Addiction to the addict: The relationship between secondary traumatization among social workers treating addicts who use psycho-active substance and post-traumatic growth

Working with patients who are addicted to psychoactive drugs is a complex task due to three essential factors: the exposure to traumatic content of therapy and to the patients’ existential issues pertaining to feelings of emptiness and lack of meaning; a sense of failure caused by the one-time or continuous consumption of drugs during any period of abstinence; coping with aggressive content of therapy expressed by the patients.

The daily experience of pain and emotional distress involved in this kind of work has profound and long-term impacts on social workers that can be expressed by secondary traumatization. However, studies have recently shown the existence of positive effects of traumatic events, including social workers indirectly exposed to trauma. One such positive effect is post-traumatic growth.        

The aim of the present research is to study the connection between secondary traumatization and post traumatic growth. This is done by comparing three groups of social workers according to their place of work, which is characterized by a different level of exposure to people with addiction: social workers working almost exclusively with clients addicted to to psychoactive substances; social workers working in welfare agencies and are less exposed to addicts; and finally social workers working with clients in the fields of rehabilitation and health and are hardly exposed to addicts. 223 social workers participated in this study. They were requested to fill a series of self-report questionnaires.

The central hypotheses of this research were that differences would be found between social workers who work with people addicted to psychoactive substances and social workers who work with welfare populations and social workers who work in the health field, i.e. that social workers working with people with addictions would experience higher levels of secondary traumatization as well as higher levels of post-traumatic growth. We also examined the question whether there were significant differences between social workers working with addicts and other social workers regarding support from colleagues, supervision and their satisfaction with supervision. Furthermore, we examined whether the higher the secondary traumatization, the higher the post-traumatic growth. Moreover, we checked whether the readiness to receive support and help from colleagues, supervisor, guidance and rumination mediated between secondary traumatization and post-traumatic growth.

The results of the research show higher secondary traumatization among social workers working with people addicted to psychoactive substances than among social workers working with other populations, except those who work in welfare agencies. However, no differences were found between the groups of social workers regarding the level of post traumatic growth and also regarding colleagues and supervisor support and satisfaction from supervision. The research showed, in agreement with the study’s hypothesis, that the higher the secondary traumatization, the higher the post-traumatic growth. This hypothesis was substantiated for social workers working in welfare agencies and in other fields, but not for social workers working with addicts to psychoactive substances. Regarding mediating variables, readiness to receive support and help from colleagues, supervisor and guidance at work were not found to mediate between secondary traumatization and post-traumatic growth. However, in agreement with the study’s hypothesis, it was found that rumination mediates the connection between secondary traumatization and post-traumatic growth, but only with regard to social workers working with people with addiction.                                                                                                  

The results of the study suggest that secondary traumatization and post-traumatic growth among social workers are not necessarily connected to the kind of population they treat. This also could show resemblance in the degree of exposure of the therapist to trauma in treatment of people with addictions and other populations as well. Moreover, it possibly refers to other resemblance among the treated populations, for example, suffering from multi-system and multi-generational problems. On the other hand, it may be connected to different characteristics of various groups of therapists. So that in spite of intensive exposure to trauma in the treatment of people with addictions, therapists do not necessarily undergo a higher  traumatisation or higher post-traumatic growth (for example as a result of personality resilience or more serious treatment failures accordingly). The resemblance between the groups in regard with the variables could result from the resemblance of administrative characteristics of the various welfare systems in Israel. Hence, no differences were found among various groups of social workers regarding support from colleagues and supervisor as well as satisfaction from guidance. Moreover, the results show that social workers are reluctant to get help from support systems at their disposal for fear of disclosing vulnerability, which they suspect, could harm their standing and even their professional promotion. 

The results of the study indicate that post traumatic growth among social workers is not only the outcome of secondary traumatization. It could be connected to other variables which were not examined in the current study. The findings could point to a special connecting path between traumatization and post-traumatic growth among social workers working with people with addictions. The research indeed shows that among this population of therapists the role of the rumination process is important in the establishment of growth out of and in parallel to the distress caused by the encounter with traumas in the treatment  room. This path exists although no encompassing connection has been detected between secondary traumatization and post-traumatic growth among social workers working with people with addictions. This could suggest the existence of additional variables which have not been examined in the current study and are liable to influence the said connection in an opposite direction. 

There are several contributions to this study, both theoretical and clinical. First, the study highlights the existence of negative and positive effects of traumatic contents among social workers and it strengthens the conception being developed currently pointing to positive consequences of secondary traumatization.            

Secondly, the present research emphasizes the importance of the rumination enables post-traumatic growth along with secondary traumatization among social workers working with people with addiction to psychoactive substances. As a consequence, it seems that the support of the management and investing resources in the development of this cognitive process could assist social workers apprehend the negative effects of their work.  

Social workers working with other populations could also benefit from this policy. The results stress the importance of constructing intervention plans at the national level, integrating the use of additional support resources originating from supervisor, colleagues and guidance. This should be achieved while decreasing social workers' concern of damaging their standing.  Finally, the study reveals the importance of ongoing research about the implications of the encounters with patients' traumas that should enrich the understanding of social workers in general and of social workers treating addicts in particular.