Letter of Intent 1 Running head: Letter of Intent Letter of Intent Vicarious Trauma CAAP Final Project Requirement Christina Stribling Supervisor: Dr. Paul Jerry
Letter of Intent 2 Problem Statement The primary focus of this project is to define vicarious trauma although definitions of both secondary traumatic stress (STS) and burnout is necessary as the three conditions are often mistakenly diagnosed or perceived as the same (Saakvitne & Pearlman, 1996). This project will illustrate the prominent theories and measuring tools for each of these three conditions and discuss preventative measures in helping decrease the risk of experiencing vicarious trauma. There is minimal research and literature on the signs and symptoms of vicarious trauma therefore this project will illustrate the research that has been conducted and the importance of future research. Literature on vicarious trauma and secondary traumatic stress is just beginning to emerge (McCann & Pearlman, 1990), while the literature on burnout is more attainable as it is generally a more recognized condition. Pearlman and Saakvitne (1995), Figley (1995), and Stamm (1995) all published texts that explore these conditions in 1995. The aim of this project is to provide organizations that deal with trauma survivor s material and information on vicarious trauma, STS, and burnout by developing information and training sessions that can be utilized within agencies in Alberta. Instead of providing a one-time workshop, the goal will be to develop study groups within organizations that can practice and become familiar with vicarious trauma and learn various strategies to cope with it. The focus for the final project will be to complete an extensive literature review and develop a guide and/or handbook to assist organizations in becoming educated with vicarious trauma. The hope is that the material will be comprehensive and straightforward enough to enable organizations to utilize prevention and coping strategies that are presented to the individual study groups. This would
Letter of Intent 3 require the organization s employees to have a certain level of commitment to enhancing their knowledge of vicarious trauma, STS, and burnout. This would also mean having follow up meetings within the organization to ensure that employees continue to be updated regarding the effects of vicarious trauma. This project will also provide resources and contact numbers should employees have additional questions or concerns. Rationale Vicarious trauma is defined as the impact on the therapist from repeated exposure to traumatic client material (Nelson & Douglas, 2005). Although vicarious trauma is a relatively new term, findings suggest that it can have a profound impact on individual s personal and professional life (Nelson & Douglas, 2005). The majority of the authors who study vicarious trauma agree that the impact is profound and that the effects are pervasive (Beaton & Murphy, 1995). There are some inconsistencies in regards to the extent of the impact however many researchers agree that the results of traumatic exposure can be detrimental (Beaton & Murphy, 1995). Therapists working with trauma survivors may be at risk for experiencing negative effects as a result of this exposure (Rosenbloom & Williams, 1999). This topic is important as many individuals in the helping profession have suffered from one of these three conditions throughout the course of their careers (Hellman, Morrison, & Abramowitz, 1995). It has often gone untreated or unidentified, resulting in further damage not only to the professional but to the client s they are assisting (Pearlman & Saakvitne, 1995). Continued research in this area is important in order to correctly diagnose the symptoms associated with these conditions and to be able to provide adequate and appropriate treatment and supports (Stamm, 1995). The primary goal for the final project
Letter of Intent 4 is to create awareness of vicarious trauma by identifying and defining similarities and differences between vicarious trauma, STS, and burnout. This is important as each condition displays different symptoms requiring different treatments and supports. Supporting Literature While literature has been slow to develop, there has been an increase in publications that attempt to define the trauma that many helpers experience (Pearlman & Saakvitne, 1995). Pearlman and Saakvitne (1995), Figley (1995), and Stamm (1995) all published texts that explore the phenomenon of vicarious trauma among helping professionals during 1995. Although there are clear similarities and differences between vicarious trauma, STS, and burnout, some ambiguity remains regarding the definition of these terms. Some of the literature on vicarious trauma, STS, and burnout was unable to distinguish a difference in the definitions of these terms, with a number of the researchers using the terms interchangeably. Vicarious trauma, as described by McCann and Pearlman (1990) is the experience of traumatic stress through observation or hearing others stories of traumatic events and the resulting shift that occurs for the caregivers. Several theories have been offered but none have been able to conclusively demonstrate what accounts for the transmission of traumatic stress from one individual to another (McCann & Pearlman, 1990). It has been hypothesized that the caregiver s level of empathy with the traumatized individual plays a significant role in experiencing vicarious trauma (Figley, 1995) and there has been some research to support this hypothesis (Salston, 2000). Future qualitative and quantitative research to assess the characteristics of vicarious trauma, STS and burnout is recommended (McCann & Pearlman, 1990).
Letter of Intent 5 Secondary traumatic stress has been described as the umbrella term with other terms, such as vicarious trauma, serving as a specific type of STS (Rasmussen, 2005). Researchers such as Joslyn (2002) argue that this is not an accurate representation of STS, vicarious trauma, or burnout. Some researchers maintain that none of the current definitions are adequate for describing helper encounters with another's traumatic material (Joslyn, 2002), or that they are not inclusive enough (Robyn, Kress, & Wilcoxon, 2004). Robyn, Kress, and Wilcoxon (2004) propose that vicarious trauma, STS, and burnout should apply not only to professionals, but also to volunteers, health care professionals, and researchers who are studying trauma. Others have questioned the impact of trauma on those that teach about trauma, emergency service workers exposed secondarily because of another s trauma, and those who directly handle trauma victim bodies (Joslyn, 2002). Edward (2002) suggests that more succinct definitions will emerge as consensus arises from use of the terms and development of theories. Because of this ambiguity regarding the terms and definitions it is important to continue research to adequately treat and identify these conditions. As there is not any conclusive evidence or support to indicate one theory is more accurate then another, it is essential that further research be conducted to better explore this phenomenon. The majority of the literature identified that working with trauma survivors on a continuous basis has an impact on the caregivers. The controversy lies in the amount of impact this exposure has and how to define this impact. Research studies should also include the impact on professionals who indirectly deal with trauma survivors and also the impact on friends and relatives who may inadvertently be affected by the trauma. Methods and Procedures
Letter of Intent 6 The focus for the final project will be to expand on the literature review and develop a guide and/or handbook to assist organizations in becoming educated with regards to vicarious trauma. The information and training provided for organizations will discuss vicarious trauma, STS, and burnout, and will also include preventative measures and ways to recognize the symptoms of each condition. The training will be provided for those employees who work with trauma survivors and other employees who may be impacted or who have an interest in learning about vicarious trauma, STS, and burnout. Relevant articles and books will be identified by searching the electronic databases of ERIC, PsychINFO, PsychLIT, PsychARTICLES, and Academic Search Premier. Publications from 2000 to present will be considered as the research related to vicarious trauma is fairly recent, therefore using resources dated any further back may provide out of date information. The search will be expanded by examining the reference section of the articles and books found in the database. Professionals who have expertise on this topic have been and will continue to be consulted throughout this research project. Qualitative and quantitative research will be considered for this review as both are relevant to this subject. The articles and books that will be used for this study will include at least one of the following criteria: 1) that the article or book discusses the similarities and differences between vicarious trauma, STS, and burnout, and the significance of this, 2) that the article or book discusses the prominent theories and measuring tools for each of these three conditions, and 3) that the article or book reviews preventative measures in helping decrease the risk of experiencing vicarious trauma. Potential Implications
Letter of Intent 7 Those that would most likely benefit from this work are the people that deal directly with trauma survivors in a helping role. It could also indirectly benefit friends and relatives of the professional impacted by the trauma. The literature review and the additional training and information provided to organizations can also be used as a preventative measure to help ensure that those working closely with trauma survivors have the resources and knowledge available to help them in preventing vicarious trauma, STS, or burnout. Presenting the information within an organization or agency could also benefit employees that work at the organization but do not have direct contact with trauma survivors. It creates an awareness of the conditions and promotes empathy and support to those who are exposed to trauma regularly. Providing information that distinguishes between vicarious trauma, STS, and burnout also assists professionals in identifying what they may be experiencing, correctly labeling it and seeking assistance in dealing with it. Counsellors who work primarily with trauma survivors experience a greater degree of vicarious trauma than counsellors with a general caseload who may only work with a few trauma survivors (Saakvitne & Pearlman, 1996). Saakvitne and Pearlman (1996) suggest that limiting the number of trauma clients per week may lessen the potential for vicarious trauma. Hellman, Morrison, and Abramowitz (1987) found similar results that indicate that less work-related stress equaled a moderate number of trauma clients on a weekly caseload as opposed to a higher number of regularly scheduled trauma clients. This information on preventative measures will enable professionals to determine if they are at risk of developing vicarious trauma. If they believe that they are at risk then they will have access to resources that can provide them with preventative
Letter of Intent 8 measures and information on vicarious trauma, STS, and burnout. This final project is intended to assist agencies and organizations in creating a healthier environment for those working directly with trauma survivors.
Letter of Intent 9 References Edwards, R. (2002). Compassion fatigue: When listening hurts. Washington, DC: Taylor and Francis Inc. Figley, C.R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Brunner/Mazel. Goff, B., Nelson, F., & Smith, D. (2005). Systemic traumatic stress: the couple adaptation to traumatic stress model. Journal of Marital and Family Therapy, 41(4), 296-306. Hellman A., Morrison, B., & Abramowitz, L. (1995). Trauma and its wake. New York: Plenum Publishing Corporation. Joslyn, H. (2002). Defeating compassion fatigue. Chronicle of Philanthropy, 14(12), 37-41. McCann, I. L., & Pearlman, L.A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 21(3), 131-149. Nelson, K., & Harris, M. (2005). Traumatic stress and child welfare workers. Journal of Social Workers, 10(3), 59-63. Pearlman, L.A., & Saakvitne, K. W. (1995). Treating therapists with vicarious traumatization and secondary traumatic stress disorders. Bristol, PA: Brunner/Mazel. Pearlman, L. A., & Saakvitne, K. W. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors. New York: Norton. Rasmussen, B., (2005). An intersubjective perspective on vicarious trauma and its impact
10 on the clinical process. Journal of Social Work Practice, 19(1), 19-30. Letter of Intent Robyn, L., Kress, W., & Wilcoxon, S. (2004). Preventing vicarious trauma: What counselors should know when working with trauma survivors. Journal of Counseling & Development, 82(1), 31-37. Rosenbloom, D.J., & Williams, M.B. (1999). Life after trauma: A workbook for healing. New York: The Guilford Press. Salston, M., & Figley, R. (2003). Secondary traumatic stress effects of working with survivors of criminal victimization. Journal of Traumatic Stress, 16(2), 167-175. Stamm, B. (2001). Work-related secondary traumatic stress. Journal of Traumatic Stress, 3(4), 24-29.