Do you work with trauma? Are you ever affected by your clinical work?
Although many of us experience great satisfaction from successful therapy experiences, we also spend our days hearing and imagining a wide variety of traumatic experiences. Trauma therapy is important, but often challenging work—for clients and providers. Unfortunately, providers who work with trauma populations sometimes experience negative consequences as a result of this type of work. It doesn’t seem to matter what type of trauma the client has experienced. These consequences are not only problematic and stressful for the provider, but also potentially affect the client. These types of responses are called vicarious trauma.
If you’re not sure if your work has negatively affected you, here are some things to look for:
- feeling emotionally exhausted
- shifts in worldviews and changes in cognitive schemas about the world and the people who inhabit it
- intrusive memories, nightmares, flashbacks, or reactivity when encountering specific cues related to your clients’ trauma
- avoidance of things that serve as reminders of trauma
- decreased interest in previously enjoyed activities
- difficulty sleeping and/or concentrating, hypervigilance, irritability, and/or exaggerated startle response
Some providers are more likely to develop issues such as burnout, or vicarious trauma, than other providers are. If you have any of the following characteristics or engage in any of the following behaviors, you may be more likely to be negatively affected by your trauma work.
Risk Factors for Vicarious Trauma:
- empathic engagement—paradoxical, right? The more we imagine ourselves in our client’s shoes, so to speak, the more we risk developing burnout or other trauma-related disorders
- female gender—women seem to be at greater risk for developing negative reactions to trauma
- age—younger clinicians are more likely to be negatively affected by trauma work
- increased exposure to traumatized clients—more trauma exposure = more risk
- length of time providing treatment—more seasoned/experienced clinicians are at lower risk
- occupational stress—the more stressors present at work that are in addition to the specific trauma work
- clinician’s own maltreatment history—those with personal trauma histories are at greater risk
If you experience any of the symptoms or reactions above, or have any risk factors listed above, here are some suggestions on how to protect yourself. If you have difficulty putting your own needs above those of others, consider this: Have you ever flown on an airplane? Do you remember the safety “coaching” airline personnel do at the beginning of your flight? Why do they tell you to put your oxygen mask on first, before helping others? You, the therapist, are a significant tool or factor in terms of client success. Here are some suggestions on how to protect yourself and your clients.
Protective Factors for Vicarious Trauma:
- genuine positive regard for clients—the more you genuinely like your clients, the more protected your will likely be
- foster your awareness of
- your inner experiences, especially if you have experienced trauma yourself
- your personal means of coping—make sure you know what works for you and use/do it
- Work/Life Balance!
- organizational issues that may impact your clinical work—e.g., variety in caseload, quotas, etc.
- the social context within which the therapy process takes place—be aware of larger cultural, social, and environmental factors that may influence your work and your life
- use of an established theoretical framework or evidence-based practices
- know and use self-care and self-soothing behaviors
- peer/case consultation – talk to and solicit support from your colleagues
- get involved in organizational efforts to directly address issues that impact provider responses to their clinical work
- consider acquiring your own therapist as/when needed
Bottom line: take care of yourself to maximize your ability to take care of others and protect against the “negative effects of caring about and caring for others” (Pearlman and Saakvitne, 1995, p. 31).
Author: Kari Finnegan
Dr. Kari Finnegan is a Licensed Psychologist at Hope Springs Behavioral Consultants. She works with adolescents and adults on issues related to anxiety, depression, relationships, and physical health. We are very glad to have her on staff.