Client, practitioner and system characteristics influencing the occurrence of secondary traumatic stress {STS} in mental health practitioners
Secondary Traumatic Stress [STS] is a constellation of conditions ranging from Post-Traumatic Stress Disorder (PTSD)-like symptoms to transformative cognitive shifts in self and world view. Prior to the mid 1990's much of the STS research focused on emergency responders (Arvay, M.J. 2001, Arvay & Uhlemann 2001), human service providers (Follette et al 1996, Bride 1995), and on one type of STS--vicarious traumatization. Since the mid 1990's STS research has increased in scope and volume, yet, little is known about how mental health practitioners experience Secondary Traumatic Stress. This dissertation differentiates itself from previous studies in two ways. First, the sample group covers a range of different providers rather than focusing on one provider type. Second, it uses a hybrid inductive-deductive thematic analysis to ascertain provider experience with STS research. Third, this is the first study to look at Christian counselors. This exploratory, qualitative research explores the ways in which Christian counselors define secondary traumatic stress, how they experience it, and what client, practitioner, and system characteristics influence STS occurrence. The primary goals of this study were to: (1) synthesize the substantive and theoretical literature on STS, (2) identify the system characteristics that promote or attenuate STS occurrence, and (3) identify the context within which STS occurs. This study drew heavily upon three theoretical frameworks. First, it used systems theory principals to explain the elements of the mental health system as they pertain to STS and its component parts. Second, it used synthetic thinking precepts to reveal how the mental health system functions regarding trauma therapists, trauma clients, and trauma therapy. Finally it drew upon chaos theory to identify the patterns within the system noise (Patton, 2007: 128). This qualitative study included twenty-five (25) in-depth interviews with Christian mental health practitioners as well as a survey. Both the interviews and the surveys included questions relating the conceptualization of STS, secondary traumatic stress experience, barriers to STS knowledge, and STS education. Results from the analysis show eight of 42 practitioners in this study evidenced high to severe secondary traumatic stress, the majority of providers were in the lowest quartile when measured using the Secondary Traumatic Stress Scale (Bride 2006) and were in the middle to low quartiles on the Professional Quality of Life Scale (Stamm 2009). All practitioners cited a need for educational changes not only around STS but around trauma as well. Practitioners acknowledged a multitude of barriers to STS education including in two-tiered unspoken difference between mental health practitioners and disaster mental health practitioners. Participants identified the need for and the types of supervision needed to prevent STS occurrence and the attendant consequences such as practitioner attrition, poor service quality, and victim retraumatization. These findings contribute to a more comprehensive analysis of the promoters of STS in mental health providers and provides a basis for making policy recommendations to identify effective educational policies. In addition, this work has implications for public policy. Having one in five practitioners showing high or severe levels of STS warrants significant changes to education policy surrounding secondary traumatic stress. (PsycINFO Database Record (c) 2011 APA, all rights reserved)
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