Painful Truths About Vicarious Trauma: Statistics From the Field

Vicarious trauma, secondary traumatic stress or compassion fatigue, and burnout are all forms of stress that may affect those working “helping” professions because that work involves direct exposure to other’s trauma.

In the past twenty years there has been a movement to bring awareness and solutions to profound negative psychological effects caused by being exposed to the trauma of others-ranging from a serious injury to the body from violence or an accident to an emotional wound creates lasting damage to a person’s psyche.

Research indicates that domestic and sexual violence advocates, therapists, nurses, physicians, social workers, law enforcement professionals, prosecutors and judges-astounding number of people in the “helping” professions are being affected by vicarious trauma, compassion fatigue, secondary trauma, and burnout daily.

What’s in the Terms?

Although there is significant overlap in concepts, there are some key differences, Francoise Mathieu, for instance, suggests that the terms compassion fatigue, vicarious trauma, and burnout are complementary, yet different from one another (2012). Here’s a summary:

1. Compassion fatigue refers to the deep emotional and physical wearing down that takes place when helping professionals are unable to refuel and renew (Figley, 1995).
2. Vicarious trauma describes profound negative changes in our worldview due to the exposure to traumatic content of clients (Saakvine & Pearlman,1996).
3. Secondary traumatic stress is the result of being a witness to a traumatic event or series of traumatic events, which can lead to PTSD-like symptoms (Figley, 1995). .
4. Burnout has to do with stress and frustration caused by the workplace (Saakvine & Pearlman,1996).

Continuous exposure to the trauma of others may lead trauma professionals to manifest the same or similar symptoms as the victims they work with. In other words, the symptoms of vicarious trauma (VT) are essentially the same as symptoms of primary trauma, and include re‐experience, avoidance, and hyper‐arousal.

Untreated, VT leads to burnout or compassion fatigue, which manifests in feeling exhausted and worn out; leads to a deep sense of ineffectiveness at one’s work; and can result in emotional distress, detachment, ineffective professional behavior, and depression.

Helpers who are worn out, traumatized, and fatigued, often tend to work harder, thus going farther down a dangerous path, which often leads to physical and mental health difficulties, such as depression, chronic pain, substance abuse, and even suicide.

Risk Factors

1. A personal history of trauma
2. Geographical and social isolation
3. Being overworked and overwhelmed
4. Working with too many clients
5. Having limited professional experience
6. Having limited training about vicarious trauma and its prevention
7. Working with a high percentage of traumatized children
8. Working with client who are underserved and disadvantaged
9. Working for poor pay, under stressful conditions, with limited resources

Statistics from the Field

Between 40% and 85% of “helping professionals” develop vicarious trauma, compassion fatigue and/or high rates of traumatic symptoms, according to compassion fatigue expert Francoise Mathieu (2012).

1. Social Workers, MSW:

• 70% exhibited at least one symptom of secondary traumatic stress (Bride, 2007).

2. Social Workers:

• 42% said they suffered from secondary traumatic stress (Adams et al., 2006).

3. Social Workers, Domestic Violence and Sexual Assault:

• 65 % had at least one symptom of secondary traumatic stress (Bride, 2007).

4. Therapists, Sexual Assault:

• 70% experienced vicarious trauma (Lobel, 1997).

5. Hospice Nurses:

• 79% moderate to high rates of compassion fatigue;
• 83% didn’t have a debriefing support after a patient’s death (Abendroth & Flannery, 2006).

6. Immigration Judges:

• Higher burnout levels than hospital physicians and prison wardens (Curtis, 2010).

7. Law Enforcement:

• 33% showed high levels of emotional exhaustion and reduced personal accomplishment; 56.1 percent scored high on the depersonalization scale (Hawkins, 2001).
• Only 15% of LE professionals were willing to seek personal counseling as a result of vicarious trauma vs. 59 % of mental health professionals (Bell, et al., 2003).

8. Forensic Investigators, Internet Crimes Against Children:

• 36 percent of investigators were experiencing moderate to high levels of secondary trauma (Perez et al., 2010).

9. Child Welfare Workers:

• 50% traumatic stress symptoms in severe range (Conrad& Kellar-Guenther, 2006).

10. Child Welfare Workers:

• 34% met the PTSD diagnostic criteria, due to secondary traumatic stress Bride (2007).

11. Child Protection Service Workers:

• 37 % reported clinical levels of emotional distress associated with secondary traumatic stress. (Cornille and Meyers,1999).

12. Child Protection Workers:

• 50% suffered from ‘high’ to ‘very high’ levels of compassion fatigue (Conrad & Kellar-Guenther, 2006).

13. Female Forensic Interviewers:

• 34 % reported experiencing symptoms of secondary traumatic stress (Perron & Hiltz, 2006).

Results

1. Physical: Exhaustion, insomnia, hipersomnia, headaches, susceptibility to illness.
2. Behavioral: Increased use of drugs and alcohol, compulsive overeating, other addictions, absenteeism, anger, avoidance of clients, blurred boundaries at work, isolation.
3. Psychological: Distancing, negative self-image, depression, inability to empathize, cynicism, bitterness, low job satisfaction and performance, heightened anxiety, irrational fear, problems with intimacy, hypervigilance, intrusive imagery, loss of hope, inability to have life outside of work.

Bottom Line

We lose dedicated, passionate, qualified, and educated employees to vicarious and secondary trauma every day, because we do not provide them with tools to address and prevent this very serious condition. Organizational leadership, including Boards, has significant capacity, and ethical responsibility, to create supportive work environments of vicarious and secondary trauma awareness and prevention. Individual prevention efforts work, but sound organizational interventions, prevention and sustainability processes ensure wellness of organization as a whole, thus strong and effective services to our communities.

References:

1. Abendroth and Flannery.(2006) Predicting the risk of compassion fatigue: A study of hospice nurses. Journal of Hospice and Palliative Nursing, 8(6), 346-356.

2. Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion fatigue and psychological distress among social workers: A validation study. American Journal of Orthopsychiatry, 76(1), 103-108.

3. Bell, H., Kulkarni, S. & Dalton, L. (2003). Organizational prevention of vicarious trauma. Families in Society, 84(4), 463-470.

4. Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1), 63–70.

5. Conrad, D., & Kellar-Guenther, Y. (2006). Compassion fatigue, burnout, and compassion satisfaction among Colorado child protection workers. Child Abuse and Neglect, 30(10), 1071-1080.

6. Cornille, T. A., & Meyers, T. W. (1999). Secondary traumatic stress among child protective service workers: Prevalence, severity and predictive factors. Traumatology, 5(1), 15-31.

7. Curtis, L. (2010). Case backload postponing deportations proceedings increases 26 percent, but immigration judges swamped. Las Vegan Review Journal, May 30.

8. Figley, C. (1995). Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder In Those Who Treat The Traumatized (Routledge Psychosocial Stress Series, 1995).

9. Figley, C. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. (New York: Brunner/Mazel).

10. Hawkins, H.C. (2001). Police officer burnout: A partial replication of Maslach’s burnout inventory. Police Quarterly, 4(3), 343-360.

11. Lipsky, L.(2009). Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others. (Berrett-Koehler Publishers).

12.Lobel,The vicarious effects of treating female rape survivors: The therapist’s perspective. (DoctoralDissertation, University of Pennsylvania, 1997). Dissertation Abstracts International: Section B: The Sciences and Engineering, Vol 57(11‐B), May 1997. pp. 7230.

13. Mathieu, F. (2012). The Compassion Fatigue Workbook. (Routledge, NY).

14. Perez, L. M., Jones, J., Englert, D. R., & Sachau, D. (2010). Secondary traumatic stress and burnout among law enforcement investigators exposed to disturbing media images. Journal of Police and Criminal Psychology, 25(2), 113-124.

15. Perron, B., & Hiltz, B. (2006). Burnout and secondary trauma among forensic interviewers of abused children. Child and Adolescent Social Work Journal, 23(2), 216-234

16. Saakvine K., and Pearlman, L. (1996). Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others (W.W.Norton).