This qualitative study was designed to identify protective practices that mitigate risks of Vicarious Traumatization (VT) among trauma therapists. The sample included six peer-nominated experienced therapists, trained at the masters or doctoral level, who self-identified as having managed well in this work. Narrative data was collected through interviews with individual co-participants, who were asked, "How do you manage to sustain your personal and professional wellbeing, given the challenges of your work with seriously traumatized clients?" Data analysis was based upon Lieblich, Tuval-Mashiach, and Zilber's (1998) typology of narrative analysis, with a primary focus on thematic content analysis within and across participants' narratives. The research findings yielded twelve major themes that describe protective practices engaged by exemplary trauma therapists: countering isolation (in professional, personal and spiritual realms); developing mindful self awareness; consciously expanding perspective to embrace complexity; openness to the unknown; sustaining and renewing hope; active optimism and problem solving; holistic self-care; maintaining clear boundaries; invoking imagery, metaphor, and ritual; exquisite empathy; professional satisfaction; and creating meaning. The novel finding that empathic engagement with traumatized clients appeared to be protective challenges previous conceptualizations of VT and points to exciting new directions for research and theory, as well as applications to practice. Participants also described experiences of vicarious post-traumatic growth. The findings confirm and extend previous recommendations for ameliorating VT and underscore the ethical responsibility shared by employers, educators, professional bodies, and individual practitioners to create time and space to address this serious problem. Participants recommend opportunities for regular supervision, support and validation (including group-based interaction), self-care (including personal therapy, as needed), and developing self-awareness within and beyond the workplace. They think taking care of the caregivers is an organizational responsibility as well as a personal one. Although the research design precludes generalizing from the data, the knowledge generated herein may be helpful to others in the fields of psychology, psychiatry, social work, psychiatric nursing, and related health care disciplines, at the levels of education, training, and practice.

This qualitative study was designed to identify protective practices that mitigate risks of Vicarious Traumatization (VT) among trauma therapists. The sample included six peer-nominated experienced therapists, trained at the masters or doctoral level, who self-identified as having managed well in this work. Narrative data was collected through interviews with individual co-participants, who were asked, "How do you manage to sustain your personal and professional wellbeing, given the challenges of your work with seriously traumatized clients?" Data analysis was based upon Lieblich, Tuval-Mashiach, and Zilber's (1998) typology of narrative analysis, with a primary focus on thematic content analysis within and across participants' narratives. The research findings yielded twelve major themes that describe protective practices engaged by exemplary trauma therapists: countering isolation (in professional, personal and spiritual realms); developing mindful self awareness; consciously expanding perspective to embrace complexity; openness to the unknown; sustaining and renewing hope; active optimism and problem solving; holistic self-care; maintaining clear boundaries; invoking imagery, metaphor, and ritual; exquisite empathy; professional satisfaction; and creating meaning. The novel finding that empathic engagement with traumatized clients appeared to be protective challenges previous conceptualizations of VT and points to exciting new directions for research and theory, as well as applications to practice. Participants also described experiences of vicarious post-traumatic growth. The findings confirm and extend previous recommendations for ameliorating VT and underscore the ethical responsibility shared by employers, educators, professional bodies, and individual practitioners to create time and space to address this serious problem. Participants recommend opportunities for regular supervision, support and validation (including group-based interaction), self-care (including personal therapy, as needed), and developing self-awareness within and beyond the workplace. They think taking care of the caregivers is an organizational responsibility as well as a personal one. Although the research design precludes generalizing from the data, the knowledge generated herein may be helpful to others in the fields of psychology, psychiatry, social work, psychiatric nursing, and related health care disciplines, at the levels of education, training, and practice.

This qualitative study was designed to identify protective practices that mitigate risks of Vicarious Traumatization (VT) among trauma therapists. The sample included six peer-nominated experienced therapists, trained at the masters or doctoral level, who self-identified as having managed well in this work. Narrative data was collected through interviews with individual co-participants, who were asked, "How do you manage to sustain your personal and professional wellbeing, given the challenges of your work with seriously traumatized clients?" Data analysis was based upon Lieblich, Tuval-Mashiach, and Zilber's (1998) typology of narrative analysis, with a primary focus on thematic content analysis within and across participants' narratives. The research findings yielded twelve major themes that describe protective practices engaged by exemplary trauma therapists: countering isolation (in professional, personal and spiritual realms); developing mindful self awareness; consciously expanding perspective to embrace complexity; openness to the unknown; sustaining and renewing hope; active optimism and problem solving; holistic self-care; maintaining clear boundaries; invoking imagery, metaphor, and ritual; exquisite empathy; professional satisfaction; and creating meaning. The novel finding that empathic engagement with traumatized clients appeared to be protective challenges previous conceptualizations of VT and points to exciting new directions for research and theory, as well as applications to practice. Participants also described experiences of vicarious post-traumatic growth. The findings confirm and extend previous recommendations for ameliorating VT and underscore the ethical responsibility shared by employers, educators, professional bodies, and individual practitioners to create time and space to address this serious problem. Participants recommend opportunities for regular supervision, support and validation (including group-based interaction), self-care (including personal therapy, as needed), and developing self-awareness within and beyond the workplace. They think taking care of the caregivers is an organizational responsibility as well as a personal one. Although the research design precludes generalizing from the data, the knowledge generated herein may be helpful to others in the fields of psychology, psychiatry, social work, psychiatric nursing, and related health care disciplines, at the levels of education, training, and practice. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Various forms of trauma are regularly reported across the spectrum of counseling settings and the potential negative psychological effects on counselors who are repeatedly exposed to traumatic material are well documented. However, many researchers suggest that vicarious traumatization can be prevented and mitigated with personal and professional self-care strategies. The American Counseling Association (ACA) Code of Ethics indicates that counselors have a professional responsibility to engage in self-care activities, as efforts to ensure the psychological health of counselors will have a direct effect on their ability to help clients. The purpose of this mixed-method, descriptive, correlational research was to explore what types of educational preparation and training counselors have received regarding self-care and what types of self-care strategies counselors are using. The efficacy of those training methods and self-care strategies when implemented were also measured, from the perspective of the participants. The Self-Care Training and Implementation Questionnaire (STIQ), a 19-item, structured and semi-structured questionnaire developed for this research, was electronically sent to 3000 randomly selected members of ACA, resulting in 310 responses, 286 of which were deemed appropriate for inclusion. Analysis included descriptive analyses (quantitative data) and content and theme analyses (qualitative data). The results of this study indicated that counselors recognized the value of self-care and participated in activities that promoted a healthy lifestyle and mitigated stress, thus working toward a balance that fostered effective work performance. However, the findings demonstrated that most counselors do not receive formal self-care training and self-care has been an endeavor pursued independently, outside of education and work settings. Implications for counselor education, training, policy and research are discussed.

Recent concerns have arisen about the effects on counselors of working with trauma survivors. Vicarious traumatization may be a normal developmental process of adapting to client trauma material and may ultimately result in vicarious posttraumatic growth, or positive changes arising from vicarious trauma. Most studies have focused on individual variables or clinician coping strategies that predict vicarious traumatization. Taking a feminist approach to vicarious traumatization, this study examined the role of workplace context variables, such as sense of belonging in the workplace and support for vicarious trauma at work, on counselor vicarious traumatization and vicarious posttraumatic growth. Stratified random sampling was used to recruit counselors from domestic violence and rape crisis centers, and recruitment messages were sent to all psychology internship and postdoctoral sites in the United States which were accredited by the American Psychological Association. Surveys were completed by 234 counselors. Counselors reported sub-clinical levels of vicarious trauma symptoms (intrusions, avoidance, and hyperarousal resulting from work with trauma survivors). Results of hierarchical regression analyses indicated that amount and intensity of exposure to client trauma material positively predicted vicarious trauma symptoms, and sense of belonging in the workplace negatively predicted vicarious trauma symptoms. Intensity of exposure, work setting, and support for vicarious trauma at work predicted vicarious posttraumatic growth, so that counselors exposed to more graphic details of client trauma, those working in domestic violence or rape crisis centers, and counselors with more support for vicarious trauma at work reported more vicarious posttraumatic growth. The relation between amount of exposure and vicarious posttraumatic growth was moderated by intensity of exposure and by sense of belonging in the workplace. Counselors with low sense of belonging at work reported less vicarious posttraumatic growth when amount of exposure was high, whereas counselors with high sense of belonging reported more vicarious posttraumatic growth with high exposure. Results suggest that counselors’ reactions to client trauma material are normal rather than pathological, are largely due to exposure to client trauma, and can be affected by workplace context factors, especially sense of belonging in the workplace and support for vicarious trauma at work.

Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that occurs when people are exposed to stressful, life-threatening experiences. Consequently, after exposure to such an event, many people may experience fear, guilt, or anger and may believe the trauma is reoccurring. According to the National Institute of Mental Health, approximately 5.2 million U.S. adults age 18-54 have PTSD in any given year. The prevalence of PTSD is even more problematic within the military where an estimated 30% of those who have spent time in war zones experiences PTSD. Researchers have been examining the impact of veterans’ PTSD symptoms on family relationships, and on children in particular yet there is little understanding of the residual impact of PTSD or its secondary effects on children. This study aims to begin to understand how the health care providers’ experiences and acumen may assist patients with addressing PTSD. Additionally, by exploring the treatments and experiences of physicians, further insight and a deeper understanding may be gained on how PTSD impacts family relationships, specifically, hardiness and parental skills. A secondary aim of this study is identify those factors that promote resiliency in hopes of creating new interventions to lessen the residual effects of PTSD and prevent intergenerational trauma. This study begins to explore the residual impact of PTSD and will contribute to inform future research to design new methods and tools which may assist physicians to address intergenerational PTSD. This study was approved by Virginia Commonwealth University (VCU) Institutional Review Board (IRB).

Several studies have suggested that compassion satisfaction (CS) promotes counsellor wellness through its mitigating effects on compassion fatigue, burnout, and vicarious traumatization. CS also contributes to career longevity and to a sense of fulfillment, balance, and wellness that extends from counsellors’ professional to personal lives. Yet, to date, very little research has been done using counsellor wellness or CS as a primary focus. While the literature on CS is relatively new, even less attention appears to have been paid to what experienced counsellors actively do to maintain CS and therefore, their wellness as counsellors. The purpose of this study was to extend the literature on counsellor CS by asking experienced counsellors how they actively maintain CS in their work. Participants (N = 6) were counsellors in the Victoria area who had worked in the field for at least 10 years, had a minimum of a Masters degree, and who were experiencing CS at the time of data collection. A social constructivist perspective was used to frame the study, and narrative interviews were used to collect the counsellors’ stories of how they had maintained CS throughout their careers. Data were analysed using thematic analysis and 6 themes are reported. Findings suggest that counsellors can actively increase their likelihood of maintaining CS by: (a) maintaining boundaries; (b) practicing self-care; (c) cultivating self-awareness; (d) developing positive, fulfilling relationships; (e) engaging in ongoing learning; and (f) embracing variety. Findings are discussed in terms of their implications for counsellor training programs, the personal and professional lives and retention of counsellors already in the field, directors of counselling agencies, and client care. / Graduate / 0621 / 0622 / 0519 / 0769 / 0569 / alexsterling7@gmail.com

Several studies have suggested that compassion satisfaction (CS) promotes counsellor wellness through its mitigating effects on compassion fatigue, burnout, and vicarious traumatization. CS also contributes to career longevity and to a sense of fulfillment, balance, and wellness that extends from counsellors’ professional to personal lives. Yet, to date, very little research has been done using counsellor wellness or CS as a primary focus. While the literature on CS is relatively new, even less attention appears to have been paid to what experienced counsellors actively do to maintain CS and therefore, their wellness as counsellors. The purpose of this study was to extend the literature on counsellor CS by asking experienced counsellors how they actively maintain CS in their work. Participants (N = 6) were counsellors in the Victoria area who had worked in the field for at least 10 years, had a minimum of a Masters degree, and who were experiencing CS at the time of data collection. A social constructivist perspective was used to frame the study, and narrative interviews were used to collect the counsellors’ stories of how they had maintained CS throughout their careers. Data were analysed using thematic analysis and 6 themes are reported. Findings suggest that counsellors can actively increase their likelihood of maintaining CS by: (a) maintaining boundaries; (b) practicing self-care; (c) cultivating self-awareness; (d) developing positive, fulfilling relationships; (e) engaging in ongoing learning; and (f) embracing variety. Findings are discussed in terms of their implications for counsellor training programs, the personal and professional lives and retention of counsellors already in the field, directors of counselling agencies, and client care. / Graduate / 2015-04-23 / 0621 / 0622 / 0519 / 0769 / 0569 / alexsterling7@gmail.com

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The breadth of interpersonal violence is continuously expanding. According to Broman-Fulks et al. (2006), current epidemiological studies estimate that between 50% and 70% of individuals in the United States have experienced some form of interpersonal violence during their lifetime. The occurrence of "traumatic incidents may create powerful affective responses in those who rescue, care for, and counsel the individuals directly affected" (Wilson & Lindy, 1994, p. 333). This emotional reactivity is especially prevalent among those that work with survivors of violent traumatic events (McCann & Pearlman, 1990). The variety of issues that mental health professionals encounter are multidimensional and include their work context, characteristics of their clients, and therapist variables. Due to such complexity, it is critical to consider the broad ramifications and scope of professional quality of life when addressing the outcomes of trauma work on mental health professionals. The purpose of this study was to analyze, through qualitative methodology, the professional quality of life of mental health professionals directly involved in the recovery efforts after the campus shootings that occurred at Virginia Tech on April 16th, 2007. A phenomenological research design was used to gather information regarding the experiences and perceptions of various mental health professionals. Two in-depth interviews were conducted to examine therapists' experiences regarding the vicarious exposure and growth potential involved in this work. Analysis from the data revealed two primary themes; changed perception due to shared traumatic exposure and the costs and benefits derived from trauma work. These themes depicted the professional consequences for mental health workers who have been directly affected by traumatic events and serve clients exposed to the same event. Findings indicate that self-awareness is a critical component to enhancing therapeutic lenses and professional and personal wellness. Further research considering the influence of shared exposure to trauma on mental health professionals could further our understanding of the professional and personal consequences of such work. This research could provide a guide for preparing current and future counselors and supervisors when working during times of crisis. / Ph. D.