How do experienced therapists manage the effects of working with trauma: an explanatory sequential design
Publication Date
November 12, 2020
Creator
Abstract
Purpose and Background:
This study explored the impact of trauma work, specifically vicarious traumatisation (VT), secondary traumatic stress (STS), and vicarious post-traumatic growth (VPTG), upon experienced therapists and how they managed the impacts. Researchers have investigated how empathically engaging with trauma narratives can impact therapists. However, results between quantitative and qualitative explorations remain inconsistent. Quantitative enquiries have often identified VT and STS, whereas qualitative explorations highlight VPTG. Furthermore, previous research has failed to separate senior and less experienced clinicians; thus, questions remain regarding how coping may differ. The overall research question was: how do experienced therapists manage the impact of delivering trauma work? Additional research questions were: firstly, is there any evidence of VT, STS, and VPTG in a sample of experienced therapists? Secondly, how do experienced therapists cope with the short- and long-term effects of trauma work?
Method:
A two-phase explanatory sequential design was used. Phase I: 125 therapists participated in a survey exploring personal trauma, coping, and VT via open-ended questions, and coping, STS, and VPTG questionnaires were administered. Quantitative data was analysed using descriptive statistics and qualitative data via thematic analysis. Purposive sampling from Phase I enabled 12 semi-structured interviews to further explore experiences in Phase II. Interviews were analysed via inductive and deductive thematic analysis. Inconsistencies between VPTG measures and qualitative results were identified via data triangulation.
Results:
Phase I: Descriptive statistics demonstrated that therapists scored higher on engagement than disengagement coping strategies, and 70% had personally experienced trauma. STS and VPTG scores were in keeping with those of similar professions and 28% of therapists were categorised as VT present. The deductive thematic analysis identified a range of coping strategies therapists applied to manage the negative components of trauma work. Participants described how their perception of coping either changed with experience, noticing a reduction in the need to cope, whereas others reported coping remained consistent. Phase II: Thematic analysis generated an overarching theme: the gains (for therapist and client) make the costs worthwhile. In addition, four themes and twelves sub-themes were created. Themes included: 1) recognising the negative impact is inevitable- therapists had come to accept and anticipate the challenges associated with trauma work; 2) seeking containment- therapists sought out an alternative container when trauma work felt intolerable; 3) a change in perspective- therapists recognised how trauma work could offer them additional insights into their personal life and provide opportunities within clinical work; and 4) remaining motivated to continue- therapists described their reasons for continuing trauma work and preparations for future work.
Discussion:
Results offer further support to the more recent notion that positive and negative impact of trauma work occur simultaneously, and contests previous assumptions that they are mutually exclusive phenomena. The results present a nuanced insight into the processes regarding the impact of working and coping with trauma work for experienced therapists. Further research should endeavour to explore a holistic view of therapists’ experience.
Item Type
ethesis
Thesis Type
DClinPsy
Subjects (LC)
Associated Schools / Departments
School of Medicine
eprints ID
61454
UoN Repository URI
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