You are on page 1of 16

This article was downloaded by: [University of Bristol]

On: 28 February 2015, At: 02:44


Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered
office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

Australian Social Work


Publication details, including instructions for authors and
subscription information:
http://www.tandfonline.com/loi/rasw20

Navigating the Challenges of Trauma


Counselling: How Counsellors Thrive
and Sustain Their Engagement
a a a
Joycelyn Ling , Sally V. Hunter & Myfanwy Maple
a
University of New England, Armidale, NSW, Australia
Published online: 01 Oct 2013.

Click for updates

To cite this article: Joycelyn Ling, Sally V. Hunter & Myfanwy Maple (2014) Navigating the
Challenges of Trauma Counselling: How Counsellors Thrive and Sustain Their Engagement,
Australian Social Work, 67:2, 297-310, DOI: 10.1080/0312407X.2013.837188

To link to this article: http://dx.doi.org/10.1080/0312407X.2013.837188

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the
“Content”) contained in the publications on our platform. However, Taylor & Francis,
our agents, and our licensors make no representations or warranties whatsoever as to
the accuracy, completeness, or suitability for any purpose of the Content. Any opinions
and views expressed in this publication are the opinions and views of the authors,
and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content
should not be relied upon and should be independently verified with primary sources
of information. Taylor and Francis shall not be liable for any losses, actions, claims,
proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or
howsoever caused arising directly or indirectly in connection with, in relation to or arising
out of the use of the Content.

This article may be used for research, teaching, and private study purposes. Any
substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing,
systematic supply, or distribution in any form to anyone is expressly forbidden. Terms &
Conditions of access and use can be found at http://www.tandfonline.com/page/terms-
and-conditions
Downloaded by [University of Bristol] at 02:44 28 February 2015
Australian Social Work, 2014
Vol. 67, No. 2, 297–310, http://dx.doi.org/10.1080/0312407X.2013.837188

Navigating the Challenges of Trauma Counselling: How Counsellors


Thrive and Sustain Their Engagement
Joycelyn Ling, Sally V. Hunter, & Myfanwy Maple*
University of New England, Armidale, NSW, Australia

Abstract
This qualitative study explored the factors that help counsellors exposed to indirect
trauma thrive personally and professionally, and sustain their engagement in trauma
Downloaded by [University of Bristol] at 02:44 28 February 2015

counselling work. The existing literature details the challenges of indirect trauma
exposure in trauma work. However, the ways in which counsellors are able to derive
rewards and maintain their engagement in trauma counselling work are less well
recognised. The study used a grounded theory approach, with semistructured interviews
conducted with 18 therapists. The study found four main interrelating themes: thriving
in trauma work; navigating the empathic journey; empathic stamina and engaging in
self-reflexivity; and sustaining interest and commitment. Important factors included
attending to both the adverse and rewarding aspects of trauma work, having access to
appropriate support structures, and incorporating variability and diversity in the work.
This study extends the current understanding of the processes, practices, and strategies
that promote the rewarding and sustaining aspects of trauma counselling work.

Keywords: Trauma Counselling; Vicarious Traumatisation; Compassion Fatigue;


Compassion Satisfaction; Qualitative Research; Counsellor Stress

All types of counselling work carry potential risks of an adverse impact on the
counsellor. However, trauma counselling work has additional challenges associated
with indirect trauma exposure (Bride, Radey, & Figley, 2007; Figley, 2002b; Iliffe &
Steed, 2000). Trauma or traumatic events can refer to a wide variety of experiences.
In this study, the term “trauma” refers to the DSM-IV-TR (American Psychiatric
Association, 2000) definition of a traumatic event, as given here: (1) the person
experienced, witnessed, or was confronted with an event or events that involved
actual or threatened death or serious injury, or a threat to the physical integrity of self
or others; and (2) the person’s response involved intense fear, helplessness, or horror
(pp. 467–468). In the current study, “indirect trauma” is used to refer to when
counsellors come to know about clients’ trauma experiences through the process of
their counselling intervention with clients.

*Correspondence to: Associate Professor Myfanwy Maple, Pat O'Shane Building (C13) 310, University of New
England, Armidale, NSW 2351, Australia. Email: m.maple@une.edu.au
Accepted 28 May 2012

© 2013 Australian Association of Social Workers


298 J. Ling, S. V. Hunter & M. Maple
There are a variety of conceptualisations and terms used in the literature in relation
to the adverse stress effects from indirect trauma exposure. “Compassion fatigue”, a
term adopted by Figley (1995a), refers to indirect traumatic stress, which is
characterised by hyperarousal, a sense of hopelessness, isolation, and feeling over-
whelmed. The effects of compassion fatigue can have an impact on various domains,
including cognition, emotions, physical wellbeing, and interpersonal relationships
(Bell, Kulkarni, & Dalton, 2003; Collins & Long, 2003; Figley, 1995a; Iliffe & Steed,
2000; Meyers & Cornille, 2002). The term “secondary traumatic stress” (STS) (Figley,
1995b; Stamm, 1999) has been used to describe the adverse impact of helping or
wanting to help traumatised people, triggered by secondary trauma exposure. The
terms “compassion fatigue” and “secondary traumatic stress” are often used
interchangeably in the literature (Baranowsky, 2002; Salston & Figley, 2003). A related
Downloaded by [University of Bristol] at 02:44 28 February 2015

concept, “vicarious traumatisation”, refers to the cumulative effect of engagement with


clients affected by trauma, which is manifested in the individual’s experience of the
self, others, and the world (McCann & Pearlman, 1990; Pearlman & MacIan, 1995).
Not all individuals exposed to trauma develop clinical levels of post-traumatic stress,
and similarly not all counsellors exposed to indirect trauma will experience
incapacitating effects. As Linley and Joseph (2004) pointed out, “focusing only on
the negative sequelae of trauma and adversity can lead to a biased understanding of
posttraumatic reactions” (p. 11). A better understanding is needed about the spectrum
of indirect trauma exposure experiences and the potential for positive personal and
professional outcomes as a result of engaging in trauma counselling work.
The literature indicates that negative and positive effects of indirect trauma
experiences can coexist. Stamm (2002) argued that there are protective mechanisms
for practitioners in relation to secondary traumatic stress. Compassion satisfaction is
one such mechanism, conceptualised as the reflection of the efficacy that workers
perceive as a result of their work (Figley, 2002a). A related concept, post-traumatic
growth (PTG), refers to the positive changes that can occur in the process of coping
with a traumatic event (Tedeschi & Calhoun, 1995, 2004). The PTG framework
emphasises the capacity of people to respond to adversity in a way that promotes
personal or other growth, though a transformational process in the positive sense.
Another related concept, positive psychology (Fredrickson, 2003; Seligman &
Csikszentmihalyi, 2000), emphasises the strengths and capacities of individuals and
communities that facilitate wellbeing and thriving. It is based on the belief that
individuals want to live meaningful lives and cultivate the factors that enhance
fulfilment. According to Seligman and Csikszentmihalyi (2000), positive psychology
changes the focus of psychology “from preoccupation only with repairing the worst
things in life to also building positive qualities” (p. 5). Salutogensis, as an approach to
health, rationalises that stress and disease are a part of life, and individuals tend
towards restoring equilibrium through adaptive coping processes (Antonovsky, 1993,
1996). These perspectives are particularly relevant to the subject matter of this study, as
they demonstrate that individuals are able to successfully manage stressors, and are
Australian Social Work 299
able to integrate and manage potentially negative experiences in such a way that
facilitates personal growth.
This study aims to explore the indirect trauma experiences of counsellors and the
strategies that counsellors use to meet the challenges associated with indirect trauma,
that enable them to thrive in trauma work. In addition, the factors that help
counsellors to sustain their continued capacity to engage in trauma counselling work
will be examined.

Method
A constructivist grounded theory approach (Charmaz, 2000) was used to explore
counsellors’ accounts of their experiences of indirect trauma exposure. Constructivist
Downloaded by [University of Bristol] at 02:44 28 February 2015

grounded theory emphasises the subjective inter-relationship between the researcher


and participant, and the coconstruction of meaning. A theory is therefore one of
many interpretations that can be derived from the data (Charmaz, 2000). Hence, a
reflexive stance was taken towards the interpretation of the data and through the
process of analyses. Through this study’s examination of the real-world experiences
of counsellors, the findings reflected the issues of interest in a way that has close
relevance for the counselling profession.
Purposive sampling was used in the initial stages of the current study. As common
patterns and themes began to emerge through the analysis of the data, theoretical
sampling was utilised to select additional informants to further examine and elaborate
on the emerging findings. Dey (2004) described theoretical sampling as involving the
selection of sites or sources to generate comparisons for the furthering or refining of
ideas.

Participant Recruitment
The target participant sample was from a range of services that provide professional
counselling services, both in trauma-specific and non-trauma-specific areas of
practice. After ethics approval was gained from the University of New England
review board, participants were recruited through various means including: advert-
isement of the study through the paper and electronic newsletters of an Australian
nationwide umbrella counselling association; advertisement through network meet-
ings with representations from a variety of relevant organisations to inform them of
the study and to invite participation from counsellors in their organisations; and
direct contact by phone to a range of organisations that offer counselling services.
Potential participants were informed that the aim of the study was to explore the
experiences of counsellors as a result of working with clients presenting with trauma
concerns (secondary trauma exposure in counsellors). A Participant Information
Sheet was made available detailing the aims, requirements of participation, voluntary
nature of participation and withdrawal without prejudice option, and ethics approval
information.
300 J. Ling, S. V. Hunter & M. Maple
The inclusion criteria included: participants had undergone specific professional
training in the practice of counselling and were members, or were eligible for
membership, of a recognised counselling-related professional organisation; partici-
pants were required to be currently engaged in the provision of counselling activities
(defined as individual, group, face-to-face, or phone counselling), and had engaged in
trauma counselling work. Diversity in the participant sample relating to the amount
of trauma counselling experience or length of experience in the field was sought, as
was the diversity across the type of service, and counselling approach. This diversity
was sought in the current study to represent perspectives from both trauma-specific
and non-trauma-specific counsellors.

Interviews
Downloaded by [University of Bristol] at 02:44 28 February 2015

Eighteen participants were interviewed: 12 individual face-to-face interviews, 2 indi-


vidual phone interviews, and 1 face-to-face group interview with 4 participants.
Interviews ranged from 30 minutes to 1 hour. Interviews occurred over an 18-month
period across 2006–08, in metropolitan and outer metropolitan areas of New South
Wales, Australia. Details regarding confidentiality, ethics approval, and contact details
were reiterated before the commencement of the interview. Semistructured interviews
were used for data collection, supported by demographic information, field notes, and
memos (Charmaz, 1995). Field notes were made as soon as possible after each
interview in relation to the environmental setting, general “vibe” of the interview, and
observations of the participant’s nonverbal communication. Initial thoughts regard-
ing the topics, themes, and other ideas were also noted. Notes about recurring
patterns, themes, ideas, or questions were also written with each successive interview,
including indications of confirmation, refutation, or new perspectives of these
recurring ideas.
Key questions asked in the interviews included: “What effects or impact did
hearing about the trauma material have on you?”, “What outcomes do you think
have resulted for you personally and professionally from working with trauma cases
(positive and negative aspects)?”, and “What keeps you going in trauma work?”

Data Analysis
Data analysis involved the constant comparative process (Strauss & Corbin, 1990,
1998) leading to further implementation of data collection until theoretical saturation
was reached. Each interview was transcribed manually, de-identified, and analysed
by the first author as soon as possible after the interview was completed. Each
transcription was examined, and stages of coding were implemented and revised
throughout the constant comparative analysis process. Three types of coding (Strauss &
Corbin, 1990) were used within the constant comparative process in this study. These
were open coding (examining and conceptualising the data), axial coding (connecting
the categories and defining the relationships of the codes), and selective coding
Australian Social Work 301
(integrating the major categories to form a larger theoretical frame). The use of
memoing, journaling, and verification of the analysis process and emerging themes
were continuously put into practice by the research team. This overall inductive
approach allowed the development of a substantive theory conceptualising counsellors’
experiences of indirect trauma exposure, and how counsellors were able to thrive and
sustain their engagement in trauma counselling work.
Rigour was addressed in this study through various means. Strategies to strengthen
credibility included audit trail and negative case investigation. The audit trail in this
study involved the use of extensive note-making about the decisions made in the
coding process; notes and memos written immediately after interviews capturing the
contextual factors involved with data collection and interviewing; memos about
personal responses; a clear description of the methodology; and the use of data
Downloaded by [University of Bristol] at 02:44 28 February 2015

extracts in the write-up. Negative case investigation and the examination of outlying
cases were strategies used to ensure that the emerging categories and themes did not
override atypical or contradictory data. Lincoln and Guba (1985) suggested involving
participants in giving feedback on the researcher’s interpretation of the data. This
process was not utilised in the current study, owing to restrictions on time and
resources. However, extensive confirmability checks were carried out in all phases of
the study, included the detailed documentation of the procedures for checking the
data throughout the study, the use of negative instances, and conducting a data audit
that examined the procedures for data collection and analyses, as a means to address
the potential for bias. It is acknowledged that the generalisability of the findings of
this study is limited, given that findings can only be relevant and applicable for
counsellors under the same or similar situations and conditions.

Findings
Demographic Data
Of the 18 participants, 4 were male (22%) and 14 were female (78%). Ages ranged
between 20 and 50+ years, with the majority of participants aged in the 30–39 years
age group. Participants tended to have either social work or psychology backgrounds.
All participants held bachelors degrees, with 45% holding masters degrees or above.
The majority of the participants had more than 6 years of experience in the
counselling field, with the range from 2 months to 17 years. One-third of the
participants worked in regional areas in the state of New South Wales.
The service types that the participants worked in included women’s and children’s
centres; domestic violence services; general community health services; community
mental health specific services; family counselling services; and youth services.
Programs for specific client groups that participants worked in included alcohol and
other drugs; mental health; gay, lesbian, bisexual, and transgender youth; gambling;
drop-in; afterschool; dual diagnosis; primary healthcare; needle and syringe program,
and crisis phone helpline.
302 J. Ling, S. V. Hunter & M. Maple
In terms of client bases, one-third of the participants saw only young people
(14–25 years), with one participant having a child client base only, and the remaining
proportion seeing either only adults, or adults and children together. Two participants
were engaged in private practice as secondary employment.

Themes
Four main themes were identified that describe how participant counsellors thrived in
trauma counselling work, and the factors that helped them to sustain their
engagement in trauma counselling work. The themes were articulated as: thriving
in trauma work; navigating the empathic journey; empathic stamina and engaging in
self-reflexivity; and sustaining interest and commitment. The themes interconnected
Downloaded by [University of Bristol] at 02:44 28 February 2015

and influenced each other in relation to how participant counsellors experienced and
managed indirect trauma exposure. This reflected the complexity of trauma
counselling work and the dynamic nature of counselling practice. Each theme is
described below. Direct quotes from participant counsellors are denoted by quote
marks and their given pseudonym.

Thriving in Trauma Work


This theme related to the reasons why counsellors engaged in and continued to
undertake trauma counselling work, despite the challenges and demands of the work.
The concept of thriving referred to the processes used to manage the impact of
indirect trauma exposure, that promote the rewarding aspects and experiences of the
work. This in turn enhanced the capacity to continue engaging in trauma work. The
findings indicated that participant counsellors perceived trauma counselling work as
involving both challenges and rewards. Participant counsellors identified that a
predominantly rewarding aspect of trauma counselling work was being able to
provide assistance to others. For example, a female domestic violence counsellor with
over 10 years’ experience stated:

I like the challenge of it and I think it’s a rewarding field. So it certainly has its
frustrations but somehow I and some of the other therapists here seem to be able to
see through that and just enjoy it. So I certainly don’t think it’s a job without its
rewards. For me there’s a sense of energy of wanting to help someone. (Olivia)

Having the view that trauma counselling work is purposeful influenced the sense of
value in engaging in the work and an overall sense of commitment: “I like the work,
I’m committed to it, I find rewards in this. That sustains me. The way I’m able to see
the work, it sustains itself” (Patrick). Participant counsellors reported that being able
to facilitate the empowerment of clients was a powerfully rewarding aspect of the
work. Reciprocally, counsellors also gained a sense of empowerment and validation in
their own work through supporting the clients’ journey: “Despite that fact that
I realise that things aren’t fair, I like to think that I have a hand in participating in
bringing about, giving people a service, enable them” (Hayden).
Australian Social Work 303
Trauma counselling was seen as more than just addressing the trauma concerns of
the client. Addressing social issues was a broader and important outcome. For this
participant counsellor, who worked in a women’s domestic violence service, her
dedication and sense of responsibility to social justice issues was a shielding
mechanism from the negative impact of indirect trauma exposure:

I think that one thing that actually protects me in those situations is my


commitment, and a commitment to justice and commitment to the service
providing an environment and community of people who will support that
woman, and say what happened to you was wrong. (Brooke)

The sense of compatibility with counselling work also helped participant counsellors
to engage and thrive in trauma work:
Downloaded by [University of Bristol] at 02:44 28 February 2015

It’s for me, it fits. Part of it is that I enjoy the work, I’ve always chosen this kind of
work, so as much as anyone can say they felt called to something or they feel they
meant to be something or rather, that’s it for me. (Patrick)

It was demonstrated that participant counsellors perceived the challenges of trauma


work in a positive way, as the challenges provided opportunities to engage in
meaningful, valued, and rewarding work.

Navigating the Empathic Journey


The theme of “navigating the empathic journey” described how participant
counsellors developed and utilised a range of strategies to manage the challenges of
trauma work. The notion of “navigating” reflected the variety of strategies and
learning processes involved in developing protective, proactive, and helpful responses
to indirect trauma exposure.
Participant counsellors identified that being emotionally perceptive was inherent in
being a counselling practitioner. It was seen to be both a personal characteristic and a
professional necessity: “Well of course my human response is that it’s horrific and
sometimes I’m shocked” (Felicia). The attribution of responses as an expected human
characteristic normalised the response and the impact. Responses such as shock and
sadness were neither unwarranted nor inappropriate in the context of trauma
counselling, and were not viewed as atypical: “I don’t think it’s unhealthy to have
quite extreme emotional response to extreme trauma” (Sean).
Participant counsellors reported that taking the view that adversity can be
triumphed over allowed for the belief that trauma counselling makes a difference.
This assisted in placing trauma work into a defined and manageable context. For
example, a helpful stance was one that emphasised the hope and optimism that
trauma can be overcome: “I don’t have to be caught up in deficit-based views about
how things damage you but that there is something in human beings that goes
beyond that” (Patrick). In contrast to the pathogenic view, salutary outcomes were
304 J. Ling, S. V. Hunter & M. Maple
acknowledged: “recognising the strengths or resilience in getting past things that have
knocked them down” (Patrick).
In order to manage the demands of trauma counselling, participant counsellors
needed to be aware of and manage their own limitations and fluctuations in
wellbeing: “I have to know my own limits and be able to help or to help with bringing
about change [for clients]” (Hayden).
An important means of managing the potential adverse effects of indirect trauma
exposure was the awareness and recognition of the likely responses to clients’ trauma
material. By normalising and placing the responses in the context of empathy and
compassion, participant counsellors were able to understand and therefore manage
stress responses more effectively.
Downloaded by [University of Bristol] at 02:44 28 February 2015

Empathic Stamina and Engaging in Self-reflexivity


All participant counsellors acknowledged the need to balance their emotional
demands and expenditure, and limit their exposure to indirect trauma in order to
sustain their empathic energy. The term “empathic stamina” arose from the inter-
pretation of participant counsellors’ descriptions of those factors as dynamic and
continuous processes.
An important means of achieving an effective balance was through setting
boundaries that limited the exposure to traumatic material, in conjunction with
containing emotional demands. Maintaining boundaries involved actively moderating
the level of emotional engagement with the clients’ trauma material, and acknow-
ledging the limitations of both the self and the role and responsibilities in counselling
intervention.

I think if I took it all to heart and couldn’t maintain some kind of distance from it,
I think it would destroy you. I think that some part of my training was knowing how
to hear it one step away from it and still be able to empathise. I’m often aware that
I’m doing that while I’m hearing the story. Consciously think about that. (Felicia)

An “ebb and flow” type of process in which the empathic engagement was adjusted
dynamically, in response to the traumatic material was described:

I think I disconnect a bit. I kind of hear the story and parts of me reach out with
such feeling for the little child and in another way I kind of pull back, I kind of
reach out and pull back I think. (Elyse)

Engaging in self-reflexivity referred to the continuous self-awareness process that


was used to monitor and maintain wellbeing. Participant counsellors utilised a range
of strategies that promoted their capacity for sustaining empathic engagement in
trauma counselling work: “I feel like I have a very good well-worn path, exercise. And
having an awareness of my own needs at that level and being attentive to them”
(Brooke).
Australian Social Work 305
I might think I need to look at my caseload, the configuration, take on different
clients, or maybe I may go to the gym more, or maybe I might try and nurture
myself and nourish myself a bit more. Because if I know I’m not looked after, I’m
going to be ineffective. (Isabel)

All participant counsellors acknowledged the importance of support in maintaining


their ability to carry out trauma counselling work. The most commonly cited means
were clinical supervision, peer support, and professional development: “I think
adequate training is really important, and I think debriefing and supervision and
having a team around you are things that really counter it [negative impact of trauma
material]” (Marie). Clinical supervision assisted by providing a means for participant
counsellors to release and lessen the stress and distress of the work: “What’s been
useful for me has been supervision, professional development is key” (Rebecca). “It’s
Downloaded by [University of Bristol] at 02:44 28 February 2015

the internal support but the external opportunities as well and under the guidance of
people who have been here longer in terms of what’s really good training” (Brooke).
Peer support was a means of sharing common responses and had the effect of
normalising the challenges of counselling: “In peer supervision there’s the sharing of
the feeling of being overwhelmed at times and ‘Oh God, what do I do with this
person?’ ” (Elyse). The action of discussing cases with peers helped with processing
the trauma material through unburdening or by weakening the intensity of the
distress: “What I’ve found is the recounting of the story to people actually helps to
dilute the effects” (Hayden).
Ongoing self-awareness and monitoring was viewed as an essential process in
maintaining the capacity to undertake trauma counselling work. This included
monitoring of the response to trauma material, the reflection of practices, and
addressing challenges and barriers. If the harmful effects of indirect trauma exposure
were not addressed by participant counsellors, future exposure could have further
detrimental effects.

Sustaining Interest and Commitment


The theme of “sustaining interest and commitment” referred to the influences of
professional and organisational aspects in sustaining participant counsellors in
trauma work. Sustainability referred to the ability of participant counsellors to
develop and maintain the conditions or processes that allow them to engage in
trauma work over time and maintain their overall wellbeing.
The factors that helped to sustain participant counsellors’ engagement in trauma
counselling work included engaging in professional development; having flexibility in
the career path; and organisational factors that promoted the sense of autonomy,
value, and support. These aspects influenced the capacity of participant counsellors to
manage the challenges and demands of trauma counselling work: “I’ve worked part-
time counselling and taught at TAFE as well, or run groups as well” (Elyse); the
diversity of tasks “is sustaining, because it’s a bit of a mix” (Natalie).
306 J. Ling, S. V. Hunter & M. Maple
The complexity and diversity of trauma counselling work were motivating aspects
for participant counsellors. The ability to extend work to broader community levels
also promoted the meaningfulness and variability of trauma work. Having oppor-
tunities to broaden the scope of intervention strengthened the sense of purpose in
engaging in the work:

So I guess started up looking at what the needs are in the community and I made
my job more flexible, and education in the schools. So I think the diversity’s been
good for me, and not just bogged down. (Lynn)

The rewarding aspects of trauma work were promoted and reinforced when
participant counsellors perceived challenges as opportunities for growth by develop-
ing new skills and knowledge:
Downloaded by [University of Bristol] at 02:44 28 February 2015

I love the clients that we work with. They’re quite complex and multifaceted
individuals and trauma work is quite diverse. There’s always an opportunity for
skills to be developed even further, it’s not like you’re doing something that never
changes. So the variety is the reason why I stay. (Rebecca)

It stretches me, it forces me to think, it forces me to check in with myself, it forces


me to go back and read some literature. So it has certain, I suppose the
combination of that somehow fits for me. (Patrick)

The main aspects identified by the participant counsellors were professional


development opportunities, the variability in the career path, and organisation
structural factors.

Discussion
This study explored how counsellors managed the challenges of indirect trauma
exposure and sustained their engagement in trauma counselling work. The findings of
this study demonstrated that participant counsellors benefited from acknowledging
and expecting to experience stress effects from indirect trauma exposure, as well as
being able to derive and enhance the rewards from engaging in the work. The
findings did not suggest that facilitating adaptive outcomes prevented adverse
outcomes; instead, as Linley and Joseph (2004) noted, personal growth could
potentially modulate the sense of distress. This process allowed counsellors to
maintain their capacity to engage in trauma work despite the stressful experiences.
When participant counsellors felt that the emotional expenditure involved in
trauma counselling work was worth it, then their perspectives about indirect trauma
exposure were more optimistic and the effects were less detrimental. It was also
indicated that placing indirect trauma experiences in a strengths-based perspective, in
contrast to a deficits-based approach, was helpful to counsellors by promoting
optimism and hope. Further, by perceiving trauma and client trauma concerns as
understandable and manageable, counsellors were able to take an objective and
Australian Social Work 307
constructive view of their own therapeutic responsibilities and capacity to help clients,
and therefore could maintain boundaries and an appropriate empathic balance.
The information gained from this study was in keeping with the principles of the
salutogenic and positive psychology frameworks, in that counsellors described being
able to hold robust, optimistic, and realistic views of the stressors experienced in
trauma counselling work. They were able to utilise a range of resources (such as
supervision, peer support, managing case load, professional development, varying
work activities, own self-care strategies) that allowed them to manage the stressors
successfully and thrive in the work. According to Antonovsky (1993, 1996),
individuals with a strong sense of coherence, or personal coping style, were more
likely to manage situations in adaptive ways than individuals with a weaker sense of
coherence. The findings also reflected Fredrickson’s (1998) broaden-and-build theory
Downloaded by [University of Bristol] at 02:44 28 February 2015

in that participant counsellors’ successful management of their previous exposure to


indirect trauma enhanced their sense of confidence and efficacy.
The issue of how counsellors sustained their engagement in trauma counselling
work over time was of particular focus in this study. Participant counsellors who were
able to engage in a range of activities adjunct to direct counselling work were more
able to sustain their interest and capacity to manage the demands of trauma
counselling work over time. Variability came in a variety of ways including sideways
career movements, taking on alternate activities such as teaching or research, working
part-time, or being employed in a secondary workplace.

Limitations of the Research


Due to the methodology and cross-sectional design of this study, it is acknowledged
that the findings are limited in terms of its generalisability, and different experiences
may be evident in a wider sample. The small nonrandom sample size has the potential
for selection bias. The interviews relied on self-report, which may be affected by
memory limitations and recall bias. The specificity of the area of counselling limits
the ability to make statements outside the scope of trauma counselling work. Other
limitations of the study relate to the characteristics of the sample group. The
counsellors who participated may have been more likely to have experienced greater
positive aspects of trauma counselling and hence be more motivated to discuss these
experiences. Participants’ response bias may have had an influence on the results
(Patton, 2002).

Implications of the Research


Despite the limitations as discussed above, the findings may be useful in giving some
guidance to practice and research. The findings suggested that counsellors may
benefit from adopting a perspective of expecting, acknowledging, and proactively
attending to the variety of experiences of indirect trauma exposure in order to
maintain their empathic capacity in trauma counselling work. This supports Badger,
308 J. Ling, S. V. Hunter & M. Maple
Royse, and Craig’s (2008) recommendations that practitioners should be educated
to expect indirect trauma exposure and be resourced to manage their reactions. In
addition, counsellors and supervisors may find it useful to identify areas that require
more attention or resources, such as professional development; needing to diversify
their activities; adequate clinical supervision; and the availability of peer support.
The influence of peer and collegial support on the impact of indirect trauma
exposure was emphasised in this study and is an area that would benefit from further
research. The engagement in multiple jobs or multiple activities within a job also
suggested a positive influence on coping with indirect trauma exposure. This is an
interesting situation that warrants further research.
Downloaded by [University of Bristol] at 02:44 28 February 2015

Conclusions
The current study makes an important contribution to the literature by demonstrat-
ing ways in which counsellors approached and engaged in practices that assisted
them to thrive and sustain their engagement in trauma work. Counsellors who
held the perception that the stressors of trauma work were expected, understandable,
and manageable, were more able to maintain their empathic balance, and this
enhanced the positive aspects of the work. The use of supervision, peer support, and
ongoing training were also important support factors. Further, being involved in a
range of activities, such as teaching, or policy or program development, as adjunct to
direct counselling work, helped counsellors to manage and sustain their capacity to
respond to the demands of direct trauma counselling work over time.

References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders
(4th ed., Text Revision). Washington, DC: Author.
Antonovsky, A. (1993). The structure and properties of the sense of coherence scale. Social Science
and Medicine, 36, 725–733. doi:10.1016/0277-9536(93)90033-Z
Antonovsky, A. (1996). The salutogenic model as a theory to guide health promotion. Health
Promotion International, 11, 11–18. doi:10.1093/heapro/11.1.11
Badger, K., Royse, D., & Craig, C. D. (2008). Hospital social workers and indirect trauma exposure:
An exploratory study of contributing factors. Health and Social Work, 33, 63–71. doi:10.1093/
hsw/33.1.63
Baranowsky, A. B. (2002). The silencing response in clinical practice: On the road to dialogue.
In C. R. Figley (Ed.). Treating compassion fatigue (pp. 155–170). New York, NY: Brunner-
Routledge.
Bell, H., Kulkarni, S., & Dalton, L. (2003). Organizational prevention of vicarious trauma. Families
in Society, 84(4), 463–481. doi:10.1606/1044-3894.131
Bride, B. E., Radey, M., & Figley, C. R. (2007). Measuring compassion fatigue. Clinical Social Work
Journal, 35, 155–163. doi:10.1007/s10615-007-0091-7
Charmaz, K. (1995). Grounded theory. In J. Smith, R. Harré, & L. Langenhove (Eds.), Rethinking
methods in psychology (pp. 27–65). London: Sage.
Australian Social Work 309
Charmaz, K. (2000). Grounded theory: Objectivist and constructivist methods. In N. Denzin &
Y. Lincoln (Eds.), Handbook of qualitative research (2nd ed., pp. 509–535). Thousand Oaks,
CA: Sage.
Collins, S., & Long, A. (2003). Too tired to care? The psychological effects of working with trauma.
Journal of Psychiatric & Mental Health Nursing, 10(1), 17–27. doi:10.1046/j.1365-2850.2003.
00526.x
Dey, I. (2004). Grounded theory. In C. Seale, G. Gobo, G. Gubrium, & D. Silverman (Eds.),
Qualitative research practice (pp. 80–93). London: Sage.
Figley, C. R. (Ed.). (1995a). Compassion fatigue: Coping with secondary traumatic stress disorder in
those who treat the traumatized. New York, NY: Brunner/Mazel.
Figley, C. R. (1995b). Compassion fatigue: Towards a new understanding of the costs of caring. In
B. H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, and
educators (pp. 3–27). Lutherville, MD: Sidran Press.
Figley, C. R. (2002a). Compassion fatigue: Psychotherapists’ chronic lack of self-care. Journal of
Downloaded by [University of Bristol] at 02:44 28 February 2015

Clinical Psychology, 58, 1433–1441. doi:10.1002/jclp.10090


Figley, C. R. (2002b). (Ed.). Treating compassion fatigue. New York, NY: Brunner/Routledge.
Fredrickson, B. L. (1998). What good are positive emotions? Review of General Psychology, 2, 300–
319. doi:10.1037/1089-2680.2.3.300
Fredrickson, B. L. (2003). The value of positive emotions. American Scientist, 91, 330–335. doi:
10.1511/2003.4.330
Iliffe, G., & Steed, L. G. (2000). Exploring the counselor’s experience of working with perpetrators
and survivors of domestic violence. Journal of Interpersonal Violence, 15, 393–412.
doi:10.1177/088626000015004004
Lincoln, Y. S., & Guba, E. G. (1985). Naturalist inquiry. Beverly Hills, CA: Sage.
Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: A review. Journal
of Traumatic Stress, 17, 11–21. doi:10.1023/B:JOTS.0000014671.27856.7e
McCann, L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding
the psychological effects of working with victims. Journal of Traumatic Stress, 3, 131–149.
doi:10.1002/jts.2490030110
Meyers, T. W., & Cornille, T. A. (2002). The trauma of working with traumatized children. In C. R.
Figley (Ed.), Treating compassion fatigue (pp. 39–56). New York, NY: Brunner-Routledge.
Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks,
CA: Sage.
Pearlman, L. A., & MacIan, P. S. (1995). Vicarious traumatization: An empirical study of the effects
of trauma work on trauma therapists. Professional Psychology, Research and Practice, 26, 558–
565. doi:10.1037/0735-7028.26.6.558
Salston, M., & Figley, C. R. (2003). Secondary traumatic stress effects of working with survivors of
criminal victimization. Journal of Traumatic Stress, 16(2), 167–174. doi:10.1023/A:10228992
07206
Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American
Psychologist, 55, 5–14. doi:10.1037/0003-066X.55.1.5
Stamm, B. H. (Ed.). (1999). Secondary traumatic stress: Self-care issues for clinicians, researchers, and
educators. Lutherville, MD: Sidran.
Stamm, B. H. (2002). Measuring compassion satisfaction as well as fatigue: Developmental history
of the Compassion Fatigue and Satisfaction Test. In C. R. Figley (Ed.), Treating compassion
fatigue (pp. 107–119). New York, NY: Brunner/Mazel.
Strauss, A. & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and
techniques. Newbury Park, CA: Sage.
310 J. Ling, S. V. Hunter & M. Maple
Strauss, A. L., & Corbin, J. M. (1998). Basics of qualitative research: Techniques and procedures for
developing grounded theory (2nd ed.). Thousand Oaks. CA: Sage.
Tedeschi, R. G., & Calhoun L. G. (1995). Trauma & transformation: Growing in the aftermath of
suffering. Thousand Oaks, CA: Sage.
Tedeschi, R. G., & Calhoun L. G. (2004). The foundations of posttraumatic growth: New
considerations. Psychological Inquiry, 15, 1–18. doi:10.1207/s15327965pli1501_01
Downloaded by [University of Bristol] at 02:44 28 February 2015

You might also like