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Working with Traumatized People
Online Resources | Print Resources
Humanitarian workers assist people who have survived terrible experiences—natural disasters, famines, accidents with mass casualties, war, civil war, ethnic cleansing, displacement, political oppression, terrorist attacks, rape, and other assaults. The physical consequences of these catastrophes are usually obvious: Schools, hospitals, and power stations are destroyed, while workplaces, livestock, and other means of making a living are ruined. The direct effects on victims are equally evident: People are killed or severely injured, and the immediate emotional effects include shock, numbness, and anger.
As the weeks and months go by, the physical effects of the disaster may fade. Houses are rebuilt, roads are repaired, and communications systems are restored. For most survivors, the bodily wounds heal, too. But the emotional wounds—the wounds to the heart, the wounds to the soul—may persist. These lasting emotional effects—what psychologists call "traumatization"—have a triple impact on aid workers.
First, the emotional state of disaster survivors has an enormous effect on their ability to cooperate with relief, recovery, and reconstruction efforts. Understanding their reactions helps field staff "not take it personally" and work more effectively. Second, although most aid workers' assignments are not explicitly focused on helping survivors of catastrophes heal emotionally, the policies and programs of humanitarian agencies and the ways in which individual aid workers carry out their tasks can make a major contribution to helping the survivors heal (or, conversely, to unintentionally worsening the situation and interfering with the survivors' ability to cope). Finally, working over long periods of time with traumatized people takes an emotional toll on the aid workers themselves. "Compassion fatigue" and "secondary" or "vicarious traumatization" symptoms, not unlike those of the direct victims of traumatic events, may appear.
The resources in this section can help you address all three of these trauma-related concerns.
Online Resources
Working with Traumatized Populations: The Impact on You
Vicarious Trauma and Relief Work, Headington Institute
Vicarious trauma occurs as a result of opening one's heart and mind to the experiences of trauma survivors, and is a frequent occurrence among aid workers. This article describes the phenomenon of vicarious trauma and its symptoms, and offers suggestions for relief workers who are suffering from vicarious trauma.
If you think you might be experiencing vicarious trauma, visit the
Idaho State University Institute of Rural Health website has several quizzes and scoring tables that will help you assess your level of stress.
Post Incident Reactions, APS Healthcare
If you are a staff member who has just endured a traumatic event or are working with traumatized populations, this document may help you identify normal reactions in yourself. Also listed are some simple yet effective tips to help with recovery
Compassion Fatigue of Relief Workers, Center for Humanitarian Psychology
Humanitarian workers may be exposed to disorder and confusion, confronted with scenes of destruction and intolerable human suffering, and may become in their turn "secondary victims". Your thoughts, your feelings, your behavior and even your health can be affected. This page described the phenomenon of compassion fatigue and offers tips to help you adjust.
The Helper's Power to Heal and To Be Hurt - Or Helped - By Trying, B Hudnall Stamm1, E. M. Varra, L. A. Pearlman & E. Giller
What do we know about vicarious trauma and what can we do about it? This one-page article briefly describes mental and physiological changes that someone suffering from vicarious trauma might experience, as well as what individuals and organizations could do to help alleviate symptoms.
Vicarious Trauma: Bearing Witness to Another's Trauma, Terri Spahn Nelson
This article was extracted from a synopsis of the 20th Annual Convening of Crisis Intervention, and discusses the meaning and implications of vicarious trauma.
Like troops, aid workers suffer stress syndrome, Chicago Tribune
While the military has made some strides in dealing with stress-related issues, public health officials, including doctors at the federal Centers for Disease Control and Prevention in Atlanta, are just beginning to address the mental health problems of aid workers. After recent attacks on workers in Afghanistan and Iraq, there is a need for support services in the field and at home, health officials said.
Rural Care - Crossroads of Healthcare, Culture, Traumatic Stress, and Technology, Idaho State University Institute of Rural Health
This website serves as a comprehensive source of information on vicarious stress. Click through the links to find insight and information compiled by Beth Hudnall Stamm, PhD, a psychologist and educator in the field of secondary trauma.
David Baldwin's Trauma Pages
Access this website for a discussion on the various types of trauma (including secondary trauma), as well as a wide variety of articles and resources on trauma and secondary trauma.
Working Effectively with Traumatized Populations
Staff Self-Care Learning Center: Humanitarian Work, Stress, and Trauma, Church World Services
Church World Services maintains a learning center that is devoted to helping aidworkers recognize and manage stress in traumatic settings. On this website you'll find discussions on recognizing symptoms, how to deal with cumulative stress and trauma, as well as how to help yourself in a stressful situation or find others who can provide support.
Aid Workers Network Forum
Aid Workers Network is a comprehensive website that's also host to a number of online forums and guides. This link brings you to a section of the site that hosts a discussion on trauma management.
Print Resources
Working with Traumatized Populations: The Impact on You
Debriefing and Treating Emergency Workers.
McCammon, S. L. & Allison, E. J., Jr. (1995).
In Figley, C. R. (Ed.). (1995). Compassion Fatigue, Coping With Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized (pp. 115-129). New York: Brunner/Mazel.
Transforming the Pain: A Workbook on Vicarious Traumatization
Karen W. Saakvitne and Laurie Anne Pearlman
Offering support and reassurance, this workbook defines and describes the process of VT (vicarious traumatization), an inescapable effect of trauma work. It includes self-assessment worksheets, guidelines, and exercises for addressing VT and improving self-care. It is designed to be used by a wide range of professionals and paraprofessionals.
Purchase this workbook
Secondary Traumatic Stress: Self-Care Issues for Clinicians, Researchers & Educators.
B. Hudnall Stamm, Ph.D.
The articles in this book attempt to raise the question of stressful experiences in an ecological perspective so that we might learn to use what we know to prevent the pathology of PTSD and to enhance the possibility of positive developmental growth in the face of trauma. They address the psychological cost of doing trauma work, offer suggestions for ways in which therapists can create safe environments in which to work, and address ethical issues related to self care and vicarious traumatization.
Click here for an outline of the book and to find out how to purchase:
Trauma and the Therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors.
Pearlman, L.A., & Saakvitne, K. (1995).New York: Norton. ISBN No.0393701832.
Stress and Trauma Handbook: Strategies for Flourishing in Demanding Environments
John Fawcett
How does stress impact human functioning? What are the signs of burn-out? What steps can be taken to reduce the effect of stress and strain? How does this research affect the practicalities of everyday humanitarian work? In this book, the answers to these questions are presented along with real stories, a series of check lists, stress indicators and burn-out monitors to track the well-being of all workers.
Working Effectively with Traumatized Populations
The Humanitarian Companion
Ehrenreich, J. (2004). The Humanitarian Companion. London: ITDG Publishing
Chapter 5 of this guide is devoted to working
with survivors of traumatic experiences.
All photos © Karl Grobl
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