Traumatization and Personal Growth among Professionals Working with Children with Disabilities

The present study examines the impact of professional continuous encounters with children with disabilities and their families, and sheds light on their perceptions and their experiences.

A child born with a disability may shatter every parent's wish for family continuity. It shatters the dream and aspiration for 'a perfect child'. Continuously encountering children with disabilities may also evoke complex emotions among professionals who work with children and their families. The underlying premise of this study is that professionals who accompany these children and their families are affected by biases, and common attitudes towards disabilities. We examined the experience of professionals which may be similar to the parents' experience often described in the literature as traumatic.

Although trauma often refers to life-threatening events; children's disabilities may constitute a traumatic threat to the quality of life of children and their parents. This study examined the experience of loss and the' shattering of the dream' from a professional perspective as an experience which potentially can generate symptoms of secondary traumatization as well as a post-traumatic growth. Thus, this study relies on the theories that relate to attitudes and biases toward people with disabilities as well as post trauma and post-traumatic growth. This study examines, for the first time, through the prism of trauma and growth, the experience of professionals from various disciplines working with children with disabilities.

The study utilized the qualitative method in a phenomenological approach. Thirty-five professionals (30 women; 5 men) from various disciplines, participated in the study: physicians, nurses, physiotherapists, social workers and psychologists. In-depth interviews were conducted with 7 interviewees from each profession. All participants worked in pediatric rehabilitation wards at various hospitals and in child development centers. The participants' ages ranged from 26-63 with various degrees of seniority at work. In addition, they held various positions due to their seniority and specific qualifications of each profession.

The interviews revealed four main themes: (1). Difficulties resulting from continuous exposure to unsettling physical appearance; the alterations in the cognitive schemas of the world as a safe place; the encounter with professional boundaries. (2). The implications of the difficulties in a post-traumatic perspective include the erosion of personal and parental confidence and professional self-worth together with the desire to restore the sense of self-mastery in light of the recognition of personal vulnerability. (3). Resilience factors come to the fore in defining boundaries and social distance, in creating a support network and in focusing on professional sense of achievement and success. (4). Personal growth among professionals.

Professionals described the difficulties which are the result of their work and of their daily encounter with children’s disability. These often lead to fears and concerns which emotionally and cognitively affect both their personal and professional life. Numerous difficulties are encountered when treating children with disabilities and their families, including: unsettling physical appearance; the shattered dreams of parents and their struggle; inner-conflicts resulting from professional obligations vs. personal feelings; and the inability to change the situation and alleviate pain. The manifestation of these difficulties among professionals can be feelings of helplessness and lack of control, which can potentially lead to trauma. The participants in this study indeed described some of the symptoms which characterize a post-traumatic disorder (as described in the DSM-V) such as changes in cognition and mood or having intrusive distressing thoughts.

This study sheds light on the unique experience of professionals regarding the impact of trauma. Their experience can be termed as ‘secondary traumatization’. Although the professionals are not parents of the child with a disability, and do not experience raising this child; they are, nevertheless, deeply affected by the daily, cumulative, and intense exposure to the various difficulties and struggles of these children and their families. Anxiety, a change of values and perceptions alongside with intrusive thoughts, often undermine their worldview and quality of life. Thus, the potential for trauma is ever-present. The accounts of professionals in this study both demonstrate and correspond with the theoretical discussions of recent years which question who is the focus of the trauma in the event of a secondary and vicarious trauma; or, according to the DSM, 2013, what constitutes the traumatic focus, namely, the ramifications resulting from stressful experience. The findings of our study indicate that both approaches can coexist without negating or cancelling the other.

The professionals also described the resilience factors and coping strategies which have assisted them in maintaining their well-being, for instance, clearly delineating a boundary between their professional and personal lives; not permitting the pain at work to permeate their personal lives; finding support among friends and family; and focusing on professional achievements and successes.

Furthermore, they reported positive changes reflecting personal growth, including a changed worldview, re-evaluation and a new appreciation for that which exists, discovering inner personal strength and bolstering personal relationships.

The importance of this study is the recognition and acknowledgement of the profound effect, 'for better or for worse', on professionals who have continuous encounters with children with disabilities and their families. The findings reflect complex experiences whereby alongside the symptoms or experience of secondary post-trauma which gradually permeate into professionals' personal lives; there is also a process of personal growth. Decision-makers and professionals need to be mindful of these work challenges in order to deepen their awareness and sensitivity to the potential traumatization and the possibility of growth.