Transcript: Episode 223
223. Guest: Jackie Burke, PhD
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Our guest today is Jackie Burke, a registered psychologist with 20 years of experience researching, practicing and developing policy in relation to trauma and vicarious trauma, as well as clinical governance and risk. She has worked in remote Australia, regional and Metropolitan New South Wales, and has directed national programs for people affected by sexual, domestic and family violence. She is an awarded researcher and published author with an adjunct position at Western Sydney University, and often speaks internationally on the topics of trauma, complex trauma, vicarious trauma and clinical supervision. After holding senior management roles for the past 15 years, Jackie established a private practice and consultancy business based in Sydney, Australia, in 2017. When not working, Jackie tries to maintain a regular yoga practice and enjoys a good murder mystery. Welcome Jackie Burke.
*Interview begins*
[Note: Podcast host is in bold. Podcast guest is in standard font]
So, hi, everyone. My name is Jackie Burke. I'm a psychologist, living and working in Sydney, Australia. And I have been involved in researching, writing and consulting about effective ways to manage vicarious trauma for over 15 years now. This podcast episode that we're recording just now is about how to manage the vicarious trauma effectively, particularly within organizations or agencies.
So there's several things that I'm excited to talk to you about. One, because I used to live in Sydney. So I'm a fan in that way already. I feel like we have a connection. [Laughter] And so that is good. It makes me-. There are all kinds of things. Certainly. I can think of what I would want to eat, where I would want to go. It is, it is the best kind of flooding. And so it's very calming and good. [Laughter]
It's a beautiful city, isn't it, Emma? I'm, I'm actually an import to Australia. So I was born and grew up in Wales in the UK. And I think my-. I feel very fortunate every day to be able to live in such a beautiful harbour City of Sydney. So I share your enthusiasm for this city.
It’s so lovely. The other thing is that I am on the vicarious trauma SIG with ISSTD. And so just sort of getting oriented and learning more about that as I start learning how to volunteer and plug myself in a little bit and try to be helpful. So that's part of why what you were sharing at the recent conference got my attention. And so just for people, whether they are clinicians, or friends of survivors, or survivors themselves even, how would you go about introducing the idea or defining vicarious trauma? Just so that we're all on the same page as we start to talk about it.
No, I think that that it sounds like a simple question ever, but that's actually a fundamentally important question when we're talking about vicarious trauma. Because there's a lot of misconception and misunderstanding about what vicarious trauma is and what vicarious trauma isn't. Particularly I find that there's a lot of confusion about the difference between burnout and vicarious trauma and countertransference. And those three things are completely, well not completely different things, but those three things are quite separate constructs. And the way that we would approach interacting with each of those three things is actually quite different. And so it's important to understand the differences between those things.
So specifically, let's talk about the differences between burnout and vicarious trauma first. So burnout is loosely defined as the detrimental impacts of work on the worker. And a person can experience burnout working in any industry at all. There are a number of factors that predict burnout. And Christina Maslach is one of the primary researchers in this area. And I would point listeners to her research on what predicts, what factors are that predict burnout. But essentially, if you're working with people, if you have a poor person-to-job-role fit, if there are certain factors within the workplace that you're working in, there is a risk of burnout. And that can apply to a great many workers.
Vicarious trauma is a little bit different in that the risk of vicarious trauma comes with exposure to traumatic content. And so we're looking at a subsection of the population of workers here, rather than potentially all workers. So those workers who are exposed to traumatic content as a product of the work that they do, those are the workers who are at risk of vicarious trauma.
And so we're looking at when we think about it, we're looking at many industries, here. We're looking at emergency services like police and fire brigade, and state emergency services and ambulance personnel, and rescue operation, and crisis aid workers. We're also looking at emergency department staff in hospitals. We're looking at counselors, social workers, psychologists, psychiatrists. We're looking also at some legal professions. We're looking at tribunals that review information. We're looking at people who work in migration and immigration situations. There's a lot of industries that are actually affected by vicarious trauma purely and simply because they are exposed to traumatic content as a product of the work that they do. So that's a little bit about the differences between burnout and vicarious trauma.
When we're talking about countertransference and vicarious trauma, so the way that I see the difference between those two things is that vicarious trauma is the effects of the work on the worker, and countertransference is something that actually goes on in the room with the worker and the client, or the patient, or the customer, in the interaction. So vicarious trauma might be happening in the room, but it actually primarily affects the worker rather than the dynamic, or rather than making an impact on the actual work as it's happening. Does that make sense?
So when you gave those examples, what I thought of was, I worked with the UNHCR, and UNICEF, and some NGOs in different war zones and different natural disasters and different sites like that. And we talk with them a lot about resiliency, and about burnout, and stress, and vicarious trauma briefly. But in those settings, they are, it's ongoing. And so we're trying to preventative care and tend to that, definitely. But you're talking about that distinct from like in the therapy setting between the therapist and the clinician, specifically? With countertransference, you're distinguishing between them?
Yes. yes, I am. So, I see countertransference as something that happens in the room, in the therapeutic relationship, in the dynamic, and it actually affects the work that's happening in that moment. Whereas vicarious trauma certainly can affect the work, but primarily, it is detrimental impacts on the worker that the worker takes out of session into their own personal life. It's detrimental effects on the worker of actually being exposed to traumatic content, that is, the content that relates to the client's life or the situation that they're working with.
So not even just in the room, or in the moment, or in the process between them, but internalized inside so even after that session, or that patient, or that client, or whatever the incident is, is finished, it's still with them outside of that.
Absolutely. So vicarious trauma symptoms, and we can get into what the symptoms are and how we understand them a little later on, but vicarious trauma symptoms exist beyond that session. There are symptoms that the worker experiences during the session, after the session, and into the next session. So vicarious trauma symptoms can be very short lived, they can be momentary, but they can also be very long. And people can indeed have vicarious trauma symptoms for years without that symptom abating or without that symptom being resolved.
What do those symptoms look like?
So I see the symptoms of vicarious trauma existing as two streams. One stream is symptoms of secondary traumatic stress. And those symptoms are essentially the same symptoms as the symptoms of post-traumatic stress disorder, as in intrusions, avoidance and arousal, but experienced in a secondary fashion. And generally speaking, at least initially, we will expect the symptoms of intrusions, avoidance and arousal to be of a lesser severity than those symptoms are when they're experienced by a person who has experienced direct trauma. Now, a caveat to that. It depends on how much exposure that person has had, how well they are able to identify vicarious trauma, and how effective their interactions with that vicarious trauma is.
So if somebody has had exposure over a long period of time, they're not easily able to identify the symptoms, and they don't interact with those in a manner that is effective at managing them-. And just to make an important point here, I always talk about managing vicarious trauma, not preventing it. I honestly believe the only way you can prevent vicarious trauma is to not be trauma-exposed in any way. So prevention is something that's incredibly difficult to do. And you know, for trauma-exposed workforces, possibly impossible to do. But we can manage vicarious trauma very effectively.
So if a person is exposed for the first time to trauma content, then the first stream of vicarious trauma symptoms are symptoms of secondary traumatic stress—intrusions, avoidance and arousal—to a lesser severity than we would expect somebody who was directly impacted by that trauma.
The second stream of vicarious trauma symptoms are those that were discovered by Karen Saakvitne and Laurie Anne Pearlman, which are the cognitive changes. So these are interruptions or disruptions to thoughts, ideas and beliefs relating to key psychological schemas of safety, trust, intimacy, or connection, control or influence, and also esteem.
You are actually the first person that I have heard say the words that you can't prevent vicarious trauma. Which is something I have tried to explain, and tried to say, but not have the framework to be able to say that, because it was an intuitive piece that I had, but I didn't have words to express it. And you put it so explicitly. Because when we are exposed to trauma, any of us, as human beings, it impacts us.
Correct. Yes, exactly. Many years ago, digested the research, and then digested it again, and then digested it again. And the conclusion that I came to was that-. You know, I was trying to answer the question, in my own mind, what predicts whether or not a person will experience vicarious trauma? And the research has examined this question at length. So there's lots and lots of studies from the 90’s onwards that have tried to answer that question, what predicts whether or not a person will experience trauma? And honestly, the research is not, in some areas, it's not great. Because there are different constructions of what vicarious trauma is.
And there are also some other methodological problems in that research where we're asking people who've experienced, we’re asking people, “Have you experienced trauma?” because there's a hypothesis in that research literature about whether experiencing trauma directly is predictive of vicarious trauma. And, you know, I mean, we know that we're asking the question, “Have you experienced trauma?” that we get confused data. Some people will not be ticking the box when they should be ticking the box, because it's things like not wishing to disclose, or traumatic amnesia, or misunderstanding. We also know that the way that the word trauma, traumatic, traumatizing, is used in our lexicon today, that it's kind of, people use it too freely, I think. And, you know, I hear things like, “I didn't get a coffee before my training session this morning. Geez, it was traumatic.” Which of course, it's not. It's disturbing, it's uncomfortable, but it's not traumatic. So, there are methodological problems in that research for sure.
However, when we take into account the methodological problems and we really analyze what's in the research, the conclusion that I come to is, there is only one reliable predictor of whether or not a person will experience vicarious trauma. And that is exposure to traumatic content. And therefore, if a person is being exposed to traumatic content, there is a risk that they're going to experience vicarious trauma. And I would also say, if they're being exposed to traumatic content fairly regularly, vicarious trauma is actually an inevitability for that person. I'm not saying that they will have a bonafide mental health disorder. I'm not saying that their symptoms will be such that they will be suffering greatly. As I said, before, vicarious trauma can be tiny little symptoms that are minimal in their impact and very easy to offset. But when we don't pay attention to that, and we don't manage that effectively, then what happens is we get pointy end vicarious trauma, which looks like people not being able to continue doing their jobs. It looks like people not earning a wage. It looks like people not being able to pay their mortgage. It looks like, you know, people ending up having lives that they never saw as a possibility into their future.
So I really firmly believe that if somebody is exposed to traumatic content as a product of the work that they do, preventing vicarious trauma is impossible. And also, it's a, it's an effort in the wrong direction. Because if we talk about preventing vicarious trauma, what we're doing is we're kind of setting a hierarchy which says that's the gold standard, that's what we should be trying to do. And oftentimes, what that can do is it can lead into hiding vicarious trauma rather than acknowledging it. And once we acknowledge it, we can do something useful in response to it. But if we're denying that it's there because we're so busy preventing it, then sometimes what can happen is it can move down the continuum and get to more pointy end vicarious trauma, because of that kind of conceptualization. So I always preferred to not talk about preventing vicarious trauma, but to talk about identifying it swiftly and managing it effectively.
That's so powerful and important, I think. I really do appreciate that. I meant when I said, because I was sent to these horrible situations where people were enduring such horrible things that no one could do anything about. Whether that was a war, or a hurricane, or the fires or something. And in the middle of it, I'm supposed to teach them how to be resilient when dealing with the trauma that's currently ongoing. And just philosophically, I had such an intuitive, like, there was such an incongruence there. It didn't, it just crawled all over me. Yeah. And I did what I could even pushing the limits of what I was supposed to do to appropriately help people and be present with them in it, and talk about managing it, while trying to stay within the framework I was given. But, but I love that you've put words to this. And, and, and have-. It's so funny to me that it was so difficult to put words to, because it's such a direct statement.
There is such a thing as vicarious resilience, and that's an important and, you know, bonafide construct. There is also such a thing as compassion satisfaction, which is part of Charles Figley's work, and that's an important and bonafide construct as well. And, in my work with vicarious trauma, I find myself working hard to help people to understand: Step One, which is, vicarious trauma is a real thing. We need to try to understand it. We need to create cultures in workplaces of being open to it and responsive to it. And what I found in-. Because I've provided consultation to, I don't know, maybe 75, 80 different organizations in Australia and in other countries to date. And what I found is that whenever an organization is able to build a culture of “It's real. It happens. We take it seriously. We do what we can.” Then what happens is the workers become more open about vicarious trauma, more effective in their ability to identify when it's at play for them, and more effective in their ability to respond to the vicarious trauma symptoms and offset them. And that's heading in exactly the direction we want to go, right? Because then we've got healthy workers doing good quality work and thriving in a challenging situation. Which is exactly what we're trying to achieve.
And I find that when we bring the word resilience in, that what tends to happen is it tends to undermine the culture of “This stuff is real. It's important. And we take it seriously.” And what it brings into the equation seems to be a sense of putting the onus of responsibility onto the individual worker to be resilient, and therefore not get vicarious trauma. And that seems to take us down the old path again. The old path being, “Vicarious trauma is not real, It's not something that we need to take seriously. It's certainly not something that we want to be open about. And it's not something that we want to be responsive to.” So workers get the message, “Hide your vicarious trauma, because if you have vicarious trauma, then that probably means that there's something wrong with you. And the something that's wrong with you is you're not resilient enough.”
So I in in the work that I do, whilst I acknowledge that there is a bonafide construct called vicarious resilience, and that's real, and there is also compassion satisfaction, and that's real, and they're both important, I think that for me it's about the right order of things. And until we're at the place where most workplaces are taking vicarious trauma seriously, and they are recognizing the reality of exposure to traumatic content equals risk of vicarious trauma, and that vicarious trauma is a frequent occurrence but that if we identify it swiftly, and we respond to it effectively, it can actually be managed very, very effectively and also very cost effectively. Until we get to that place, I just don't see it as useful to be talking so much about vicarious resilience and compassion satisfaction. Because what tends to happen is that tends to give the message that workers are responsible for their own vicarious trauma. And when you have vicarious trauma, that means that there's something wrong with you. And I do not see it that way at all given that my reading of the research tells me that the only reliable predictor of whether or not a person will experience vicarious trauma is their exposure to traumatic content.
I would absolutely agree. And I think when we're talking about organizations and agencies involved in some of these settings, in particular, I feel like that gets echoed even in the structure. So, because they rely on donations, for example, some of them, they want to keep administrative costs low, because people can research that and see how the money is getting spent. So to keep admin costs low, they don't hire enough people. And because the people costs comes out of that. And then what happens is, I have these people in crisis calling me for consults because they are supposed to be doing exactly what you just talked about, they're not supposed to have vicarious trauma and they're supposed to be resilient. But they're literally-.
I had one person, literally one woman, fresh out of college in charge of an entire hurricane cleanup. Wow. And no, no, no helpers. No, no other support. She could connect with locals or she could work with other agencies as well to coordinate things. But really just her all by herself in that while she herself was also enduring the hurricane. Or the earthquakes, or you know, all these different settings and similar things in the war zones. And so that's just, for the audience, for listeners, I just want them to hear like a practical example of how that can show up in very practical ways besides even the trauma itself.
And then when we're talking about the trauma itself, another way it shows up in America-. [Laughter] So many problems. [Laughter] Oh, sorry. One of the ways that it shows up too often-. [Laughter] One of the ways it shows up too often here is this toxic positivity where everything's going to be okay because we're going to think that it's okay, and we're going to wish that it's okay, or we're going to pray that it's okay. When instead part of making things okay is what you said about being present in the pain and recognizing how hard it is or how wrong it is, or why we should not be doing this to people, or why should not treat people this way, and acknowledging those things so that we can be together in it and heal that together as a people. But instead, it gets dismissed or ignored. And then there's sort of a cultural misattunement that happens. And things just escalate. And so I see that in practical settings. I see that in with colleagues who are clinicians, or emergency workers, or first responders. And now, in America, we have COVID cases off the charts again, and the health care workers never got even a break from anything. And so, I literally have 150 people assigned to me every day. And to help listen to them and be present with them while they're trying to keep people alive, because other people want to argue about things. I can't help 150 people a day. Yeah. Yeah. Yeah. That’s right. It just, every, it’s like dominoes. So many different ways it shows up in so many different settings.
They really are so many different ways in so many different settings. And I certainly agree with your analysis that healthcare workers at this point in time, due to the pandemic, are suffering a huge amount of vicarious trauma. A huge, huge amount of vicarious trauma. And, you know, I would love to say that-. At the moment, I think what happens in terms of vicarious trauma is people say the answer to vicarious trauma is self-care. And, you know, it partly is. But I think that when we may take that answer, when we decide that the answer to vicarious trauma is self-care, again, we're putting the onus back on the individual who is doing a very difficult job, being detrimentally impacted by that very difficult job, and saying, “And now you need to do something else as well, which is this thing called self-care.” Now, I'm not saying people don't need to do self-care. That's an important part of the picture. But one of the focuses of my work has been trying to move people away from “it's the individual workers responsibility to take care of the risk of vicarious trauma,” and move that into a new space, which is “actually it's a shared responsibility.”
So I don't know about the work, health and safety legislation in the States. But in Australia, we have legislation that says when you identify a workplace hazard, two things need to happen. First of all, the employer or manager or organization or agency needs to take steps to make sure that they are mitigating the hazard from that particular thing, whatever it is, so that it reduces the risk that it presents to the worker. And simultaneously, the individual worker has to interact with the hazard and the protocols that are put into place to manage or mitigate the risk from that hazard in an proactive and effective fashion. So what that legislation sets up is it sets up a dual kind of process of the organization and the worker working together to minimize and mitigate the risk that's produced by this hazard.
And so in my work, what I've been trying to do is I've been trying to take the focus away from “it's the individual's responsibility to do difficult work, be affected by that work, and be resilient to those effects.” And move that into, “actually, what we know is that we can have systemic programs in organizations where there are systems and processes set up for workers to be able to do exactly what is effective in offsetting and managing vicarious trauma.” And if we have those systems and processes in the organization's as standard protocols, then those workers will engage with those processes, will benefit from those processes, vicarious trauma levels will reduce because they're being managed, they won’t reduced to zero because they're still being exposed, but they will reduce, the worker will be more healthy. And as a result of that we have a whole bunch of organizational bottom lines that are positively affected. And those include: attrition rates go down, so people stay in the workforce longer; unplanned absence goes down, so we have the workforce on deck doing the work more and more of the time; the quality of work increases, because people have access to all of their internal resources to make difficult decisions and do difficult work; productivity increases, which is the quantity of work that actually happens; and also, vicarious trauma levels go down. And the last factor that also reduces when we manage vicarious trauma systemically within organizations is that the costs for the organization actually reduces costs relating to replacing staff members who don't stay in the workplace, costs related to unplanned absence, and costs relating to workers compensation issues, as well.
So I've been trying throughout my work over the last 15 or so years in vicarious trauma to move the focus away from the individual being responsible for effective self-care and being resilient, to more of a focus on the agency and the worker managing this issue together. And what we've found repeatedly is that when we do that effectively, there are positive impacts on the worker, positive impact on the agency or organization and its bottom lines, and positive impacts for the clients who the services are delivered to.
I think it's a wonderful thing to be able to find a way to help a company or an organization have sustainable practices that give it as an entity the safety of integrity, meaning that they will be able to keep doing what they want to do. Like, to be able to stay with what they want to accomplish, and to be able to do that by being good stewards of their people, not just their resources. But I also love how part of that process is supporting and giving resources to the worker. Because when people put that pressure on the worker to be responsible for the vicarious trauma or their resilience against it, they, it assumes, what it does really is assume a lot of privilege. Because it is a privilege thing to have choices and have resources to deal with so many things on your own. And in reality, most people don't have access to those things. And they are in the context of the workplace. So it makes sense. Yes. And I think even just in a social justice perspective it brings that full circle where there is that interdependence and the help. Because from a relational traumas standpoint, when we put all of that burden on the individual, and they can't do it because that's not how they're designed—that's not how we as people are designed—and yet, we also assigned to them the failure of that, then we're creating shame, which is only going to make everything worse.
Yes. It is a parallel process, right? So we have some of the same dynamics then happening in the client group that we're working with, and in the workforce that are doing work. Which is one of the one of the things that we really want to avoid in terms of trauma work.
I agree with your point about access to resources. And there's an assumption that the workers have access to the resources to be able to be resilient to vicarious trauma. But I would also add that, you know, even having the information about what is vicarious trauma and what isn't vicarious trauma is something that unless the worker has worked in an organization that has really talked about and looked at the constructs around vicarious trauma, most workers don't actually know the difference between those things. And, you know, the lived experience of vicarious trauma is convoluted. And in the research that that we did for [indistinguishable name] very recently, we found that there was a lot of conflation between vicarious trauma, burnout, countertransference, other workplace stressors, and direct personal experiences of trauma. And that's how human beings work. You know, we don't have compartmentalized experiences. We have experiences from multiple different factors that are all loading on us at the same point in time. So I would say that, you know, not only is it a problem in terms of assuming that workers have access to the resources to create resilience to vicarious trauma, but also it's a problem in terms of imagining that workers actually can clearly differentiate between vicarious trauma and those other factors that load on us when we're doing difficult work.
I think that's really profound. Whether we're talking about organizations, or even in the one on one clinical setting, that we can't make an assumption that they have the knowledge or the resources, or that it's even a cognitive problem. Yes. Or implying that there's a choice assumes that it's a cognitive thing that you can have some control over doing. And that’s, it’s such an understatement of the problem, and it's such a simplification of everything, that that then again becomes misattunement, if nothing else, and complicates things. Uh huh. Because then they're still having big feelings, but they're wrong for having them, but also they're not actually getting help because what the problem was is getting dismissed. It's such a cycle.
Yes. Yes, absolutely. And maybe the cycle is actually a spiral, because maybe what happens is as that cycle starts to happen, it then spirals down into, you know, the quality of services delivered to clients becomes less, the amount of services that that one worker can deliver to clients is less, the amount of health and well-being that that worker is enjoying becomes less. And so then it becomes multifactorial. Then the impacts pass not just from that worker, but pass on to the client and the organization as well as the worker. So that's kind of how I see it. I see it as a spiral that's either heading downwards, or with effective carriers trauma management programs it starts to head upwards. And, you know, what I know from the work that I've been able to do over the last 15 years with various organizations and agencies, is that it's entirely possible to put into place vicarious trauma management programs that are effective, that change the organization's bottom lines in terms of attrition rates, and quality, and quantity, and unplanned absence, and costs, as well as levels of vicarious trauma, that keep all of those processes nice and robust so the worker is well, the client is getting better services, etc, etc. And it's actually not that complicated. You know? You don't have to have, you know, a PhD and vicarious trauma in order to put these processes into place.
And what I found time and time and time again, is that every organization that I've worked with to put these processes into place, who has done so effectively, has found that ultimately they save money by managing vicarious trauma effectively. They are reaping the benefits financially, rather than what they initially thought, perhaps, which was “It's going to cost a lot of money to do the right thing in terms of the workers to manage vicarious trauma.” It doesn't. It actually saves money to do it that way.
Well, and I think that like with the upward spiral, any sort of repair, whether that's one on one, or as an organization, any sort of repair or healing becomes exponential.
Yes, indeed. Yes, indeed. Exponential and also multifactorial over the levels of worker, client and organization. Yes, I agree.
What does that look like? Or what do clinicians need to know, or agencies need to know when they're considering some of these issues and asking so much?
First of all, I think that people need to understand what vicarious trauma is and what vicarious trauma isn't. Workers need to be able to differentiate vicarious trauma from those other concepts that we were talking about earlier. So having some education about vicarious trauma that has a clear conceptualization of what it is and what it isn't. Education that helps workers to really identify when symptoms of vicarious trauma are present, so that they can identify it. Because once you can identify it, you can respond to it effectively. So number one, and number one I mean first cab off the rank. So the first thing to do is to make sure that the workers are understanding what is vicarious trauma and what is not vicarious trauma.
The second thing that I would suggest is that we need to look at ways to reduce the risk of vicarious trauma. Not to prevent vicarious trauma, but to reduce the risk of pointy end, maximum impact vicarious trauma that's highly detrimental to people's lives. And you know, that's a tricky thing, because when we look from a work, health and safety perspective, the organization is responsible for risk reduction and for hazard management, but it's difficult to manage the hazard of trauma exposure when the work that you do contains traumatic content. However, there are ways that that can be managed. And particularly one of the things that I think is important there is to make sure that there are systems and processes for processing the trauma that the worker has been exposed to before the end of their work shift. So whether that's a shift, whether that's a day, whether that's a week, whatever that is, and it can look differently for different organizations. But having some systems and processes for identifying the vicarious trauma that has happened as a result of the exposure, and for processing that, so that it's not sitting in working memory bothering away at that person after they finish work.
I also recommend that there are robust processes within organizations to monitor levels of vicarious trauma. So we do have reliable and valid psychometric measures that can measure levels of vicarious trauma across those two streams that I was talking about earlier of secondary traumatic stress and cognitive changes. So having some sort of systems or processes where workers get some feedback on their vicarious trauma at different points in time. And I think that that needs to be managed carefully because we need to have enough confidentiality in that process. We need enough of a culture of acceptance of the reality of vicarious trauma in order for workers to feel like it's possible for them to be real in their disclosures and their reporting of levels of vicarious trauma. But having some sort of a regular process where people get feedback on what their vicarious trauma levels are at different points in time, I think, can be useful too and can contribute to a process of gaining mastery over vicarious trauma.
As well as monitoring I like to see that organizations have some early intervention approaches. And they are simple, easy to implement strategies that workers can utilize within work hours, that they have permission to utilize within work hours. So that when they take a difficult call, attend a difficult situation, you know, finish a shift of crisis aid work, whatever that might be, there are some strategies that they know that they can turn to that will start to support and resource itself, and therefore start offsetting the symptoms of vicarious trauma that are arising or have arisen.
And lastly, I also work with organizations frequently to develop tailored self-care plans that respond to the particular shape and severity of vicarious trauma for each individual worker. So using the monitoring process, using the psychometric evaluation of vicarious trauma, what we can do is we can match up the sorts of self-care strategies that might work for a person with the shape and severity of vicarious trauma that is present, that we know is present from the monitoring. And we can put together a self-care program that the worker can then implement that has a really good chance of offsetting the vicarious trauma. As well as offsetting and managing that vicarious trauma effectively, what that process does is it really helps the worker to understand “what works for me” in terms of managing vicarious trauma. And that's why those individual self-care plans do need to be tailored. And I think that they are, you know, it's important that they're developed with expertise around what works for vicarious trauma really effectively.
And in my experience, when I've been working with the data from the psychometrics and developing tailored self-care plans for people, what I found is most of the time, you can take a moderate to high level vicarious trauma symptom, and have it resolved or pretty much on the way to resolution with the right sort of self-care strategy within around about three weeks. Now, there are exceptions to that, of course. And if somebody is suffering highly detrimental impacts and those have been unmanaged for a long period of time, then that's a different picture. It's also a different picture of there's unresolved direct trauma as well as vicarious trauma in the system, in the human system, the nervous system. But when those two factors are not the case, mostly what I found is with the right strategies, we can offset vicarious trauma symptoms within a period of around about three weeks.
So if we get that stuff right, we can have workers being robust and vivid in their health and well-being whilst doing very challenging work. And that seems to me like a recipe for success for everybody concerned.
So those five things that I encourage organizations to think about is: education for workers; strategies to reduce the risk, and particularly what I mean by that is strategies for workers to dump work at work, process the impacts of the day and then go and leave work at work; ways to monitor levels of vicarious trauma using valid and reliable psychometrics; understand that what early interventions and these simple little processes are permitted during the work time to offset vicarious trauma; and then a robust tailored self-care plan that responds to the levels of the shape and severity of vicarious trauma that was revealed in the monitoring. With those five protocols in place, what I found is that vicarious trauma can be managed very effectively indeed.
I feel like it takes workers from being objects of the agency or organization, and lets them be humans again. Yes. And there's something powerful about that.
Because we need the worker’s humaneness in order to do the work effectively when we're working with human beings who've been traumatized. The humaneness of the worker is a necessary part of what they bring to the work. And so if we're requiring that they bring their humaneness, then we must support that humaneness to actually be present and be well.
That's so beautiful. Thank you for sharing with us today. I really appreciate professionally what you're doing. And I love it personally so much. It helps give a framework for some of the things I've wrestled with over the last year. Yes. And gives me words to express that and let myself be human again, and has so many personal applications as well, I really think. It's so powerful. Thank you.
That’s wonderful, Emily. That's exactly what the work is trying to do is to, you know, help people to have a conceptual frame for vicarious trauma and know what they can do and situate themselves in a positive position in terms of that work. So it's greatly heartening for me to hear you say that. Thank you.
I absolutely mean it. I feel like you have summed up my wrestling with 2020 and given me answers to take into the new year. [Laughter] There is great healing for that. And it's something we'll continue talking about on the podcast as I figure out ways to apply it. And I am excited to ponder that and think about it more deeply. Thank you.
Great. You're really welcome. Thank you for inviting me to speak in a podcast.
Thank you so much, truly, and I'm grateful you are there in Sydney because Australia with the sunshine in your window tells me there is hope for tomorrow because you are already there.
There we go. Absorb, absorb. Thank you for the interview.
Thank you! Have a good day.
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