TABLE OF CONTENTS Page number 1 INTRODUCTION General introduction...1 Definition of terms...2 Lay trauma counsellor...2 Secondary traumatic stress...3 Constructivism...3 Aim and Rationale of the Study...4 Design of the Study...6 Sampling and Selection...7 Data Collection...7 Data Analysis...8 Format of the Study...8 Conclusion...10 2 TRAUMA COUNSELLOR TRAINING Introduction...11 Brief overview: Origin and nature of lay counselling...11 Basic lay trauma counselling skills...14 Creating an atmosphere conducive to communication..15 Calmness...19 Cognitive techniques...20 Making plans...22 Boundaries of lay counselling role 23
Group Counselling...24 Multicultural sensitivity...26 Taking care of the trauma counsellor...27 Conclusion...28 3 THE EFFECTS OF TRAUMA COUNSELLING ON LAY TRAUMA COUNSELLORS Introduction...30 Trauma Counsellors: The Cost of Caring...30 Secondary Traumatic Stress Reaction (STS)...31 Reported indicators of psychological distress in trauma counsellors...33 Distressing emotions...30 Intrusion...33 Avoidance...33 Somatic complaints...34 Physiological arousal...34 Impairment of day-to-day functioning in social and personal roles...34 Cognitive changes in the beliefs, expectations and assumptions that trauma counsellors hold...34 Relational disturbances...35 How does STS occur?...36 Multidimensional model for understanding the onset of secondary traumatic stress...37 The trauma counsellor...38
Personality characteristics...38 Empathic ability...38 Lack of assertiveness...39 Cognitive thoughts that engender burnout...39 Demographic characteristics...40 Trauma counsellor=s history...40 Human Services Organisations...41 Resources...41 Structure...41 Roles...42 Unique features of the job of trauma counselling...42 Nature of the trauma...43 Profile of survivors or care-recipients...43 Individual behaviours...44 Demographic variables of clients...44 Chronicity...44 Acuity...45 Context B macro-environment...45 Media...45 South Africa...45 Dynamics and implications of the multidimensional approach...46 Generalisations from Research...47 Implications...47 Learning without experiencing the pain?...49 Positive effects of working with trauma survivors...49
Conclusion...50 4 CONSTRUCTIVISM Introduction...52 Brief overview of objectivist or modernist principles...52 Application of modernist principles to the treatment domain...53 Shift from modernism to postmodernism...54 Schools of constructivist thought...57 Radical constructivism and social constructionism......58 Co-constructivism....60 Language, stories and constructivism.....60 A constructivist perspective on problems and therapy...63 Constructivism and the present study...67 Conclusion...68 5 RESEARCH APPROACH Introduction...69 Constructivist objection to a quantitative research paradigm.....69 Qualitative research paradigm...71 Justification for choosing a qualitative research approach...72 Reliability and validity in qualitative research...73 Reliability with reference to this study...74 Validity with reference to this study...75 Role of the researcher...75 Some thoughts which informed the researcher=s thinking...76
Normal and abnormal behaviour...77 Views of counselling...77 Selection of participants...77 Data analysis...80 Closing remarks on the research approach...83 6 SANDY=S STORY Personal data...85 Introduction...85 The Background...86 Researcher=s initial impressions of Sandy...87 How Sandy became involved in counselling and her impressions of the training course...87 Effects of counselling.......88 View of the world...89 Repeated thoughts about clients...90 Lack of concentration...91 Helpfulness (control) vs. helplessness (lack of control)...92 Questioning her counselling effectiveness...93 Experienced similar fear as clients...94 Physical Effects...96 Personal Growth...97 Self esteem/finds meaning...97 Renewed appreciation for life...99 Learning about herself...99 Learning new skills and ways of coping...101
Analysis of the effects of counselling on Sandy...102 What helps Sandy to cope...102 Idiosyncratic strategy...103 Talking...103 Life experience...104 Appreciation from clients...105 Achieving a balance between detachment and involvement 105 Organisational support...107 Balance: Distinction between counselling role and full-time job...108 Expected responses from clients...109 Boundaries of lay counselling role 109 Flexibility...111 Network of family and friends...112 What could hamper her coping...112 Desire to help versus inability to let go...113 Impatience...114 Language barrier...116 Researcher=s perception of Sandy=s functioning116 Summary and Conclusion...118 7 DOMINIQUE=S STORY Personal data...121 Introduction...121 The Background...122 Researcher=s initial impressions of Dominique...122
How Dominique became involved in counselling and her impressions of the training course...123 Effects of counselling...124 Emotional distress...124 Feelings of helplessness and incompetence...126 Questioned her counselling effectiveness...128 Pessimistic view of the world...129 Physical effects...131 Analysis of effects of counselling on Dominique 132 What could have hampered Dominique=s ability to cope...133 Lack of supportive systems...133 Over-exposure to trauma...134 Insufficient training...135 Suitability for counselling...136 Disengagement and involvement...138 Inability to deal with uncertainty...139 Researcher=s perception of Dominique=s functioning...140 Summary and Conclusion...141 8 NOMSA=S STORY Personal data...143 Introduction...143 The background...144 Researcher=s initial impressions of Nomsa...144 How Nomsa became involved in counselling and her impression of the
training course 144 Effects of counselling...146 Questioning her counselling effectiveness...146 Physical effects...147 Experiencing similar pain as client...147 Personal growth...148 Seeing the positive in others and self-esteem...151 Analysis of effects of counselling on Nomsa...152 What helps Nomsa to cope...152 Talking...153 Humour...154 Learning and meaning...154 Boundaries of lay counselling role 155 Detachment vs. involvement...156 Positive attitude...158 Job experience...160 Life experience...162 Strong identity/culture...162 What could hamper Nomsa=s coping...163 Over-exposure...163 Impatience...163 Researcher=s perspective of Nomsa=s functioning...164 Summary and Conclusion...165 9 COMPARATIVE ANALYSIS Introduction...167
Effects of counselling...167 Maintaining a questioning attitude...167 Physical Effects...169 Emotional distress...170 Positive effects...172 What helps them to cope...173 Personal style...173 Life experience...176 Training...177 Support systems: organisational and personal...178 What could hamper their coping...180 Personal style...180 Organisational support and training...183 Conclusion...184 10 CONCLUSION Introduction...185 Evaluation of the study...185 Strengths of the study...186 Limitations of the study...191 Recommendations for future research...194 Conclusion...195 BIBLIOGRAPHY...196
APPENDIX A (literal transcription: Sandy B interview 1)...209 APPENDIX B (literal transcription: Sandy B interview 2)...221 APPENDIX C (literal transcription: Dominique)...232 APPENDIX D (literal transcription: Nomsa)...240