VICARIOUS TRAUMA

Mickey Skidmore, AMHSW, ACSW, FAASW

Last month I had a phone call from a previous supervision client who was exploring the possibility of referring someone for clinical supervision. Of particular note is he was looking for someone with awareness and expertise with vicarious trauma. Our conversation touched on the prevalence of this phenomenon (along with moral injury) in a range of Social Work practice settings and organisations, as well as the limited resources in acknowledging let alone addressing such concerns.

As a casual academic I make it a point in highlighting this issue in the preparation of students embark oning a journey aimed for Social Work practice  — in particular in practice skills oriented courses.

The Social Work profession is uniquely positioned for its practitioners to be exposed to vicarious trauma in the course of their service delivery. Moreover, in addition to the dynamic of their duties, the organisation sanctioning their roles may not acknowledge or emphasise this aspect of their duties. Or if they do, they may not constantly enforce the necessary steps to adequately manage such hazards.

Child protection is a classic arena where Social Workers are constantly exposed to vicarious trauma in assessing dysfunctional, neglectful, abusive or even violent family environments in service of protecting children. This aspect of Social Work is hard, difficult and stressful work — under the best of circumstances. The caseloads are high; the issues often complex; with workers contending with a range of cultural sensitivities. Moreover, the resources and solutions are limited. 

While child protection is but a single example, nearly any aspect of Social Work practice where a client is sharing or revealing their stories, their issues, their vulnerability, their disenfranchisement, their trauma, their mental anguish or despair, they are exposing the worker to vicarious trauma. And I simplify this dynamic to my students I ensure that they receive this message:

No matter how intelligent, talented, experienced, creative, resilient, or resourceful you might be — no one is immune from being exposed to vicarious trauma. There is no superman. Ignore this reality at your own peril. 

So, the real question becomes — what to do about it? How do Social Workers manage vicarious trauma? Some circumstances warrant a crisis debriefing process. However, few organisations adhere to consistent processes regarding debriefing practices in my experience. Some organisations rely on EAP services. This too is often a limited or even superficial response given that many organisations often have the ability to pierce or circumvent the confidentiality of the service leaving individuals to feel increasingly vulnerable (or compounding their trauma) if they are exploring, discussing or processing details or information the organisation is unhappy with.

Beyond the crucial first step of acknowledgment and recognition, this is an opportunity to highlight and reinforce the value and importance of clinical supervision. Social Work programs highlight the role of regular ongoing supervision in their programs. Yet, as both a casual academic as well as a professional providing supervision, I still find far too many students and professionals reluctant to embrace this process.

There are those that avoid supervision due to cost. There are those who scoff at the need for such a process following successful completion of a recognised Social Work degree. And of course there are those in the denial camp, who feel that somehow they are either well-adjusted enough to manage vicarious trauma on their own, or that somehow such dynamics do not apply to them (The Donald Trump syndrome).

For those who hope or inspire to hold an AASW credential at some point in their career, you will find that the AASW recognises the value and importance of regular ongoing supervision as one of the requirements of holding certain credentials. 

In my teaching, I too implore students to embrace the notion that supervision be recognised as a component of regular, ongoing professional Social Work practice. I also highlight that the most important aspect of supervision has less to do with hierarchy, pedigree, or intelligence. Rather, supervision is an opportunity for Social Workers to reflect on their practice with another human being who shares some of the fundamental values of the profession. Sharing your thoughts, confusion, concerns, struggles, difficulties, uncertainties, mistakes and successes with another person with core skills of active listening, being non-judgmental and supportive affords an opportunity for you to not cary the burden of carrying vicarious trauma around by yourself, and may even spark a range of strategies to aid in your management of these ongoing challenges.

Avoiding this aspect of professional Social Work practice will likely result for many in a professional crash and burn scenario accompanied by burnout, compassion fatigue and unresolved complex trauma of their own.

My own points of emphasis to manage vicarious trauma:

-Be clear on what your personal and/or professional values are; and strive to be constant with this.   Accordingly, be clear about your professional boundaries. Endeavour to adhere to sound professional practices (crisis debriefing, following models of care protocols, etc) outlined by the AASW Code of ethics, whether your organisation consistently does so or not. If these values do not align with your organisation, it may be time to re-evaluate your employment.

-Make supervision a priority in your professional practice. It is not uncommon for organisations to be erratic or inconsistent in this regard. Don’t expect your agency to take responsibility for your professional practice. Make certain you have access to or engage in regular supervision — whether or not your organisation provides this or not. And if your supervision is not a priority for your supervisor, take steps to find one that is a committed as you.

-Consider journaling. Such reflections may be a resource to aid or guide you in your supervision sessions.

-Identify and establish professional support networks in addition to your supervision. Discussing your reflections with other professionals with diverse viewpoints will further contribute to your own professional well-being. 

-Remember that your professional life is but a single component of your overall well-being. Striking and maintaining a reasonable and heathy work-life balance is one of the secrets of modern life.

-And know, even if you successful incorporate all of these strategies, you are still not immune for exposure to further (ongoing) vicarious trauma as long you continue your professional Social Work practice.