"Feeling heavy"

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

Does anything predict vicarious trauma?

As already stated, vicarious traumatisation is a normal response to repeated exposure to traumatic material. As McAllister (2003) stated:

It is the nature of the trauma that causes [vicarious traumatisation], not some weakness or failure within the provider or organisation. (p. 1)

Thus, plainly put, exposure to trauma is the clearest predictor of vicarious traumatisation. Related to this, 'caseloads', or the extent of trauma exposure, have been found to be predictive factors of vicarious traumatisation.

Extent of trauma exposure and caseloads

Time spent counselling trauma victims is the best predictor of trauma scores among counsellors (Bober & Regehr, 2006). Research has also found that counsellors with a higher percentage of sexual assault survivors in their caseload reported more disrupted beliefs, more PTSD symptoms, and more self-reported vicarious trauma (Schauben & Frazier, 1995). This has implications for preventing or addressing vicarious traumatisation, which we discuss below.

The role of empathy is important here. Empathy is a major resource for trauma workers, who use it to assess survivors' problems and work out a treatment approach (Campbell, 2002). Empathising with survivors of rape helps workers understand their experience of being traumatised, although in the process, the professionals may be traumatised as well (Figley, 1885, cited in Campbell, 2002).

Counselors must personally endure repeated exposure to distress and use their own feelings of sorrow as tools for therapy. As such, it is impossible to escape this kind of work without personal consequences. (Campbell, 2002, p. 101)

Level of experience in the field

Level of experience may also be relevant in predicting vicarious trauma, but existing research on this is contradictory. Providing sexual abuse treatment to survivors over a shorter length of time has been found to predict greater 'intrusive' symptoms in clinicians, but it is also suggested that clinicians most affected by trauma may leave the field prematurely and therefore they may not have been represented in this study (Way, VanDeusen, Martin, Applegate, & Jandle, 2004). On the other hand, number of years' experience working in the field was found to be associated with more disruptive beliefs regarding intimacy with others (Bober & Regehr, 2006). These researchers suggest degree of exposure has an impact on intrusion and avoidance symptoms, but that altered beliefs do not appear to occur in the short term. Finally, some researchers suggest that symptoms may also be recognised to a lesser extent over time, becoming 'normalised', and so less noticed (Iliffe & Steed, 2000).

What about a worker's own abuse history?

Given the prevalence of sexual assault, many workers in the field will also be primary victim/survivors, although it is worth noting that, while inconclusive, research does not suggest a higher proportion of abuse survivors among those in the 'helping' professions (Stevens & Higgins, 2002). Some research suggests an association between personal history of abuse and experiencing vicarious traumatisation; in one study of trauma therapists, counsellors with a personal trauma history showed greater disruptions (in, for example, their beliefs about themselves and the world) than those without such a history (Pearlman & MacIan, 1995).

However, other research has not found a personal history of abuse to be a relevant factor in predicting vicarious traumatisation. For example, Schauben & Frazier (1995) found that vicarious traumatisation 'symptomology' was not related to personal trauma history, including experience of sexual assault. Another study found that personal histories of abuse were not associated with vicarious trauma, except in individuals who had sought treatment, which suggests that those who were distressed or unresolved about their personal histories were likely to seek appropriate assistance (Bober & Regher, 2006). Stevens & Higgins (2002) found that a personal history of maltreatment predicted current trauma symptoms, but not burnout. Thus, while personal experience of abuse may sometimes be salient to the experience of vicarious trauma, and sometimes not, research also has found that it is traumatising within itself to be exposed to traumatic material.