Wednesday, February 6, 2013

Vicarious Trauma and Advocate Responsibility


Vicarious trauma is real and can lead to poor morale and health in advocates who are regularly exposed to the trauma of others.  The effects of vicarious trauma can mirror the reactions that we see in victims of domestic violence and sexual assault – depression, difficulty planning and making decision, and problems following through with a course of action.  An advocate may become hyper-vigilant and have difficulty sleeping. 

In order to keep on providing good advocacy services, there is a high level of responsibility on the part of the advocate to manage her/his own trauma effects.  Hopefully, an advocate is working as a part of an organization that promotes good self-care but the mission of domestic violence or sexual assault organization cannot be fulfilled if it is spending all of its time managing the trauma of its advocates.  Advocates need to consider self-care a responsibility to themselves, their organizations, and to the victim/survivors who are seeking services.  Given that an advocate is expected to perform his/her duties and provide support as a part of employment, it is imperative that self-care be done pro-actively rather than be used as an excuse not to be available to a victim/survivor.

This is becoming increasingly important as agencies are expected to do more with less.  It is not fair to the agency, co-workers, and victims if an advocate decides that the effects of vicarious trauma are so bad that she cannot provide advocacy for an afternoon or a day.  In the same way that first responders and emergency personnel are expected to work through the stress, advocates may need to find a way to continue to provide support and perform work tasks even while dealing with the effects of trauma.  Yes, we expect our agencies to be trauma informed/responsive and have an understanding of the trauma that advocates experience. However, it is the advocate’s responsibility to create a plan to manage the effects of trauma during both work and off-work hours. 

Supervision can be used to discuss the effects of vicarious trauma and can also be used to determine whether or not an advocate is truly dealing with the effects of VT or is experiencing burnout or compassion fatigue.  It may be a time to explore boundary issues, grapple with organizational skills and managing workload, or re-define success or expectations.

For some people who continue to grapple with the stress of providing advocacy to victims of abuse, it may be necessary to self-reflect on whether this particular choice of occupation is a good fit.  Sometimes it is important to admit that it is time to move on and make other choices rather than continue to work in a job that affects your health and well-being and makes it difficult for you to fulfill the expectations and mission of the organization and the victims who seek help.  This does not mean that one has failed. It just means that there was not a good fit.  There are many jobs which I have not applied for because it would not be a good fit and a few jobs in which I worked that I eventually left because it was not a good fit.  By learning what fit and what didn’t I was able to make better career decisions that fulfilled me and used my talents.  I also know, however, that I am responsible for my own self care.

The following information is from The Headington Institute.  It is an outline for managing vicarious trauma for advocates and managers. 


Make a vicarious action plan
You probably wouldn’t set out to help the people you serve without a plan. Why not give yourself the benefit of that same approach? This exercise can be completed in 15 minutes, or you can spend more time on it. We strongly recommend that you repeat it at least every couple of months.
As you complete the exercise, you might like to refer back to the text of this module. For each question we’ve included links back to the relevant section. You can also follow this link to download a list of all the “Think about” questions in this module. If you have been taking notes in response to these questions, those notes will help you complete this exercise. 
1.     List your important risk factors for vicarious trauma. These are things that get in the way of you helping others. They come from three main areas:
a.     From personal factors (e.g., past and current stress in your life)
b.     From your situation (e.g., work-related factors)
c.     From the cultural context (e.g., discrimination and attitudes of intolerance)
2.     List any signs or symptoms of vicarious trauma that you are experiencing. Think about the following areas:
 .      Physical
a.     Psychological
b.     Behavior and relationships
c.     Worldview or frame of reference (spirituality, identity, and beliefs)
3.     What are things that you can do to cope better with these symptoms? (Hint: Think about how you can counteract your risk factors, and remember that good coping strategies for vicarious trauma are things that help you take care of yourself – especially things that help you escape, rest, and play.) How can you take care of yourself in the following areas:
 .      Physical
a.     Mental and emotional
b.     Behavior and relationships
c.     At work
4.     What steps can you take that can help you transform your vicarious trauma on a deeper level? (Hint: remember that transforming vicarious trauma means identifying ways to nurture a sense of meaning and hope).
 .      Outside work
a.     During work
5.     Pick two things you have listed in response to questions 3 or 4, and think about how you will put those into practice this week. Set two specific, realistic, goals by completing the sentence below (Hint: think about how, when, and where you achieve these goals and put that in your answer too):

This week I will ______________________ to help prevent or manage vicarious trauma. 
6.     What obstacles might get in the way of you doing the two things you identified in item 5, above?
7.     What might you to do overcome the obstacles listed above? What will support you in accomplishing your goals (Hint: think about people who can support you and how they might encourage you.


What managers can do
Are you a manager? Managers can take many steps to help lessen the impact of vicarious trauma on staff they are supervising. Here are some of them.
1.     Understand the psychological and spiritual impact of humanitarian work:
a.     Be alert to how the cumulative exposure to stressful and traumatic situations may be affecting staff.
b.     Regularly check in with staff about how they’re coping – do not wait for them to approach you with a problem.
c.     Support staff in seeking counseling or coaching if and when needed.
2.     Set a good example in the way that you care for yourself, including:
 .      Work at a sustainable and reasonable pace over time, and encourage staff you supervise to do the same;
a.     Openly value things and people outside of work (e.g., time spent with your family);
b.     Take allocated leave time;
c.     Acknowledge that humanitarian work can be challenging and that healthy work/life balance takes practice and intentionality.
3.     Especially during times of increased pressure or crises, look for ways to help staff keep current challenges in perspective by:
 .      Reminding staff of the bigger picture of the organization’s mission and purpose, and how this assignment or disaster response fits into that bigger picture; and
a.     Reminding staff of the value the organization places upon them both as people and the organization’s most important resources. Encourage staff to work in sustainable ways. If that does not appear possible in the short-term, encourage them to take extra time after the immediate impact phase is over to rest and regain equilibrium.
4.     Express concern for the general well-being of your staff and not just the quality of the work they are doing.
5.     Make sure that staff suggestions and feedback about their jobs and the organization are heard and valued – even if you are fairly sure they will not result in tangible change in the near future.
6.     Do not say or do things that would stigmatize staff who are struggling with vicarious trauma or other stress or trauma-related issues.
7.     Strive to stay positive, and to praise and acknowledge effort and results whenever possible.

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