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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
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Australian Social Work, 2014
Vol. 67, No. 2, 297–310, http://dx.doi.org/10.1080/0312407X.2013.837188
Abstract
This qualitative study explored the factors that help counsellors exposed to indirect
trauma thrive personally and professionally, and sustain their engagement in trauma
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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.
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
Method
A constructivist grounded theory approach (Charmaz, 2000) was used to explore
counsellors’ accounts of their experiences of indirect trauma exposure. Constructivist
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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
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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
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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
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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.
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:
The sense of compatibility with counselling work also helped participant counsellors
to engage and thrive in trauma work:
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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)
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)
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.
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:
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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)
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
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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.
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