Vicarious posttraumatic growth in the trauma therapist : do organizational factors impact differently on therapists working in private practice compared to therapists employed in clinic/institutional workplaces?
Following a traumatic event many people experience on-going negative symptoms; in contrast some who survive trauma become stronger or grow from the experience in some way (Tedeschi & Calhoun, 1995, 1996; Linley & Joseph, 2002). In addition to those who experience an event directly, there are those who experience the event indirectly or vicariously (Figley, 1995; Kassam-Adams, 1995; McCann & Pearlman, 1990; Pearlman & MacIan, 1995). Professionals likely to experience a traumatic event vicariously include emergency response workers and police officers. These professionals attend a traumatic event and witness the atrocities occurring; however there may also be a therapist, social worker or a psychologist who hears about the event, days, weeks or even years down the track and who is potentially exposed to similar experiences many times during their career. It is those who have been vicariously exposed to the traumatic experience of others that this literature review is interested in. In particular, it focuses on the consequences for therapists who are vicariously exposed to trauma only via their clients retelling of the event, and the schema transformations they may encounter. A recent shift to positive psychology approaches in research and the therapeutic setting has created a focus on the salutary outcomes of trauma on primary victims, therefore vicarious trauma and/or compassion fatigue in the trauma therapist is reviewed and the occurrence of posttraumatic growth following primary and secondary exposure to trauma is also examined. Of particular interest are the personal and organizational variables which may assist in facilitating vicarious posttraumatic growth for the trauma therapist. In order to accommodate the diverse occupational contexts in which therapists work, this review draws a distinction between and compares the experiences of those who work in a clinic or institutional employment with those who work in private practice. An extensive literature illustrates the possible negative effects that providing trauma therapy can have on the therapist. Yet little is known about the potential positive outcomes experienced by therapists as a result of this work. An influencing factor on a therapists well being and mental health may be the climate of their work environment and the hassles or uplifts they experience in their workplace, and personal differences such as their own experience of trauma, and personal therapy. This questionnaire based study aimed to investigate firstly, the existence of positive outcomes or vicarious posttraumatic growth for therapists as a result of working with trauma clients, but also examines organizational differences in therapists who work in private practice and those who work in clinic/institutional employment, and sought to determine if those differences impede or facilitate vicarious posttraumatic growth. Sixty four therapists completed the Posttraumatic Growth Inventory, demographic questionnaire and the Work Hassles and Uplifts scales. Data were divided into two groups based on type of work place (private practice vs. clinic/institution). Results show that most therapists reported positive outcomes as a result of their work. No difference was found between the employment groups and levels of posttraumatic growth. However, therapists who reported more work uplifts also reported higher levels of posttraumatic growth. No difference was found between the two workplace groups on the uplifts scale, however, clinic/institutional therapists scored significantly higher on the work hassles questionnaire. Implications for the workplace are discussed and suggested directions for further research is outlined.
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Unpublished
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Copyright 2010 the author Thesis (MPsych(Clin))--University of Tasmania, 2010. Includes bibliographical references