How Do We Help the Helpers?

How Do We Help the Helpers?

Saturday, November 16th, 2013

By Elissa J. Brown, Ph.D. & Alana Moses, M.A.

Most traumatic events, including violence exposure, motor vehicle collisions, and medical illness, affect individuals and their families. Helpers, including physicians, mental health providers, and law enforcement are outsiders—they meet the family after the trauma and often can leave the trauma “at the office” when they return to their homes at the end of the day.

In contrast, large-scale traumas, such as natural disasters and war, have a community-level impact. The emotional reactions to the trauma seem universal and unavoidable because they are experienced by all who live and work in the affected area—including those who will be expected to help the trauma survivors recover.

Shared trauma is defined as a traumatic event that is experienced by both clients and their helping professionals. There have been a number of traumatic events over the past 15 years in which this “shared” experience was the norm. According to the United Nations Office for Disaster Risk Reduction (UNISDR), from 2000-2012, 2.9 billion people were affected by natural disasters, 1.2 million people were killed by natural disasters, and damages from natural disasters amounted to $1.7 trillion. In many of these situations, therapists were both trauma survivors and helpers. They lived and worked in the vicinity of the trauma and faced the economic, practical, and psychological challenges that emerged.

What impact does shared trauma have on mental health providers? How does that influence the effectiveness of their therapy? What do these providers need to recalibrate and provide trauma-informed interventions? In short…we don’t know.

In spite of the large numbers of providers who have experienced shared trauma, we know little about their responses and needed interventions. Research suggests that therapists with their own trauma histories and those with higher trauma caseloads may be especially susceptible to adverse reactions, such as secondary traumatic stress (PTSD due to their clients’ trauma exposure). In turn, providers with high levels of secondary traumatic stress have higher scores on job burnout, turnover intention, poorer psychological well-being, and lower scores on job satisfaction and occupational commitment.

What do we need to do to learn how to help the helpers?

Helping professionals constantly are called upon in communities after natural disasters to address the mental health needs of children and adults who have been traumatized. Community-wide trauma, such as natural disasters, are becoming increasingly more frequent and debilitating to communities. Significant amount of money is being invested in the training of current providers in evidence-based, trauma-informed mental health services. If we don’t figure out how to protect and sustain these providers, job turnover will result in additional psychological and economic crises following community trauma.

We are suggesting a call to action for research on shared trauma. Studies using a prospective longitudinal design could provide information on the short- and long-term responses of providers, and factors that are associated with higher levels of secondary traumatic stress. Reliable and valid measures of both client and provider exposure will ensure an understanding of the similarities and differences in experience and responses. Intervention studies are needed to examine strategies that might prevent and treat secondary traumatic stress. We ask those in charge of disaster preparedness, funding, and children’s health and welfare to step up and demand knowledge and guidance for our communities.