Employee and Family Assistance You have invested thousands of dollars in your staff's training in both a direct and sometimes a more indirect and casual way. But invest in them you certainly have. When one of your staff has problems of a personal nature, perhaps at work or at home , there is a likelihood that this will impinge upon their work and affect the quality of their work and performance , and indeed others that they have dealings with in the workplace. We live in challenging times with a seeming increase in violence and tolerance in the aftermath of 911. Mental health, law related, educational and training professionals may need to process the trauma related stories of victims. Research into vicarious traumatization is continuing to develop. Given that 9/11 affected many of us-- especially in New York-- it can be challenging to separate out what is primary and what is secondary, or vicarious trauma. Stressed populations may experience increased violent crime, a fear of racial minorities, terrorism and domestic violence (Williams, 1999, p. 1). This environment can lead to key challenges for professionals who may work with vulnerable groups, such as women and people with disabilities who may be the victims of domestic violence. The literature suggests that training, education and other forms of professional development can be solutions to challenges associated with vicarious traumatization. Reference
Williams, D. (1999). Fear and Violence in Stressed Populations. Stress, Violence and Peace in the Balkans. UK: Eos Life-Work Resource Centre http://www.eoslifework.co.uk/gturmap.htm
______________________________________ Vicarious Traumatization and the Helping Professions. by the Director (PhD, BSW, MSW, MDED, MED, Master [Social Policy]).
This article incorporates theoretical literature on vicarious traumatization since its original conceptualisation by McMann and Pearlman in 1990. The writer discusses the concept of vicarious traumatization of professionals. Vicarious traumatization, secondary trauma, compassion fatigue, countertransference and burnout are linked with varying reactions to secondary stress (Williams & Sommer, 1999, p. 240). One of the themes that binds these concepts is the acknowledgment that work with clients who have experienced trauma can be challenging, tiring and deplete the personal lives of professionals (Kottler, 2000, p. 76, 84). Next, the writer examines the psychological and social costs of vicarious traumatization and raises key potential solutions to manage this process. Keywords - vicarious traumatization, posttraumatic stress syndrome, professionals
Educators can be of instrumental value to help mediators and other professions to access high quality training programs. This can ultimately enhance the effectiveness and reputation of the dispute resolution profession. It is important for mediators and other helping professionals to be aware of the manner in which vicarious trauma can impact upon their practice. Focus in the social sciences has tended to be on victims rather than on the vicarious victims of those who have sought to help primary victims (Figley, 1999, p. 9). More recently interest in the vicarious trauma of professionals has increased (Williams & Sommer, 1999, p. 230). Stamm (1999b) refers to vicarious traumatization and states - “Clearly this is an exciting, emerging field in which to do research.” (p. xxxix) Individuals or groups who have been directly impacted by trauma can have an affect upon professionals and may cause them to experience vicarious traumatization (Figley, 1999, p. 7). The trauma may be related to such factors as war, accidents, unanticipated death, hostage taking and domestic violence situations. Ultimately if professionals experience vicarious traumatization they may become ineffective in their interventions with primary victims (Figley, 1999, p. 10; Williams & Sommer, 1999, p. 244). 1) The Helping Professions
When professionals lack the joint internal and external strengths to manage anticipated external threat vicarious traumatization could occur (Bloom, 1999, p. 261 Saakvitne & Pearlman, 1996, 26). The term professional implies a person who has a specialized knowledge. This knowledge may be associated with a vocation or occupation that requires comprehensive training in law or the social sciences (Scheurich, 1997, pp. 9-13). McMann and Pearlman (1990) coined the term vicarious traumatization (Rosenbloom, Pratt & Pearlman, 1999, p. 67). The concept of vicarious traumatization arose from Constructivist Self Development Theory (Saakvitne & Pearlman, 1996, p. 27). Constructivist Self Development Theory (CSDT) can be a useful lens to help professionals to become aware of how trauma can impact upon the psyche of victims. Trauma can involve developmental, personal, social, cultural and familial factors. As work and research with victims of trauma continued it became apparent that helpers are not necessarily immune from secondary trauma. It is important for professionals to be warned about the shadow side of being involved with clients who have experienced trauma (Kottler, 2000, p. 73; Munroe, 1999, p. 213). Part of this shadow side is that professionals may experience secondary trauma. Secondary trauma may contribute to symptoms such as perceived helplessness, being susceptible to setbacks and hostility (Munroe, 1999, p. 211). Secondary trauma can impact upon the personal and professional lives of individuals and groups. This kind of work can also be most rewarding. Kottler (2000, pp. 30 - 32) mentions the immense satisfaction that people may experience in helping others. This satisfaction may in part be due to professionals’ perspectives about being involved in something larger than they are (Saakvitne & Pearlman, 1996, p.97). Kottler (1992, p. xi) indicates that professionals will need to be prepared to be reflective and manage their own unresolved challenges. To assist clients’ professionals may be required to be adaptive, flexible and ingenious (Kottler, 1992, pp. 167-168, 191, 196, 198, 224). Professionals may need to view conflict as being a potential teachable moment rather than maladaptive. Professionals can derive significant benefit from educating rather than negating the worth and dignity of their clients (Kottler, 1992, p. 168). Professionals who may be more susceptible than others to vicarious traumatization can include mediators, trainers, educators, crisis workers, peace keepers, the military, the police, fire fighters, health and social service providers, lawyers, judges, journalists and researchers (Figley, 1999, p. 5; Pearlman, 1999b, p. 52; Saakvitne & Pearlman, p. 19; Stamm, 1999a, p xxi; Williams & Sommer, 1999, p. 230). Often these professionals may work with primary victims over a prolonged period of time. This exposure can increase the risk of secondary trauma perhaps associated with domestic violence and death (Figley, 1999, p. 20; Nelson, 1998, pp. 1). The work environments of professionals and their personal characteristics may increase incidents related to vicarious traumatization. Personal characteristics of professionals who may be at increased risk of vicarious traumatization may include impatience, having a poor sense of self (Kottler, 2000, p. 82, 109). Self-exploration and development may be of instrumental value to develop the ego integrity of professionals (Saakvitne & Pearlman, 1996, p.108). Professionals may be drawn to crisis management due to an earlier trauma that they themselves may have experienced (Figley, 1999, p. 21; Saakvitne & Pearlman, 1996, p.98). For example, professionals who may have experienced the death of a husband, a sister, a child and/or grandparents may be drawn to work in the area of hospice and or sudden death support. Trainers and educators may experience vicarious trauma when they cover curriculum associated with crisis management. Trainers who may be particularly vulnerable to the process of vicarious traumatization can be those with trauma histories (McCammon, 1999, p. 105). When professionals undertake work that triggers their own earlier experiences that may be at increased risk of suffering from vicarious traumatization (Kassam-Adams, 1999, p. 45; Rosenbloom, Pratt & Pearlman, 1999, p. 75). It is important for professionals to be aware of the types of triggers that may reawaken previous trauma for them (Williams & Sommer, 1999, p. 242). 2) Vicarious Traumatization
Vicarious traumatization can occur due to professionals’ exposure to repeated indirect trauma in the work environment or to clients who are particularly stressed (Figley, 1999, p. 3; James & Gilliland, 2001, pp. 439, 461, 619-620; Stamm, 1999a&b, p. xxiii, xxxvi). Vicarious traumatization can involve interpersonal and environmental factors and cumulative permanent negative interpersonal and intrapersonal change (McCammon, 1999, p. 106; Pearlman, 1999a, p. xlviii; Pearlman, 1999b, p.52; Rosenbloom, Pratt & Pearlman, 1999, p. 67). Kassam-Adams (1999, p. 36) infers that trauma is contagious. Different stressors may impact upon professionals in varying ways. Not all professionals will experience trauma with the same stressors. Vicarious traumatization is a process that may resemble symptoms associated with posttraumatic stress disorder (PTSD). Professionals may experience feelings of terror, helplessness and perceive that they are not in control of their own emotions (Bills, 1999, p. 127; Figley, 1999, pp. 11-12; Rosenbloom, Pratt & Pearlman, 1999, p. 70). Professionals may experience changes in their sense of identity, self worth, feelings of safety, trust in others, key values and spiritual beliefs (Pearlman, 1999b, p. 54; Rosenbloom, Pratt & Pearlman, 1999, p. 68; Saakvitne & Pearlman, 1996, p. 36). In an attempt to retain control professionals may block out thoughts and actions connected with the vicarious trauma. Those who experience vicarious traumatization may suffer from amnesia have diminished energy and become socially isolated (Chrestman, 1999, p. 32; Figley, 1999, p. 17; Kottler, 2000, p. 94). Secondary victims of trauma may recall cumulative thoughts and images that primary victims may have mentioned as they have sought to resolve their own issues in therapy (Bills, 1999, p. 141; Chrestman, 1999, p. 30; Kassam-Adams, 1999, p. 42; Kottler, 2000, pp. 49 -51; Munroe, 1999, p. 214; Pearlman, 1999b, p. 61; Rosenbloom, Pratt & Pearlman, 1999, pp. 67- 75; Saakvitne & Pearlman, 1996,p. 40, 86, 129; Williams & Sommer, 1999, p. 240). Saakvitne & Pearlman (1996, p. 41) indicate that staff that work with women’s refuges and rape crisis centres may experience vicarious traumatization. Vicarious traumatization can lead to a loss of balance, self and social awareness and feelings of being isolated from others (Saakvitne & Pearlman, 1996, p. 75). Secondary victims may experience changed cognitive schemata, confusion and poor memory, stressful images, survivor guilt, impoverished personal and social relationships, nightmares, physical challenges, feelings of foreboding and being out of control (Kottler, 2000, pp. 75-76; Saakvitne & Pearlman, 1996, p. 59). These victims may attempt to soothe themselves through the inappropriate use of food and other substances and may become a workaholic. These victims may also seek to control others in an attempt to develop a sense of equilibrium (Kottler, 2001, p. 12, 31, 37). Professionals may experience primary and secondary trauma. At times of disaster and/or in isolated regions professionals may need to treat significant others for trauma that professionals may have experienced themselves. This situation can contribute to professionals having a lack of energy, vision and compassion to assist clients (Figley, 1999, p. 15; Kottler, 2000, p. 29, 73, 94, 119, 1992, p. 52; Stamm, 1999a, p. xi). Professionals who experience vicarious traumatization may no longer find that their personal, professional and social lives have meaning (Saakvitne & Pearlman, 1996, p. 73). Some professionals may lack the ability to be nurturing and empathetic with some clients who may remind them of their own unresolved issues (Kottler, 1992, p. 34). Clients may pick up on the negative views of professionals towards them and may challenge the power of mediators and therapists. If professionals impose their values on others they may experience emotional suffering that may contribute to vicarious traumatization. To enhance professional practice and ultimately the well being of clients it is important to explore possible solutions for vicarious traumatization. 3) Possible Solutions to Manage Vicarious Traumatization
Chrestman (1999, p. 30) and Harris and Linder (1999, p. 96) suggest that professionals who may be most at risk for vicarious tramatization are those who lack adequate personal strengths, coping mechanisms and who work with significantly traumatized clients in stressful environments. Pearlman (1999b, p. 52) indicates that the strengths of professionals and/or clients are not necessarily directly related to an increased risk of vicarious traumatization. Pearlman (1999b, p. 62) suggests that professional caseloads should include traumatized and non-traumatized clients. Rudolph & Stamm (1999, p. 285) suggest that if professionals have lower caseloads they are less likely to experience vicarious traumatization. Professionals who have lower caseloads will ideally have time for administrative work and self-care. Professionals can optimise their potential by developing their personal and social supports. There is merit in the development of collaborative relationships for professionals to support each other (Kottler, 2000, p. 19; Pearlman, 1999b, p. 60; Terry, 1999, pp. 166-175). These collaborative relationships should not deny that difference exists. It is important for professionals to gain access to timely support from their colleagues to discuss challenges that they may be facing (Kottler, 1992, p. 164). Social support can be of instrumental value to professionals to maintain their own psychological health (James, 2000, p. 1; Kottler, 2000, p. 111). This support may include education and mentoring (Kottler, 2000, p. 36). The Alberta College of Social Workers (2003, pp. 1-2) reinforces the need for continuing competency through reflective thinking and lifelong learning – however there are preconditions for this. If professionals are stressed then it is difficult to be reflective and/or to educate their clients and each other. Perhaps computer-mediated communication and the establishment of virtual communities can be of instrumental value to manage and limit vicarious traumatization. i) Computer-Mediated Communication and Virtual Communities.
Due to challenges often associated with space and time there is a role for computer-mediated communication to develop virtual communities (Stamm, 1999c, p. 180; Terry, 1999, p. 171). Computer-mediated communication may include email, bulletin boards, conferences, chat, instant messaging (Stamm, 1999c, p. 184). Stamm (1999c, pp. 188-191) refers to the strengths of email in the area of supervision, training and support. Virtual communities can support professionals, in particular those who may be experiencing vicarious traumatization (Stamm, 1999a, p. xii; Stamm, 1999c, p. 179). Stamm refers to advances in technologies and indicates that it is more cost effective than was the case in 1995. Stamm (1999c) states, "More importantly, technology is less expensive and easier to use, making it a realistic tool for increasing our ability to do our work well.” (p. 179) Some professionals may live in rural and remote areas and may work night shift. Professionals who reside in rural regions may operate in isolated conditions and may be over worked (Stamm, 1999c, pp. 187-188; Williams & Sommer, 1999, p. 241). These professionals may have little opportunity to gain access to face-to-face training and education. Internet based technologies and the telephone can assist professionals to gain access to support, information and supervision that may not otherwise be available to them in part due to their work schedules (Stamm, 1999c, p. 180, 189, 193; Williams & Sommer, 1999, p. 241). These supportive services can assist professionals to make informed decisions, to enhance their competency in their work in the area of crisis management (Stamm, 1999c, p. 181). This enhanced competency is likely to increase the quality of service to clients. The Internet has led to the development of online resources for professionals in the world community (Stamm, 1999c, pp. 182-185). There can be challenges associated with the Internet. These challenges may include not being able to safeguard sensitive information contained in databases. Some individuals may gain unauthorised access to sensitive information. Further email messages may be sent in error to unintended recipients. Professionals and clients may only have access to text generated through computer-mediated communication. This text may not have body language and other cues from which to place it into context. This can lead to miscommunication and aggression. This aggression may become overt through flame wars. Flame wars may occur when parties are disrespectful and hostile towards each other. If this situation occurs it may be important for a moderator to engage separately with the flamer to manage the conflict in a more constructive manner. With the development of computer-mediated communication information can be brought to professionals that is almost independent of time and space. Through the Internet supervision, further education, training and networking can be established for groups of professionals (Stamm, 1999c, pp. 186-188; Saakvitne & Pearlman, 1996, p. 137). It is important for professionals to enhance their ethical responsibilities and roles in part through self-care (Shay, 1999, p. 255). Often professionals do not spend time on maintaining self -care (Saakvitne & Pearlman, 1996, p. 61, p. 129). The neglect of the personal and professional self may compromise practice, the integrity of the professions and deplete interpersonal relationships with significant others. If professionals who become involved in crises and trauma do not maintain and develop self-care they may give flawed messages to clients (Munroe, 1999, p. 225). Many victims may not be assertive with aggressive persons and may give up on themselves. This can contribute to the violence against victims being continued. In this article the writer has discussed the concept of vicarious traumatization of professionals. Mediators, trainers and other professionals who may become involved in crises and trauma may experience the process of vicarious traumatization. Vicarious traumatization can impair the emotional, physical and social health of professionals. In this article the writer has also examined the psychological and social costs of vicarious traumatization and has raised a few potential solutions to manage crises and trauma. 4) References
Alberta College of Social Workers (2003). Continuing Competence: A Journey of Lifelong Learning. An Introductory Handbook for Alberta’s Registered Social Workers. Edmonton: Alberta College of Social Workers Bills, L. (1999). Trauma-Based Psychiatry for Primary Care. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Bloom, S.L. (1999). The Germ Theory of Trauma: The Impossibility of Ethical Neutrality. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Chrestman, K.R. (1999). Secondary Exposure to Trauma and Self-Reported Distress Among Therapists. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Figley, C.R. (1999b). Compassion Fatigue: Toward a New Understanding of the Costs of Caring. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Harris, C.J. & Linder, J.G. (1999). Communication and Self Care: Foundational Issues. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press James, R. (2000). Vicarious Traumatization/Compassion Fatigue. Memphis http://www.uic.edu/orgs/convening/vicarious.htm James, R. & Gilliland, B. (2001). Crisis Intervention Strategies (4th edition). Belmont, CA: Wadsworth/Thompson Learning Kassam-Adams, N. (1999). In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Kottler, J.A. (2001). Making Changes Last. Philadelphia: Brunner-Routledge Kottler, J.A. (2000). Doing Good. Passion and Commitment for Helping Others. Philadelphia: Brunner-Routledge Kottler, J.A. (1992). Compassionate Therapy. Working with Difficult Clients. San Francisco: Jossey Bass McCammon, S.L. (1999). Painful Pedagogy: Teaching About Trauma in Academic Training Settings. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Munroe, J.F. (1999). Ethical Issues Associated with Secondary Trauma in Therapists. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Nelson, T.S. (1998). Vicarious Trauma: Bearing Witness to Another’s Trauma. USA: WebPages of Dr. Jontry http://www.drjontry.com/handouts/vicarious.htm Pearlman, L.A. (1999a). Notes from the Field: Laurie Anne Pearlman. What is Vicarious Traumatization. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Pearlman, L.A. (1999b). Self-Care for Trauma Therapists: Ameliorating Vicarious Traumatization. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Rosenbloom, D.J; Pratt, A.C. & Pearlman, L.A. (1999). Helpers’ Responses to Trauma Work: Understanding and Intervening in an Organisation. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Rudolph, J.M. & Stamm, B.H. (1999). Maximising Human Capital: Moderating Secondary Traumatic Stress through Administrative & Policy Action. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Saakvitne, K.W. & Pearlman, L.A. (1996). Transforming the Pain. A Workbook on Vicarious Traumatization for Helping Professionals who Work with Tramatized Clients. New York: W.W. Norton & Company. Scheurich, J.S. (1997). Research Method in the Postmodern. London: The Falmer Press Shay, J. (1999). No Escape from Philosophy in Trauma Treatment and Research. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Stamm, B.H. (1999a). Preface to the First Edition. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Stamm, B.H. (1999b). Introduction to the First Edition. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Stamm, B.H. (1999c). Creating Virtual Community: Telehealth and Self Care Updated. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Terry, M.J. (1999). Kelengakutelleghpat: An Artic Community-Based Approach to Trauma. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press Williams, M.B. & Sommer, J.F. (1999). Self-Care and the Vulnerable Therapist. In B.H. Stamm, (Ed), Secondary Traumatic Stress. Self-Care Issues for Clinicians, Researchers and Educators. (2nd Edition). Baltimore: Sidran Press _________________________ You may feel that this is unacceptable and consider letting them go. But is this the most sensible and indeed productive way to go? As previously stated, you have thousands of dollars invested in them and you may be facing spending even more dollars to replace them in your workforce. There is also the likelihood that their colleagues may feel that members of your staff are not appreciated when problems that they face impinge upon their own work performance and perhaps they will feel at risk and that they should look for an employer who is perhaps more understanding. The answer is Employee Assistance Programs and /or Employee Family Assistance Programs. These can be included in the benefits packages that you supply to your staff. The Trident Foundation offers these programs. Areas covered include - but are not limited to - grief, sadness and despondency, addictions, family violence, child & family therapy and finally vicarious traumatization. An article about vicarious traumatization appears above. The programs offered by the Trident Foundation are, of course, entirely confidential and are provided by a trained professional. Trident assists service recipients to discover the reason(s) for their problems within themselves or their relationships to enable them to resolve them or perhaps come to terms with them. Trident hopes that by helping them to do this they will have the opportunity to feel better at peace within themselves and become a full and productive member of society and your organization. The very clear benefits are that your organization is recognized as being seen as a caring employer that values its staff beyond just seeing them as working units. Which is very good for employee/employer relations. In this way you are much more likely to engender staff loyalty from a considerably healthier and indeed cost effective, productive staff. Contact Trident today and let us see if we can be of service to you and your staff. ________________________________ Trident: Home also see local imagery Previous Service: Witness Preparation & Support Programme
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