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Ghafoori B, Triliva S, Chrysikopoulou P, Vavvos A. Psychological adaptation among health care workers who work with trauma-exposed refugees in Greece. J Trauma Stress 2024; 37:483-491. [PMID: 38374536 DOI: 10.1002/jts.23022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 02/21/2024]
Abstract
Greek health care workers (HCWs) working with refugee and asylum-seeker populations may be at risk of trauma exposure and related distress. The current study sought to further understand the factors that may promote or hinder psychological adaptation among HCWs working with trauma-exposed refugee populations in Greece. Participants were HCWs (N = 20) who completed semistructured interviews. Thematic analysis procedures identified three main themes: vicarious traumatization, (b) mismatch of expectations, and (c) difficulty coping. Our study findings highlight the need to provide adequate training, supervision, and mental health support for HCWs to prevent mental health issues in this population. Additional studies are necessary to understand the long-term consequences of working with refugee populations and explore ways to assist HCWs with self-care.
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Affiliation(s)
- Bita Ghafoori
- Department of Advanced Studies in Education and Counseling, California State University Long Beach, Long Beach, California, USA
| | - Sofia Triliva
- Department of Psychology, University of Crete, Rethimno, Greece
| | | | - Andreas Vavvos
- Department of Psychology, University of Crete, Rethimno, Greece
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Levy E, Herzog D, Ryder CH, Grunstein R, Gidron Y. Indirect Exposure to Atrocities and Post-Traumatic Stress Disorder Symptoms among Aid Workers: Hemispheric Lateralization Matters. J Clin Med 2024; 13:2373. [PMID: 38673646 PMCID: PMC11051319 DOI: 10.3390/jcm13082373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/13/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Humanitarian aid workers (HAWs) are indirectly exposed to atrocities relating to people of concern (POC). This may result in a risk of secondary traumatization demonstrated by post-traumatic stress symptoms (PTSSs). Previous studies have demonstrated that hemispheric lateralization (HL) moderates the relationship between threat exposure and post-traumatic stress symptoms (PTSSs). Aims: We hypothesized that indirect exposure to atrocities (IETA) would be positively correlated with PTSSs among HAWs with right and not left HL. Method: Fifty-four HAWs from several countries that provided humanitarian support in Greece and Colombia participated in this correlational and cross-sectional observation study. They completed scales relating to IETA, PTSSs were assessed using a brief, valid scale, and HL was measured. Results: IETA was positively and significantly related to PTSSs (r = 0.39, p < 0.005). Considering HL, IETA was unrelated to PTSSs among people with right HL (r = 0.29, p = 0.14), while IETA was related to PTSSs among people with left HL (r = 0.52, p = 0.008). Right HL emerged as a protective factor in the relationship between IETA and PTSS. Conclusions: An assessment of dominant HL can serve as one consideration among others when deploying HAWs in specific locations and roles, vis à vis IETA. Moreover, those found to have a higher risk for PTSSs based on their HL could be monitored more closely to prevent adverse reactions to IETA.
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Affiliation(s)
- Einav Levy
- Department of Social Work, Tel Hai College, Qiryat Shemona 1220800, Israel;
- Research Center for Innovation in Social Work, Tel Hai College, Qiryat Shemona 1220800, Israel
- The Israeli School of Humanitarian Action, Tel Aviv 4632825, Israel
| | | | - Chen Hanna Ryder
- Brain & Behavior Research Institute, Western Galilee Academic College, Akko 2412101, Israel;
| | - Rachel Grunstein
- Department of Social Work, Tel Hai College, Qiryat Shemona 1220800, Israel;
| | - Yori Gidron
- Department of Nursing, Haifa University, Haifa 3498838, Israel;
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Dolan E, Cosgrave C, Killackey E, Allott K. Foundations of support: Processes associated with adolescents supporting a peer who experienced a traumatic event. Aust J Rural Health 2023; 31:1060-1071. [PMID: 37452497 DOI: 10.1111/ajr.13015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/15/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND There is limited research on how supporting a peer through a traumatic event is experienced by adolescents. The aim of this research was to understand the personal and interpersonal processes of adolescents supporting a peer who experienced a traumatic event based on youth definitions. METHOD In-depth qualitative interviews were conducted with 22 adolescents aged 14-19, residing in Gippsland, Victoria, Australia. A constructivist grounded theory methodology was used to develop a substantive theory. RESULTS The substantive theory 'Foundations of Support' was developed which explained the support process phenomena. Specifically, adolescents who had shared responsibility for supporting their peers went back to life as normal, whereas adolescents who maintained sole responsibility experienced mental health problems. DISCUSSION The 'Foundations of Support' grounded theory highlights the importance of adolescents having strong connections to their trusted others, such as family, friends and community. This theory implies that facilitating connections with positive supports such as place and community are essential in guiding adolescents back to their foundations of support. Without strong connections, adolescents are at risk of maintaining sole responsibility, losing their sense of identity and feeling alienated within their community.
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Affiliation(s)
- Erin Dolan
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Catherine Cosgrave
- Adjunct - University of New England School of Rural Medicine, Armidale, New South Wales, Australia
| | - Eóin Killackey
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Kelly Allott
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Al-Janaideh R, Speidel R, Colasante T, Malti T. Evaluating a Social-Emotional Training Program for Refugee Families and Service Providers: Pilot Study. JMIR Form Res 2023; 7:e42606. [PMID: 37145855 PMCID: PMC10199395 DOI: 10.2196/42606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 02/07/2023] [Accepted: 02/26/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Refugee children are often exposed to adversities that present a threat to their healthy development. Promoting refugee children's social-emotional capacities may be an opportune, strengths-based avenue to nurture their resilience, coping strategies, and mental health outcomes amid these risks. Furthermore, supporting caregivers' and service providers' capacities to provide strengths-based care may result in more sustainable, caring environments for refugee children. However, culturally adapted initiatives that aim to promote social-emotional capacities and mental health in refugee children, caregivers, and service providers are limited. OBJECTIVE In this pilot study, we aimed to assess the feasibility and efficacy of a brief, 3-week social-emotional training program for refugee caregivers of children aged between 2 and 12 years and service providers who support refugees. This study had 3 central objectives. First, we examined whether refugee caregivers' and service providers' knowledge of core social-emotional concepts increased from pre- to posttraining, whether these increases were maintained 2 months later, and whether caregivers and service providers reported a high use of training-based strategies after the training. Second, we assessed if refugee caregivers reported any improvements in their children's social-emotional capacities and mental health from pre- to posttraining and 2 months later. Finally, we evaluated whether caregivers and service providers experienced any improvements in their own mental health symptoms from pre- to posttraining and 2 months later. METHODS A total of 50 Middle Eastern refugee caregivers of children (n=26) aged between 2 and 12 years and service providers (n=24) were recruited using convenience sampling and participated in a 3-week training program. Training sessions were delivered via a web-based learning management system and involved a combination of asynchronous (video-based) and synchronous (web-based live group) sessions. The training was evaluated using an uncontrolled pre-, post-, and 2-month follow-up design. Caregivers and service providers reported their understanding of social-emotional concepts and mental health at pre-, post-, and 2 months after training and reported their use of training strategies after training. Caregivers reported their children's social-emotional capacities and mental health through a presurvey, a series of postsurveys (after each module session and 1 week after the training), and a 2-month follow-up survey. The participants also reported their demographic information. RESULTS Caregivers' and service providers' knowledge of social-emotional concepts increased significantly from pre- to posttraining, and the service providers' knowledge increase was sustained at the 2-month follow-up. Both caregivers and service providers reported high levels of strategy use. Furthermore, 2 markers of children's social-emotional development (ie, emotion regulation and sadness over wrongdoing) improved after training. CONCLUSIONS The findings highlight the potential of strengths-based, culturally adapted social-emotional initiatives to support refugee caregivers' and service providers' abilities to provide high-quality social-emotional care to refugee children.
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Affiliation(s)
- Redab Al-Janaideh
- Research and Assessment, Centre for Leadership and Learning, York Region District School Board, York Region, ON, Canada
| | - Ruth Speidel
- Centre for Child Development, Mental Health and Policy, Department of Psychology, University of Toronto, Mississauga, ON, Canada
| | | | - Tina Malti
- Faculty of Education, Leipzig University, Leipzig, Germany
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Muñoz Bohorquez J, Parra DC, Saperstein SL, Aparicio EM, Lewin AB, Green KM. Feasibility of Implementing a Mindfulness-Based Online Program for Latina Immigrants and the Staff that Work with Them. Mindfulness (N Y) 2023; 14:1148-1161. [PMID: 37304657 PMCID: PMC10160716 DOI: 10.1007/s12671-023-02123-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 06/13/2023]
Abstract
Objective Post-migration stress and trauma impact the way Latino/a immigrants in the USA experience everyday life. Mindfulness-based interventions (MBIs) reduce stress and strengthen mental health by improving the response to stressors and promoting physical and psychological well-being; however, they have not been tested extensively with Latino/a immigrants in the USA, particularly MBIs implemented online. Thus, more information is needed about the feasibility of online MBIs adapted for Latino/a immigrants. Method This study focuses on the feasibility of an online MBI for Latina mothers and community staff members working with them (n = 41). Qualitative (three focus groups) data were collected to assess feasibility, appropriateness, acceptability, and quantitative (questionnaires) data asking about self-reported changes on stress, mindfulness, mind-body connection, subjective well-being, and perceived physical and mental health after the program. Results Participants in the three groups indicated the program was appropriate, feasible, and acceptable for Latina immigrant mothers and the staff serving them. Mothers' and Promotoras' (community health workers) mean scores for subjective well-being and perceived physical and mental health increased significantly from baseline to post-test. No significant changes were observed in surveys completed by the staff, even though focus group participants reported meaningful improvement. Conclusion Overall, the feasibility study was well received and relevant for the organization and the population they serve. The study's findings provide guidance to others who are implementing online mindfulness practices with Latina immigrants and the staff that work with them. Preregistration This study is not preregistered. Supplementary Information The online version contains supplementary material available at 10.1007/s12671-023-02123-6.
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Affiliation(s)
- Juliana Muñoz Bohorquez
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, 4200 Valley Dr, College Park, MD 20742 USA
| | - Diana C. Parra
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO USA
| | - Sandra L. Saperstein
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, 4200 Valley Dr, College Park, MD 20742 USA
| | - Elizabeth M. Aparicio
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, 4200 Valley Dr, College Park, MD 20742 USA
| | - Amy B. Lewin
- Department of Family Science, School of Public Health, University of Maryland, College Park, 4200 Valley Dr, College Park, MD 207 USA
| | - Kerry M. Green
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, 4200 Valley Dr, College Park, MD 20742 USA
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Tessitore F, Caffieri A, Parola A, Cozzolino M, Margherita G. The Role of Emotion Regulation as a Potential Mediator between Secondary Traumatic Stress, Burnout, and Compassion Satisfaction in Professionals Working in the Forced Migration Field. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2266. [PMID: 36767632 PMCID: PMC9915968 DOI: 10.3390/ijerph20032266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Professionals working with refugees are vicariously exposed to complex traumatic experiences lived by forced migrants, which can lead to the risk of developing secondary traumatic stress, burnout, and a poor compassion satisfaction. The current study aimed to explore the effects of secondary traumatic stress on burnout and compassion satisfaction in 264 Italian professionals working with refugees and forced migrants. Moreover, it examined the mediating role of emotion regulation between secondary traumatic stress and both burnout and compassion satisfaction. METHODS A structural equation modeling (SEM) was performed to test the hypothesis. RESULTS The results showed that increased levels of secondary traumatic stress were associated with an increase of burnout both directly and indirectly through the mediation of emotion regulation. Emotion regulation also totally mediated the relationship between secondary traumatic stress and compassion satisfaction. CONCLUSIONS The results suggested that prevention or interventions programs targeting emotion regulation might be important to improve the professional quality of life of operators working with refugees and forced migrants.
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Affiliation(s)
- Francesca Tessitore
- Department of Humanities, Philosophical and Educational Sciences, University of Salerno, 84084 Fisciano, Italy
| | - Alessia Caffieri
- Department of Humanistic Studies, University of Naples Federico II, 80138 Naples, Italy
| | - Anna Parola
- Department of Humanistic Studies, University of Naples Federico II, 80138 Naples, Italy
| | - Mauro Cozzolino
- Department of Humanities, Philosophical and Educational Sciences, University of Salerno, 84084 Fisciano, Italy
| | - Giorgia Margherita
- Department of Humanistic Studies, University of Naples Federico II, 80138 Naples, Italy
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Tsouvelas G, Kalaitzaki A, Tamiolaki A, Rovithis M, Konstantakopoulos G. Secondary traumatic stress and dissociative coping strategies in nurses during the COVID-19 pandemic: The protective role of resilience. Arch Psychiatr Nurs 2022; 41:264-270. [PMID: 36428058 PMCID: PMC9428110 DOI: 10.1016/j.apnu.2022.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 08/07/2022] [Accepted: 08/22/2022] [Indexed: 12/14/2022]
Abstract
During the COVID-19 pandemic, nurses are repeatedly exposed to acute stress at their workplace, and therefore, they are at high risk for developing mental health symptoms. The prolonged exposure of healthcare professionals may lead to Secondary Traumatic Stress (STS). STS is an aspect of "cost of care", the natural consequence of providing care to people who suffer physically or psychologically. The purpose of this study was to investigate the levels of STS in nurses during the first phase of the COVID-19 pandemic in Greece and to detect aggravating and protective factors. Participants were 222 nurses (87.4 % women; mean age 42.3 years) who completed an online survey. The questionnaire comprised of the Secondary Traumatic Stress Scale, the Brief Resilience Scale, and the Brief Coping Orientation to Problems Experienced Inventory. Nurses had high levels of STS. The hierarchical regression analyses showed that STS and its dimensions Avoidance and Arousal were positively predicted mainly by denial and self-distraction coping strategies and inversely by resilience. Resilience exhibited a protective (partial mediation) effect on the strong relationship between the dissociative coping strategies (denial, self-distraction, venting and behavioral disengagement) and STS. Trauma-informed care psychosocial interventions are needed to support the already overburdened nursing staff during the coronavirus pandemic.
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Affiliation(s)
- George Tsouvelas
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece.
| | - Argyroula Kalaitzaki
- Department of Social Work, Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Affiliated Researcher of the Research Centre 'Institute of Agri-Food and Life Sciences', Hellenic Mediterranean University, CP: 71004 Heraklion, Greece.
| | - Alexandra Tamiolaki
- Department of Social Work, Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Hellenic Mediterranean University, CP: 71004 Heraklion, Greece
| | - Michael Rovithis
- Department of Nursing, Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life, Affiliated Researcher of the Research Centre 'Institute of Agri-Food and Life Sciences', Health Sciences Faculty, Hellenic Mediterranean University, CP: 71004 Heraklion, Crete, Greece.
| | - George Konstantakopoulos
- Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece; Department of Clinical, Education and Health Psychology, University College London, London, UK.
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Vukčević Marković M, Živanović M. Coping with Secondary Traumatic Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12881. [PMID: 36232179 PMCID: PMC9564895 DOI: 10.3390/ijerph191912881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
Exposure to the traumatic experiences of others can lead to secondary traumatization (STS), a condition comprising trauma-related symptoms. There is a lack of evidence on efficient ways to mitigate STS among professionals working with refugees, who are secondarily exposed to traumatic content. This study examines the latent structure of coping mechanisms and explores the predictive power of coping strategies for STS in a sample of professionals working with refugees. A total of 288 participants (age: M = 34.01, SD = 10.03; 57.3% female) working with refugees completed the COPE Inventory and Secondary Traumatic Stress Scale. Factor analysis of the COPE Inventory showed that coping mechanisms are grouped around four interrelated factors-Problem-focused, Socially supported emotion-focused, Avoidant, and Passive coping-which accounted for 46.7% of the variance. The regression model showed that Avoidant coping positively predicts negative alterations in cognition, mood, and reactivity (NACMR) and intrusions, and Passive coping was positively associated with NACMR and avoidance. Problem-focused coping was related to lower NACMR and avoidance, while Socially supported emotion-focused coping was not associated with any of the STS symptoms. In total, coping factors accounted for 10.8%, 6.3%, and 4.3% of the variance of NACMR, intrusions, and avoidance, respectively. The study provides a foundation for programs to mitigate STS among professionals working with refugees.
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Affiliation(s)
- Maša Vukčević Marković
- Laboratory for Research of Individual Differences, Department of Psychology, Faculty of Philosophy, University of Belgrade, 11000 Belgrade, Serbia
- Psychosocial Innovation Network, 11000 Belgrade, Serbia
| | - Marko Živanović
- Laboratory for Research of Individual Differences, Department of Psychology, Faculty of Philosophy, University of Belgrade, 11000 Belgrade, Serbia
- Psychosocial Innovation Network, 11000 Belgrade, Serbia
- Institute of Psychology, Department of Psychology, Faculty of Philosophy, University of Belgrade, 11000 Belgrade, Serbia
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Jeffery AJ, Salt RJ. Voices of the community: Exploring the experiences of resettled refugee interpreters at a refugee clinic in a large multicultural city in Texas, United States of America. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1951-1959. [PMID: 34549469 DOI: 10.1111/hsc.13574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/26/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
Worldwide refugees numbered nearly 25.9 million in 2018 and, according to the United Nations High Commissioner for Refugees, the crisis grows each year. Research reports that refugees have a high prevalence of mental health conditions and are at increased risk for emotional and mental distress during resettlement. Furthermore, interpreters have been shown to be at increased risk for secondary re-traumatisation, a condition similar to Post Traumatic Stress Disorder, where client trauma shares commonalities with trauma experienced by the interpreter. The purpose of this study was to explore the experiences of resettled refugee interpreters. Based on previous data from this community, the research team determined that a qualitative methodology was best practice to explore the experiences of resettled refugee interpreters. In May of 2019, seven participants were recruited from a pool of resettled refugee interpreters who worked at a refugee health clinic in a large multicultural city in Texas. One-on-one interviews were conducted, and the data were analysed using content analysis. Five themes emerged that represented the experiences of these participants: speaking for others, developing interpretation strategies, advocating for the community, receiving social support and overcoming challenges specific to the healthcare setting. The findings from this study add to the current body of literature that addresses the experiences of resettled refugee interpreters. Furthermore, these data may be used to create additional resources for refugee interpreters who work at health clinics, such as training on medical terminology, access to mental health services and site-specific incentives.
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Affiliation(s)
- Andrew J Jeffery
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Rebekah J Salt
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Benuto LT, Yang Y, Bennett N, Lancaster C. Distress Tolerance and Emotion Regulation as Potential Mediators Between Secondary Traumatic Stress and Maladaptive Coping. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP11557-NP11581. [PMID: 33076751 DOI: 10.1177/0886260520967136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The extant literature has illustrated that protective service workers experience negative repercussions associated with their job (including the development of secondary traumatic stress; STS) and may utilize maladaptive coping mechanisms. Developing an improved understanding of factors that might explain the relationship between STS and the utilization of maladaptive coping mechanisms is warranted. This study sought to examine emotion regulation and distress tolerance as potential mediators between STS and the utilization of maladaptive coping mechanisms. Participants were 152 elder protective service workers and 105 child protective service workers who completed an online survey of self-report measures of emotion regulation, distress tolerance, STS, and coping behaviors. A parallel multiple mediator model was analyzed using structural equation modeling (SEM) to examine the hypothesis that distress tolerance and emotion regulation would mediate the relationship between STS and the utilization of maladaptive coping. Our hypothesis was partially supported as the effect of STS on maladaptive coping was mediated by emotion regulation but not by distress tolerance. The results from this study have both prevention and intervention implications. From a prevention perspective, efforts could be directed at teaching emotion regulation skills to those at risk for developing STS as a mechanism for decreasing the probability of denial, substance use, behavioral disengagement, and self-blame that may occur as a consequence of STS. From an intervention perspective, some of the negative sequelae of exposure to STS may be averted by teaching EPS and CPS workers who present with STS symptoms, emotion regulation skills.
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Yazıcı H, Özdemir M. Predictors of Secondary Traumatic Stress in Mental Health Professionals: Trauma History, Self-Compassion, Emotional Intelligence. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2022. [DOI: 10.1007/s10942-022-00458-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Grasser LR. Addressing Mental Health Concerns in Refugees and Displaced Populations: Is Enough Being Done? Risk Manag Healthc Policy 2022; 15:909-922. [PMID: 35573980 PMCID: PMC9094640 DOI: 10.2147/rmhp.s270233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 04/26/2022] [Indexed: 01/22/2023] Open
Abstract
There are over 82.4 million forcibly displaced people worldwide, about a quarter of whom are resettling as refugees. In the wake of the global refugee crisis spurred by conflict, religious and political persecution, human rights violations, and climate disasters, a mental health has crisis followed. Not only does trauma experienced in home countries and as part of forced migration affect mental health, so too do post-migration traumatic events, discrimination, lack of access to quality and affordable healthcare and housing, and acculturation. To address mental health concerns in refugees and displaced populations, collective action is needed not only from health care providers but also from mental health researchers, funders, journals, resettlement agencies, government entities, and humanitarian organizations. The present review highlights the work of numerous scholars and organizations with the goal of understanding the mental health concerns of forcibly displaced persons within and across ecological systems. The present review seeks to bring attention to the experiences of forcibly displaced persons, summarize the growing body of research understanding the acute and chronic effects of forced displacement and possible interventions, and give a call to action for all members of the global community at every level to engage in joint efforts to improve mental health in refugees and displaced persons. Notably, there is a need for more interventions at the familial and community level that serve not only as treatment but also as prevention. Smartphone-based interventions, mind-body modalities, and interventions delivered by lay and non-clinician community members hold promise. Numerous strides could be made in refugee mental health and treatment when funding agencies include these goals in their research priorities. Despite the challenges they have faced, persons who resettle as refugees are incredibly resilient and deserve to be afforded every right, opportunity, dignity, and respect.
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Affiliation(s)
- Lana Ruvolo Grasser
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
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Secondary Traumatic Stress, Depression, and Anxiety Symptoms Among Service Providers Working with Syrian Refugees in Istanbul, Turkey. J Immigr Minor Health 2022; 24:1421-1430. [PMID: 35212824 DOI: 10.1007/s10903-022-01344-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 10/19/2022]
Abstract
This paper examines the mental health of service providers working with Syrian refugees. Using the Professional Quality of Life framework, we hypothesize greater stress/less support from the work, person, client environment is associated with symptoms of STS, depression, and anxiety. We surveyed a sample of 104 service providers throughout Istanbul late 2018. Multivariable logistic regression examined associations between work (organizational support, caseload, supervision), person (perceived social support), client environment (trauma disclosure, percent Syrian refugees) on STS, depression, and anxiety. We found rates of moderate-to-severe STS to be 27.88%; depression 40.38%; and anxiety 29.81%. Our hypothesis was partially supported. Lower organizational support was associated with moderate-to-severe STS (aOR 0.91, 95% CI 0.84, 0.99) while lower social support with anxiety (aOR 0.89, 95% CI 0.81, 0.99). Caseload, supervision, trauma disclosure, percent refugees did not show significant associations. Organizations working with Syrian refugees may benefit from enhancing organizational support and promoting social support for staff.
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Listopad IW, Michaelsen MM, Werdecker L, Esch T. Bio-Psycho-Socio-Spirito-Cultural Factors of Burnout: A Systematic Narrative Review of the Literature. Front Psychol 2021; 12:722862. [PMID: 34925130 PMCID: PMC8672245 DOI: 10.3389/fpsyg.2021.722862] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/01/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Burnout is a widespread, multifactorial, and mainly psychological phenomenon. The pathogenesis of burnout is commonly described within the bio-psycho-social model of health and disease. Recent literature suggests that the phenomenon of burnout may be broader so that the three dimensions might not reflect the multifaceted and complex nature of the syndrome. Consequently, this review aims to identify the diversity of factors related to burnout, to define overarching categories based on these, and to clarify whether the bio-psycho-social model adequately describes the pathogenesis of burnout-holistically and sufficiently. Method: Five online databases (PubMed, PubPsych, PsychARTICLES, Psychology and Behavioral Sciences Collection, and Google Scholar) were systematically searched using defined search terms to identify relevant studies. The publication date was set between January 1981 and November 2020. Based on the selected literature, we identified factors related to burnout. We aggregated these factors into a comprehensible list and assigned them to overarching categories. Then, we assigned the factors to the dimensions of an extended model of health and disease. Results: We identified a total of 40 burnout-related factors and 10 overarching categories. Our results show that in addition to biological, psychological, and socio-environmental factors, various factors that can be assigned to a spiritual and work cultural dimension also play an important role in the onset of burnout. Conclusion: An extended bio-psycho-socio-spirito-cultural model is necessary to describe the pathogenesis of burnout. Therefore, future studies should also focus on spiritual and work cultural factors when investigating burnout. Furthermore, these factors should not be neglected in future developments of diagnosis, treatment, and prevention options.
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Affiliation(s)
- Ian W. Listopad
- Institute for Integrative Health Care and Health Promotion, Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
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15
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Mavratza T, Adamakidou T, Apostolara P, Fasoi G, Mantzorou M, Mantoudi A, Drakopoulou M, Misouridou E. Professional Quality of Life in Greek Health Professionals Working with Refugees and Migrants. Mater Sociomed 2021; 33:94-99. [PMID: 34483735 PMCID: PMC8385739 DOI: 10.5455/msm.2021.33.94-99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Expatriation and relocation into a new cultural context constitute a psychological journey marked by exposure to potentially traumatic events, the abandonment of the homeland and the effort of seeking safety and a new beginning at all levels. Objective: The aim of this study was to investigate the Professional Quality of Life in Greek health professionals working with refugees and migrants. Methods: The Professional Quality of Life Scale (ProQOL V) and a demographic and work-related characteristics questionnaire were distributed to 90 health professionals working with migrants and refugees. Results: 25.6% of participants reported high CF risk while 75.7% expressed high to moderate potential for CS. Awareness of the factors associated with CF may help health professionals to prevent or offset the development of this condition. Conclusion: A compassionate organizational culture, clinical supervision and on-going education may protect health professionals working with migrants and refugees from absorbing or internalizing unmanageable emotions which may lead to compassion fatigue and also help them to gain a deeper understanding of their communication and interactions during the emotionally laden moments of trauma care.
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Affiliation(s)
| | | | | | - Georgia Fasoi
- Nursing Department, University of West Attica, Athens, Greece
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16
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Zehetmair C, Kindermann D, Tegeler I, Derreza-Greeven C, Cranz A, Friederich HC, Nikendei C. A Qualitative Evaluation of a Mother and Child Center Providing Psychosocial Support to Newly Arrived Female Refugees in a Registration and Reception Center in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094480. [PMID: 33922525 PMCID: PMC8122916 DOI: 10.3390/ijerph18094480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/20/2021] [Accepted: 04/20/2021] [Indexed: 12/29/2022]
Abstract
Female refugees are frequently exposed to sexualized, gender-based violence and harassment before, during, and after their flight. Yet female refugee-specific care and protection needs are rarely addressed in host countries. This study aimed to evaluate a mother and child center (MUKI) for female refugees in a reception and registration center in Germany. In 2017, we conducted semi-structured qualitative interviews with 16 female refugees attending the MUKI and with its five main staff members. We asked the participants about the MUKI’s relevance, encountered difficulties, and suggestions for improvement. The interviewees appreciated the MUKI’s sheltered environment, care services, and socializing opportunities, as well as its women-only concept. Overall, the participants saw overexertion, social engagement-related difficulties, and the MUKI’s noisy environment as key attendance barriers. Interviewed staff primarily reported problems regarding the working conditions, including the high staff and attendee turnover and low general service awareness. The participants advocated an expansion of the MUKI program. The MUKI project underlines that providing newly arrived, vulnerable female refugees with sheltered surroundings and psychosocial services is an essential step toward addressing female refugees’ specific care needs.
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17
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Žilinskienė J, Šumskas L, Antinienė D. Paediatric Type1 Diabetes Management and Mothers' Emotional Intelligence Interactions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3117. [PMID: 33803528 PMCID: PMC8002982 DOI: 10.3390/ijerph18063117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/11/2021] [Accepted: 03/13/2021] [Indexed: 11/16/2022]
Abstract
The functioning of the parents' emotional sphere is very important to a child's mental and physical health. This study focused on investigating the association between mothers' emotional intelligence (EI) and paediatric type I diabetes (T1DM) disease management in their children. We hypothesized that mothers' EI is associated with T1DM outcomes. Mothers of children with T1DM aged 6-12 years were surveyed. One hundred and thirty-four mothers, the main caregivers of their diabetic children, provided measures of EI and completed a demographic questionnaire. The primary indicator of diabetes management was haemoglobin A1c (HbA1c; the main form of glycosylated haemoglobin). EI scales and subscales were associated with glycaemic management indices. Logistic regression analysis was applied for the assessment of the association between parents' EI and their paediatric with T1DM disease management. The analysis demonstrated a statistically significant correlation between T1DM management and mothers' ability to understand and control own emotions, to transform their own negative emotions into positive and to control own negative emotions. Mothers' EI scales and subscales of understanding and regulating their own emotions, subscales of transforming their own negative emotions into positive ones and controlling their own negative emotions were statistically reliable predictors of glycaemic control in children with T1DM.
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Affiliation(s)
- Jolanta Žilinskienė
- Department of Health Psychology, Faculty of Public Health, Lithuanian University of Health Sciences, A. Mickevičiaus Street 9, LT-44307 Kaunas, Lithuania;
| | - Linas Šumskas
- Department of Preventive Medicine and Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, A. Mickevičiaus Street 9, LT-44307 Kaunas, Lithuania;
| | - Dalia Antinienė
- Department of Health Psychology, Faculty of Public Health, Lithuanian University of Health Sciences, A. Mickevičiaus Street 9, LT-44307 Kaunas, Lithuania;
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18
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Gemignani M, Giliberto M. Constructions of burnout, identity, and self-care in professionals working toward the psychosocial care of refugees and asylum seekers in Italy. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2021. [DOI: 10.1080/10720537.2019.1700853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Marco Gemignani
- Department of Psychology, Universidad Loyola, Seville, Spain
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19
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Miró E, Martínez MP, Sánchez AI, Cáliz R. Clinical Manifestations of Trauma Exposure in Fibromyalgia: The Role of Anxiety in the Association Between Posttraumatic Stress Symptoms and Fibromyalgia Status. J Trauma Stress 2020; 33:1082-1092. [PMID: 32567748 DOI: 10.1002/jts.22550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 12/13/2019] [Accepted: 12/15/2019] [Indexed: 12/16/2022]
Abstract
Little research has investigated how traumatic experiences relate to fibromyalgia (FM). We explored the presence of trauma exposure in a sample of Spanish participants with FM and examined the associations between (a) the number and type of traumatic experiences and posttraumatic stress disorder (PTSD) symptoms and (b) the severity of clinical manifestations in FM, testing for possible mediation models. Participants were 173 FM patients and 53 healthy controls aged 24 to 66 years. Traumatic event type (physical trauma, physical and sexual abuse, psychological trauma), PTSD symptoms, pain intensity, sleep disturbance, anxiety, depression, coping style, and daily functioning were evaluated via self-report. Fibromyalgia patients reported a higher percentage of trauma exposure than controls, more traumatic experiences (mainly emotional and physical trauma), and more PTSD symptoms, Hedges' gs/Cohen's ds = 0.42-0.76. Most FM patients reported having experienced their most distressing traumatic experience and PTSD symptoms before FM diagnosis. PTSD symptom severity was associated with more pain, sleep disturbances, anxiety, depression, coping style, and functional impairment, rs = .23-.33, ps = .025-.008. A multiple mediation analysis showed a significant indirect effect of anxiety in the association between PTSD symptoms and daily functioning. In a subset of FM patients, PTSD symptoms were associated with major clinical symptoms. The results suggest future research should explore the effectiveness of trauma-focused therapy compared to standard cognitive behavioral therapy for these patients.
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Affiliation(s)
- Elena Miró
- University of Granada, Department of Personality, Assessment, and Psychological Treatment, Granada, Spain.,The Mind, Brain and Behavior Research Center, Granada, Spain
| | - M Pilar Martínez
- University of Granada, Department of Personality, Assessment, and Psychological Treatment, Granada, Spain.,The Mind, Brain and Behavior Research Center, Granada, Spain
| | - Ana I Sánchez
- University of Granada, Department of Personality, Assessment, and Psychological Treatment, Granada, Spain.,The Mind, Brain and Behavior Research Center, Granada, Spain
| | - Rafael Cáliz
- Service of Rheumatology, Virgen de las Nieves University Hospital, Granada, Spain
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20
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Mesa H, Doshi M, Lopez W, Bryce R, Rion R, Rabinowitz E, Fleming PJ. Impact of anti-immigrant rhetoric and policies on frontline health and social service providers in Southeast Michigan, U.S.A. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:2004-2012. [PMID: 32462702 DOI: 10.1111/hsc.13012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 03/02/2020] [Accepted: 04/01/2020] [Indexed: 06/11/2023]
Abstract
Rising hostility towards immigrants characterised the 2016 Presidential election in the United States (US) and subsequent policy priorities by the new presidential administration. The political shift towards aggressive policies targeting undocumented immigrants is far-reaching and extends into other communities that convive con-or coexist with-immigrant communities. Our study aims to examine the rippling effects of these anti-immigrant policies and rhetoric on health and social service providers in Southeast Michigan who predominantly serve Latino immigrants. Between April and August 2018, we conducted in-depth individual interviews in two Federally Qualified Health Centers and a non-profit social service agency at a county health department. We interviewed 28 frontline health and social service providers. After coding and thematic analyses, we found that staff members' experiences in supporting immigrant clients was congruent with definitions of secondary trauma stress and compassion fatigue, whereby exposure to clients' trauma combined with job burden subsequently impacted the mental health of providers. Major themes included: (a) frontline staff experienced a mental and emotional burden in providing services to immigrant clients given the restrictive anti-immigrant context; and (b) this burden was exacerbated by the increased difficulties in providing these services to their clients. Staff described psychological and emotional distress stemming from exposure to clients' immigration-related trauma and increased mental health needs. This distress was exacerbated by an increased demand to meet clients' needs, which involved explaining or translating documents into English, assisting with legal paperwork, referring clients to mental health resources, addressing increased transportation barriers, and reestablishing trust with the community. Our findings add qualitative data on the mental health implications for frontline providers who support Latino immigrant clients impacted by immigration and highlights the need for further research and resources that address the workplace-related stress generated by heightened immigration enforcement.
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Affiliation(s)
- Hannah Mesa
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Monika Doshi
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - William Lopez
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Richard Bryce
- Community Health and Social Services Center, Detroit, MI, USA
| | | | - Ellen Rabinowitz
- Washtenaw Health Department, Washtenaw Health Plan, Ypsilanti, MI, USA
| | - Paul J Fleming
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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21
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Živanović M, Vukčević Marković M. Latent structure of secondary traumatic stress, its precursors, and effects on people working with refugees. PLoS One 2020; 15:e0241545. [PMID: 33125384 PMCID: PMC7598499 DOI: 10.1371/journal.pone.0241545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/17/2020] [Indexed: 12/31/2022] Open
Abstract
The study aims to examine the latent structure of secondary traumatic stress (STS), its precursors, and the psychological effects of it on the population of service providers working with refugees passing through the Balkan route. A total of 270 service providers (57% female) of different professional backgrounds working directly with refugees took part in the study. Participants were assessed for STS using the Secondary Traumatic Stress Scale, the extent of secondary exposure to trauma (i.e., clients’ traumatic experiences from the countries of origin and travel that were communicated to them directly), depression, anxiety, and quality of life. Comparisons of several confirmatory factor analyses following prominent PTSD conceptualizations showed that the model with three relatively distinct but highly correlated factors–intrusion, avoidance, and the blend of negative alterations in cognitions, mood, and reactivity (NACMR), had the best fit. STS has been shown to be positively correlated both with the amount of different traumatic experiences that were communicated to them as well as with the specific content of those experiences. Path analysis showed that the amount of secondary exposure to the clients’ traumatic experiences during travel, but not in the country of origin, had exclusive relationships with all three factors of STS. NACMR demonstrated direct effects on anxiety and depression symptoms, while intrusions exhibited a direct effect on anxiety-related symptomatology only. The avoidance factor did not have any independent direct effects on anxiety or depression. Finally, the effects of STS factors on quality of life were fully mediated by an increase of depression-related symptomatology. Results provide evidence on the latent structure of the STS which partially deviates from the prominent models of PTSD thus questioning the isomorphism of two constructs on the empirical level. Additionally, findings provide insights on the cascade of events that make professionals working with traumatized people especially vulnerable to STS and broader psychological distress.
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Affiliation(s)
- Marko Živanović
- Department of Psychology, Institute of Psychology, University of Belgrade, Belgrade, Serbia
- Psychosocial Innovation Network, Belgrade, Serbia
- * E-mail:
| | - Maša Vukčević Marković
- Department of Psychology, Institute of Psychology, University of Belgrade, Belgrade, Serbia
- Psychosocial Innovation Network, Belgrade, Serbia
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22
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Capielo Rosario C, Abreu RL, Gonzalez KA, Cardenas Bautista E. “That day no one spoke”: Florida Puerto Ricans’ Reaction to Hurricane María. COUNSELING PSYCHOLOGIST 2020. [DOI: 10.1177/0011000019899382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We conducted two focus groups and four individual interviews to examine the experiences of Florida Puerto Rican adults ( N = 26) with secondary exposure to the devastation caused by Hurricane María. Results from our thematic analysis yielded four major themes and eight subthemes depicting responses to Hurricane María. Four major themes emerged across participant responses: 1) Participants’ Experience with Hurricane María, 2) Participants’ Negative Reactions to Hurricane María, 3) Participants Providing Support, and 4) Resilience and Growth. We also found that Florida Puerto Ricans’ secondary stress reactions were influenced by Puerto Rico’s political status and economic crisis. Results also indicated that participants experienced vicarious posttraumatic growth not only at the individual but also at the community level.
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