In the early 1970s it became apparent that there were significant consequences for those working with people who had experienced physical or emotional harm. Investigation of this phenomenon among such groups as disaster relief workers, emergency room staff, and “hotline” workers suggested a syndrome which has been variously described as “compassion fatigue”, “burnout”, and more recently “vicarious traumatisation”. The principal symptoms reported relate to mood disorders, changes in perspective taking, and disrupted interpersonal relationships. More recently, similar symptoms have been observed in those providing services to the perpetrators of sexual offending.
A number of studies indicate that at least some therapists who work with sexual abusers experience vicarious trauma. These therapists report a range of symptoms including intrusive thoughts, avoidant behaviours, and hypervigilance (over-suspiciousness).
When factors which were thought to play a role in the development of this syndrome were investigated, there were several counterintuitive findings. The most surprising of these was that, although a proportion of those working in this field had a history of personal trauma, this was not related to symptoms of vicarious traumatisation of therapists. Similarly, neither the size of the practitioner’s caseload, nor the type of treatment which they delivered were related to negative symptoms.
There was some indication that years of experience in the field was a factor, with most of those reporting negative symptoms being relatively new to the area (less than two years) or with an extensive history of working with this type of offender population. Those practitioners who worked in a more secure prison setting reported the highest level of traumatisation.
Overall, however, the strongest association with vicarious traumatisation was whether or not the practitioner had good coping strategies.
While the authors acknowledge that this area is still fraught with methodological difficulties, they consider that research supports the notion that some practitioners working with sex offenders do experience traumatic reactions related to their work, and these consistently involve descriptions of emotional and cognitive changes in the way they experience the self, others, and the world. Further, unless this is adequately managed by way of good supervision, these reactions will not only have negative consequences for the individual, but are also likely to compromise the integrity of the therapy which they provide.
The authors conclude by recommending that training for sexual offender therapists should include education regarding the possible negative impact which this work may have, and guidelines for addressing this reaction through quality supervision. They also suggest that positive coping strategies, particularly peer or collegial support, may lessen the risk for workers in this field and encouragement to become involved in professional associations where these matters are debated and discussed is indicated(1).
1 Maulden H. M., and Firestone P. (2007), Vicarious Traumatisation: The impact on therapists who work with sexual offenders, Trauma, Violence, and Abuse, 8, pp 67 - 83.
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