For More Information About Vicarious Trauma
The VTT has a number of resources to help you further understand vicarious trauma, its prevalence, and its impact on those working in victim services, emergency medical services, fire services, law enforcement, and other allied professions. The following is just a small sample of the nearly 500 resources in the VTT Compendium of Resources.
Vicarious Trauma Compassion Fatigue And Burnout: What Causes Them And How Do We Prevent Them
Much research is needed to understand the impact of what is referred to as vicarious trauma , compassion fatigue , and burnout in forensic mental health professionals. Doing so will assist in efforts to ensure clinicians are engaging in their work competently and professionally. This is the bottom line of a recently published article in Professional Psychology. Research and Practice. Below is a summary of the research and findings as well as a translation of this research into practice.
Recognising The Signs And Symptoms Of Burnout
Burnout describes the prolonged physical and psychological exhaustion that workers can experience from continuous exposure to structural oppression and social injustice at work.
A 2017 Victorian family violence workforce census found that almost one third of specialist family violence practitioners were considering leaving their job due to burnout.
Burnout can sometimes be misinterpreted as the result of working with clients who are experiencing family violence and trauma. However this framing fails to centre the political and structural nature of family violence work, nor does it acknowledge the transformation, strength and resilience that comes from working alongside people with experiences of abuse and trauma, which can be understood as vicarious resistance .
The effects of burnout vary from person to person. For some people, there may be a wide range of signs and symptoms, while others may experience problems in one particular area of their lives.
Common signs of burnout:
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Common Signs Of Vicarious Trauma
If you are currently or have recently been working with survivors of traumatic incidents or torture survivors, you should be aware of the following signs:
- experiencing lingering feelings of anger, rage and sadness about patient’s victimisation
- becoming overly involved emotionally with the patient
- experiencing bystander guilt, shame, feelings of self-doubt
- being preoccupied with thoughts of patients outside of the work situation
- over identification with the patient
- loss of hope, pessimism, cynicism
- distancing, numbing, detachment, cutting patients off, staying busy. Avoiding listening to client’s story of traumatic experiences
- difficulty in maintaining professional boundaries with the client, such as overextending self .
If you are experiencing any of these signs, this could indicate that you are suffering from vicarious trauma.
What If I Think That Someone Close To Me Is Suffering From Cf
Be kind and supportive. It can be hard to hear that something you have been trying to hide is obvious to others.
Unfortunately, with a main focus on self-care and work-life balance as the sole solutions to compassion fatigue, some helpers have felt blamed for their CF. They have received a strong message from their workplace If you feel burnt out, it means you are not taking good enough care of yourself.
This can further silence people in pain and it is actually not true. The biggest contributors to CF are where you work, your workload, your working conditions and the amount of high quality training you have received in trauma-related areas not the amount of kale you eat and yoga you practice
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Relevant Interventions And Approaches
Addressing compassion fatigue needs to occur at both the individual and organizational levels and falls into two categories: prevention and treatment. Helpers can adopt lifestyle and work habits that help them maintain strong practice approaches and personal boundaries that can be protective in relation to a helping role. Sometimes even the most seasoned and personally balanced professionals find themselves struggling with secondary traumatization.
What Is The Difference Between Compassion Fatigue Vicarious Trauma And Burnout
These three terms are complementary and yet different from one another.
While Compassion Fatigue refers to the profound emotional and physical erosion that takes place when helpers are unable to refuel and regenerate, the term Vicarious trauma was coined by Pearlman & Saakvitne to describe the profound shift in world view that occurs in helping professionals when they work with clients who have experienced trauma. Helpers notice that their fundamental beliefs about the world are altered and possibly damaged by being repeatedly exposed to traumatic material.
Burnout is a term that has been used since the early 1980s describe the physical and emotional exhaustion that workers can experience when they have low job satisfaction and feel powerless and overwhelmed at work. However, burnout does not necessarily mean that our view of the world has been damaged, or that we have lost the ability to feel compassion for others.
Most importantly, burnout can be fairly easily resolved: changing jobs can provide immediate relief to someone suffering from job-related burnout. This is not the case for CF and VT. Helpers can simultaneously experience Compassion Fatigue and Vicarious Trauma. They are cumulative over time and evident in our personal and professional lives. They are also an occupational hazard of working in the helping field.
Read through the examples below and notice if you recognize elements of these scenarios in yourself:
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Burnout Anxiety And Panic Attacks
Many psychotherapists have noted a connection between a persons attachment style and how burnout manifests.
- For individuals with an avoidant attachment style, symptoms of burnout often take on the form of depression, lethargy, and fatigue.
- For individuals with a preoccupied attachment style, its more common for them to experience anxiety, panic attacks, and highly emotional disturbances when they experience burnout.
This difference occurs because each human has a tendency towards responding to overwhelming stimuli with either hypoarousal or hyper-arousal . Although, many individuals have a wide capacity to tolerate many experiences between the two extremes.
What Is The Temporal Nature Of Empathy
In order to address a major gap in the literature, the temporality of empathy-based stress, quantitative research will be beneficial. Measurement, study design , and analysis are primary areas for improvement to fill this knowledge gap.
How Should We Measure Empathy-Based Stress?
Current practices in empathy-based stress measurement may be insufficient to uncover information about the temporal nature of empathy-based stress. Indeed, the sufficiency of psychometric evidence for existing measures has been debated for over a decade , with continued calls for more rigorous validation efforts . For purposes of this discussion, we place particular emphasis on the two most widely used measures of empathy-based strain: the Professional Quality of Life scale and the Secondary Traumatic Stress Scale .
How Should We Design Studies of Empathy-Based Stress?
How Should We Analyze Empathy-Based Stress Data?
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Understanding Vicarious Trauma And Compassion Fatigue
Research shows how profoundly influenced we are by other peoples emotional states and how rapidly our interpersonal affective responses occur, and how dynamically our physiology responds to others emotional states. This is why trauma can be emotionally contagious. I have experienced it personally. When I was working doing assessments of very violent and sexually abusive men, I was exposed to many kinds of trauma and abuse inflicted on children, young people and adults. Over time, the distress I was witnessing and hearing about began to intrude into my inner life and personal sense of parental security. I only really noticed what was happening to me when I found myself becoming overly protective of my children. This became intrusive and culminated in my waking up on the floor of my daughters bedroom and my partner asking me what was wrong. The vulnerability of the children I was working with had surfaced within me as a need to demonstrate my protection for my children. I had realised a very important fact: the bad guys look just like everyone else. That was when I fully realised what exposure to trauma can do.
Dealing with the trauma that the young people you work with have experienced and in some cases continue to experience is difficult however, that is also a reminder of how important the work is. Ensuring that you take care of yourself is equally important.
Further Reading:
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What Are The Warning Signs Of Compassion Fatigue
Watch for these symptoms of compassion fatigueFeeling helpless, hopeless or powerless. Feeling irritable, angry, sad or numb. A sense of being detached or having decreased pleasure in activities. Ruminating about the suffering of others and feeling anger towards the events or people causing the suffering.
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What Factors Contribute To Cf/vt And Burnout
There are many reasons for which helping professionals can develop compassion fatigue and vicarious trauma. These are described in Saakvitne and Pearlmans book Transforming the Pain :
The Individual:
Your current life circumstances, your history, your coping style and your personality type all affect how compassion fatigue may impact you.
Most helpers also have other life stressors to deal with. Many are in the sandwich generation meaning that they take care of both young children and aging parents in addition to managing a heavy and complex workload. Helpers are not immune to pain in their own lives and, in fact, some studies show that they are more vulnerable to life changes than people who do less stressful work.
The Situation:
Helpers often do work that other people dont want to hear about. They spend their time caring for people who are not valued or understood in our society. This may include individuals who are homeless, abused, incarcerated or chronically ill.
Furthermore, our working environments are often stressful and fraught with workplace negativity. This negativity is often a result of individual compassion fatigue, burnout and general unhappiness. The work itself is also very stressful. Dealing with clients/patients who are experiencing chronic crises, who have difficulty controlling their emotions, and/or those who may not get better can be draining.
Compassion Fatigue In The General Public
A secondary definition of compassion fatigue refers to the experience of any empathetic individual who is acutely conscious of societal needs but feels helpless to solve them. People who actively engage in charity, or volunteering, may come to feel that they cannot commit any more energy, time, or money to the plight of others because they feel overwhelmed or paralyzed by pleas for support and that the worlds challenges are never-ending.
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Vicarious Trauma: Signs And Strategies For Coping
How to cope with the aftermath of traumatic incidentsand spot the signs of trauma in those who have been involved in caring for others.
Vicarious trauma is a process of change resulting from empathetic engagement with trauma survivors.
Anyone who engages empathetically with survivors of traumatic incidents, torture, and material relating to their trauma, is potentially affected, including doctors and other health professionals.
How Does Qualitative Research Contribute To Our Understanding Of Empathy
Qualitative research can be valuable given the state of conceptual and operational variability in the empathy-based stress literature . There are many qualitative studies aimed at finding common themes to understand empathy-based stress, though these studies do not tend to replicate, coalesce, or use themes for scale development purposes.
One potential reason for a lack of replication within qualitative research is unrepresentative sampling. Sample sizes for qualitative research tend to be smaller than for quantitative research. For example, qualitative studies commonly employ purposive samples with approximately twenty participants , whereas quantitative studies employ samples of approximately 100 or more participants at minimum . It is understandable that sample sizes are low given the time-consuming nature of qualitative research. However, from a theoretical viewpoint, many qualitative studies aiming to find common themes across participants should aim to ensure a representative sample if these themes are intended to reflect a common empathy-based stress process . We recommend more rigorous qualitative methods to improve the literature and better identify whether discrepancies are a product of actual differences or, rather, of methodological issues.
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Why Does Burnout Happen
Burnout is a form of exhaustion caused by constantly feeling swamped. Its a result of excessive and prolonged emotional, physical, and mental stress. In many cases, burnout is related to ones job. Burnout happens when youre overwhelmed, emotionally drained, and unable to keep up with lifes incessant demands.
Conceptual Disagreement In The Literature
While the distinction between vicarious traumatization on the one hand and compassion fatigue and secondary traumatic stress on the other hand is fairly clear, the distinction between compassion fatigue and secondary traumatic stress is not. In some places, secondary traumatic stress is conceptualized as synonymous with compassion fatigue , as a sub-component of compassion fatigue , or as a broader typology of stress that itself includes compassion fatigue . In a recent conceptual review of the empathy-based stress literature, Newell et al. present compassion fatigue as a divergent construct from secondary traumatic stress, suggesting secondary traumatic stress is a potential consequence of compassion fatigue. Moreover, some research describes compassion fatigue as cumulative and progressive rather than sudden and acute in nature . Other research emphasizes the compassion component of the construct and its implications for empathic engagement and performance outcomes .
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What Are Some Of The Signs Of Compassion Fatigue And Vicarious Trauma
Researchers have discovered that helpers, when they are overtaxed by the nature of their work, begin to show symptoms that are very similar to their traumatized clients. These symptoms can negatively affect the workplace and create a toxic work environment.
- Difficulty concentrating
- Negative outcomes
Ology For The Present Review
A detailed coding guide was developed by the first author to direct the review process of interest), the construct definition provided and the specific core constructs considered , the methodology used , the predictor and outcome variables measured in the study , and a general summary of the results. These coded components were then translated directly into sections of the present review, as described below.
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What Can Be Done
Organizational health researchers have been busy studying the most effective strategies to reduce, mitigate and prevent CF and VT in helping professionals. Here is what has been shown to be most effective:
Working in a Healthy Organization:
Studies show that who you work for is one of the biggest determinants of employee wellness. This includes:
- Access to a supportive, flexible manager who is open to regular workload assessments in order to reduce trauma exposure
- Leadership from a manager who encourages staff to attend ongoing professional education and who provides timely and good quality supervision as needed.
- Employees who had more control over their schedule reported a higher rate of job satisfaction overall. Reducing hours spent working directly with traumatized individuals was the single most effective way of reducing VT.
Personal Strategies:
The top personal strategies identified includes:
- Developing and maintaining a strong social support both at home and at work
- Increased self-awareness through mindfulness meditation and narrative work such as journaling
- Regular self care
Other Interesting Tidbits For Researchers And Clinicians
More research on VT, CF, and BO in forensic mental health is desperately needed. At least ostensibly, those working in this arena may be quite vulnerable to developing such problems therefore, we need to gain a better understanding on the specific prevention measures that can be taken by practitioners, academics, researchers, students, and trainees in forensic mental health. Once we have a better understanding of the actual inci- dence and prevalence of these problems across forensic subgroups, we can begin to develop a more nuanced perspective on the particular factors that are distinctly associated with VT, CF, and BO in the forensic arena.
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Does Resilience Training Help
A 2015 study in the Journal of Continuing Education in Nursing argues for resilience training, a program designed to educate care workers about this type of fatigue and its risk factors. Such training teaches how to employ relaxation techniques and build social support networks to cope with symptoms that arise.
Individual Prevention Strategies To Consider:
- Life balance work to establish and maintain a diversity of interests, activities and relationships.
- Relaxation techniques ensure downtime by practicing meditation or guided imagery.
- Contact with nature garden or hike to remain connected to the earth and help maintain perspective about the world.
- Creative expression things like drawing, cooking, or photography expand emotional experiences.
- Assertiveness training learn to be able to say no and to set limits when necessary.
- Interpersonal communication skills improve written and verbal communication to enhance social and professional support.
- Cognitive restructuring regularly evaluate experiences and apply problem-solving techniques to challenges.
- Time management set priorities and remain productive and effective.
- Plan for coping determine skills and strategies to adopt or enhance when signs of compassion fatigue begin to surface.
Individual Treatment Strategies to Consider:
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Who Coined The Term Compassion Fatigue
The understanding that exposure to the trauma of others could put people at risk has long been understoodhistorian Samuel Moyn has said, Compassion fatigue is as old as compassion, but the term was coined by historian Carla Joinson in 1992, and further defined and researched by psychologist Charles Figley, who describes it as a state of exhaustion and dysfunction, biologically, physiologically and emotionally, as a result of prolonged exposure to compassion stress.
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What Causes Cf And Vt
There are many reasons why helping professionals and addicted individuals loved ones have the potential to develop compassion fatigue and vicarious trauma. The 1996 book, Transforming the Pain written by Saakvitne and Pearlman states that an individuals current life circumstances, history, coping style, and personality type all affect how compassion fatigue may impact them. Helpers are not immune to the pain in their own lives and, in fact, many studies have shown that those who help other people are more vulnerable to life changes, such as divorce and addiction than people who deal with less stressful situations.
Those in the helper role often deal with things that most other people do not want to hear about or deal with. Such people spend their time caring for people who are not seen, valued, or understood in society because of their disease and addiction. Exposure to these constant negative environments often results in compassion fatigue, burnout, and general unhappiness. Dealing with people on a daily basis who are experiencing chronic crises and who have difficulty controlling their emotions can be draining and hopeless. The good news is that individuals can protect themselves from these feelings when dealing with an addicted individual in their life.
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