Secondary traumatic stress and adjustment in therapists who work with sexual violence survivors: the moderating role of posttraumatic growth

ABSTRACT

Due to their secondary exposure to the traumatic events disclosed by clients, therapists who work with sexual violence survivors are at risk of experiencing secondary traumatic stress. We examined whether the negative effects of secondary traumatic stress on therapist adjustment would be buffered by posttraumatic growth. Sixty-one therapists who work with sexual violence survivors completed measures of secondary traumatic stress, posttraumatic growth and a range of adjustment indicators. Hierarchical multiple regression analyses demonstrated that posttraumatic growth moderated the negative impact of secondary traumatic stress on therapist depression, anxiety, personal meaning and satisfaction with life. Posttraumatic growth sustained positive affect through a direct effects model only. This study provides support for the protective role of posttraumatic growth in adjustment to secondary traumatic stress.     

Emotion Regulation Strategies,Secondary Traumatic Stress,and Compassion Satisfaction in Healthcare Providers

The aim of the present study is to examine the relationships between two emotion regulation strategies (cognitive reappraisal and expressive suppression), secondary traumatic stress, and compassion satisfaction in a sample of 190 healthcare providers. Another aim of this study is to examine if the relations between emotion regulation strategies and traumatic stress symptoms are moderated by compassion satisfaction. The respondents volunteered to take part in the research and completed self-reporting measures describing the use of emotional regulation strategies, the symptoms of secondary traumatic stress, and the compassion satisfaction. The results revealed negative associations between cognitive reappraisal and secondary traumatic stress, while expressive suppression is positively associated with arousal. Moreover, cognitive reappraisal is positively related to compassion satisfaction, while secondary traumatic stress symptoms are negatively correlated with compassion satisfaction. Furthermore, the relationship between expressive suppression and intrusions is moderated by compassion satisfaction. The implications of these results for enhancing professional quality of life in the context of secondary exposure to traumatic life events are discussed.     

Walking in sacred spaces in the therapeutic bond: therapists' experiences of compassion satisfaction coupled with the potential for vicarious traumatization

The therapeutic bond is at the heart of effective therapy, yet few studies have examined therapists' experience of this bond. Using a qualitative study design, this exploratory study examines the experiences of couple and family therapists in relation to their perceptions of the satisfactions and risks involved in the therapeutic bond. The research was conducted using grounded theory methodology and eight in-depth interviews were conducted with therapists working in five counseling agencies in Sydney, Australia. Therapists described the importance of the 3 component parts of the therapeutic bond: the empathic connection between therapist and client; the role investment of the client; and the mutual affirmation experienced by both therapist and client in the therapeutic process. Walking in sacred spaces with the client was seen as both enriching and challenging for the therapist. The therapeutic bond gave therapists intense satisfaction and posed risks for them, especially when working with traumatic client experiences. However, the findings suggest that the experience of compassion satisfaction and the development of vicarious resilience counter-balanced the intense difficulty of bearing witness to clients' traumatic experiences and the potential for vicarious traumatization. The implications for sustaining couple and family therapists in their work are discussed.     

Vicarious traumatisation of counsellors and effects on their workplaces

The literature on therapists' reactions to clients' traumatic material is Critically reviewed. The various attempts within this relatively new literature to conceptualise this phenomenon include countertransference, compassion fatigue and vicarious traumatisation. The limited research evidence is evaluated and found to support anecdotal accounts by trauma therapists. Empathic engagement with trauma survivors is necessary for effective psychotherapeutic intervention. However, empathic engagement also makes therapists vulnerable to the detrimental effects of vicarious trauma, with consequent negative effects on individual counsellor effectiveness and organisational dynamics in the workplace.     

Context matters: the benefits and costs of expressing positive emotion among survivors of childhood sexual abuse

Positive emotions promote adjustment to aversive life events. However, evolutionary theory and empirical research on trauma disclosure suggest that in the context of stigmatized events, expressing positive emotions might incur social costs. To test this thesis, the authors coded genuine (Duchenne) smiling and laughter and also non-Duchenne smiling from videotapes of late-adolescent and young adult women, approximately half with documented histories of childhood sexual abuse (CSA), as they described the most distressing event of their lives. Consistent with previous studies, genuine positive emotional expression was generally associated with better social adjustment two years later. However, as anticipated, CSA survivors who expressed positive emotion in the context of describing a past CSA experience had poorer long-term social adjustment, whereas CSA survivors who expressed positive emotion while describing a nonabuse experience had improved social adjustment. These findings suggest that the benefits of positive emotional expression may often be context specific.     

Anxiety,Compassion and Pride. How Emotions Elicited by the Government’s Handling of Covid-19 Influences Health-Promoting Behavior

This article explores how emotions connected to the Government’s handling of the Covid-19 outbreak in Sweden relates to behaviors to stop the spread of the virus, and which emotions functions as mediators in this relationship. The Swedish approach to handling the outbreak greatly differed from how many other Western European countries handled the situation and thus makes an important case to study. In a large representative survey (N = 2449), we found that satisfaction with how the Government handled the situation was related to more positive and less negative emotions. Anxiety, compassion and pride mediated the effect of satisfaction on compliance with the national recommendations such that anxiety and compassion increased compliance, while pride decreased it. Importantly though, satisfaction increased compassion and pride, but only compassion led to more compliant behaviors. In fact, satisfaction was indirectly related to less compliant behaviors via anxiety and pride. Shame mediated the effect on the tendency to wear face masks, a behavior that was explicitly not endorsed by the Swedish Public Health Agency. We speculate if the face mask, which was intensely debated, became a politicized symbol of dissatisfaction with the Swedish approach. In sum, it seems that individuals who were dissatisfied with how the government handled the Covid-19 outbreak were in fact engaging more in health-promotional behaviors to stop the spread of the virus.     

Nice to know you: Positive emotions, self-other overlap, and complex understanding in the formation of a new relationship

Based on Fredrickson's ((1998). What good are positive emotions? Review of General Psychology, 2, 300-319.; (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56, 218-226) broaden-and-build theory and Aron and Aron's ((1986). Love as expansion of the self: Understanding attraction and satisfaction. New York: Hemisphere) self-expansion theory, it was hypothesized that positive emotions broaden people's feelings of self-other overlap in the beginning of a new relationship. In a prospective study of first-year college students, we found that, after 1 week in college, positive emotions predicted increased self-other overlap with new roommates, which in turn predicted a more complex understanding of the roommate. In addition, participants who experienced a high ratio of positive to negative emotions throughout the first month of college reported a greater increase in self-other overlap and complex understanding than participants with a low positivity ratio. Implications for the role of positive emotions in the formation of new relationships are discussed.     

VICARIOUS TRAUMA The Effects on Female Counselors of Working with Sexual Violence Survivors

The primary purpose of this study was to assess the effects on counselors of working with sexual violence survivors. Members of a women psychologists' organization and a group of sexual violence counselors completed questionnaires regarding the extent of their work with survivors and their psychological functioning. Counselors who had a higher percentage of survivors in their caseload reported more disrupted beliefs, (particularly about the goodness of other people), more symptoms of post-traumatic stress disorder, and more self-reported vicarious trauma. Symptomatology was not related to counselors' own history of victimization. Qualitative data regarding difficult and enjoyable aspects of working with survivors also were gathered, along with data on the strategies used by counselors to cope with work-related stress. implications for counselor training are discussed.     

Secondary Traumatic Stress in Social Science Researchers of Trauma-Exposed Populations

There is an expanding research database regarding secondary trauma exposure among helping professionals across disciplines and settings. However, there is limited research on the incidence of secondary traumatic stress in social science researchers studying traumatized populations. Various disciplines engage in this area of research, which exposes them to the details of aversive events, especially those engaging in qualitative research. This study explores the impact of such exposure by measuring indicators of secondary traumatic stress (STS), burnout (BO), and compassion satisfaction in a group of 104 researchers. Findings revealed high rates of exposure to traumatic material and a subset of researchers at risk for STS. Regression analyses revealed potential risk factors for STS and BO, and qualitative analysis was conducted to further explore the effects of this work on researchers from multiple disciplines.     

“Why would you want to do that work?” The positive impact on therapists of working with child victims of sexual abuse in Ireland: a thematic analysis

Abstract

Research on the impact on psychotherapists of working with trauma has typically focused on negative impact and protective strategies and supports for therapists working in this field, such as self-care strategies and supervision. Yet many clinicians speak of the rewarding and fulfilling experiences of working with those who have been sexually abused. This study explored the positive impact of working with children who have been sexually abused in a sample of psychotherapists in Ireland. Unstructured interviews were conducted with nine female therapists who work in a specialist sexual abuse service with child victims of sexual abuse. An inductive thematic analysis identified four key themes: “the struggle to talk about the positive impact”, “professional satisfaction from helping children”, “learning life lessons from children” and “the magical connection that happens in therapy”. The findings show that, despite therapists’ tendency to think about negative impact, when encouraged to do so they described finding the work professionally rewarding, experiencing an enhancement of their own attitudes and lives through learning from the children they worked with and feeling uplifted within the therapeutic relationship with the child. Suggestions are offered for future research that may provide a broader understanding of the positive impact of this work.     

关注助人者的心理健康：共情疲劳的涵义、结构及其发生机制

共情疲劳是心理咨询师、消防战士、急救医护人员等助人者救助受创伤人员后出现的特有的心理健康问题。共情疲劳的二因素模型含二次创伤与职业倦怠, 三因素模型还包括共情满足。共情疲劳的临床症状与创伤后应激障碍、二次创伤、替代(间接)性创伤、倦怠相似, 但上述概念并不等同于共情疲劳。共情疲劳是助人者在间接接触创伤性事件并向他人共情的前提下, 产生共情压力, 降低了对他人共情的兴趣与能力, 出现二次创伤症状, 产生工作倦怠感。同时, 助人者人口统计学特征(如婚姻状况、学历、工作年限、个人创伤史等)、接触或暴露于创伤事件的程度、个人心理资源都会影响共情疲劳发生的过程。     

Sekundäre Traumatisierung

During the past several years there has been a growing interest in the negative effects that therapy may have on therapists. Of special interest is a phenomenon called secondary traumatization, which can arise while working with traumatized clients. As yet it has not been verified that secondary traumatization consists of posttraumatic symptoms and leads to clinically significant distress. In an exploratory study 21 therapists were interviewed who declared that they had experienced an incident of this form of work-related stress. The presented study reveals that in fact such a ?vicarious“ traumatization can arise, even without direct contact to the original trauma. It consists of post-traumatic stress disorder (PTSD)-like symptoms, but in severe cases it can also manifest itself in symptoms which are far beyond the typical PTSD spectrum. Conditions for the development of secondary traumatization are high empathic ability and dissociative processing of the trauma material by the therapist.     

Therapeutic Work with Trauma,Revictimization, and Perpetration: Bearing Witness,Offering Hope,Embracing Despair

ABSTRACT

This paper offers a case study of a survivor of childhood incest who in adulthood has become a victim of violence in her relationships with chosen partners and is concerned that she herself may be a perpetrator of sexual abuse. It examines selected literature on attachment, dissociation, transference/countertransference, role responsiveness and sadomasochistic therapeutic enactments, the two-system superego model, and the triadic self. The paper focuses on long-term treatment dynamics with survivors of cumulative trauma and explores such psychodynamic psychotherapy issues as the therapist as a perpetrator of violence, the development of sacred space, authenticity, and the importance of both offering hope and embracing despair in this work.     

Predictors of Emotional Security in Survivors of Interpersonal Violence

As emotional security theory has recently been extended to understand recovery from interpersonal violence, the present study aimed to understand whether and to what extent trauma-specific aspects of the family environment (caregiver responses to disclosure, non-disclosure) and more general aspects of the family environment (interparental conflict, parental invalidation of emotions) explained variance in emotional security in the family in a sample of emerging adults with a history of interpersonal violence (physical or sexual abuse or assault). Results indicated that substantiated aspects of the interparental subsystem (interparental conflict) and parent–child subsystem (parental invalidation of emotions) predicted all three aspects of emotional security (preoccupation, disengagement, and security) in regression models where trauma-specific variables were included. Additionally, non-supportive caregiver response to disclosed trauma also accounted for significant variance in felt security, supporting the idea that problematic caregiver responses to traumatic events can erode emotional security for survivors of interpersonal violence, in addition to broader patterns in the interparental and parent–child subsystems.     

Association of Burnout with Emotional Coping Strategies,Friendship, and Institutional Support Among Internal Medicine Physicians

Physician burnout influences physician mental health, staff stress, safety events, and patient outcomes. The association of burnout with compassion satisfaction, secondary stress, emotional coping strategies and many psychosocial variables, such as institutional support, friendship, and spirituality, have not been well studied. A convenience sample of internal medicine physicians was emailed a survey using validated instruments to explore these associations. The response rate was 337/1021 (33%), with a burnout prevalence of 175/337 (52%). Grit, acceptance, active coping, positive reframing, and strategy planning were associated with lower burnout domains and greater compassion satisfaction. Certain emotional coping strategies such as denial, disengagement, self-blame, substance abuse, and venting were associated with greater burnout and lower compassion satisfaction. Greater institutional support was associated with lower burnout (r?=????.35, p?<?.001), secondary stress (r?=????.14, p?<?.05), and compassion satisfaction (r?=?.28, p?<?.0001). Friendship was associated with lower burnout (r?=????.25, p?<?.0001) and greater compassion satisfaction (r?=?.28, p?<?.0001). This study suggests that amelioration of burnout requires both intrinsic strategies that emphasize physician coping skills as well as extrinsic strategies that address institutional support.

     

儿童期创伤与有留守经历大学生负性情绪：心理韧性的调节作用

本研究旨在考察有留守经历的大学生儿童期创伤与负性情绪关系,以及心理韧性在其间的调节作用。对391名有留守经历的大学生进行间隔3个月的两次问卷调查。结果:(1)相较于没有儿童期创伤的个体,有儿童期创伤的个体心理韧性更低,抑郁、焦虑、压力水平更高;(2)在控制性别、城乡来源、是否独生、年龄与T1时间点负性情绪的作用后,T1时间点的儿童期创伤、心理韧性均能显著预测T2时间点的负性情绪;(3)低心理韧性水平下,儿童期创伤显著预测留守经历大学生的负性情绪;高心理韧性水平下,预测作用不再显著。表明儿童期创伤是有留守经历的大学生负性情绪的风险因素,心理韧性可以调节儿童期创伤对有留守经历大学生的负性情绪的预测。     

Compassion satisfaction,compassion fatigue,and burnout in a national sample of trauma treatment therapists

Abstract

For behavioral health professionals working with traumatized clients, continuous and prolonged exposure to the stress of working with the myriad of trauma-related stressors experienced by their clients can lead to various responses including burnout, compassion fatigue, and compassion satisfaction. The present study investigates the impact of using evidence-based practices on compassion fatigue, burnout, and compassion satisfaction in a random, national sample of self-identified trauma specialists (N=532). The 30-item Professional Quality of Life Scale (Stamm, 2005) and the 19-item Trauma Practices Questionnaire (Craig & Sprang, 2009) were included in a survey to licensed social workers and psychologists from professional membership rosters. Age and years of experience proved to be powerful predictors of only two of the three criterion variables, with younger professionals reporting higher levels of burnout and more experienced providers endorsing higher levels of compassion satisfaction. The utilization of evidence-based practices predicted statistically significant decreases in compassion fatigue and burnout, and increases in compassion satisfaction. The utility of these findings in understanding the process of trauma transmission between therapist and client as well as directions for future research are discussed.