Search Results (34)

Background: Palliative care is a clinically, relationally and emotionally demanding field. Continuous exposure to suffering and death exposes professionals to compassion fatigue, vicarious trauma and grief, and burnout, while also offering opportunities for compassion satisfaction and meaning-making. How professionals cope is central to sustaining the supporting role in diseases with a poor prognosis. Objectives: To explore the emotional and experiential dimensions of palliative care work and the coping strategies, individual and team-based, that professionals deploy when accompanying patients and families at the end of life. Methods: Reflexive thematic analysis of 16 semi-structured interviews with palliative care professionals (5 physicians, 7 nurses, 3 psychologists, and 1 social-health worker; 14 women and 2 men) recruited from hospices, hospital wards and home-based services in Northern Italy. Sample size was guided by an information power model. Reporting follows the COREQ checklist. Results: Four themes were constructed: (1) the unsustainability of the workload; (2) the pleasure of care between empathic relationship, listening and welcoming; (3) the holistic role of the professional; and (4) the awareness of death. Across themes, participants mobilised a layered repertoire of problem-, emotion- and meaning-focused coping. Narratives fitting a structured moral-distress pattern were comparatively limited in participants’ accounts. Conclusions: Sustaining supporting roles in poor-prognosis care may require more than individual resilience; it depends on organisational support—structured supervision, reflective spaces, and communication and emotional training—that makes professionals’ largely informal coping work a shared and sustainable resource. Full article

Mental health professionals are exposed to clients’ traumatic experiences, placing them at risk for vicarious trauma (VT). However, such exposure may also facilitate vicarious post-traumatic growth (VPTG). The present study examined the mediating role of rumination (intrusive and deliberate) in the relationship between VT and VPTG, and the moderating role of clinical supervision. The personal trauma history of the therapist was kept as a covariate. Using a cross-sectional correlational design, data were collected from 278 mental health professionals, including psychologists, counsellors, social workers, and therapists, through purposive sampling. Correlational analyses and moderated mediation analyses were conducted using IBM SPSS. The analysis revealed that VT is positively related to VPTG, and deliberate rumination mediates the relationship between VT and VPTG. Clinical supervision moderates the association between vicarious trauma and deliberate rumination and the association between deliberate rumination and vicarious post-traumatic growth. The findings highlight the role of participation in clinical supervision in shaping these relationships. This study contributes to the limited empirical literature on VT and VPTG and offers implications for clinical supervision practices and professional training. Full article

Vicarious Posttraumatic Growth (VPTG) is a critical yet underexplored phenomenon among trauma-focused helping professionals. While secondary trauma (ST), compassion fatigue, and burnout are widely recognized negative aspects of working with trauma survivors, less is known about the potential benefits of this work and its contributions to well-being. This qualitative study explored peer-support specialists’ perceptions of growth arising from indirect exposure to trauma and examined how these experiences relate to well-being. Using interpretative phenomenological analysis, researchers conducted semi-structured interviews with 13 participants, independently coded transcripts, and developed themes through consensus. Findings suggest VPTG may follow a similar path to Posttraumatic Growth (PTG), with participants reporting challenges to core beliefs, emotional distress, and transformative cognitive-emotional shifts that facilitated growth across domains that appear to mirror the five PTG domains. Outcomes of working with trauma survivors extended beyond the PTG domains to include compassion satisfaction, hope, expanded coping skills, and improved mental health. Taken together, these findings illustrate the participants’ subjective experiences of both challenge and transformation through their work with trauma survivors, offering preliminary insight into how indirect trauma exposure may contribute to VPTG and well-being. Full article

Minority stress appears to be consistently associated with a heightened risk of developing eating disorders. There is limited data investigating the role of witnessed heterosexist experiences (vicarious trauma), such as discrimination, harassment, or violence happening to other LGBTQ+ people. The present study aims to examine the association between vicarious trauma and eating disorder risk while surveying the mediating role of emotional dysregulation, self-esteem, and shame. An anonymous online survey was conducted involving 376 LGBTQ+ people from Italy. Participants completed self-report questionnaires regarding heterosexist experiences and factors associated with eating behavior. Descriptive, bivariate, and mediation analyses were conducted using the “PROCESS” macro. Statistically significant positive associations were found between all the main variables in bivariate analyses. Mediation analyses highlighted a direct effect of vicarious trauma on eating disorder risk and indirect effects of vicarious trauma on eating disorder risk through low self-esteem and emotion dysregulation. The indirect effect through shame was nonsignificant. Vicarious trauma appears to have a significant direct effect on eating disorder risk and small but significant indirect effects through emotional dysregulation and low self-esteem. Health promotion contexts would benefit from policies at the institutional, organizational, and social levels to prevent minority stress and reduce observed health disparities. Full article

Jurors play a critical role in the administration of justice, yet their compulsory exposure to graphic and distressing evidence during criminal trials is often overlooked in discussions of mental health and legal reform. This paper investigates the psychological impact of jury service in trials involving murder, domestic violence, sexual assault, and child abuse, where laypeople are required to view autopsy photographs, listen to emergency calls, and assess disturbing testimonies without any formal training or mandatory psychological support. While vicarious trauma, secondary traumatic stress, and moral injury are recognised in research on law enforcement, social work, and healthcare, there is limited acknowledgement that no professional group consistently receives adequate trauma prevention or recovery support. This gap is particularly concerning for jurors, who are laypeople compelled to participate in the justice process. Drawing on legal case studies, psychiatric research, and international precedent, this paper argues that the justice system imposes an invisible emotional burden on jurors while offering limited, inconsistent, and mostly reactive support. Although applicable to many countries, particular attention is given to Australian jurisdictions, where counselling services are sparse and optional, and where juror confidentiality laws restrict therapeutic disclosures. This research also considers the legal and ethical implications of exposing untrained civilians to traumatic material and explores whether the state could, or should, bear legal liability for post-trial psychological harm. Ultimately, this paper calls for the introduction of clearly defined trauma-informed jury procedures, including pre-trial psychological briefings, structured debriefings, and systemic reform, to acknowledge juror well-being as a necessary component of fair and ethical justice. Full article

In recent years, psychological research has increasingly focused on the impact of media exposure on mental health, identifying young adults as particularly vulnerable due to their high levels of media engagement. To explore these effects, the construct of Media Vicarious Traumatization (MVT) has been introduced as an extension of vicarious traumatization, aimed at capturing the psychological impact of emotionally intense media content. MVT offers a relevant framework for understanding the mental health risks of media exposure, especially in relation to socially significant issues like war, now central in contemporary media discourse. This study aims to culturally adapt and psychometrically validate the Media Vicarious Traumatization Scale (MVTS) within the Italian context, and to investigate the relationship between the war-related MVT construct, generalized anxiety, and future anxiety among young adults. Study I, conducted on a sample of 250 participants (M = 22.40, SD = 2.63), explored the latent structure of the MVTS using Parallel Analysis and Exploratory Factor Analysis (EFA), yielding promising psychometric properties in terms of reliability and factorial stability. An independent sample of 553 participants (M = 22.43, SD = 2.37) was recruited for Study II to confirm the MVTS’s latent structure via Confirmatory Factor Analysis (CFA), which indicated good model fit. This study also evaluated measurement invariance across gender, internal consistency, and convergent, discriminant, and predictive validity, alongside psychometric properties assessed through Item Response Theory (IRT). The results of both studies confirm the stable and robust psychometric properties of the scale. Furthermore, Study II provides novel insights into the predictive role played not only by the war-related MVT but also by the recently introduced construct of Worry about War in exacerbating both generalized anxiety and future anxiety among Italian young adults. Full article

Mental health professionals are often confronted with clients’ traumatic narratives, which may lead to increased levels of vicarious trauma and burnout, especially when work-related risk factors are present. This study aims to investigate the relationship between vicarious trauma and burnout among mental health professionals in Greece while taking into account work-related and intrapersonal factors using a sample of 266 mental health professionals, who completed the Core Self-Evaluations Scale, Self-Compassion Scale, Vicarious Trauma Scale, and Counselor Burnout Inventory, and provided information about work-related variables, such as caseload, clinical supervision, clinical training, and therapeutic experience. The findings showed that Greek mental health professionals’ burnout positively associated with vicarious trauma and caseload, while negatively associated with intrapersonal factors and work-related factors, namely, years of clinical supervision, clinical training and therapeutic experience. Vicarious trauma negatively correlated with core self-evaluations, self-compassion, and clinical experience. Finally, low core self-evaluations and self-compassion were found to explain greater burnout levels together with higher vicarious trauma and work overload per week, while core self-evaluations were the only variable that moderated the relationship between vicarious trauma and burnout of Greek mental health professionals. These findings indicate that in order to address the interplay between vicarious trauma and burnout, targeted interventions that focus on personal attributes, coping strategies, and systemic organizational support are needed. Full article

The global Black Lives Matter movement and COVID-19 pandemic drew attention to the urgency of addressing entrenched structural dynamics such as racialization, gender, and colonization shaping health inequities for diverse racialized people. Canadian community-based research with racialized immigrant women recognized the need to enhance service provider capacity using a strengths-based activism approach to support client health and wellbeing. In this study, we aimed to understand the impacts of this mental health promotion practice on service providers and strategies to support them. Through purposeful convenience sampling, three focus groups were completed with 19 service providers working in settlement and mental health services in Toronto, Canada. Participants represented varied ethnicities and work experiences; most self-identified as female and racialized, with experiences living as immigrant women in Canada. Postcolonial feminist and critical mental health promotion analysis illuminated organizational and structural dynamics contributing to burnout and vicarious trauma that necessitate a focus on trauma- and violence-informed care. Transformative narratives reflected service provider resilience and activism, which aligned with and challenged mainstream biomedical approaches to mental health promotion. Implications include employing a postcolonial feminist lens to identify meaningful and comprehensive anti-oppression strategies that take colonialism, racialization, gender, and ableism and their intersections into account to decolonize nursing practices. Promoting health equity for diverse racialized women necessitates focused attention and multilevel anti-oppression strategies aligned with critical mental health promotion practices. Full article

This study aims to illustrate the impact of accumulated traumatic experiences in adolescence and to evaluate the potential of brief focal psychotherapy (BFP) as a treatment approach for complex trauma. We present the case of a 14-year-old boy who experienced vicarious gender-based violence, child abuse, early maternal separation without alternative secure attachment figures, and forced sudden migration. The patient exhibited symptoms consistent with post-traumatic stress disorder (PTSD) and complex trauma. The culturally sensitive intervention, delivered at a public child and adolescent mental health center, consisted of twenty weekly individual sessions of 45 min each, complemented by three 45 min psychoeducation sessions with the caregiver. The assessment was conducted using a multitrait and multi-informant approach, systematically gathering information across multiple domains of functioning (emotional–behavioral, physical, cognitive, self-perception, and relational) and from different sources (the adolescent, his mother, and the clinician) through clinical interviews, projective techniques, and parental feedback. The primary therapeutic focus was the establishment of a secure therapeutic alliance to facilitate emotional exploration and trauma processing. Following treatment, the patient demonstrated significant improvements in emotional regulation, family relationships, and school performance, as measured by both self-report and parental observations. This case highlights the potential of BFP in addressing complex trauma in adolescents, particularly during a developmental stage marked by increased vulnerability to the effects of chronic trauma exposure. The findings suggest that BFP can effectively reduce both acute symptomatology and broader psychosocial consequences associated with prolonged and cumulative trauma. Further research, particularly controlled studies and longitudinal follow-ups, is needed to refine and optimize the use of BFP by mental health professionals working with adolescents affected by complex trauma. Full article

In the current clinical psychiatric practice in most of the world, treatment decisions are based on a person’s capacity to make these decisions. When a person lacks the capacity to understand and appreciate treatment decisions, in many jurisdictions a third-party substitute decision maker (SDM) is appointed on his or her behalf in order to promote safety and optimal clinical outcome. In Ontario, Canada, for example, family members (typically) or public guardians are appointed as SDMs, and they form an integral part of the medical–legal system in psychiatric care. Clinicians working with both patients and their SDMs in these circumstances encounter unique challenges and deliver care in specialized ways, though little research has focused on their experiences and reflections. Based on focus group data, this qualitative study uses a descriptive and interpretative phenomenological approach through thematic analysis to examine these aspects from clinicians working in both inpatient and outpatient settings of an urban teaching hospital’s psychiatric services in Toronto, Canada. Seven key themes emerged: Clinicians (1) appreciate hardships and challenges in lives of SDMs and patients—including the challenging emotions and experiences on both sides, and the risks and relational changes from being an SDM; (2) have an understanding of the patient’s situation and respect for patient autonomy and wishes—they are promoter of autonomy and mindful of patients’ prior wishes amidst patients’ fluctuating capacity, facilitating communication, keeping patients informed and promoting transitioning from SDM to self-determination; (3) have a special working relationship with family SDMs—including supporting SDMs, avoiding harm from delayed or denied treatment, and educating and collaborating with SDMs while maintaining professional boundaries; (4) at times find it difficult working with SDMs—stemming from working with over-involved or uninterested family SDMs, coping with perceived poor SDM decisions, and they sometimes ponder if SDMs are necessary; (5) delineate differences between family and Public Guardian and Trustee (PGT) SDMs—they see PGT as closely aligned with medical decision makers, while family SDMs are more intimately involved and more likely to disagree with a physician’s recommendation; (6) recognize the importance of the SDM role in various contexts—through seeing social values in having SDMs, and acknowledging that having SDMS help them to feel better about their actions as they work to protect the patients; and (7) express ideas on how to improve the current system—at public, societal, and family SDM levels. We conclude that clinicians have unique mediating roles, with privilege and responsibility in understanding the different roles and challenges patients and SDMs face, and have opportunities to improve patient and SDM experiences, clinical outcomes, carry out education, and advocate for ethically just decisions. These clinical roles also come with frustration, discomfort, moral distress and at times vicarious trauma. Clinicians’ unique understanding of this complex and nuanced intersection of patient care provides insight into the core issues of autonomy, duty to care and protect, advocacy, and emotional dynamics involved in this sector as a larger philosophical and social movement to abolish SDMs, as advocated by the Convention on the Rights of Persons with Disability (CRPD), is taking place. We briefly discuss the role of supported decision making as an alternative as. Full article

The coronavirus pandemic shaped challenges for marginalized groups. Specifically, lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) people experienced community-building constraints, notably in predominantly rural regions. People are also navigating digital geographies, or online social environments, in novel ways to develop virtual communities in the face of prejudice, discrimination, and potential trauma. Through a minority coping approach, the present study explored LGBTQ+ people’s experiences navigating the dynamics of digital geographies during the pandemic while residing in socially conservative, highly rural physical spaces where they may be exposed to vicarious trauma. Using qualitative semi-structured interviews, data were gathered from 43 LGBTQ+ identifying individuals between 19 and 59 years old (M/SD = 27.7/9.2) between October 2020 and January 2021. Nearly 14% identified as transgender, nonbinary, or queer individuals, 35% as bisexual individuals, and 21% as people of color including Hispanic/Latina/o. Thematic analysis of the narratives described participants’ exposures to online discrimination and stigmatization of minority groups (racial and/or sexual/gender minority groups) during the COVID-19 pandemic, institutional constraints to identity expression, utilizing social technologies to manage their identities, and negotiating digital strategies to promote social ties. Findings emphasize improving marginalized people’s experiences with digital geographies through identity affirmation and community relationship-building to offset potentially traumatic experiences. Furthermore, service providers can utilize the findings to tailor effective virtual LGBTQ+ community programming to support underserved, marginalized populations. Full article

Women are the fastest-growing segment of the incarcerated population and experience high rates of cumulative trauma exposure, mental illness, and PTSD. The aim of this study is to assess the implementation of a peer-led Seeking Safety (an evidence-based intervention for addressing trauma and addiction) pilot program for women in jail. Guided by principles from community-based participatory research and cooperative inquiry, participant surveys were analyzed (secondary data) using descriptive methods (n = 60), and qualitative interviews with program facilitators were conducted and analyzed using a general inductive approach (n = 7). Peer-led Seeking Safety is feasible, acceptable, and appropriate for women in jail, with high levels of participant satisfaction. We describe several “lessons learned” related to the jail context, including structure and security processes and vicarious and retraumatization experiences among facilitators. Preventing facilitator burnout is necessary for the sustainability of the program. Future implementations of Seeking Safety in jails should consider the lessons learned in this study. Full article

While the occupational health of sign language interpreters has traditionally focused on physical health, evidence demonstrating mental health concerns is growing and supporting a shift to a more integrated approach. We embarked on a qualitative study to guide the adaptation of a previously developed Total Worker Health^® program to the context of sign language interpreting. Eight unstructured 90-min focus groups were conducted. Interpreters reported occupational safety, health, and well-being concerns and shared their solutions for management. Twenty-seven interpreters participated (aged 53.7 years; 81% female; 85% white). Predominant concerns centered on topics like workplace violence, secondary traumatic stress or vicarious trauma, lack of work–life integration or boundaries, and loss of agency or loss of self. The organizational culture of the field fostered deprioritization of self, oppression, elitism, sexism, and unhealthy relationships with interpreter peers and community members. Physical health remained a contributor, specifically the physical effects of non-physical work, aging, and differences in exposures across interpreting settings but paled in comparison to mental health and organizational culture. Solutions for management included but were not limited to prioritization of jobs, creating safe spaces/communities of supported practice, and exercise. This study supports the evolution of future research, practice, policy, and capacity building aspiring to a more integrated approach. Full article

Addiction workers play a crucial role in addressing the complex interplay between trauma and addiction, often navigating empathic connections with clients who have trauma histories. This study delves into the phenomena of vicarious trauma (VT) and vicarious post-traumatic growth (VPG) among addiction workers, exploring (counter)transference dynamics and the trauma–addiction nexus. Thematic analysis was conducted on narratives provided by six experienced addiction workers (mean age = 33 years, SD ≈ 5.86), comprising 33.33% men and 66.67% women. The analysis identified key themes including boundary dilemmas, therapeutic victories, defensive responses, and potential risk factors. The study highlights the detrimental effects of trauma on addiction workers while also revealing coping mechanisms and avenues for personal growth. Understanding the impact of trauma on addiction workers is vital for developing effective support strategies. By acknowledging both the risks of vicarious trauma and opportunities for vicarious post-traumatic growth, organizations can better support addiction workers and improve client care. Full article

(1) Background: As helping professionals, social workers are more susceptible to compassion fatigue, vicarious trauma, and burnout due to regular exposure to clients’ trauma, traumatic situations, and heavy caseloads. Social work students also face similar experiences during their field placement as they prepare to enter the profession. In addition, stress, a significant factor affecting academic performance, is prevalent among social work students. Prolonged stress can lead to chronic health conditions, emphasizing the need to develop effective stress management practice techniques. (2) Objective: To examine the impact of a four-week mindfulness strengths-perspective synchronous series and the impact on social work students’ personal strengths, self-care, stress, and coping strategies. (3) Methods: The purpose of this study was to examine social work students’ experiences with using mindfulness from a strengths perspective. Twenty-three (n = 23) social work students participated in a four-week synchronous mindfulness series that incorporated a strengths perspective, focusing on stress reduction and self-care practices. The series consisted of weekly mindfulness activities and writing prompts, concluding with a focus group in the final week. A thematic analysis was utilized to identify key themes. (4) Results: The researchers identified six themes: consistency and commitment, affirmations and self-love, a caring community, mindfulness strategies, physical restoration, and enrichment and learning. (5) Conclusion: Students were able to develop a better understanding of self-care and the benefits of taking time to incorporate practices for their health and wellness. Full article