Ameliorating the Effects of Vicarious Trauma in the Workplace

Romaine Mossromaine.moss@dbb.org.

au

Our Out of Home Care Service

Category 6 Intensive Support Service6 residential care houses -accommodate

up to 4 young people (10-18 years)70 residential care workers – permanent

& casual24/7 rostered Residential Care WorkersStaff range in age, educational and

employment backgrounds

Background

• High turnover – loss of knowledge & consistency • High number of incident reports• Complex and costly workers compensation

claims• Disempowered Staff – unconsciously identifying

as victims

Elements of VT• Burnout - long-term exhaustion & diminished

interest

• Secondary Traumatic Stress – similar symptoms to PTSD

• Compassion Fatigue – gradual lessening of compassion

• Vicarious Trauma – “The effects of hearing about or

witnessing the aftermath of traumatic events”

• Often suffered in helping professionals where workers are required to take part in empathic interaction with trauma survivors (Pearlman & Saakvitne, 1995)

Vicarious Trauma

Detrimental Effects

Secondary Traumatic Cognitive ChangesStress Re-experiencing Frame of Reference

changesAvoidance Self CapacitiesHyper arousal Disruption to psych needs

Pearlman’s ABC Model of Managing VT

Awareness of the effects of VT

Balance of work and life

Connection with people and community

Essential Components of our VT Management Program

1. Education2. Risk reduction strategies 3. Monitoring for VT symptoms 4. Early Intervention of VT symptoms 5. Promoting longer term wellbeing

Aim to retain staff in better psychological health to improve outcomes for Young People in care

1. Education

Acknowledge that VT is inevitable in this work

Understand the construct of VTRecognise the symptoms of VTStrategies to manage VT

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2. Risk Reduction Strategies – Leaving work at work

Risk Reduction strategies thatReduce exposure to trauma content by

building capacity for individual to “leave work at work”

Physical & psychological ritualsFlexible work arrangements

3. Monitoring for SymptomsCritical incident monitoringVT Testing – Biannual

1. Compassion Fatigue Self Test for Practitioners

(CFST – Figley 1995)Scores for risk of Compassion Fatigue & Burnout

2. Trauma Attachment Belief Scale (TABS – Pearlman 2003)

Scores for cognitive schemas about self & others10 subscales – (Safety, trust, esteem, intimacy &

control) x (self or others)

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4. Early Intervention of Symptoms

SupervisionDefusing/debriefing following critical

incidentsEmployee Assistance Program (EAP)VT Intervention Support Line

5. Promoting Wellness - Self Care

Self Care strategies that:Address the individual’s VT profile -

target symptoms most experienced or most severely.

Actively oppose the results of VT – attempt to offset symptoms & reduce problematic impacts on the worker

Funded and non funded

Research Project (2013 – 2015)

MethodologyCombined quantitative and qualitative methods in 2 phase

process.Phase 1:

Comparative analysis of VT testing (2 x biannual tests – CFST & TABS)

12 month qualitative survey12 month analysis turnover, sick leave & worker’s

compensation data.Phase 2

Repeat above analysis in 12 months Evaluation of tailored individual self care plans and VT

Intervention Support Line

Phase 1 results (2013 -2014)

Qualitative Survey (n=38)No difference in change in VT levels (n = 34) TABS – average to low average range, slight

downward trend but not significant CFST - population at high risk for

experiencing secondary traumatic stress symptoms

Organisational bottom line - drop in turnover, sick leave, & workers compensation leave

Recommendations to Manage VT

Acknowledge the risks – build a culture of inevitability

Reduce the risk – Professional development, supervision & shift handover

Early Intervention – debriefing, VT Support, EAP.

Monitor Symptoms – direct & indirect monitoring

Build Resilience – individual nature of VT, tailored self care

Quotes:“Becoming a Therapist: When trying to

help a broken person always remember that you will be hurt by their shattered pieces and that is okay.” (Cornercanyoncounselling.com)

“In dealing with those who are undergoing great suffering, if you feel “burnout” setting in, if you feel demoralised and exhausted, it is best, for the sake of everyone, to withdraw and restore yourself. The point is to have a long term perspective” Dalai Lama

Thank You...

I would like to acknowledge the work & dedication of Michael Cashin (OOHC Manager), our 6 coordinators and their staff for the amazing work that they do.

I would like to thank the following organisations for their support of our program.Catholic Social Services Australia (CSSA)Rape and Domestic Violence Services Australia

Contact details: Romaine Moss (romaine.moss@dbb.org.au)