Risk of Secondary Traumatic Stress in Treating Traumatized Military Populations: Results from the PTSD Clinicians Exchange

Personal trauma history and secondary traumatic stress in mental health professionals: A systematic review

INTRODUCTION

Caring for those who have been traumatized can place mental health professionals at risk of secondary traumatic stress, particularly in those with their own experience of personal trauma.

AIM

To identify the prevalence of personal trauma history and secondary traumatic stress in mental health professionals and whether there is an association between these two variables in mental health professionals.

METHOD

We preregistered the review with PROSPERO (CRD42022322939) and followed PRISMA guidelines. Medline, Embase, PsycINFO, Web of Science and CINHAL were searched up until 17th August 2023. Articles were included if they assessed both personal trauma history and secondary traumatic stress in mental health professionals. Data on the prevalence and association between these variables were extracted. Quality assessment of included studies was conducted using an adapted form of the Newcastle-Ottawa scale.

RESULTS

A total of 23 studies were included. Prevalence of personal trauma history ranged from 19%-81%, secondary traumatic stress ranged from 19% to 70%. Eighteen studies reported on the association between personal trauma history and secondary traumatic stress, with 14 out of 18 studies finding a statistically significant positive relationship between these variables. The majority of studies were of fair methodological quality.

DISCUSSION

Mental health professionals with a personal history of trauma are at heightened risk of suffering from secondary traumatic stress.

IMPLICATIONS FOR PRACTICE

Targeted support should be provided to professionals to prevent and/or address secondary traumatic stress in the workforce.

Therapist and operator experiences utilizing multi-modal motion-assisted Memory Desensitization and Reconsolidation (3MDR) for treatment of combat related posttraumatic stress disorder amongst military and veteran populations

BACKGROUND

As provisions of mental healthcare services to military and veteran populations increases the risk to service providers developing secondary traumatic stress (STS), efforts are needed to examine the impact of delivering novel interventions which may include 3MDR. As a virtual-reality supported intervention, 3MDR exposes the patient, therapist and operator to graphic and sensory stimuli (i.e. narratives, imagery, smells, and music) in the course of the intervention. 3MDR is actively being researched at multiple sites internationally within military and veteran populations. It is, therefore, crucial to ensure the safety and wellbeing of 3MDR therapists and operators who are exposed to potentially distressing sensory stimuli.

OBJECTIVE

The purpose of this study is to qualitatively examine the impact and experiences of STS amongst therapists and operators in delivering 3MDR. For this study, impact will be defined as therapists or operators experiencing perceived STS as a result of delivering 3MDR.

METHODS

This exploratory qualitative study recruited 3MDR therapists and operators (N = 18) from Canada, the Netherlands, the United Kingdom, and the United States who had previously delivered 3MDR therapy. Telephone or video-conferencing interviews were used to gather data that was subsequently transcribed and thematically analyzed.

RESULTS

Four themes emerged among the therapists (n = 13) and operators (n = 5): (1) personal cost and benefits of 3MDR, (2) professional paradox of a 3MDR therapist, (3) perceived effect of 3MDR on patients, and (4) recommendations for future 3MDR use.

CONCLUSIONS

STS was not noted to be a significant challenge for 3MDR therapists and operators. Future research may investigate optimal means of providing training and ongoing support for 3MDR therapists and operators.

HIGHLIGHTS

Secondary Traumatic Stress was not noted to be a significant challenge for 3MDR therapists and operatorsFuture research may investigate optimal means of providing training and ongoing support for 3MDR therapists and operators.

The contribution of organisational factors to vicarious trauma in mental health professionals: a systematic review and narrative synthesis

BACKGROUND

The negative impact of trauma work has been well documented in mental health professionals. There are three main phenomena used to describe these effects: Secondary Traumatic Stress (STS), Vicarious Trauma (VT) and Compassion Fatigue (CF). To date, the majority of research has focused on the contribution of individual level factors. However, it is imperative to also understand the role of organizational factors.

OBJECTIVES

This review examines the role of organizational factors in ameliorating or preventing STS, VT, and CF in mental health professionals. We further aimed to identify specific elements of these factors which are perceived to be beneficial and/or detrimental in mitigating against the effects of STS, VT, and CF.

METHOD

Studies were identified by searching the electronic databases Medline, PsycINFO, Embase, Web of Science and SCOPUS with final searches taking place on 10 March 2021.

RESULTS

Twenty-three quantitative studies, eight qualitative studies, and five mixed methods studies were included in the final review. A narrative synthesis was conducted to analyse the findings. The results of the review highlight the importance of regular supervision within supportive supervisory relationships, strong peer support networks, and balanced and diverse caseloads. The value of having an organizational culture which acknowledges and validates the existence of STS was also imperative.

CONCLUSIONS

Organizations have an ethical responsibility to support the mental health professionals they employ and provide a supportive environment which protects them against STS. This review provides preliminary evidence for the types of support that should be offered and highlights the gaps in the literature and where future research should be directed. Further research is needed to evaluate which strategies - and under what conditions - best ameliorate and prevent STS.