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Professional psychology: research and practice.

Brady, J.L., Guy, J.D., Poelstra, EL., and Brokaw, B.F.

Vicarious Traumatization, Spirituality, and the Treatment of Sexual Abuse Survivors: A National Survey of Women Psychotherapists

Vol. 30, 386-393 (1999)

Working with trauma victims is something many professional psychologists do on a daily basis. However, little is known about the consequences that this may have on the therapist. Vicarious traumatization is the idea that through hearing about sexual trauma in clients, therapists will also experience a level of trauma. While this is not the exact same thing as burnout or secondary traumatic stress (i.e., experiencing symptoms similar to PTSD), vicarious traumatization is a result of being indirectly exposed to trauma. Some of the factors that may impact therapists' ability to adapt to repeatedly hearing about trauma of their clients are the therapists own sexual trauma history, level of exposure to details of the client trauma, and amount of time with sexual trauma victims. Previous research has also shown that therapists who see children with sexual trauma may experience higher levels of stress than therapists who see adult victims; the authors hypothesize that they will find similar results. While previous research does support the link between vicarious traumatization, little is known about the cause or direction of this link.

Brady et al. used a national survey of professional female psychologists (n = 446) who do trauma work with individuals. They collected information on demographics, including exposure to sexual trauma (e.g., current percentage of sexual trauma clients in caseload, current number of clinical hours spent with sexual trauma victims, and reported level of exposure to graphic details regarding the sexual trauma), the Impact of Events Scale (IES), the Traumatic Stress Institute (TSI) Belief Scale, and Spiritual Well-Being Scale. The sample appeared to be representative of the population of interest. The majority of participants were not in supervision (63%) and hours of formal training in how to treat sexual trauma ranged from 0 to 3,000.

Analysis of variance (ANOVA) results revealed that exposure variables was significantly associated with higher scores on the IES, but not the TSI Belief Scale. Results also indicated that there was no significant relationship between greater number of child sexual trauma clients and vicarious traumatization. Finally, a higher level of overall exposure to sexual trauma through clients was significantly associated with higher spiritual well-being.

While the results indicated a link between exposure to client trauma and trauma symptoms in therapists who see them, vicarious traumatization was not supported. Furthermore, the severity of trauma symptoms found in therapists was mild, which is important in training future clinicians and preparing them for what to expect in working with trauma victims. Authors stressed the need for continued education for all therapists who work in this area, as well as self-care, in order to have the resources needed, to reduce isolation in therapists, and to better treat and not harm the client. Finally, the results indicated that more exposure to clients' sexual trauma was associated with higher spiritual well-being. The results are consistent with other literature stating that in working with this population, therapists find meaning in life and feel more spiritually satisfied. The authors also discuss the possibility that maybe individuals who seek to treat trauma victims are already, in fact, higher in spiritual well-being, which could be what leads them to this work.

Further Reading

Askay, S. W., & Magyar-Russell, G. (2009). Post-traumatic growth and spirituality in burn recovery. International Review of Psychiatry, 21(6), 570-579. doi: 10.3109/09540260903344107

Berrett, M. E., Hardman, R. K., O'Grady, K. A., & Richards, P. S. (2007). The role of spirituality in the treatment of trauma and eating disorders: Recommendations for clinical practice. Eating Disorders: The Journal of Treatment & Prevention, 15(4), 373-389. doi: 10.1080/10640260701454394

Calder, A., Badcoe, A., & Harms, L. (2011). Broken bodies, healing spirits: Road trauma survivor's perceptions of pastoral care during inpatient orthopaedic rehabilitation. Disability and Rehabilitation: An International, Multidisciplinary Journal, 33(15-16), 1358-1366. doi: 10.3109/09638288.2010.532280

Chapple, A., Swift, C., & Ziebland, S. (2011). The role of spirituality and religion for those bereaved due to a traumatic death. Mortality, 16(1), 1-19. doi: 10.1080/13576275.2011.535998

Parley, Y. R. (2007). Making the connection: Spirituality, trauma and resiliency. Journal of Religion & Spirituality in Social Work: Social Thought, 26(1), 1-15. doi: 10.1300/J377v26n01_01

Harris, J. I., Erbes, C. R., Engdahl, B. E., Thuras, P., Murray-Swank, N., Grace, D., ... Le, T. (2011). The effectiveness of a trauma-focused spiritually integrated intervention for veterans exposed to trauma. Journal of Clinical Psychology, 67(4), 425-438. doi: 10.1002/jclp 2077

McCann, R. A., & Webb, M. (2012). Enduring and struggling with God in relation to traumatic symptoms: The mediating and moderaring roles of cognitive flexibility. Psychology of Religion and Spirituality, 4(2), 143-153. doi: 10.1037/a0026404

Morgan, O. J. (2009). Thoughts on the interaction of trauma, addiction, and spirituality. Journal of Addictions & Offender Counseling, 30(1), 5-15. doi: 10.10021.2161-1874.2009.600052.x
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Title Annotation:Journal File; 'Vicarious Traumatization, Spirituality, and the Treatment of Sexual Abuse Survivors: A National Survey of Women Psychotherapists'
Publication:Journal of Psychology and Theology
Article Type:Book review
Date:Dec 22, 2012
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