the intersections among social identities related to gender, ethnicity/race, sexual orientation, social class and socioeconomic status, religion, disability, and nationality. Articles provide insights and perspectives about specific groups of women include African American women, Latinas, women with disabilities, women in poverty, women who have experienced trauma, and American Muslim women. Also featured are a range of additional multicultural feminist psychological practices such as feminist multicultural mentoring, teaching, training, and social activism.
Convict criminology (CC) teaches us that it is essential for critical prison studies to foreground the voices, views and lived experiences of those who have endured criminalization and incarceration, for without access to the experiential, we are unable to accurately conceptualize or understand the pains of imprisonment. Critical criminologists, both those who identify as formerly incarcerated and as ‘noncons’ or prisoner allies (for example, see ‘Qualities of a Prisoner Ally’ information sheet created by prisoners of the Prisoner’s Justice Day Committee, Vancouver, BC. Available at: https://penalpress.com), have taken up this charge primarily via qualitative research that incorporates fieldwork, interviews, observation and autoethnography – and where possible, ethnography. Following the edict ‘nothing about us, without us’, convict criminology advances a critical approach to prison research that centres notions of justice, diversity and inclusivity as primary research values. We situate this chapter within a CC perspective to help us unpack the emotional labour involved in doing critical prison research. Given the traumatic nature and long-lasting effects of incarceration, we showcase how this kind of inclusion and representation in critical prison research can take different emotional tolls on formerly incarcerated scholars. Using the second author’s lived experience of incarceration and her participation in a large-scale qualitative research project on the emotional geography of the Canadian federal penal landscape as the primary object lesson, we also outline the advantages of inclusive research team membership for the project and those who are involved in it, namely, the differently located research team members as well as the participants. We conclude the chapter with a discussion of some of the ways that allied prison researchers can support their research assistants, graduate students and colleagues with criminal histories as they cope with the emotional labour of conducting critical prison research and outline a series of possible coping strategies for researchers who are exposed to and who may be struggling with the emotional toll of the research topic and content, including the intense and oftentimes emotional participant interactions and observations they witness while in the field.
Background
Rates of aggressive offending among Justice-Involved Young Women (JIYW) have increased over the past few decades. Yet, there is little discourse, research, or intervention to address it among young women.Aims/hypotheses:This study hypothesized that a higher capacity for self-restraint measured on the Weinberger Adjustment Inventory (WAI) scale among 14-18-year-old JIYW would moderate the relationship between the exposure to violence and serious aggressive offending.Methods
The pathways to desistance project, a multi-site, longitudinal study, included a sample of JIYW aged 14–18 years old (n = 184). The baseline data were analyzed using linear multiple regression.ResultsAfter controlling for two variables, race and neighborhood conditions, the overall model was significant (F = 8.31 (df = 7,176), p = .001). The predictor variables (exposure to violence and self-restraint) explained 25% of the outcome variable (level of aggressive offending). The moderation result was significant such that higher self-restraint weakens the relationship between exposure to violence and aggressive offending (B = − 0.01, t (176) = -2.39, p = .018).Conclusions/implicationsThis study highlights the need to disrupt the trauma- to- prison pipeline by enhancing positive social skills in a trauma-responsive manner, which could mitigate the effect of exposure to violence among JIYW.
This paper examines the written reflections of 30 Canadian undergraduate students who participated in an international field course focusing on migration and human rights in Mexico. It endeavors to understand how the students reconciled their thoughts and feelings about trauma and oppression in an intercultural setting. Borrowing Foucault’s ‘ethic of discomfort’, which emphasizes the proactive and transformative potential of discomfort in education, the paper extends existing scholarship in teaching and learning around study abroad and social justice by focusing on ethically complex situations in the field. The findings reveal that while preparation for unprecedented and unforeseeable scenarios during an international field course was challenging for faculty, exposing students to the realities of migration ultimately facilitated learning.
Recent studies have highlighted the increased risk of exposure to PTSD among military personnel who are faced with extreme stressor events, the stress related to the peacekeeping mission, indicates that even peacekeepers could be at risk of developing PTSD independently of war attacks or wounds. The resilience's construct has a strong theoretical background, and in a pragmatic way has been shown to be a significant stress resistance resource in multiple groups, like those involved in military and security operations. The aim of this study was to examine the impact of resilience on the relationship between post-traumatic stress disorder (measured through the Davidson trauma scale) and professional quality of life. Our sample included 399 (138 females, 261 males) military who carried out peacekeeping operations between 2017 and 2019. In order to test the moderation hypothesis, a hierarchical regression analysis was performed, and a three-step regression model was carried out. The results that emerged in our study reveal that the moderating effect of resilience is evident in all the effects of on the professional quality of life.. The moderating effect of the dispositional resilience on the relationship between Post-traumatic Stress Disorder and the professional quality of life of the military returning from the peacekeeping operations.
Recent studies have highlighted the increased risk of exposure to PTSD among military personnel who are faced with extreme stressor events, the stress related to the peacekeeping mission, indicates that even peacekeepers could be at risk of developing PTSD independently of war attacks or wounds. The resilience construct has a strong theoretical background, and in a pragmatic way has been shown to be a significant stress resistance resource in multiple groups, like those involved in military and security operations. The aim of this study was to examine the impact of resilience on the relationship between post-traumatic stress disorder (measured through the Davidson trauma scale) and professional quality of life. Our sample included 399 (138 females, 261 males) military who carried out peacekeeping operations between 2017 and 2019. In order to test the moderation hypothesis, a hierarchical regression analysis was performed, and a three-step regression model was carried out. The results that emerged in our study reveal that the moderating effect of resilience is evident in all the effects of on the professional quality of life..The moderating effect of the dispositional resilience on the relationship between Post-traumatic Stress Disorder and the professional quality of life of the military returning from the peacekeeping operations.
This is the official manual for the ProQOL (the Professional Quality of Life Scale) which is a 30 item self-report measure of the positive and negative effects of working with people who have experienced suffering and trauma. The ProQol contains three subscales measuring Compassion Fatigue (Burnout and Secondary Traumatic Stress scales) and Compassion Satisfaction (Compassion Satisfaction scale). The ProQOL is the most commonly used measure of the negative and positive affects of helping others who experience suffering and trauma. The measure has been in use since 1995 and is cited in over 1,000 peer-reviewed papers. The manual explains the background, theory, practical and research uses for the measure.
Homelessness continues to be a pervasive problem nationally and internationally. In the USA, the National Law Center on Poverty and Homelessness has estimated the annual number of homeless individuals to be in the range of 9.9–10.9 million sheltered and unsheltered persons, including those who have moved in with others due to financial hardship. Many of these persons suffer from severe mental illness or chronic substance abuse disorders. Additionally, many homeless persons have trauma histories, including abuse, neglect, and family and community violence. Many more have also experienced the traumatic effects of homelessness itself, including violence, revictimization, stigma, hunger, poor health, and other negative outcomes. To address the ongoing effects of traumatic stress, homelessness service settings are implementing trauma-informed care (TIC). This chapter will review the tenets of TIC and examine the personal and organizational barriers that may impede its successful implementation. Strategies for overcoming these barriers will also be highlighted.
The results trap happens when social workers believe they are responsible for and/or that they have control over the outcomes of their clients. This article explains the etiology and signs of the results trap along with highlighting how it can impair a social worker’s practice as it fosters stress and burnout. The article explores how a spiritual-based examination of practice perspectives and self-care can help practitioners avoid or limit the impact of this trap. Examination and consideration of spiritual and religious voices as part of a spiritual self-care strategy can help practitioners utilize these approaches while simultaneously avoiding this trap.
Writing in a narrative style, the authors describe the continuing education model of the Red Well Theater Group. The model combines a study group format with a play reading performance module to enhance the professional development of the Group’s members and their audiences of colleagues. The educational goals are to: 1) didactically study the principles and practice of group therapy; 2) theatrically illuminate concepts, relational themes, and small group dynamics relevant to group therapy; 3) experientially deepen therapist empathy for the challenge of being in a group; and 4) provide a vitalizing experience in support of therapist well-being. As an example of this model in action, the authors elaborate their experience preparing The Great God Pan, by Amy Herzog, for presentation at the 2014 American Group Psychotherapy Association (AGPA) Annual Meeting.
Child welfare workers speak of the satisfaction of knowing they have made a critical difference in children’s lives; at the same time, there is also the difficulty of dealing with the stressful aspects of working in this field. Some level of stress is inherent in child welfare work, and this affects both individuals and organizations. Exposure to details of the suffering of maltreated children is a job requirement for child welfare workers as they carefully investigate maltreatment allegations and interact with people who often do not want to see them and who may threaten them or try to hurt them. In addition to their day-to-day responsibilities, child welfare workers may also have to face the news of a child’s injury or death that they could not prevent. The combination of all of these factors can certainly be extremely taxing, and severely stressful events can result in negative effects on functioning in child welfare workers, such as traumatic stress, depression, and anxiety.
More than three quarters of youth involved in the juvenile justice system have been exposed (usually repeatedly) to traumatic stressors, including abuse or family or community violence, life-threatening accidents or disasters, and interpersonal losses. The prevalence of posttraumatic stress disorder (PTSD) among justice-involved youth is three to ten times greater than in community samples. In addition, justice-involved youth with PTSD are at high risk for problems, including depression and suicidality, oppositional-defiant and conduct disorders, risk taking, and substance abuse. This chapter provides an overview of clinical epidemiology research on PTSD, comorbid emotional and behavioral disorders, and complex traumatic stress disorders associated with the poly-victimization experienced by many youth in the juvenile justice system. Evidence is described of complex forms of PTSD among justice-involved youth that include: (1) persistently reduced adaptive arousal reactions and episodic maladaptive hyperarousal, (2) impaired information processing and impulse control, (3) self-critical and aggression-prone cognitive schemas, and (4) deviant peer relationships that model and reinforce disinhibited reactions, maladaptive ways of thinking, and aggressive, antisocial, and delinquent behaviors. Findings are highlighted concerning PTSD and vulnerable subpopulations, including girls, ethnoracial minority youth, and juveniles charged with sexual offenses. Finally, the chapter concludes with a discussion of trauma-informed approaches for court proceedings, juvenile justice facilities and rehabilitation services, and mental health treatment.
The aim of the current study was to identify personal and work-related risk factors for vicarious traumatization among social workers in Israel, as well as the contribution of relational-oriented supervision in mitigating the consequences of working with traumatized clients. Data was collected from 109 social workers who were employed in various agencies. Participants were asked about their personal trauma history, trauma work experience, work-related measures of trauma exposure, and supervision characteristics. Findings showed that social workers with trauma history, who worked mainly with survivors of human-induced trauma, and who had experienced more threat while working with traumatized clients, had higher levels of vicarious traumatization. Furthermore, social workers who reported they were receiving a more relational-oriented supervision and who evaluated their supervision as more effective had lower levels of vicarious traumatization. These findings suggest that beyond personal characteristics, the level of exposure to traumatized clients has a significant effect on social workers’ well-being. Additionally, these findings underscore the importance of a relational-oriented supervision in the context of trauma. Implications for social work practice are emphasized, as well as recommendations for future research.
Although research has examined secondary traumatic stress (STS) among mental health workers, child welfare workers, and other human service professionals, such examination among public school teachers has only recently begun. This study represents the first investigation to examine the factors that influence STS levels in public School teachers. Qualitative methods were utilized to develop a thick description of the experience of educators relative to their STS level in public school settings. Themes that were explored included characteristics of students, class load size, and a personal history of trauma. Additional themes emerged during data analysis. The assessment also included extrapolation on the quantitative measures that were described in a previous study. Implications and recommendations for such programs are discussed.
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