Therapist traumatization from exposure to clients with post-traumatic stress disorder

Albert Bruce Curtis (1996)

This study was designed to explore the notion that psychotherapists who treat trauma survivors are themselves subject to traumatization through a vicarious or secondary process. "Secondary Traumatization" is a term used by Figley (1983) to describe a process by which those who are in close contact with trauma survivors may become indirectly traumatized by the trauma. While some authors conceptualize therapist traumatization with the larger context of burnout (Doyle & Bauer, 1989) or countertransference (Newbury, 1985; Kinzie & Boehnlein, 1993), others argue that it is a distinct process (McCann & Pearlman, 1990). This study relationship between therapists' exposure to six major diagnostic categories drawn from DSM-1V (Schizophrenia, Mood Disorders, Post-Traumatic Stress Disorder, Substance Abuse, Borderline Personality Disorder, Adjustment Disorders) and the therapists' own PTSD Symptomatology as measured by the Impact of Events Scale (Horowitz, Wilner & Alvarez, 1979) and the Brief Symptom Inventory (Derogatis & Spencer, 1982). Sixty therapists in outpatient and inpatient urban mental health centers in the Northeastern United States completed self-report instruments. Therapists' level of PTSD symptomatology was found to be significantly related to their degree of exposure to schizophrenic clients. Other variables found to be related to therapists' symptoms were: (1) support from personal therapist, (2) perceived effectiveness with adjustment disorders, (3) years of experience as a therapist, (4) education level, and (5) field of study. PTSD symptomatology was not found to be related to exposure to other difficult client populations including Post-Traumatic Stress Disorder. The results suggested that working with schizophrenic clients may result in PTSD symptomatology in therapists and that other factors such as years of experience, education level, and social support may be important.