VICARIOUS TRAUMA�IN HELPING PROFESSIONS

Dr. Aaron D. Chatman, Psy.D

Director of Wellness

Chicago Police Department

OVERVIEW

• Definition
• Etiology
• Impacted Professions
• Related patient disorders: PTSD
• Managing risk exposure
• Caregiver self-care and resiliency
• Evidenced-based treatment
• References

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VICARIOUS TRAUMA �DEFINITION

• Vicarious Trauma –

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… the physical, mental and emotional/psychological condition caused by exposure

to the trauma narrative of a trauma survivor (Horowitz, 1976).

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Secondary trauma

Compassion fatigue

Secondary traumatization

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VICARIOUS TRAUMA �VIDEO SLIDE

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VIDEO

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https://www.youtube.com/watch?v=o_l4Ab5FRwM&list=RDo_l4Ab5FRwM

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VICARIOUS TRAUMA�ETIOLOGY

Contributing Factors:

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• The individual helper's personal history
• Prior traumatic experiences
• Internalized coping resources/resilience
• Emotional/psychological functioning
• Experience with population
• Helper’s support network
• Frequency & intensity of exposure

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• Case study: Alice

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VICARIOUS TRAUMA �SIGNS AND SYMPTOMS

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1. Compassion Fatigue
2. Intrusive thoughts
3. Avoidance – missing work
4. Mood disturbance –depression, anxiety, irritability, agitation
5. PTSD signs and symptoms
6. Sleep disturbance / nightmares
7. Reduced job satisfaction
8. Burnout
9. Social withdrawal / isolation

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• https://www.apa.org/ptsd-guideline/treatments/prolonged-exposure

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VICARIOUS TRAUMA�WHO IS IMPACTED

• Therapist
• Social workers
• Caregivers
• Doctors/Nurses
• Police Officer
• Fire Fighters
• Paramedics

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VICARIOUS TRAUMA�SELF-CARE

• Work/Family life balance
• Social Support
• Exercise
• Health diet – nutrition
• Individual Therapy
• Spiritual engagement
• Sleep
• Wellness training /CEUs
• Hobby

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VICARIOUS TRAUMA�TREATMENTS

VT Evidenced Based Treatment Approaches

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• Eye Movement Desensitization and Reprocessing (EMDR)
• Stress Inoculation Training (SIT)
• Cognitive Processing Therapy (CPT)
• Trauma Focused CBT
• Prolonged Exposure Therapy (PE)
• Family Systems Therapy

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�

PTSD

WILL YOU BE PROVIDING CARE FOR A POLICE OFFICER OR MILITARY VETERAN

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WHAT IS TRAUMA?

• At the core: confusion of past and present through the abnormal coding of memories
• Impacts brain physiology and functioning, memory, thoughts, behaviors, emotions, body, relationships and occupational functioning
• Fight Flight Freeze/Submit: human evolutionary response to threat
• Triune brain model

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VICARIOUS TRAUMA �POST-TRAUMATIC STRESS DISORDER (PTSD)

• Criterion A: Exposure to a Stressor
• Death, threatened death, actual or threatened injury, or sexual assault
• Direct or indirect exposure, or witnessing in person, OR repeated or extreme indirect exposure to aversive details of the event
• Criterion B: Intrusion Symptoms
• Recurrent, involuntary and intrusive memories, traumatic nightmares, dissociation
• Intense or prolonged distress after exposure to traumatic reminders
• Criterion C: Avoidance
• Persistent effortful avoidance of distressing trauma-related stimuli after the event
• Trauma-related thoughts or feelings or external reminders
• Criterion D: Negative alterations in cognitions and mood
• Inability to recall key features of traumatic event; inability to experience positive emotions
• Persistent distorted blame of self or others for causing event or consequences OR persistent negative beliefs and expectations or emotions
• Markedly diminished interest in pre-trauma activities; feeling alienated from others
• Criterion F: Duration more than 1 month
• Criterion G: Significant symptom-related distress or functional impairment

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ACUTE Trauma –

Experiencing serious injury,

threat, or violation of physical

integrity to yourself or witnessing.

Associated with overwhelming

feelings of terror, horror or

helplessness.

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CHRONIC Trauma –

Exposure to trauma occurring

repeatedly over long periods

of time. Often associated with

intense feelings of fear,

mistrust in others, decreased

sense of personal safety, anger,

guilt and shame.

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VICARIOUS TRAUMA �PTSD: VETERANS AND POLICE

MILITARY VETERANS

50% live with PTSD or depression

30% of service will receive mental health treatment within 3 months of returning from a deployment

Suicide risk 21% higher among veterans in 2014: Civilians 15.2/100,000 and veterans 35.3/100,000. Average of 17 veterans die from suicide each day

POLICE OFFICERS

50% live with PTSD or depression

Police suicide risk is 2O% higher than the normal population; and, Chicago Police Officers have a suicide rate that is 60% higher than departments

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VICARIOUS TRAUMA �DE-ESCALATION

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De-escalation:

Is a communication technique used to safely and effectively intervene in a mental-health crisis and/or manage a high risks encounter.

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TIC-TACS

VICARIOUS TRAUMA �DE-ESCALATION: TIC-TACS

Tone:

• Tone communicates our feelings when we speak.
• Use words that are consistent with your feelings

Inflection:

• Inflection is variation in the tone, strength, and vocal range of one’s voice
• Adjust volume, pitch, and pace to match message

Communication:

• Communication is an interactive phenomenon that involves words, behaviors, and context

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VICARIOUS TRAUMA �DE-ESCALATION: TIC TACS

Words (Verbal):

• Avoid words that can be misconstrued/misunderstood
• Avoid offensive or provocative language

Body Language (Non-Verbal):

• Stance
• Gestures (movements of the body and face)
• Eye movements
• Facial expressions
• Personal attire
• Motor movements

vicarious trauma �de-escalation: Tic-Tacs

VICARIOUS TRAUMA�DE-ESCALATION: TIC-TACS

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• The Mehrabian Communication Model highlights the importance of verbal and nonverbal messages:

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• Body language (55%)

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• Tone of voice (38%)

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• Words used (7%)

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Effective communication has

congruence among all three.

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VICARIOUS TRAUMA�DE-ESCALATION: TIC-TACS

Time:

• Slow down

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• Use time to your advantage and:
• Assess the problem
• Develop a plan
• Gather resources, as appropriate (emergency assistance CFD/CPD)
• Build rapport
• Give subject time to process what you’re saying
• Give subject time to vent

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VICARIOUS TRAUMA�DE-ESCALATION SKILLS

Atmosphere:

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• Atmosphere is the tone or mood of a place or situation
• Keep the scene calm and controlled
• Reduce distractions (people, noise, electronics)

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Context:

• Context is the totality of information and helps to assess and understand an event/encounter

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VICARIOUS TRAUMA�DE-ESCALATION: TIC-TACS

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Space:

• Space as distance in face-to-face encounters
• Proxemics, the study of the human use of space, identifies four types of distance in interactions:
• Intimate (0-1.5 ft)
• Personal (1.5 ft-4 ft)
• Social (4 ft-12 ft)
• Public (>12 ft)

VICARIOUS TRAUMA�CRISIS ESCALATION CYCLE

VICARIOUS TRAUMA �SELF-CARE

• Work/Family life balance
• Social Support
• Exercise
• Health diet – nutrition
• Individual Therapy
• Spiritual engagement
• Sleep
• Wellness training /CEUs
• Hobby

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Dr. Aaron D. Chatman Psy.D

Licensed Clinical Psychologist

Director of Wellness

Chicago Police Department

3510 S. Michigan Ave. Chicago, IL. 60605

Office: (312) 745-5511

Email: aaron.chatman@chicagopolice.org

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REFERENCES

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• Branson, DC (2019) Vicarious trauma, themes in research and terminology:

Psycnet.apa/record/2018-34355001

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• Brough, P (2004) Comparing the influence of traumatic stre

ssors on police, fire ambulance officers

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• Clay RA, et al. (2020) Are you experiencing compassion fatigue? New York, NY: springer

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• Horowitz, M. (1976) Stress response syndrome New York, NY: Jason Aronson

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• Mertens, DM. (2010). Research and evaluation in education and psychology, Sacramento CA. Sage Publications.

• Lasarus RS.(1985). The psychology of stress and coping. Issues in mental health nursing 399-318

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• Sills, F. (2003) Core process trauma. Sacramento, CA: North Atlantic Books.

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• Violanti, J.M. (2008) Sources of police stressors. Psychol Rep, 3, 899-904

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