Effects of treating trauma survivors: Vicarious traumatization and style of coping
The purpose of this study was to examine vicarious trauma and coping in psychotherapists as they are related to a reduction in posttraumatic stress disorder (PTSD) and disruptions in cognitive schemas. Ninety-five therapists completed the Ways of Coping Questionnaire (WCQ: Folkman & Lazarus, 1988), the Impact of Event Scale (IES: Horowitz, Wilner, & Alvarez, 1979), the Traumatic Stress Institute Belief Scale (TSI: Pearlman, 1994), and a demographic questionnaire. Seventy-one percent of therapists experienced PTSD symptomatology that was clinically significant. There was no support for the hypothesis that therapists with doctoral degrees and more than 10 years of professional experience would experience less PTSD symptomatology and fewer disruptions in cognitive schemas than therapists in all other conditions. There was no support for the hypothesis that therapists with a trauma history experience more symptomatology when treating adults who were traumatized recently than when treating adults who were traumatized long ago. Therapists with a personal history of trauma were also expected to experience greater PTSD symptomatology and more cognitive disruptions when they treated children traumatized recently than when they treated adults recently traumatized. There was a main effect for personal trauma history. Traumatize therapists experienced more intrusive symptomatology but no more avoidance or cognitive disruptions than therapists with no trauma history. Prediction models were tested for individual and professional factors that buffer a therapist from vicarious trauma. Individual factors that were expected to mediate the effects of vicarious trauma included lower levels of education, fewer years of professional experience, female gender, lower levels of income, coping style and younger age. Professional factors that were expected to mediate the effects of vicarious trauma include having fewer hours of trauma-specific training and having a low percentage of survivors in one's current and cumulative caseload. The results of these analyses were presented and discussed. Therapists who employed emotion-focused coping strategies had significantly higher levels of PTSD symptomatology but no more disruptions in cognitive schemas than therapists who employed emotion-focused coping styles. Implications for theory, research, training, and practice were discussed, as well as limitations to the current research and directions for the future.