"Feeling heavy"

Vicarious trauma and other issues facing those who work in the sexual assault field
ACSSA Wrap No. 4 – September 2007

Can vicarious trauma be prevented?

A variety of strategies are recommended in the literature to both prevent and deal with vicarious traumatisation. However, if vicarious traumatisation is a common response to repeated exposure to trauma, to what extent are these strategies effective? In fact, despite all the advice, little research has been done to assess various strategies' effectiveness (Bober & Regehr, 2006). Of the research that as been done on strategies undertaken by individuals, use of coping strategies was associated in one study with lower levels of PTSD symptoms in rape counsellors (Schauben & Frazier, 1995). However, other research has found no association between time devoted to coping strategies and traumatic stress levels (Bober & Regher, 2006). Also, use of particular coping strategies is not associated with lower levels of trauma or symptoms of burnout (Stevens & Higgins, 2002). Another study also found that even if therapists believed recommended coping strategies worked (such as leisure activities, self-care and supervision), this did not translate into spending time on these activities (Bober & Regher, 2006). Bober and Regher concluded that 'there is no evidence that using recommended coping strategies is protective against symptoms of acute distress' (2006, p. 7).

As mentioned above, results regarding the lack of success in suggested individual coping strategies has recently led some researchers to question these recommended intervention strategies, and particularly coping strategies focused at the level of the individual (Bober & Regher, 2006).

Indeed, emphasising individual coping strategies or 'resilience' could be a form of 'victim-blaming', and misunderstanding of the causes of vicarious trauma, which has implications for how vicarious trauma should ultimately be addressed:

As mental health professionals dedicated to the fair and compassionate treatment of victims in society, we have been strong in vocalizing concerns that those who are abused and battered not be blamed for their victimization and their subsequent traumatic response. Yet when addressing the distress of colleagues, we have focused on the use of individual coping strategies, implying that those who feel traumatized may not be balancing life and work adequately and may not be making effective use of leisure, self-care, or supervision ... In light of findings that the primary predictor of trauma scores is hours per week spent working with traumatized people, the solution seems more structural than individual. (Bober & Regehr, 2006, p. 8)

Bober and Regeher (2006) argued that attention needs to shift from education to advocacy for improved and safer working conditions.

The significance of the organisational environment

[Counsellor advocates] described the organizational support that they received as instrumental in their ability to continue providing supportive services to sexual assault survivors. (Wasco, Campbell, & Clark (2002), p. 749)

Ecological theorists argue that the self-care routines of workers when dealing with vicarious traumatisation can best be understood as interactions between individuals and their environments. Wasco et al. (2002) stated that, because vicarious traumatisation occurs in the work place, this environment is highlighted as particularly important. Their research found links between the organisational setting and counsellor advocates' ability and propensity to engage in self-care activities. They found that:

  • specific organisational procedures or cultures facilitate or bar opportunities for certain self-care routines; and
  • organisational cultures or policies create situations that necessitate or eliminate the use of particular types of self-care activities or routines.

Research has also found that, no matter what organisation a counsellor worked within, all counsellors needed to regulate the amount of rape-related pain in their lives through cathartic self-care routines. However, those counsellors who worked in organisations with higher levels of support tended to employ more 'integrative self-care strategies' (see below) than those working in organisational settings with less support.

Given these findings, let us look firstly at workers' own proactive self-care strategies to assist with dealing with vicarious traumatisation, and then turn to looking at aspects of a supportive organization.