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Article Excerpt
Counseling is a risky and rewarding business. While counseling invites mental health counselors to participate with their clients in the awesome process of human growth and healing, it also may threaten their well being through exposure to their clients' trauma and its painful consequences. The authors present a metaphor of a healthy tree to organize an overview of recent research regarding the risk and protective factors of vicarious traumatization of counselors. Implications for the practice, supervision, and management of counseling are presented.
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In the epilogue of his book concerning burnout prevention, Skovholt (2001), aptly compared the well-functioning counselor to a healthy vibrant tree. His analogy suggested that just as a tree must take in sunlight, water, carbon dioxide, and withstand external stressors ranging from pruning to insects, so too, must the counselor work hard at staying healthy. Extending his metaphor, this brief review of the literature regarding vicarious traumatization suggests that what keeps the counselor healthy and well-functioning are the vibrant branches of professional and personal activities, the nurturing soil of professional and personal relationships, and the deep roots of professional and personal ideology, as depicted in Figure 1.
[FIGURE 1 OMITTED]
Before exploring what makes us strong, it may be helpful to discuss the difficulties that threaten to weaken and impair counselors. Much attention has been focused in the literature on the stressors that impact counselors throughout their career (e.g., Figley, 1995; Stramm, 1999; Lerias & Byrne, 2003). Like the dangers to our metaphorical tree, the stressors for counselors are many and varied. From the leaf mites of managed care to the lightening bolt of a malpractice suit, the professional dangers loom large. It is beyond the scope of this article to address all facets of the various stressors inherent in the counseling profession and their impact on the lives and careers of mental health counselors. Rather, it is our intention to focus on the specifics surrounding what is known thus far about vicarious traumatization and the counselor's role in its prevention and development. According to Pearlman and MacIan (1995), vicarious traumatization refers to "the transformation that occurs within the therapist (or other trauma worker) as a result of empathic engagement with clients' trauma experiences and their sequelae" (p. 558). These researchers stated that "vicarious traumatization implies changes in the therapist's enduring ways of experiencing self, others, and the world" (p. 558). Essentially, through the development of empathic relationships with traumatized clients, some therapists themselves may become traumatized. The impact of this traumatization is not limited to the therapeutic environment and may trickle into other aspects of the therapist's life. Understanding vicarious traumatization is essential in order to assess those at risk, promote protective factors, treat those who are already suffering from its impact, and protect clients from enduring further, albeit unintended, trauma at the hands of impacted counselors.
Previous research has identified various symptoms associated with vicarious traumatization. Schauber and Frazier (1995) found the impact on counselors of working with adult sexual abuse survivors to include professional difficulties such as: problems managing therapy (including maintaining boundaries, setting limits, and premature termination), difficulty dealing with clients' negative emotions, and problems with systemic issues such as the legal system and insurance payments. In addition Schauber and Frazier (1995) found the respondents in their study to report such personal difficulties as negative changes in their beliefs about the world and increased negative emotion including anger and fear. Other empirical investigations have found vicarious traumatization to be associated with avoidance reactions (Weiss, Marmar, Metzler & Ronfeldt, 1995); increased social isolation, anger, anxiety, and sadness (Sexton, 1999); and intrusive thoughts and self-doubt (Pearlman & MacIan, 1995).
The consequences of vicarious traumatization on affected counselors and the lives of their clients were summarized by Trippany, Kress, and Wilcoxon (2004), in their review article. They stated that vicarious traumatization alters basic psychological needs, such as those for safety, trust in self and others, esteem for self and others, intimacy, and control. Such drastic changes in one's view of the world, self, and other people are related to the counselor's existential and spiritual beliefs, and thus vicarious traumatization may have a devastating impact upon the very foundation of one's life. They asserted that, "without a sense of meaning, counselors may become cynical, nihilistic, withdrawn, emotionally numb, hopeless, and outraged" (p. 35). Just as certain parasites and insects can erode the internal structure of a seemingly healthy tree, so too, can vicarious traumatization leave the counselor with a sense of emptiness and...
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