Professional and Emotional Coping of Social Workers Accompanying Women Affected by Ongoing Trauma While They Continue to be Harmed
Women who experienced sexual abuse as children are at increased risk of continuing to be exposed to abuse in adulthood, whether in romantic relationships or by a family member who continues to abuse. Experiences of sexual abuse during childhood may leave lasting emotional, mental, and social consequences, including damage to self-image, a sense of "false self," and conflicts between feelings of guilt, shame, and dependency and anger and a desire to distance themselves from the abuser. When the abuse occurs within early attachment relationships, it may lead to damaged attachment patterns, difficulty with emotional regulation, and impaired ability to form safe intimate relationships. The accompaniment of women who continue to be abused places social workers at high exposure to traumatic content and they are at risk of developing secondary traumatization and burnout.
Social workers who accompany women who continue to be harmed are faced with an ethical dilemma between the desire to respect the woman's autonomy and choice, and the desire to protect her from repeated harm. Exposure and dealing with this dilemma can lead to moral distress and intensify secondary traumatization. Against the background of the complexity and challenges faced by social workers who accompany women who survive trauma who continue to be harmed, the purpose of the study is to examine the emotional experiences, ethical dilemmas, and coping methods of social workers accompanying survivors of ongoing trauma when the harm continues to occur.
The study was conducted using a qualitative method with a descriptive phenomenological approach. Through semi-structured interviews with social workers who accompany women over the age of 18 who experience ongoing trauma while they continue to be harmed. The study population included 10 social workers, some of whom worked as treatment coordinators and some as therapists in public institutions and in private clinics. The data analysis was conducted using a qualitative method according to the descriptive phenomenological theory and in accordance with Brown and Clark's six-stage model.
Three central themes were found: The first theme dealt with conflict and the social worker's dilemma. The conflict is between their sense of professional and ethical responsibility towards the patients and the inability to realize this commitment, which was expressed in the experience of helplessness. The ethical dilemma is between the desire to protect the patients from harm and maintaining their autonomy and respecting their right to decide how to act in their lives. The second theme dealt with the social worker's emotional response - this theme presents the variety of emotions through three different points of view and focus: emotions stemming from the patient's situation, which include fear, anxiety and guilt. Emotions focused around the offender, which include anger, hatred and disgust. Emotions focused on themselves as therapists, which include loneliness, stress and burnout. The third theme dealt with ways of dealing with the dilemma - the positioning of social workers along a continuum between a paternalistic approach and the preservation of the autonomy of the patients. This theme is divided into four subthemes: (a) External paternalism as an action for the protection of women carried out by involving external factors. (b) Internal paternalism as an action for the protection of women by expressing a position and counseling within the session. (c) Retrospective autonomy as providing a choice out of the lack of choice for the therapists. (d) Providing autonomy from the start.
The current study indicates the ethical and emotional complexity in the work of social workers who accompany women who encounter ongoing harm. This complexity is expressed both in ethical conflicts, when they experience helplessness due to the difficulty of acting in accordance with their professional commitment to the patients, and in ethical dilemmas, when they have difficulty deciding between the value of autonomy and the value of protection. The study expands the understanding of the concept of secondary traumatization, focusing on the aspect of negative emotions, by referring to three focal points: the therapist, the patient, and the perpetrator. In addition, the study emphasizes the ethical and emotional aspects associated with the feeling of guilt, which is reflected as an expression of moral distress, which stems not only from barriers to acting according to the commitment but also from the emotional and value-based difficulty involved in dealing with ethical dilemmas between autonomy and protection from harm. Finally, the current study expands the discourse on paternalism versus autonomy and emphasizes that the understanding of this issue is not limited to a dichotomous position between two poles, but rather offers a wide range of possibilities and movements between intermediate states. The ethical dilemma between the desire to protect and maintaining autonomy is revealed as a continuous process of balancing and maneuvering between values, needs, and circumstances. The findings of the study fit into the broader theoretical discussion of context-dependent autonomy, which emphasizes that an individual's ability to choose does not exist in a vacuum, but is influenced by relationships, personal history, and cultural and social contexts. The understanding of dilemmas as dynamic situations, and of ethical positioning as context-dependent, points to the importance of developing sensitive therapeutic policies, supportive professional guidance, and reflective discourse in the field of social work.
Last Updated Date : 28/01/2026
