Personal and professional consequences on therapists treating trauma victims compared to therapists treating offenders

In the therapeutic process, the therapists are exposed to the patients' experiences and life stories. This exposure may evoke a variety of negative, mental and physical reactions. The most prominent phenomena that are unique to trauma therapy are secondary traumatization (Figley, 1983) - psychological distress resulting from exposure to a traumatic event experienced by another person; and vicarious traumatization (McCann & Pearlman, 1990) - a gradual and continuous effect of change in the therapist's inner experience and perceptions of the world.

Research in the field in general and in Israel in particular is limited and contains inconsistent findings about the phenomena and the contributing variables. Our purpose is to examine the prevalence and intensity of each of the phenomena separately. Firstly we aim to explore the development and variance of secondary and vicarious trauma. Based on the ecological model of trauma (Harvey, 1996) we examine the contribution of empathy, organizational commitment, and the characteristics of exposure to traumatic material, separately for each of the phenomena.

The exposure variable was defined as the patients’ population– trauma victims or offenders and how they have caused trauma to others. The concept of secondary and vicarious traumatization was developed from work with trauma victims. However, a developing field of study in recent years indicates that offenders’ therapists experience similar reactions and changes to victims’ therapists. We hypothesized that offenders’ therapists would experience lower levels of secondary trauma compared to victims’ therapists, due to their increased need for emotional control. On the other hand, we hypothesized that offenders' therapists would experience higher levels of vicarious trauma than victims’ therapists due to the risk and continuing effect of their work. It was also hypothesized that the two groups would differ significantly with regards to levels of empathy and organizational commitment. Due to differences in exposure to traumatic material and tendency to use them as a protection mechanism against the negative consequences of their work.

We assumed that the independent variables would correlate significantly to the dependent variables.  Based on the theoretical models of Figley (1995) and McCann & Pearlman (1990), which place empathy as a transition mechanism to the traumatic materials. We hypothesized that there would be a positive correlation between secondary and vicarious trauma to empathy. Empathy has been defined as a multi-dimensional structure that contains a cognitive component - an intellectual response to the patient's experiences, and an emotional component - the therapist's ability to experience the patient's emotional experience. The organizational commitment was defined as the strength of the individual's identification with the organization he works in and his involvement in it. Based on burnout and stress at work research, we assumed that organizational commitment may serve as a protection mechanism against the negative consequences of the therapeutic work, but also as a risk factor. Therefore, we hypothesized to find a curve-linear relationship between organizational commitment  to secondary and vicarious traumatization. We assumed that therapists with low and high levels of organizational commitment, will experience higher levels of secondary and vicarious trauma, in comparison to therapists with medium organizational commitment.

The research sample consisted of 128 therapists, 64 offenders’s therapists and 64 victims’ therapists, in various services throughout Israel, sampled in a convenience sample. The research instruments included a self-report questionnaire that examined the dependent variables (STSS, TABS), the independent variables (IRI, OCQ) and a demographic questionnaire. The data analyze stage included three steps that was built from several statistical tests as T – test, Anova and linear regression and etc. In order to test the ability of the background variables and the independent variables to explain the variance in the investigated phenomena, we conducted two hierarchical regression models. 

The findings of this study revealed low to moderate levels of secondary and vicarious trauma amongst the participants of this study. Cognitive empathy and organizational commitment were found to be a protection mechanism against secondary and vicarious trauma. One of the main conclusions of the study is that there are many resources available to therapists for effective coping and prevention of the negative consequences of their work. The emotional empathy was an exception by placing therapists who tended to experience it as vulnerable to secondary and vicarious trauma. In addition, many similarities were found between the two groups of therapists, in the secondary and vicarious trauma levels, empathy and organizational commitment. Rising the question as to the ability to create a distinction between these two groups regarding to the therapeutic and traumatic content, the burden of care etc.

The innovation of the research lies in the correlation between organizational commitment and secondary and vicarious trauma. As well as the conspicuous contribution of the organizational commitment to explaining the differences in each of the phenomena (18% of the variance in the secondary trauma and 9% of the variance in the vicarious trauma). In addition, the research allows discourse and legitimacy for the experiences of trauma therapists and a perspective that challenges the perception of the inherent risk in treating trauma victims and offenders.