Therapists Vicarious Trauma

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Table of Contents

Introduction
Vicarious trauma among clinicians in First Nations Communities
Working in Northern Ontario locations
Experiencing trauma and impact to therapists
Managing Vicarious Trauma in First Nations communities
Conclusion
References

Introduction

Literature concerning professionals working with traumatized clients or patients is enormous. The interaction between the professional and clients takes place on daily basis where the professional may be affected by the client’s problem through exposure to the problem.

Vicarious traumatization (VT) was first identified in early 1990s through an extensive research done by McCann and Pearlman (1990) and the two defined the concept as, “cumulative transformative effects upon therapists resulting from empathic engagement with traumatized clients” (Harrison and Westwood, 2009, p.1).

Generally, part of clinician’s job is to listen to the narration a client gives about a horrific event, and the clinician is forced to bear witness to the psychological and in other cases to physical aftermath of actions that can be described as intense in cruelty or aggravated violence (Harrison and Westwood, 2009).

As clinicians go through these cumulative experiences largely reflecting empathic engagement, they invite injurious effects upon themselves whereby, in most instances, they may experience physical, emotional, and cognitive symptoms similar to those of their traumatized clients (Pearlman and Saakvitne, 1995 cited in Harrison and Westwood, 2009).

While noting the emergence of vicarious trauma among clinicians, the consensus backed with relative evidence shows that little or scanty literature exists of the known factors that might lead or results into vicarious trauma, with further literature existing on the possible available practices that may thwart or improve its harmful effects (Figley, 2004 cited in Harrison and Westwood, 2009).

Nevertheless, some considerable research and theory have started to emerge detailing information and investigating the vulnerability of VT and the possible treatment (Figley, 1995 cited in Harrison and Westwood, 2009). Equally, it has become essential to understand the necessary protections that are effective in ensuring clinicians work well with the traumatized population.

The current trend is worrying where clinicians with appropriate training to be instrumental and providing help to clients resign from their duties as the issue of caring for traumatized clients become challenging. When this occurs, then the profession loses enormous and most useful assets leaving a vacuum.

At the same time, when the very clinicians stick to their roles but are largely dissatisfied as due to strong impact of VT effect, then the general welfare of the community is compromised as instances of disservice become evident and clear (Harrison and Westwood, 2009).

First Nations communities, as numerous literature would postulate, are characterized by many factors or instances of deficiency, vulnerability, hopelessness, traumatized and general health problem specifically with regard to mental.

Today, little literature exists on most First Nations communities, an aspect that has further made it impossible to have enough literature or information about vicarious trauma (VT) in these societies.

As their situation would dictate, these communities experience many mental problems both historical emanating from historical injustices and present or newer problems originating from various hardships that these communities face in order to live.

Therefore, motivated by such factors, this essay paper intends to explore and investigate the available literature review with regard to vicarious trauma (VT) among First Nations communities. The objective is to bring out, through literature review, the essential areas that have attracted a lot of attention while at the same time, identify the negligent areas that similarly carry a lot of importance.

Vicarious trauma among First Nations is a fact that cannot be disputed and it is from reviewing the current existing literature that it becomes possible to provide or suggest for necessary recommendations to be effected in dealing with the problem.

Vicarious trauma among clinicians in First Nations Communities

First nation communities are generally portrayed and identified by negative elements. The health and social differences between these communities and other non-First Nations communities have received extensive study.

Characteristically, First Nations communities, especially in Canada, are seen to exhibit high rates of suicides, chronic and communicable diseases, low rates of employment and general low levels of educational attainment (Health Canada, n.d).

Clinicians of different backgrounds have dedicated their lifetime to work with abused women, children, youth and their abusers in communities lived by First Nations people. Always, the aim of these professionals is to promote individual, professional, and organizational solutions to support them (Richardson, 2001).

Vicarious trauma seems to result to snowballing effects that are dependent on the past memories or narrations of nasty and inhumane acts; and this in turn leads to creation of enduring, noticeable change in the personal, political, spiritual, and professional attitude of the counselor or clinician or even advocates dealing with the traumatized clients (Richardson, 2001).

In other words, vicarious trauma has a “life-changing impact on individuals, ultimately affecting their view of the general world and their relationships and connections to families, friends, and community” (Richardson, 2001).

There has not been a clear definition for vicarious trauma; however, different terms have been used to refer to this new concept in clinical health. For example, numerous words used to refer to the concept include compassion fatigue, vicarious traumatization, secondary traumatization, secondary stress disorder, insidious trauma, and vicarious trauma (Richardson, 2001).

Experts at the same time continue to participate in a continuous process of collecting evidence about the role and importance of recognizing the impacts of vicarious trauma that is of developing healthy personal solutions, and of promoting organizational responses to preserve the strength of counselors and advocates (Richardson, 2001).

Vicarious trauma has been seen to emanate from subjecting the clinicians on “exposure to the realities of intentional cruelty and through the inevitable participation and traumatic reenactments” in traumatic reenactments in the therapy relationship (Richardson, 2001).

Due to this, the therapist becomes vulnerable and traumatized spiritually and emotionally; and their effects become enduring and cumulative over a sustained period of time and it becomes evident in both the therapist’s professional and personal life (Figley, 1995 cited in Richardson, 2001).

At the same time, Figley (1995) associate secondary stress disorder with vicarious trauma where he defines the former as, “the natural consequent behaviors and emotions resulting from knowing about traumatizing event experienced by a significant other; it is the stress resulting from helping or wanting to help a traumatized or suffering person” (cited in Richardson, 2001, p.19).

In summing up, Richardson (2001) studies vicarious trauma and note that, it constitutes the experience of being witness to the atrocities committed against another individual where the therapist get involved in absorbing the sight, the smell, the sound, the touch and also the feel of the numerous stories he or she is told especially in detail by those who have undergone any particular abuse and in so doing they are looking for ways to release their pain.

Working in Northern Ontario locations

Northern Ontario constitutes a Canadian region that is inhabited by communities of First Nations.

Generally, First Nations communities, as compared to non-First Nations communities, exhibit characteristics of low employment rate, low levels of education, little development, affected by diseases, levels of attempted and actual suicides are high, sexual assault and abuse cases are high, mental illness cases are rampant, and in general they are victims of historical injustices and legacies.

Sexual assault in these communities has been rampant and survivors of such sexual actions have experienced trauma sometimes leading to majority of them committing suicide or developing negative attitudes throughout their life span as memories of past experiences haunt them (Coholic and Blackford, n.d).

Majority of social workers have been working with these individuals and as a result, vicarious trauma has affected some of them. Vicarious trauma has had negative impact on majority of clinicians working in these communities such as perceiving world as evil and violent; disruption and failure in many of their relationships; and increasing feelings of helplessness (Coholic and Blackford, n.d).

As a distinct location, Northern Ontario has shaped many clinicians and interventionists in the problems of the region, and reliance on learned strategies alone has been automatic successful. One might ask why sexual assault in Northern Ontario is that rampant.

Though not adequately done, the little carried out research findings indicate that gender politics in this region is still unheard and little awareness has been done to promote it, patriarchy is still live and women oppression is widespread, community support is less and the general perception of the community members remains unchallenged over the issue (Coholic and Blackford, n.d).

Further, Northern Ontario women still face marginalization an aspect that has contributed to negative stereotyping and reinforcement of traditional roles of women.

Kauppi et al. (1996) reinforce these beliefs and understanding by noting that Northern Ontario women unlike their sisters in south or their counterparts men in north have higher chances of obtaining low income that is if they ever happen to get employment, they mostly depend on their men counterparts, and they are accorded status of second-class in workplaces (Coholic and Blackford, n.d).

The conclusion and almost consensus reached on has been that collaboration of social and economic structures together with cultural values have literary made the independence and self-sufficiency among Northern Ontario women a mirage (Coholic and Blackford, n.d).

More research done in the communities of this region point to the fact that lack of women role models in the area has continued to relegate women further lower on the social scale while others have pointed to the male-dominated economy in the area where major economic activities of the region centers on mining, logging, administrative local leaders are largely men hence employment opportunities for women in the area are limited (Coholic and Blackford, n.d).

Clinicians and counselors working in the area have been confronted with the issue of privacy and confidentiality where on large scale their has been lack of anonymity for majority of counselors working in Northern Ontario a situation that has contributed to their already stressful situations and work (Coholic and Blackford, n.d).

As Delaney et al. (1997) note, “social workers in the north live as part of their community rather than apart from it, which can lead to ethical dilemmas as well” (Coholic and Blackford, n.d, p.3). At the same time, social workers working in Northern Ontario live part of their community rather than apart from it, which can lead to ethical dilemmas as well (Coholic and Blackford, n.d).

In these communities, social workers generally come to know about their issues through the client reports normally about their neighbors, relatives, or other famous people who in one way or the other have perpetrated sexual assault.

Working with First Nations communities, specifically the traumatized people, the various therapist tends to become traumatized themselves. Generally, listening to the victims is always painful and to many therapists it leaves lasting symptoms and impacts.

In most cases, vicarious trauma manifest itself among therapists through subclinical, where this concept refers to the symptoms that are not dramatic or fast in nature to warrant clinical diagnosis rather ones that are capable of transforming a therapist’s life into misery (Johnson and Stephens, 2000).

Dealing with traumatized First Nations clients and victims, therapists come to discover how traumatized these victims are, how grief-stricken they are, how depressed they appear, or even how suicidal they feel.

As a result, the therapist becomes “burned out, anxious, cynical, depressed, distrustful, suicidal, suspicious, irritable, pessimistic, cold, and unfeeling, alienated, despairing, fearful, and largely ineffective” (Johnson and Stephens, 2000, p.88).

In essence, traumatized people take special energy, elicit compassion, trigger unfinished business and their general experiences and suffering become an issue that affects or influence the concerned therapists (Fahy, 2007).

Experiencing trauma and impact to therapists

Trauma has received a lot of attention in terms of research from many writers and researchers. Basically, traumatic event has been described to generally involve the actual or threatened death or form of injury to individual’s self or to other related and close people in which feelings of fear, helplessness or horror become present and prevalent (Hesse, 2002).

Such traumatic events in nature may include war, natural disasters, accidents, rape, or assault, physical or emotional abuse or even death of a loved and close member, friend (Hesse, 2002). Almost all people are potential victims of trauma as the general condition of living environment remains dynamic.

All people have almost equal likelihood of developing trauma regardless of their age, race, sex, ethnicity, sexual orientation, religious affiliation, or educational level (Hesse, 2002).

In the same measure, any therapist experiencing or being exposed to these events have high likelihood of developing vicarious trauma which in most cases manifest itself in different forms of emotional, behavioral, and cognitive symptoms (Hesse, 2002).

Different kinds of violence and injustices are met on people every day. First Nations communities record high rates of these cases. In committing or facilitating these injustices upon other innocent people, the perpetrators are prepared in all form to suspend their moral and humanitarian consideration and values instead their concern become largely centered on injuring the other person (Shamai and Ron, 2009).

However, what are products of any kind of injustices to other people? According to Shamai and Ron (2009), there exist numerous consequences that victims of these actions experience or go through.

For instance, the victims may end up losing their lives, sustaining permanent or long-term injuries, increased anxiety and fear living in the society, and many of them end up suffering from distress reactions (Shalev and Tuval-Mashiach, 2005 cited in Shamai and Ron, 2009).

Suffering from distress the victims demonstrate the following symptoms: a state of generalized fear and anxiety, constant repeated thoughts about what happened, exhibition of avoidance behavior, manifestation of physiological symptoms, accelerated depression, numerous problems in daily functioning, and problems and difficulties in relating to and trusting others (Shamai and Ron, 2009).

In some cases where the reaction from distress can result in varying severity levels of posttraumatic stress disorder (PTSD) AS described by Barnes and Ephross in 1994 and Difede, Apfeldorf, Cloiter, Spielman and Perry in 1997 (cited in Shamai and Ron, 2009).

The primary factor that has explained the likelihood of occurrence of such physical and psychological responses constitute the level of exposure and injury mainly through indirect exposure emanating from physical proximity to the event, the state of being close and near who was abused, injured or who experienced any actions of injustices, or through exposure to media coverage (Shamai and Ron, 2009).

In most cases when therapist being extended to a victim it is discovered that the perpetrator of the injustice constitute a close member of the victim, the therapist either clinician, social worker, counselor or advocate are at high risk of experiencing secondary traumatic stress disorder-STSD (Figley, 1995 cited in Shamai and Ron, 2009).

Constant exposure to victim experiences by therapist, in many instances, lead to negative consequences on the part of the therapist. McCann and Pearlman (1990) referred to it as vicarious traumatization; while Figley (1888) called the experience, secondary victimization which he later refined to, secondary traumatic stress order (STSD) in 1995 (cited in Shamai and Ron, 2009).

Developing vicarious trauma has been linked to various factors on the part of the therapist: the enormous therapist’s caseload, personal and professional experience, and exclusive exposure to traumatized victims (Shamai and Ron, 2009).

In terms of symptoms, vicarious trauma constitute intrusive thoughts that in most cases appear as flashbacks or nightmares in which the particular traumatic experience re-appear; avoidance, where the therapist might try to avoid victims with extreme experiences of trauma; hyperarousal, which in general include physiological signs of hypervigilance or increased startle response (Hesse, 2002).

Many questions have been asked as to how therapists develop, perform, and carry out their duties, especially in the face of exhibiting or manifesting instances of vicarious trauma. Such questions revolve on: do the therapists recover from these traumatic events as they are told by victims after some time, especially when they become accustomed to constant exposure of these traumatic events in their profession?

Is there existence of cessation mechanisms of vicarious trauma symptoms, especially when intervention is adopted? Do the therapists have to seek professional help in order to overcome it? What actually happens in situations in which the therapists and their clients have to live with the same threats and dangers, which is actually a form of danger that could increase the probability of traumatization? (Shamai and Ron, 2009).

Manifestation of vicarious trauma among therapist who works with traumatized clients has been explained by a theory known as constructivist self-development theory (CSDT) that was developed by McCann and Pearlman in 1991 (Shamai and Ron, 2009).

The theory states that almost all human being establish and develop their own personal realities that develop into constant and changing at the same time cognitive structures which according to Piaget constitute ‘schemas’ (Shamai and Ron, 2009). These schemas may include beliefs, assumptions, and expectations largely about self and the general beliefs about the world around, which result into people making sense of both.

McCann and Pearlman (1991) theorized that any form of trauma experience has the ability to cause dangerous distraction of certain aspects of individual’s schema and that working and interacting with traumatized victims can have the same effect for therapists (Shamai and Ron, 2009).

Beliefs, assumptions, and general expectations that are disrupted or modified differ for each therapist and largely depend on two factors: particular aspects of the work and aspects intrinsic to the individual therapist.

In this regard, aspects of work might include nature of the clients, specific and particular facts of the event, organizational factors, and social together with cultural issues. Aspects with regard to therapist include personality, personal history, current personal circumstances, and level of professional development (Shamai and Ron, 2009).

Pearlman and Saakvitne (1995), working with traumatized victims and conducting numerous researches in the communities, identified seven primary schema which are most prone to being changed by experiences emanating from trauma: frame of reference about the self and the world; trust; safety; power and control; independence; esteem; and intimacy (cited in Shamai and Ron, 2009).

Person’s frame of reference refers to the person’s identity, worldview, and spirituality and to most therapists vicarious trauma results into the therapists questioning their particular own identity, role or duty, and self-worth.

Getting much involved in the victim’s materials of trauma results into interference in the therapist’s ability to be total conscious and involved in his or her own life experiences that sometimes cause dissociation from the self and at the same time create distance from others (Shamai and Ron, 2009).

When the therapist participates in constant activities of hearing and sometimes internalizing horrific trauma stories from the victim the therapist in a gradual way starts to change how he or she perceives the world and generally his or her views change. Sometimes the therapist becomes hopeless and diminished optimism in humanity.

As a result of these: emotional numbing, feeling of grief, shock, anger, or even terror, the therapist’s spirituality get affected. Further, as the therapist experiences trauma second-hand, he or she develops defenses such as denial, intellectualization, isolation of affect, dissociation, and projection become more evident in the circumstance of the therapist (Shamai and Ron, 2009).

Trust is another aspect that gets injured on the part of the therapist as he or she becomes more and more exposed to peoples’ actions that in most circumstances reflect cruelty, deception, betrayal, or even violation of trust towards their victim clients (Shamai and Ron, 2009).

Therapists, because of these elements, lose trust and in most cases, they become cynical, suspicious of peoples’ motives and intentions or even perceive and regard other people to be largely trustworthy (Trippany, Kress and Wilcoxon, 2004).

As this gets implanted into the therapist system of thinking and acting, his or her relationship with other close members may be affected; for instance, they may view their intimate friends, partners, and family with the same mistrustful thoughts (Shamai and Ron, 2009). Trauma survivors experience thought of insecurity. They in large part loss feelings of safety and the therapist may share these same experiences of insecurity.

Therapists in these circumstances become hypervigilant, harbor feelings of being possible victims, and lose trust in general and along these levels sense of helplessness develops as victims share and reveal their stories of trauma events in which they might have been helpless (Shamai and Ron, 2009).

Victims, as well as therapists, may develop and feel loss of independence because of feeling vulnerable and out of control. At the same time, other effects of vicarious traumatization have been identified as loss of esteem on the part of therapist.

In general, as much as the therapist become critical about other peoples’ capabilities, Driscoll and Jackson, n.d. devaluing their abilities and just being cynical, the therapists in the process may question their self-worth and they proceed in their work, they may end up thinking they are committing more harm to victims than providing help (Shamai and Ron, 2009).

On the other hand, constant subjection to vicarious trauma therapist may experience impairment in self-capacities, inability to make sound judgments, violation of therapeutic boundaries, and difficulties in managing resources, inappropriate decision-making, poor therapeutic-client relationship, and general lack of interest in others (Shamai and Ron, 2009).

Managing Vicarious Trauma in First Nations communities

Hayes (2004) conducted research among therapist working with victims of severe trauma and suggested that therapist self-insight, self-integration, conceptual ability, empathy, and anxiety management facilitate management of vicarious trauma (cited in Harrison and Westwood, 2009).

Another research by Hayes, Gelso, Van Wagoner, and Diemer (1991) carried out research on vicarious trauma management and found out that vicarious trauma emanates from the therapist’s inability to disengage from identification with a client, rather than from empathy itself which in most cases involves a process of partial or trial identification balanced with relative disengagement (Harrison and Westwood, 2009).

Conclusion of their research was that therapist self-integration and self-insight, including cohesion of individual therapist, self-understanding, and differentiation of self from others played the most critical and vital steps in managing vicarious trauma (Harrison and Westwood, 2009).

Van Wagoner, Gelso, Hayes and Diemer in another research in 1991 carried out on therapists working with traumatized victims discovered and identified five essential qualities that were found to be vital in the management of vicarious trauma (Harrison and Westwood, 2009).

Basing their evidence from a sample of 93 field therapists the researchers noted that reputable excellent therapists were identified by their colleagues as: having or possessing greater insight into the nature and basis of their feelings have or possess increased capacity for empathy; are better at differentiating between client needs and their own; being less anxious both in session with the clients and in general; and are more adept at case conceptualization (Harrison and Westwood, 2009).

All these were perceived to contribute to better management of vicarious trauma. Coster and Schwebel (1997) conducting research among experienced psychologist with advanced education and training with experience of more that ten years found out that well-functioning, especially with regard to trauma environment, is defined as, “the enduring quality in one’s professional and personal stressors” (Harrison and Westwood, 2009, p.4).

Further through content analysis the authors found out that well-functioning among therapist dealing with trauma victims could be realized in the presence and functioning of the following conditions: peer support, stable personal relationships, supervision, a balanced life, affiliation with a graduate department or educational institution, personal psychotherapy, continuing education, family of origin as source of personal values, awareness of cost of impairment, and coping mechanisms that may include-vacations, relaxation, rest, exercise, spirituality, and also time spend with friends (Harrison and Westwood, 2009).

The authors in their recommendations note that there is need for a strong role of professional organizations in promoting professional well-being and sees the importance of carrying investigation in order to investigate the current imbalances existing in the professional education (Driscoll and Jackson, n.d).

Ladany, Friedlander, and Nelson (2005) in their research, investigated and found out that supervision plays an important role in VT management (Harrison and Westwood, 2009).

On his part, Walker (2004) noted that supervision was significant in that it acted as a vital protective factor for VT in that it ensured early recognition and response and through this, it acted as protection against burn out and subsequent damage to both therapist and the client (Harrison and Westwood, 2009).

Bernard and Goodyear (2004) observe that supervision functions mainly for restorative purpose, beyond its formative and normative functions and their assertion, is that “the responsibility of the supervisor to provide supervisees the opportunity to express and meet needs that will help them avoid burnout” (Harrison and Westwood, 2009, p.4).

In order to transform vicarious trauma, numerous proposals and key strategies have been given.

According to McCann and Pearlman (1990) reflecting on their experiences of working with trauma victims in various societies note that clinicians and therapists of all kinds have to acknowledge, express and work through painful experiences in a supportive environment to avoid therapist numbness and emotional risk with regard to ongoing empathic engagement with the clients (Harrison and Westwood, 2009).

The authors provide numerous suggestions as to how management of vicarious trauma can be conducted through initiatives of weekly case conferences and other groups for therapists who are involved in working with traumatized victims.

Through this weekly case conferences the therapist are able to deal with issues of professional isolation and at the same time provide emotional support by providing help to return to state of normalcy and enable the therapist handle the victim of trauma case with necessary appropriateness (Harrison and Westwood, 2009).

Further, the authors provide for more recommendations where they postulate that therapists need to receive regular supervision, balance caseloads with trauma victims and non-victim clients, balance therapeutic work with other professional responsibilities such as teaching and research, and maintain balance between personal and professional life (Harrison and Westwood, 2009).

Other related coping mechanisms for therapists include advocacy; enjoyment; realistic expectations of self such as being able to realize and comprehend the darker and deficiency side of humanity, acknowledging the ways in which trauma work, maintaining a sense of hope and optimism, and having belief that humans have that ability to endure and transform pain (Harrison and Westwood, 2009).

On overall, researches that have been done and generalized on wide samples have articulated the following as key to therapists’ ways and mechanisms of managing vicarious trauma.

First, vicarious trauma management can be undertaken in nine brad themes of: “countering isolation (in professional, personal and spiritual realms); developing mindful self-awareness; consciously expanding perspective to embrace complexity; active optimism; holistic self-care; maintaining clear boundaries; exquisite empathy; professional satisfaction; and creating meaning” (Harrison and Westwood, 2009).

The identified mechanisms for management of vicarious trauma as suggested through research include:

Training, professional development, and organizational support

Therapists have identified the importance of training as key to professional development and in turn to the management of vicarious trauma. The observation made is that through effective and good training, constant and up-date professional development, mentorship, and organizational support therapist have the opportunity to reduce the likelihood of occurrence of vicarious trauma (Harrison and Westwood, 2009).

These aspects integrate the therapist very well and effectively into the professional community, which in turn helps the therapist to realize decreased isolation, decreased anxiety, and reduced despair.

At the same time from the perspectives of therapists organizations that incorporate services of therapists need to take responsibility of fostering therapist’s self-awareness through creating some time from the therapist’s schedule and subsequently use that time to involve the therapist in self-reflection of his or her work while at the same time instituting forums in which the therapist can discuss vicarious trauma in an open, supportive and nonjudgmental environment (Harrison and Westwood, 2009).

Goldblatt, Buchbinder and Eisikovits (2009) see the importance of training, especially with regard to dealing with intimate partner violence cases.

The recommendations made by the author centers on: the appropriate or specified training should put more emphasis on how to prepare for emotional burdens arising from the particular kind of trauma.

The therapists should learn and acquire knowledge on how to use constructive mechanisms of working with the victims and the learning should largely dwell on enriching the therapists with adequate interpersonal skills while interacting with their clients.

Therapists have to be taught on how to deal with the development and manifestation of self-reflective attitude towards themselves and their intimate relationships, including the possibilities of critical examination of their interpersonal status quo; more learning and training need to be facilitated with regard to gender relations and gender inequality and the best ways to overcome this.

There is need for therapists to learn about victims’ culture, ways of knowing and feeling of the people found in the culture, and also their specific unique needs together with their actualization; lastly the specific necessary training is required that should focus both on pre-employment socialization and on-the-job socialization and issues such as individuation, freedom, choice, identity, and culture should be incorporated in ensuring there is a holistic professional (Goldblatt, Buchbinder and Eisikovits, 2009).

Diversifying professional roles

Research carried out on numerous therapists in different environments concluded or found out that through getting involved in variety of professional responsibilities such as practicing therapeutic directly, teaching, supervising, and administration, therapists have an opportunity to protect and promote professional challenges that might arise.

Diversity was regarded to be effective since it expanded the role of the professional while at the same time enabling them to have a wider interaction in the larger community an opportunity that enables therapists to have that sense of interconnection and renewal of hope (Harrison and Westwood, 2009).

Support from personal community

Therapist has been found to appreciate and embrace the role and initiatives played by their personal community involving family members, friends or peers in providing the necessary help needed to maintain balance and separate work from the rest of their life (Harrison and Westwood, 2009).

The moment professionals belong or identify themselves with a rich network of mutually caring relationships that can provide necessary help and guidance during times of needs, the therapist is seen to have effective ways of dealing with vicarious trauma experiences.

These strong networks of relationships were seen to play the role of sustaining relationships that in turn helps therapists to experience fewer instances of work depletion (Harrison and Westwood, 2009).

Other therapists turn to these networks of relationship in times of sorrow and discouragement and their solace and comforting counseling helps the therapist to soldier on with his or her therapeutic activities (Harrison and Westwood, 2009).

Developing self-awareness approaches

The overall practicing of appropriate self-care has been noted as another effective strategy that therapists can undergo and employ, especially when dealing with emotionally destabilized clients and victims of trauma.

For example, field suggestions and comments from wide array of therapist postulated that while carrying or interacting with victims of trauma they themselves had minimized contact with television news and gone further to avoid dramas concerning violence, crime, or trauma (Puterbaugh, 2008).

Further, other therapists noted the importance of the professional being constantly conscious, and possessing acute awareness of his or her victims and have self-monitoring tools that are constructed on the premise of physical, emotional, and spiritual responses to the victim. Self-monitoring tool has been regarded by many as a blueprint for self-nurturing, spiritual direction, and clinical supervision (Puterbaugh, 2008).

At the same time, enriching self-awareness, tools by incorporate aspects such as peer debriefing, constant and frequent supervision, and consultation have the impact of ensuring the success of the therapist’s work.

For majority of therapists, their observation is that, immediately after having interaction with the victims it requires the therapist to incorporate aspects of good nutrition to replenish his or her health, participate in exercise, have enough and quality sleep, take time for quality and replenishing relaxation, and in general maintain appropriate balance and boundaries between work and personal time (Puterbaugh, 2008).

Conclusion

Therapists working among First Nations communities face numerous challenges due to prevalence of all kinds of abuse and injustices in these communities. In most cases, the therapists’ report emotional turmoil while attempting to identify and deal with the source of their despair following victim’s disclosure of trauma.

Although in actual sense, they are not directly affected by the traumatic events being described in more significant part; they are left pondering and grappling with their own emotions, spiritual, and physical reactions.

Richard James notes that even when vicarious trauma might appear to be temporal in nature the situation has the ability to permanently change the psychological constructs of therapists who in their actual nature engage in long-term trauma because of their occupation.

In order to deal and address the problem adequately (James, 2008) proposes for effective crisis intervention where therapists need to have easy access to consultation and supervision. At the same time, carrying out any form of intervention should not take place in isolation.

Suggested intervention strategies that seem to work, which can be used to address the therapists’ situation working in First Nations countries include training, debriefing, intervention with the organization, interventions to diversify professional roles, incorporation of community into therapist’s vicarious trauma management approaches, and developing self-awareness approaches.

What needs to be remembered is that working among First Nations communities comes with challenges resulting from both historical and present circumstances prevalence in the community. Therefore, any intervention mechanism to address the issue of vicarious trauma should be designed and implemented in line with the regions environmental, social, economic, political, and cultural orientation.

References

Coholic, D. and Blackford, K. Exploring Secondary Trauma in sexual assault workers in Northern Ontario Locations: The challenge of working in the Northern Ontario context. (Attached notes).

Driscoll, L. and Jackson, C. What Makes First Nations Communities Successful? Web.

Fahy, A. (2007). The Unbearable Fatigue of Compassion: Notes from a Substance Abuse Counselor who dreams of working at Starbuck’s. (Attached notes).

Goldblatt, H., Buchbinder, E. and Eisikovits. (2009). Between the Professional and the Private: The Meaning of Working with Intimate Partner Violence in Social Worker’s Private Lives. Journal of Violence Against Women, Vo. 15, No. 3. (Attached notes).

Harrison, R. L. and Westwood, M. J. (2009). Preventing Vicarious Traumatization of Mental Health Therapists: Identifying Protective Practices. American Psychological Association, Vol. 46, No. 2. (Attached notes).

Hesse, A. R. (2002). Secondary Trauma: How Working with Trauma Survivors Affects Therapists. Clinical Social Work Journal, Vol. 30, No. 3. (Attached notes).

James, R. K. (2008). Crisis intervention strategies. OH, Cengage Learning. Web.

Johnson, K. and Stephens, R. D. (2000). School crisis management: a hands-on guide to training crisis response teams. CA, Hunter House. Web.

Puterbaugh, D. T. (2008). Spiritual Evolution of Bereavement Counselors: An Exploratory Qualitative Study. American Counseling Association, Vol. 52. (Attached notes).

Richardson, J. I. (2001). Guidebook on Vicarious Trauma: Recommended Solutions for Anti-Violence Workers. Family Violence Prevention Unit, Health Canada. Web.

Shamai, M. and Ron, P. (2009). Helping Direct and Indirect Victims of National Terror: Experiences of Israel Social Workers. Qualitative Health Research Journal, Vol. 19, No. 1. (Attached notes).

Trippany, R. L., Kress, V. E., and Wilcoxon, S. A. (2004). Preventing Vicarious Trauma: What Counselors should know when working with trauma survivors. Journal of Counseling and Development, Vol. 82, No. 1. (Attached notes).

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