Impact of Trauma Work on Social Work Clinicians: Empirical Findings.

A body of research exists on the effect of traumatic events on victims (Briere & Runtz, 1990; Brock & Perry, 1995). However, less attention has been focused on the people indirectly exposed to trauma. As an increasing number of traumatized clients are treated in a variety of settings, interest in the effect of this work on clinicians is growing. Terr (1989) said that indirect exposure to a traumatic event occurs when someone "happens to see the psychiatric symptoms, defenses, and raw emotions that accompany someone else's psychic trauma" (p. 16). Vicarious traumatization characterizes the effect of trauma on clinicians and other professionals who work with trauma survivors. In an effort to provide empirical support for vicarious traumatization, the present study explored the possibility that clinicians may experience reactions associated with traumatic stress as a result of indirect exposure to their client's trauma. Historically, concepts such as countertransference and burnout have been used to describe the experience of clinicians in the therapeutic process. The classical definition of countertransference focuses on the individual characteristics of the clinician, often assuming that unresolved personal conflicts account for the clinician's reaction (Gorkin, 1987; McCann & Pearlman, 1990; Pearlman & Saakvitne, 1995). Factors frequently cited in the development of burnout include the isolation of the work, the difficult or demanding client, workload, the need to constantly be empathetic, and bureaucratic and administrative factors (Deutsch, 1984; Freudenberger & Robbins, 1979). Neither countertransference nor burnout alone adequately accounts for the impact on the clinician of the graphic material presented by the traumatized client. Furthermore, studies indicate that vicarious traumatization is distinct from burnout. In Munroe's (1990) study, clinicians working with large caseloads of combat veterans not diagnosed with posttraumatic stress disorder (PTSD) did not report PTSD-like symptoms, whereas clinicians working with similar size caseloads of veterans who were diagnosed with PTSD did report symptoms. Schauben and Frazier (1995) found that clinicians working with victims of sexual assault reported effects on the vicarious traumatization measure, but not on the burnout measure.