Keeping Our Trauma Therapists Healthy with Vicarious Resilience
Making the shift from therapist to administrator can be tough. Being an effective leader is not the same as being a great therapist and many of us get promoted without any formal training in leadership.
With the help of my organization, I am completing a PhD program in Organizational Leadership at The Chicago School of Professional Psychology. Deciding on a dissertation topic was a process of considering what our field could most use in terms of children’s mental health and also in terms of leadership. As our profession has become better at trauma-informed care we have done an excellent job at educating and preparing our staff for the phenomenon of vicarious trauma. However, I have seen a mindset develop where the risk of vicarious trauma becomes such a strong focus that it almost becomes a self-fulfilling prophecy. Leadership responds by communicating about self-care and work life balance. I began asking myself, if our work is so traumatizing, then why would anyone do it? The answer is vicarious resilience, the topic of my dissertation.
Vicarious Trauma and Vicarious Resilience
Vicarious trauma is a term that can be somewhat interchangeable with things like burnout or secondary traumatic stress. It materializes as we listen to the stories of clients who have known horror, unspeakable fear or near death experiences. As we hear these stories over and over the risk of showing the symptoms of trauma become very real.
Vicarious trauma is deeply ingrained in our dialogue and training to mental health professionals, and staff is quick to fulfill our predictions. We address vicarious trauma by urging staff to focus on self-care - things like taking vacation days and exercising. This may provide temporary relief but it does little to reduce the trauma felt once returning to work. I have supervised many brand new therapists in the trauma field and they are always eager to make a difference and help the kids through the tough things that have happened in their lives. We train them for what they will likely experience and the personal struggles that will come with the job of trauma professional. This is important, however, it can become a primary topic of conversation with both the supervisor and the therapist becoming overly focused on the trauma. The point of healthy awareness often becomes overwhelmed by the perseveration and anxiety about traumatic experiences. Taking time away from the job is often where the “self-care” plans end. If we, as leaders in the mental health field, want to reduce our staff turnover and keep our trauma therapists healthy and thriving, we need to do more than grant vacation days.
Where we are falling short is completing the cycle of trauma work and neglecting a critical piece of the process which leads our staff to heal and makes our difficult work worthwhile: vicarious resilience. Vicarious resilience happens when the professional experiences personal growth in their own life through witnessing the growth of their clients.
The concept of Vicarious Resilience was first defined by Hernandez, Gangsei, & Engstrom (2007). Their grounded theory study examined the experience of psychotherapists working with victims and families of political violence. They found that witnessing their clients overcome adversity demonstrating an immense capacity to heal had a positive effect on the therapist. The therapists’ own attitudes and emotions were changed allowing them to reassess their own problems and were better able to cope with their own adversity. The main finding for trauma professionals is their work does have a positive effect on the therapists, and this effect can be strengthened by bringing conscious attention to it (Hernandez, Gangsei & Engstrom, 2007).
Those of us who have been in the field for decades and still love coming to work every day do it because we experience vicarious resilience. Resilience is succeeding against all odds; it's overcoming adversity and having the grit within you to rise above what is trying to keep you down. As the client taps into their resilience with the help of the professional they begin to get better and as a result the professional shares in the process of getting better. A therapist who can fully embrace this phase of the process will find themselves becoming stronger and more resilient in their own lives leading to higher job satisfaction, less burnout and less turnover in employees.
Harnessing the Power of Resilience
Research shows that by simply talking about the concept of vicarious resilience and letting people know that it exists (just like we do with vicarious trauma) will raise the likelihood of people having the experience. I have found (in research and in practice) that adding resilience to the conversation brings an immediate shift to the dialogue. We develop insight into our own response to the trauma work and then shift to the successful moments where healing is starting to develop. When the professional can maintain a focus on what has been accomplished instead of the struggle that remains, they create a sense of purpose, fulfillment, and motivation within themselves to stay in the profession. This leads to successful cases of healing and resilience in the child, giving the professional more opportunity to experience vicarious resilience within themselves. In the end, it’s really a simple concept. Stay positive! But in practice, it is predominantly missed and overlooked.
My training on vicarious resilience resonated with Faith, a Northwood residential counselor, who reflected,“Our jobs are hard sometimes and we forget to focus on the success stories. Learning about Vicarious Resilience immediately turned my mood around and I felt like a weight was lifted off my shoulders”.
As leaders, we need to support our staff by helping them realize that self-care does not mean take time off of work only to come back to these traumatizing clients. Self-care should focus on resilience including taking time to play, have fun and notice the positive steps. Look for the successes, no matter how small. Focus on the struggles that have been overcome in the past. Identify strengths and potential. Know that anything is possible and healing really does happen. Use inspirational photographs or phrases that focus on resilience. Remind yourself of the greater purpose in what you are doing. Find encouragement in a smile, a laugh. I’ve found incorporating these success stores into my everyday interactions with colleagues and staff is an effective way to reinforce this as a concept. At your next case record review or team meeting, in addition to focusing on the usual questions, you might try asking staff to tell you about a success from the past year. Connecting a tangible, specific example to the concept of vicarious resilience helps reinforce the power of what could otherwise be abstract. When I did this recently, one of my staff recalled a client recently sharing that she had taught him how to smile again. That is a powerful example to call upon and connect to the concept of vicarious resilience. Following up on those moments of resiliency 3 months later and taking the time to check in on the successes can make all the difference. Remember “this too shall pass” (Persian adage) and “what doesn’t kill you makes you stronger” (philosopher Friedrich Nietzsche). Make a difference in the clients’ lives and help them find their resilience because that is how you find yours. If we are asking our clients to get out bed each morning in the face of their challenges, we realize we need to be, and are, able to do the same. They get better, we get better.
We stress personal resilience in our therapeutic models for our clients and it’s time to start stressing it with our staff. Mental health professionals undoubtedly see resilience in their clients. To be a child who has experienced significant trauma and come out on the other side takes significant strength and resilience. We see the resilience in them, and it makes us better people. This is why we do the work that we do. We absorb the strength we see in them each day and we are able to incorporate it into our own lives - in our work, with clients and with others. The impact is exponential.
It’s an exciting time for vicarious resilience as we begin to recognize and name it in our work. If this concept resonates with you in your personal and professional experience, we’d love to hear about it in the comments below!
Hernandez, P., Gangsei, D., & Engstrom, D. (2007). Vicarious Resilience: A New Concept in Work with Those Who Survive Trauma. Family Process, 46(2), 229-241 13p
The views, information and opinions expressed herein are those of the author; they do not necessarily reflect those of the Council on Accreditation (COA). COA invites guest authors to contribute to the COA blog due to COA's confidence in their knowledge on the subject matter and their expertise in their chosen field.