The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.Naomi Rachel Remen, MD
The case management team from the Institute’s Life Outside of Violence (LOV) program recently presented, “This is About Us: When self-care is not enough”, a presentation showing that front line workers may experience what’s known as vicarious trauma as they interrupt the cycle of violence by treating victims of violent crime. The case managers (who are also mentors to LOV participants) presented at the annual national conference of The Health Alliance for Violence Intervention (HAVI), which gathers members of the national network of hospital-based violence intervention programs.
The presentation acknowledged that people who work with victims of violence routinely can experience secondary or vicarious trauma, a common occupational hazard for victim service providers, law enforcement, EMTs, therapists and other helping professionals. The repeated exposure to traumatic material can cause, among other symptoms, physical and mental exhaustion, emotional duress and burnout. Providers may react physiologically, emotionally, cognitively, behaviorally, and spiritually.
Several studies have shown that:
- Between 40 and 85% of helping professionals have developed vicarious trauma, compassion fatigue, and/or high rates of traumatic symptoms (Mathieu, 2012)
- Immigration judges reported higher levels of burnout than hospital physicians and prison wardens (Curtis, 2010)
- Professionals whose caseloads consist of 60% or more clients with a significant trauma history are at increased risk of experiencing secondary trauma (VISTAS, 2016)
LOV case managers also point out that what is traumatizing is a person’s actual experience however, what is traumatic to one person may not be to another. The presentation also gave measures to cope with vicarious trauma including the “EQUIP” method:
The team also presented the following option of implementing an ecological systems framework of self-care:
Other self-care activities that can help mitigate the impact of vicarious trauma can include recreation, professional development, praying/meditation, family time such as game nights or vacation, practicing a balanced diet and sleep patterns, and maintaining boundaries with clients and colleagues.
When basic self-care is not enough, other strategies include:
In conclusion, presenters reiterated that triggers to vicarious trauma can be everywhere: in past experiences, the media, from clients and in our own personal lives. Self-care is a lifestyle and it is important to find a strategy that works best for the individual.
Additional national resources include:
Led by the Institute for Public Health at Washington University in St. Louis, Life Outside of Violence (LOV), helps those harmed by stabbing, gunshot or assault receive the treatment, support and resources they need to find alternatives to end the cycle of violence. The free program works to help decrease incidences of retaliation, criminal involvement, re-injury, and death.