Working in the Field of Complex Psychological Trauma: A Framework for Personal and Professional Growth, Training, and Supervision

[Impact of care for victims of gender violence on the health professionals]

Professionals who work with women victims of gender violence face difficult emotional situations, and it is important to be aware of the emotions and feelings that the attitudes and behaviour of victims and aggressors generate in them. These emotions can become barriers to communication and seriously affect the professional's relationship with victims. Furthermore, they can generate situations of sustained stress, lead to emotional exhaustion, and affect their health, life, and work performance. We describe the consequences, risk factors and warning signs, as well as protective or resilience factors, that are important to know, and we list the current challenges and some recommendations for professionals and management in order to help prevent such effects and improve professional performance without health risks.

Providing Gender Sensitive and Responsive Trauma-Informed Psychiatric Nursing Care. How Hard Can It Be?

This paper addresses the challenge of providing gender sensitive and responsive trauma-informed care (TIC) in psychiatric nursing practice. Gender identity, gender subordination, and gender-related trauma history are examined as three key individual-level factors that affect nurses' capacity to engage therapeutically to provide gender sensitive and responsive TIC. Using Peplau's Interpersonal Theory and building on a shared trauma and resilience model, gender-sensitive and responsive TIC is situated within interpersonal science and the ability of the psychiatric nurse to attune to her own and her patient's gender ideologies. Strategies for transforming practice including self-reflection, self-compassion, and peer and supervisor support are reviewed. Noting the import of the practice environment, several observations of changes needed at the level of the unit, organization, and society to effect gender equitable policies that enable the implementation of gender-sensitive and responsive TIC are made.

Vicarious Post-traumatic Growth in Professionals Exposed to Traumatogenic Material: A Systematic Literature Review

Repeated exposure to traumatogenic material as part of work with traumatised individuals can have detrimental effects on professionals' well-being. Growing research has explored this phenomenon, known as 'vicarious traumatisation'. Nevertheless, little research has focused on the positive effects of this work on professionals, namely, 'vicarious post-traumatic growth'. This literature review aims to identify existing research demonstrating mental health professionals' experiences of growth, along with environmental and personal factors that facilitate this growth. Eight qualitative and seven quantitative articles were identified following a systematic search of six electronic databases and assessed for their quality using standardised checklists. Qualitative studies were assessed using the Quality Appraisal Checklist for Qualitative Studies (NICE, 2012), and quantitative studies were assessed using the Appraisal Tool for Cross-Sectional Studies (Downes et al., 2016). Professionals described changes in the way they view themselves, the value they place on their relationships and their appreciation for life. Important organisational factors and personal traits were identified as significant predictors for professionals' growth. Our findings have the potential to inform practical recommendations and directions for future research.

The Impacts of Working With Victims of Sexual Violence: A Rapid Evidence Assessment

AIM

Supporting clients who have experienced trauma can lead to trauma symptoms in those working with them; workers in the sexual violence field are at heightened risks of these. This article collated and critically appraised papers, published from 2017 onward, in the area of people assisting victims of sexual violence. It explores the impacts and effects the work has on them, their coping and self-care mechanisms, and organizational support offered to them.

DESIGN

A question-based rapid evidence assessment with a triangulated weight of evidence approach was used. Academic and nonacademic databases were searched. Twenty-five papers were included for analysis based on the inclusion/exclusion criteria.

RESULTS

Most studies were of medium to high methodological quality. Negative impacts included trauma symptoms, disrupted social relationships, behavioral changes, and emotional and psychological distress. Ability to manage negative impacts was influenced by overall organizational support, availability of training, supervision and guidance, workloads and caseload characteristics, individual characteristics, and their coping and self-care mechanisms. Positive impacts included empowering feelings, improved relationships, compassion satisfaction, and posttraumatic growth.

CONCLUSIONS

Impacts are significant. Support at work and in personal life increases staff's ability to cope and find meaning in their role. Implications for research and practice are discussed.

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.

"Guarding the Gatekeepers": Suicides among Mental Health Professionals and Scope of Prevention, A Review

Suicide is a social evil that is considered to be a global epidemic. Mental healthcare professionals (MHP) (psychiatrists, clinical psychologists, psychiatric social work, etc.) are often involved as 'gatekeepers' in the management of suicidality and suicide prevention. Even though the risk of suicide in medical profession has received attention in research, there has been scarcity of literature related to the same in MHPs. They are not immune to the perils of psychological distress and its cascading consequences including suicide, contrary to the popular societal myths. The intrinsic and extrinsic pressures of the profession, persistent discourse in managing the psychological distress of others, professional burnout, self-stigma, societal apathy and easy access to psychotropics are certain factors making the MHPs more vulnerable. This disengagement and stress can contribute to depression, anxiety and complex trauma in the MHPs. The situation is furthermore compounded in developing countries with resource constraints, low MHP: patient ratio and inflexibility of work schedules. This makes tailored interventions, peer counselling, periodic mental health screenings and administrative understanding and accountability necessary at all levels. Keeping this in background, the review glances at the risk factors of suicide related to MHPs, highlights the problem statement and discusses the possible interventions.