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VICARIOUS TRAUMA 2

The Impact of Vicarious Trauma on Peer Recovery Counselor’s Ability to Self-Disclose

R7035 Methods and Analysis of Qualitative Research

Running Head: VICARIOUS TRAUMA 1

Background

Peer counseling is a professional job that involves mediating problems, by helping peers to find answers for themselves. A peer counselor, therefore, is a mediator, who acts as a compassionate guide by applying knowledge, using specific tools and following specific rules and regulations in an effort to help people get past obstacles, thereby reaching their goals and desires. It follows, therefore, that peer counselors are bound to be fatigued, as they have to act as mediators to numerous problems brought to them by different people. It is important to note, that it is a job requirement for them to build a close connection with their clients. Therefore, the more the number of clients, the higher the number of connections they are required to make. In the long run, this brings about “compassion fatigue”, also described as vicarious trauma (1Al-Mateen, Linker, Damle, Hupe, Helfer & Jessick, 2015). This paper, therefore, intends to investigate the impact this has on the peer recovery counselor’s ability to self-disclose and help their next patient recover from their own problems.

Vicarious trauma is a term that generally described as the price associated with providing ‘caring’ services to others. The term was first coined by Perlman & Saakvitne in 1995. It has since been adopted by several other researchers including Stemm (1995, 1997) who named it as ‘secondary traumatic stress’ and Figley, (1982) who termed it as secondary victimization. Indeed, going by the last two names described by these authors, vicarious trauma is a condition that affects the counselor offering peer counseling services while on duty. According to Hernandez-Wolfe, Killian, Engstrom & Gangsei, (2015), working with trauma survivors can be traumatizing in itself, given that it involves listening to the traumatic experiences of clients and trying to find a long-lasting solution for them. For some, it might take months or even years to overcome them, yet all the while a peer counselor is expected to maintain a professional relationship with them, which basically involves being compassionate.

Vicarious trauma can also be described as the emotional residue of exposure that counselors have from working with people, as they are hearing their trauma stories, and become witnesses to the pain, fear, and terror that trauma survivors have endured (Killian, Hernandez-Wolfe, Engstrom & Gangsei, 2017). This should not be mistaken for being tired or burnt out. In contrast, getting burnt out often implies that a person is simply tired of taking the same routine over and over again. It also means that this person needs a change in environment, such as when a person is tired of doing the same job that requires them to do the same duties and responsibilities every day. Putting this into context, it means that a peer counselor is said to be burnt out because they get to take the same route to work, the same subway back home, and meet the same people in the process. Simply put, this can easily be fixed by changing the environment (Quitangon & Evces, 2015). Vicarious trauma, on the other hand, can be experienced by a counselor as soon as they start working. Welsh, (2014) noted that this may occur as result of the experiences brought forth by a single client. It can also be triggered midway, or at the end of a career in peer counseling.

Signs and Symptoms

Makadia, Sabin‐Farrell & Turpin, (2017) also described vicarious trauma as a state of tension and preoccupation as a result of the traumatic stories told by clients. According to them, such experiences come in different forms. For instance, a counselor may choose to avoid thinking about a specific experience that caused them to be traumatized themselves when it is mentioned by a client. They may also find themselves in a state of arousal that is persistent, have difficulty talking about their own experiences or feelings and get constant feelings of anger and agitation. Others may feel jumpy or startled, are sleepy or stay awake for long periods of time thinking about their clients while others take it out on themselves by overeating or undereating (Cummings, Singer, Hisaka, & Benuto, 2018). Some have dreams about the experiences told by clients. It is also common for counselors to have feelings of diminished joy towards the things they once enjoyed doing. This leads to feelings of dissatisfaction and provide zero value for personal accomplishment because they feel trapped by being a counselor. Eventually, counselors with vicarious trauma end up battling with intrusive thoughts, feelings of hopelessness and blame others for their misfortunes (Cosden, Sanford, Koch & Lepore, 2016).

Impact on Behavior

Based on the above-mentioned characteristics, Molnar, Sprang, Killian, Gottfried, Emery & Bride, (2017) indicated that the behavior experienced by counselors, suffering from vicarious trauma will be characterized by a frequent need to change jobs, tardiness, exhaustion, and absenteeism. They are also likely to be irresponsible, irritable, reject physical and emotional closeness, while at the same time, overwork themselves. The American Counseling Association’s Traumatology Interest Network (2018) pointed out that it is likely that counselors will avoid being alone or choose to drop community affairs altogether. This is also bound to cause interpersonal issues including staff conflict, poor personal relationships, poor communication and lead to avoidance of working with clients with trauma histories. This, in itself, affects the quality of service offered by the affected counselor. Furthermore, it may also lead to a lack of collaboration and withdrawal or isolation from colleagues, difficulty having rewarding relationships and overall impatience towards issues (Molnar, Sprang, Killian, Gottfried, Emery & Bride, 2017)

Besides affecting interpersonal relationships, counselors with vicarious trauma are also likely to have their personal values and beliefs affected. As pointed out by Pack (2014), a person who was satisfied and had a positive perception could lose both due to vicarious trauma. They can also experience apathy, lack appreciation skills or have a constant desire to do more because they are worried, they are not doing enough. They are also likely to disrupt their ability to maintain a positive sense of self, their ability to modulate strong effect, and their ability to maintain an inner sense of connection. All these will affect their job performance as illustrated by (American Counseling Association, 2018).

Indeed, the performance of a counselor affected by vicarious trauma is not only poor but is also concerning worrying, considering that they may be in need of the help they are providing in the first place. Setti, Lourel & Argentero, (2016), indicated that an affected counselor is likely to be low motivated, have increased error, be over-involved in details, have a need for perfectionism and generally avoid responsibilities of any kind. This, coupled with a lack of flexibility, leads to a severe decrease in the quality of service offered. The American Counselling Association also associates several physical signs and symptoms to vicarious trauma including, but not limited to, heart problems, anxiety, headaches, allergies, arthritis, eating problems, infections, and high blood pressure. Other issues include immune system problems, nervous tics, rapid heartbeat, backaches, stroke and ulcers, sleep disorders, addiction as well as depression, burnout, poor self-esteem, the flu and bowel problems (ACA, 2018).

Based on the description above, it is clear that vicarious trauma has a huge impact on the ability of a counselor to deliver quality counseling services. A pointed out by the Headington Institute, a red flag for a full-blown condition, is indicated by three things; a change in spirituality, identity and beliefs. Indeed, this was backed up by findings from Setti, Lourel & Argentero, (2016), which pointed out that a counselor suffering from vicarious trauma is likely to change their beliefs regarding meaning, causality, and connection in faith. They are also likely to change the way they think about some of their closest friends and family members as well as how they view safety, trust, and intimacy. This is a clear concern, and as a result, this study intends to find out how this relates to the functions of a peer review counselor.

Purpose of Study

The purpose of this study is to investigate the impact of vicarious trauma as it relates to the functions of a peer review counselor. There is no doubt that peer recovery counselors play a big role in helping others find their way back from traumatic experiences. However, in so doing, they may find themselves immersed in these experiences, leading to high levels of stress which impacts their ability to deliver quality services. Additionally, the risk factors associated with such fallout can be categorized into personal, work-related and community risk factors. This study, therefore, intends to identify these risk factors and recommend ways to mitigate them. A literature review will also be conducted to establish what has already been investigated and the most current trends among patients with vicarious trauma. This will also help the researcher identify the research gap that will be pursued.

The results of this study will be of critical importance to a number of stakeholders. For starters, all peer counselors will find it to be a good read, as it will not only identify the main risk factors associated with vicarious trauma, but it will also provide some recommendations as to how best handle it. Risk factors that will be identified will include individual level, work-related and community level factors. This will help determine the extent to which the condition affects both the external and internal life of an affected person. The study will also seek to establish how vicarious trauma impacts the preparedness and self-efficacy of a peer counselor, how this self-exposure impacts the peer counselor and the client’s past trauma experiences, how psychological trauma relates to substance abuse and the peer counselor’s ability to discuss their personal experiences that result and finally whether exposure to trauma always causes vicarious trauma. The, therefore, the following research questions will be of primary concern to the study.

Research Questions

This section indicates the research question that this study intends to investigate. It is important to highlight the overarching question which states as follows;

What the association between shared trauma experiences and the likelihood of being re-traumatized?

The specific research questions are indicated below;

i. Does vicarious trauma impact the preparedness and self-efficacy of the peer counselor?

ii. How does self-disclosure impact the peer counselor and the client’s past trauma experiences?

iii. Are substance abuse peer counselors appropriately trained to handle the trauma experiences of others?

iv. How does psychological trauma impact substance abuse peer counselor’s ability to discuss their personal experiences?

References

Al-Mateen, C. S., Linker, J. A., Damle, N., Hupe, J., Helfer, T., & Jessick, V. (2015). Vicarious traumatization and coping in medical students: a pilot study. Academic Psychiatry, 39(1), 90-93.

Cosden, M., Sanford, A., Koch, L. M., & Lepore, C. E. (2016). Vicarious trauma and vicarious posttraumatic growth among substance abuse treatment providers. Substance abuse, 37(4), 619-624.

Cummings, C., Singer, J., Hisaka, R., & Benuto, L. T. (2018). Compassion satisfaction to combat work-related burnout, vicarious trauma, and secondary traumatic stress. Journal of interpersonal violence, 0886260518799502.

Finklestein, M., Stein, E., Greene, T., Bronstein, I., & Solomon, Z. (2015). Posttraumatic stress disorder and vicarious trauma in mental health professionals.

Hernandez-Wolfe, P., Killian, K., Engstrom, D., & Gangsei, D. (2015). Vicarious resilience, vicarious trauma, and awareness of equity in trauma work. Journal of Humanistic Psychology, 55(2), 153-172.

Killian, K., Hernandez-Wolfe, P., Engstrom, D., & Gangsei, D. (2017). Development of the Vicarious Resilience Scale (VRS): A measure of positive effects of working with trauma survivors. Psychological trauma: theory, research, practice, and policy, 9(1), 23.

Makadia, R., Sabin‐Farrell, R., & Turpin, G. (2017). Indirect exposure to client trauma and the impact on trainee clinical psychologists: Secondary traumatic stress or vicarious traumatization? Clinical psychology & psychotherapy, 24(5), 1059-1068.

Molnar, B. E., Sprang, G., Killian, K. D., Gottfried, R., Emery, V., & Bride, B. E. (2017). Advancing science and practice for vicarious traumatization/secondary traumatic stress: A research agenda. Traumatology, 23(2), 129.

Pack, M. (2014). Vicarious resilience: A multilayered model of stress and trauma. Affilia, 29(1), 18-29.

Quitangon, G., & Evces, M. R. (Eds.). (2015). Vicarious trauma and disaster mental health: Understanding risks and promoting resilience. Routledge.

Setti, I., Lourel, M., & Argentero, P. (2016). The role of affective commitment and perceived social support in protecting emergency workers against burnout and vicarious traumatization. Traumatology, 22(4), 261.

Swain, S. (2015). Transitional Justice Workers and Vicarious Trauma. In Apologies and the Legacy of Abuse of Children in ‘Care’ (pp. 181-190). Palgrave Macmillan, London.

Welsh, M. C. (2014). Vicarious traumatization and vicarious resilience: an exploration of therapists' experiences conducting individual therapy of refugee clients: a project based upon an investigation at Family Health Center of Worcester, Worcester, Massachusetts.

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