SOCW6333 - Discussion - The Art of Caring (wk1)

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Question Description

Due Tuesday 2/26/2019

Please be detailed in response, use 2 APA references and use bulleted headings in response

As a helping professional you have three primary roles in relation to vicarious trauma. First, you must be able to identify vicarious trauma symptoms within yourself and in other trauma-response helping professionals (e.g., emergency room nurses, emergency response personnel). Second, you must be able to apply intervention and prevention methods effectively. Third, you must be able to educate future professionals on recognizing vicarious trauma within themselves and those with whom they may interact. How might the trauma of others impact you as a helping professional?

  • Post a brief description of a specific individual with whom you have worked who experienced a trauma, and briefly describe the incident.
  • Then, briefly describe the impact this experience had on you as a helping professional.
  • Explain how you were or were not prepared for exposure to this individual’s trauma. Be specific and use examples.

References

Morrissette, P. J. (2004). The pain of helping: Psychological injury of helping professionals. New York, NY: Taylor & Francis.

  • Chapter 1, “Traumatology: An Overview”

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Chapter 1 Traumatology: An Overview The study of human reactions to traumatic events is not new (e.g., Birmes, Hatton, Brunet, & Schmitt, 2003; Weisaeth, 2002). Reports of human reactions to traumatic events, “…can be traced to the earliest medical writings in 1900B.C. in Egypt” (Figley, 1989a, p. 574). Weisaeth (2002) provided a European history of traumatology and wrote, “The recognition of psychic trauma as a perceived causal factor in psychiatry and psychosomatic medicine and even general medicine has a long pedigree. Homer’s Iliad, the oldest text in Western literature, is an impressive account of psychological trauma” (p. 443). Specific to posttraumatic stress disorder, Ben-Ezra (2002) suggested evidence of PTSD symptoms extended over the period from 350 years ago to over 4,000 years ago. The historical evolution of PTSD from Freud to the creation of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, (DSM-IV, American Psychiatric Association, 1994) has been discussed by Wilson (1994a). HISTORICAL PERSPECTIVE For decades, there has been interest in how people are affected by events outside the normal range of human experiences. Perhaps more than any other area, curiosity surrounding the effect of military and peacekeeping on soldiers has propelled a continued onslaught of research and clinical interest. Weisaeth (2002) wrote, A perusal of the scientific history of traumatic stress shows that the Great War, 1914–18, was a watershed. The study of combat stress in that war led to new understanding of traumatic stress disorders, of their etiological and prognostic factors, and of how they could be prevented and treated.” (p. 443) It appears that interest in the response of soldiers to traumatic and shocking events prompted researchers and helping professionals to eventually consider the effect on others who are exposed to similar experiences. The response to traumatic experiences has received enormous attention and different labels have been created for what is perceived as similar symptomatology. The following section provides a historical overview and briefly describes how and when various psychological syndromes evolved. More important, such a timeline demonstrates how clinical attention gradually moved from an organic focus to one where individual psychology was recognized. For example, there is a stark contrast between how human responses to trauma were perceived during the U.S. Civil War as compared to the horrific events of September 11. During the Civil War, soldiers who exhibited emotional despair after witnessing human suffering and death were perceived as psychologically defective. The heightened emotional response (e.g., distress, grief, disbelief) of rescue and public service personnel during the horrific events of September 11, however, was viewed as a normal and expected reaction to human devastation. A negative response to caregiver distraught was absent and emotionally wounded caregivers were embraced, comforted, and honored worldwide. Over time, a better understanding regarding the human reaction to trauma has developed and a greater compassion toward the emotional experiences of caregivers has emerged. An important distinction was drawn between acute combat stress reaction and PTSD during the Vietnam War. It is worth mentioning that PTSD was initially referred to as post-Vietnam syndrome. A distinction between acute combat stress reaction and PTSD pertains to the emergence of symptomatology. In terms of acute combat stress reaction, there are immediate consequences associated with traumatic events. The consequences of PTSD, on the other hand, are long-term. For example, Vietnam nurse veterans with a diagnosis of PTSD who were exposed to imagery of militaryrelated nursing events showed much higher physiologic responses when compared to non-PTSD nurses (Carson et al., 2000). Based on this study, it appears that witnessing death and injury can result in enduring psychophysiologic arousal. CONTEMPORARY TRAUMATIC EVENTS The events of September 11 clearly illustrated the devastating effect of trauma. Eidelson, D’Alessio, and Eidelson (2003) vividly recounted this event and wrote, An entire nation was stunned by the destruction of life and property brought on by the crashing of four passenger airliners into the World Trade Center in New York City, the Pentagon in Washington, D.C., and a field outside Shanksville, Pennsylvania. Ultimately, over 3,000 lives were lost and countless others were forever changed in both obvious and immeasurable ways. The disaster was experienced not only directly by thousands of individuals but repeatedly by millions of television viewers from around the world. For many, the repetitive viewing of the attacks, eyewitness accounts, and stories of survivors and rescue workers had its own traumatizing and retraumatizing effects. (p. 144) To better understand the psychological impact on caregivers, Eidelson, D’Alessio, and Eidelson (2003) focused specifically on the experience of psychologists. Survey data suggested that psychologists were not immune from the fallout of this traumatic event and reported both positive and negative reactions. Respondents felt good about providing assistance and support to clients and making a genuine contribution to others. They also, however, experienced “…the sense of inadequacy and/or helplessness in the face of such enormity of suffering” (p. 147). Psychologists struggled with similar issues, feelings of unpreparedness for such magnitude, increased referrals, and increased demands on their time. These professionals had two different responses regarding their personal lives. For example, some felt closer to their families while others experienced feelings of increased anxiety, fatigue, and sorrow over personal loss. PROGRESSION OF TRAUMATOLOGICAL INQUIRY Despite its long history, it appears that a closer examination of psychological trauma developed during the past century and has been marked by two distinct phases. The first phase involved challenging the generalization that individuals who demonstrated psychological distress following a traumatic event (e.g., battlefield combat, tragic accidents) were emotionally unstable and susceptible prior to the occurrence of the traumatic event. In reference to rescue workers, for example, Dunning and Silva (1980) stated, The prevailing sentiment, both in and out of the profession, is that if you can’t take the heat, get out of the kitchen. Such a stance precludes the opportunity for the research and development of screening, training, and support programs to forestall the negative consequences of disaster in those persons who can least afford to be so affected. (p. 289) It became clear that becoming traumatized after experiencing, witnessing, or learning about a horrific event was a normal human reaction (Waters, 2002) and that the prevalent theory suggesting a predisposition of personal weakness and psychological defect had to be reconsidered and eventually discarded. Until the psychological defect theory was challenged, traumatized individuals manifesting psychological symptomatology would sometimes be perceived as emotionally unstable and vulnerable to mental disorders. Their response to a traumatizing event was evidence of a preexisting emotional fragility. Steed and Bicknell (2001, para. 1) commented: “Initially, psychological theories, research and development of effective intervention techniques, methods and processes were client focused.” Adherence to these theories disregarded the influence of an individual’s environment and factors that contributed to an individual’s distress were ignored. It appears that due to the absence of a theory of anxiety, the physical signs of anxiety were misperceived as symptoms of organic illness (Weisaeth, 2002). Everstine and Everstine (1993) elaborated, The fact is that one’s ego must contend with any environmental stimulus that comes along. Sudden stimuli must be dealt with swiftly and painful stimuli must be met by a healing force. This is true no matter what the person’s condition before the event and whether or not the person was emotionally vulnerable in advance. In short, anyone can be traumatized, from the most welladjusted to the most troubled. (p. 7) Over time, these theories were given less importance and a greater connection was made between the experience of trauma and normal human response. On a cautionary note, however, subscribing to a single theory or broad-brush perspective is discouraged. One should not leap to conclusions and discount the possibility that some individuals who appeared psychologically injured following a traumatic event may have had a preexisting psychological disorder that was aggravated by the traumatic experience (Regehr, Goldberg, Glancy, & Knott, 2002). As with most issues, a balanced perspective is encouraged in order to invite varying perspectives and to stimulate debate and discussion. The second phase, which appeared to take hold during the past decade, involved an appreciation of how family members and significant others of helping professionals (e.g., mental health workers, emergency medical, fire, and safety personnel, disaster workers) and caregivers could be vicariously traumatized. The ripple effect inherent of trauma has been noted and it has been suggested that damage spreads in waves out from victims to significant others with whom the victim has intimate contact (Remer & Ferguson, 1998, 1995). Remer and Ferguson (1998) remarked, “For each primary victim, there are numerous secondary victims—partners, children, parents, family, friends. When one considers the number of people touched directly or indirectly by the traumatic events, the magnitude of the problem becomes apparent” (p. 140). As a result of new insights, the notion of an emotional membrane believed to shield and protect helping professionals and significant others from the emotional effect of a traumatic event was challenged. Appreciating the contagion effect of trauma opened up the new and exciting field of traumatology. As discussed below, the vulnerability and impact of trauma on helping professionals and significant others began to gain increased attention (e.g., Wee & Myers, 2003). ABSORBING THE PAIN OF OTHERS Historically, psychological trauma described the emotional experiences of individuals who found themselves in harm’s way and minimal concern was devoted to caregivers (Dunning & Silva, 1980; Figley, 1995b; Haley, 1974; Raphael, Singh, Bradbury, & Lambert, 1983). Attempts, however, have been made to classify types of victims associated with disasters (Shepherd & Hodgkinson, 1990). In 1981, Taylor and Frazer proposed the following victim classification: primary (maximum exposure to a catastrophic event), secondary (grieving relatives and friends), third-level (rescue and recover personnel), fourth-level (community members), fifth-level (individuals affected although directly uninvolved), and sixth-level (survivors who are vicariously affected) (Shepherd & Hodgkinson, 1990). The importance of secondary trauma has been underscored, “It is highly unlikely that an individual will avoid the direct experience of a traumatic event or events during his or her lifetime. However, if that person is fortunate enough to avoid direct contact with trauma, secondary exposure to the trauma of others is unavoidable” (Williams & Sommer, 1994, p. xiii). Stamm (1997) also presented a literature review that tracked the progressive interest in helpinginduced trauma. The Sin-Eater A metaphor for people who found themselves psychologically traumatized as a result of their work and service to others was presented by Janik (1995, para. 8). The metaphor is entitled the sin-eater. Janik noted that the sin-eater, “… is a social scapegoat role played by members of the superstitious society of Wales during the Dark Ages” and provided the following description, In Welsh villages, sin-eaters would eat meals offered by the families of deceased villagers. The food consumed was believed to have absorbed the sins committed by the villager during his or her life on earth, and consumption of the food by the sin-eater released the deceased from obligatory punishment in the next life and freed him or her for heavenly rewards. Sin-eaters ordinarily would consume only a small portion of the food and take the rest home for their families. Thus, sin-eaters and their families were able to survive through their social service to the community. (para. 9) Janik pointed out that earning their sustenance by assuming the role of sineater was not inconsequential. For example, realizing that sin-eaters were accumulating the sins of others, villagers would worry about contamination and, thus, view sin-eaters with suspicion. Sin-eaters experienced, “…the honor and degradation of fulfilling a formal social role of scapegoat and detoxifier” (para. 11). Just as sin-eaters would metaphorically swallow the transgressions and faults of villagers, correction officers harbor toxic and corrosive ideas, images, and memories associated with their work (Janik, 1995). This scenario presents challenges for the individual, significant others, and clients and reminds us that, “There is a cost to caring” (Figley, 1995b, p. 1). EXPANDING THE PARAMETERS OF TRAUMA Familiar terms such as combat fatigue and shell shock characterized the experiences of war veterans. These terms were very useful in helping people better understand the emotional experiences of some veterans. A broader picture eventually emerged and the emotional experiences of other professionals who experienced trauma gained increased attention. Attention was directed to the spillover of traumatic events outside of combat (e.g., emergency personnel). This natural evolution was accompanied by an interest in the vicarious impact of trauma on significant others and caregivers (e.g., offspring, colleagues). Realizing that personal trauma could extend beyond the actual victim and profoundly effect the lives of significant others, particularly spouses and offspring (Shakespeare-Finch, Smith, & Obst, 2002) exemplified trauma’s permeating force. In reference to significant others, “…little, if any direct attention has been paid to identifying them, validating their experiences, or assisting them in either their support of the victims, or even more important, their personal struggles to cope with their own victimization” (Remer & Ferguson, 1995, p. 407). The effect on families was addressed by Nelson and Schwerdtfeger (2002, para. 1) who wrote, “Partners, parents, and siblings often must endure the effects when a family member is traumatized. The family may serve as a resource for support or an obstacle that blocks a traumatized member’s recovery.” These authors remarked that traumatized parents may be overwhelmed by a personal traumatic experience and can sometimes underestimate their own trauma and how their children are vicariously affected. There could be a negative impact associated with prolonged service on caregivers and patients (Chen & Hu, 2002). Research conducted by Sisk (2000) supported the notion that “…both caregiving activities and the feelings associated with caregiving may negatively affect the caregiver’s ability to participate in various health-promoting behaviors” (p. 41). It has been proposed that caregivers store away their emotional pain—a pain which can later devastate individuals, their families, or both (Harbert & Hunsinger, 1991). Realizing that caregivers may hide, underestimate, or otherwise obfuscate their psychological distress is a disconcerting scenario that warrants ongoing attention. Helpers and Family Traumatization A more complete consideration regarding the systemic costs of caring within families was offered by Figley (1998); the researcher asserted that the field of traumatology has overlooked families and other supporters of psychologically injured people. As described below, families could be traumatized via simultaneous effects, vicarious effects, chiasmal effects, and intrafamilial trauma (Figley, 1989a). Simultaneous Effects The simultaneous effect refers to when an entire family experiences a traumatic event. In general families who are traumatized, “…are relatively free of disasterrelated emotional difficulties” (Figley, 1989a, p. 19). According to Figley this response could be attributed to the fact that the event is shared by a group whose members can provide mutual support. Vicarious Effects It was Figley’s (1989a) contention that individuals could be vicariously traumatized when learning about events experienced by significant others. For example, a father can experience emotional trauma when learning about a catastrophe involving his son or daughter. Figley suggested that a significant other may experience more stress than an actual victim. Chiasmal Effects Originally termed secondary catastrophic stress response, chiasmal effect refers to a process whereby significant others are emotionally touched when attending to the victimization of a close friend, relative, or family member. Significant others are affected through their efforts to help. Referring to an earlier study regarding crime victims and their supporters, Figley (1989a) wrote, …as expected, the major predictor of supporter distress was victim distress [and] it is clear that a pattern of effects emerged in both the victim and supporter. The crime victims as well as their supporters suffered from the crime episode long after the initial crisis had passed. (p. 20) Intrafamilial Trauma Figley (1989a) stated: “Families certainly have the capacity to be extremely helpful in enabling family members in recovering from traumatic stressors. They may become traumatized through their assistance” (p. 21). It is only logical that the close bond between family members would increase a likelihood of shared trauma. Family Burnout In an attempt to better understand how families can be affected by trauma, for example, Figley (cited in Peeples, 2000) described burnout in families. Based on earlier interviews regarding combat-related stress disorder, Figley discovered that family members “…were living the war indirectly through the emotional responses of their veteran family member” (Peeples, 2000, para. 2). As the construct of secondary trauma was emerging, caution was recommended regarding global and unsubstantiated statements (Jenkins & Baird, 2002; Waysman, Mikulincer, Solomon, & Weisenberg, 1993). It was noted: There is a growing body of literature on secondary traumatization, but it is almost entirely anecdotal. There have been virtually no systematic empirical studies aimed at documenting and understanding these phenomena. Very little is thus known about factors that may influence the process of secondary traumatization, such as the degree of empathy and responsibility family members feel for one another, the quality of the marital relationship, the social climate, and so forth. (Waysman et al., 1993, p. 104) As discussed below, the void regarding secondary trauma research was acknowledged and is gradually being addressed. HELPING PROFESSIONAL TRAUMA RESEARCH: ANSWERING THE CALL Over the years, researchers have begun to answer the call for more investigation regarding caregiver burden and strain (Sisk, 2000; Chen & Hu, 2002) and secondary traumatization (e.g., Baird & Jenkins, 2003; Bride, Robinson, Yegidis, & Figley, 2003; Dunning & Silva, 1980; Raphael, Singh, Bradbury, & Lambert, 1983). Preliminary research also demonstrates a relationship between the degree of exposure to trauma-associated material and the experience of secondary traumatic stress disorder (Arvay & Uhlemann, 1996; Collins & Long, 2003; Follette, Poluusny, & Milbeck, 1994; Kassam-Adams, 1995; Motta, Kefer, Hertz, & Hafeez, 1999; Nelson ...
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SOCW6333 Week One Discussion
Post a brief description of a specific individual with whom you have worked who
experienced a trauma, and briefly describe the incident.
Vicarious trauma can occur when a social worker is exposed to the trauma of clients
(Stockwell, 2017). One client was a 19-year-old female named R. The client experienced
physical and mental abuse at the hands of her Mother but she would only be removed for a short
time before being returned. The last incident of abuse resulted in her permanent removal from
the home. The incident occurred when the client was 16. Her Mother came hom...

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Anonymous
Tutor went the extra mile to help me with this essay. Citations were a bit shaky but I appreciated how well he handled APA styles and how ok he was to change them even though I didnt specify. Got a B+ which is believable and acceptable.

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