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Secondary traumatic stress among psychotherapists: determinants and consequences

Authors:

Abstract

The 1 aim of the paper is to present the phenomenon of secondary traumatic stress (STS), i.e. stress resulting from contact with trauma victims. The authors discuss conceptual issues related to STS (as well as terminological questions), characterize several methods of assessment of STS and data on its prevalence in samples from various populations. The main part of the article is devoted to considering STS among psychotherapists treating survivors of trauma. The problem is examined from the point of view of occurrence of STS among therapists, its predictive factors and consequences.
*, University of Finance and Management in Warsaw
Gestalt Therapy Institute in Cracow
University of Finance and Management
in Warsaw
Secondary traumatic stress among
psychotherapists: determinants and
consequences1
Abstract
The1aim of the paper is to present the phenomenon of secondary traumatic stress (STS),
i.e. stress resulting from contact with trauma victims. The authors discuss conceptual
issues related to STS (as well as terminological questions), characterize several methods
of assessment of STS and data on its prevalence in samples from various populations.
The main part of the article is devoted to considering STS among psychotherapists treat-

STS among therapists, its predictive factors and consequences.
Keywords
secondary traumatic stress (STS), psychotherapists
Introduction
 

contact with them.
* 
   
gmail.com.
1 



respectively.
  
   -
2. Although
many authors treat these concepts as roughly synonyms (Bride, 2012), in this
-

R. Figley          Compassion
fatigue: coping with secondary traumatic stress disorder in those who treat
the traumatized         
    
Such a stress may lead to symptoms identical to posttraumatic stress dis-
        
          

   
         
Statistical Manual of Mental Disorders (DSM-III). The diagnostic criteria for



-
ary traumatic stress and secondary traumatic stress disorder (STS / STSD)

Assessment of secondary traumatic stress
Compas-
sion Satisfaction / Fatigue Self-Test for Helpers
Beth Hudnall Stamm      
        Compassion Satisfaction
2 In the last paragraph of our paper we devote some space to the consideration of these
terminological variants.
              
    
Traumatology: An International Journal
B.H. Stamm was a professor and director of Institute of Rural Health at Idaho State
    
  

65Secondary traumatic stress among psychotherapists: determinants and consequences
and Compassion Fatigue (PROQOL) version 5 (Stamm, 2010)5. Apart from

  -

There are also other diagnostic instruments to detect symptoms of sec-


  -

 
-

Prevalence of secondary traumatic stress

 
on studies using STSS as a diagnostic tool and DSM-IV-TR6 criteria B, C, and
       -
        
-

          
          -

Secondary trauma among psychotherapists

psychotherapists, especially those, who deal with traumatic stress.
         
        
5   

6           

66  
 



in the Trauma Symptom Inventory.
         
-
ly hypervigilance, suspiciousness and fear for the safety of loved ones.
           

           


 

-

       
      
          
the therapist. The authors call this transformation vicarious traumatization.
      
           
   
a given therapy, vicarious traumatization is “accumulative across many ther-

Determinants of secondary trauma among psychotherepists
Research suggests that some of the psychotherapist characteristics are
important for developing symptoms of secondary traumatic stress.
One of such characteristics, which are mentioned in literature, is a thera-
.
         

     


Secondary traumatic stress among psychotherapists: determinants and consequences
    -
       

symptoms.
Many authors are convinced that if a therapist has an increased capac-
 
           
a curse to feel everything so deeply”.
   
       -
           

Higher rates of secondary traumatic stress are noted among those men-

caseload.
        
        
a higher percentage of survivors in their caseload reported more symptoms
of post-traumatic stress disorder independently from their own history of
victimization.


Age, gender, and education level ot the therapist have not shown clear

           
-


-
sus on the impact of therapist gender on the occurrence of STS (Meldrum et
al., 2002).
Consequences of secondary trauma among psychotherapists
There are several long-term effects of secondary traumatic stress, which
         


  
-

       

Secondary trauma can also impact the therapist on a personal level. More

 


-

 
  
          


-

        


       
      
  
-
fore, trauma therapists should consider participating in clinical supervision,
consultation, or engaging in other forms of self-care. In particular, profession-
  
to the lessened daily interaction with other mental health professionals and
greater isolation. Mental health professionals should also continue to engage
 
         -

           
         
-



Secondary traumatic stress among psychotherapists: determinants and consequences
Trauma Releasing Exercises
-


Remarks on terminology
       

search. Among terms used in titles of searched documents the most frequent

-

            -
pects of terminology: one is semantic point of view, another is historical one:



-

    
  
        
    . A psychotherapist,


10.
            



    -

10              

           

  
     11     
   -

   
-

12 (for instance: Craig & Sprang, 2010). In order to prevent
the suggestion that helping has mainly negative consequences some authors
-

 
          
  -

 -



-
passion fatigue”.
Prospects for the future
     
related to secondary stress.
11   




          
12             


    
     

  
of trauma.
Secondary traumatic stress among psychotherapists: determinants and consequences
For sure a further research is needed to increase the accuracy and scope

-
ing research studies and a paucity of literature dealing with applied questions.
-
ary traumatic stress disorder” (or any of its equivalents) as a nosological

  

as a disease.
However in principle it should not hinder continuing accumulation of

References
  
therapist trainees. Training and Education in Professional Psychology, 2(1) 

 Diagnostic and statistical manual of men-
tal disorders         
Association.
    
stress: A research synthesis. Counselling Psychology Quarterly 


    Violence and
Victims
            -
search implications. In C. Figley (ed.), Compassion fatigue: coping with secondary
traumatic stress disorder in those who treat the traumatized   


groups. Australian Family Physician, 34(6)
  

             
            

  
   Encyclopedia of
trauma 
    -
dation of the secondary traumatic stress scale. Research on Social Work Practice,
13
        Oncology Nursing Forum, 36,

          
Secondary traumatic
stress: self-care issues for clinicians, researchers, & educators -

         
among therapists, in: B.H. Stamm (ed.), Secondary traumatic stress: Self care is-
sues for clinicians, researchers, and educators

-

The Journal of Nervous
and Mental Disease
Craig, C.D., & Sprang, G. (2010). Compassion satisfaction, compassion fatigue, and
   Anxiety, Stress, &
Coping, 23(3)
         
Journal of Offender Rehabilitation,
Compassion fatigue: Coping with secondary traumatic stress disor-
der in those who treat the traumatized
    
An overview, in: Ch. R. Figley (ed.), Compassion fatigue: coping with secondary
traumatic stress disorder in those who treat the traumatized

  
Test. In B.H. Stamm (ed.), Measurement of Stress, Trauma and Adaptation. Balti-

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       The Guardian. Retrieved on Octo-
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

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     -
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         
Professional burnout. Recent developments in the the-
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-
Treating
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      -
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   -
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           
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Professional Psychology, Re-
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
Journal of Family
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19 (1)
  



  
pdf.
... Examination of the similarities and differences between these concepts has found that all concepts share at least one or more of the following symptoms: indirect exposure to traumatic material, symptoms of PTSD, and negative shifts in therapists' cognitive schema (Jenkins & Baird, 2002). ST, VT, STS, and CF are therefore used interchangeably in the literature (Cieslak et al., 2013;Gołąb et al., 2014) and are referred to and researched as the same thing, as these concepts are not generally considered to be conceptually distinct (Bercier & Maynard, 2015). While this creates some confusion for researchers trying to measure these concepts, there is a general consensus regarding the fact that all of these constructs result from working with traumatized people (Bercier & Maynard;Cieslak et al.;Gołąb et al.;Greinacher et al., 2019;Huggard et al., 2017;Nimmo & Huggard, 2013;Sodeke-Gregson et al., 2013). ...
... ST, VT, STS, and CF are therefore used interchangeably in the literature (Cieslak et al., 2013;Gołąb et al., 2014) and are referred to and researched as the same thing, as these concepts are not generally considered to be conceptually distinct (Bercier & Maynard, 2015). While this creates some confusion for researchers trying to measure these concepts, there is a general consensus regarding the fact that all of these constructs result from working with traumatized people (Bercier & Maynard;Cieslak et al.;Gołąb et al.;Greinacher et al., 2019;Huggard et al., 2017;Nimmo & Huggard, 2013;Sodeke-Gregson et al., 2013). ...
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It has been almost twenty years since the term "burnout" first appeared in the psychological literature. The phenomenon that was portrayed in those early articles had not been entirely unknown, but had been rarely acknowledged or even openly discussed. In some occupations, it was almost a taboo topic, because it was considered tantamount to admitting that at times professionals can (and do) act "unprofessionally." The reaction of many people was to deny that such a phenomenon existed, or, if it did exist, to attribute it to a very small (but clearly mentally disturbed) minority. This response made it difficult, at first, for any work on burnout to be taken seriously. However, after the initial articles were published, there was a major shift in opinion. Professionals in the human services gave substantial support to both the validity of the phenomenon and its significance as an occupational hazard. Once burnout was acknowledged as a legitimate issue, it began to attract the attention of various researchers. Our knowledge and understanding of burnout have grown dramatically since that shaky beginning. Burnout is now recognized as an important social problem. There has been much discussion and debate about the phenomenon, its causes and consequences. As these ideas about burnout have proliferated, so have the number of empirical research studies to test these ideas. We can now begin to speak of a "body of work" about burnout, much of which is reviewed and cited within the current volume. This work is now viewed as a legitimate and worthy enterprise that has the potential to yield both scholarly gains and practical solutions. What I would like to do in this chapter is give a personal perspective on the concept of burnout. Having been one of the early "pioneers" in this field, I have the advantage of a long-term viewpoint that covers the twenty years from the birth of burnout to its present proliferation. Furthermore, because my research was among the earliest, it has had an impact on the development of the field. In particular, my definition of burnout, and my measure to assess it (Maslach Burnout Inventory; MBI) have been adopted by many researchers and have thus influenced subsequent theorizing and research. My work has also been the point of departure for various critiques. Thus, for better or for worse, my perspective on burnout has played a part in framing the field, and so it seemed appropriate to articulate that viewpoint within this volume. In presenting this perspective, however, I do not intend to simply give a summary statement of ideas that I have discussed elsewhere. Rather, I want to provide a retrospective review and analysis of why those ideas developed in the ways that they did. Looking back on my work, with the hindsight of twenty years, I can see more clearly how my research path was shaped by both choice and chance. The shape of that path has had some impact on what questions have been asked about burnout (and what have not), as well as on the manner in which 2 answers have been sought. A better understanding of the characteristics of that path will, I think, provide some insights into our current state of knowledge and debate about burnout. In some sense, this retrospective review marks a return to my research roots. The reexamination of my initial thinking about burnout, and an analysis of how that has developed and changed over the years, has led me to renew my focus on the core concept of social relationships. I find it appropriately symbolic that this return to my research roots occurred within the context of a return to my ancestral roots. The 1990 burnout conference that inspired this rethinking took place in southern Poland, from which each of my paternal grandparents, Michael Maslach and Anna Pszczolkowska, emigrated to the United States in the early 1900s. Thus, my travel to Krakow had great significance for me, at both personal and professional levels.
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