Helping professionals play an essential role in the recovery of victims of trauma. However, research has demonstrated that, as a result of their work, helping professionals' indirect exposure to clients' trauma increases the likelihood of experiencing negative psychological responses, including vicarious trauma (VT), secondary traumatic stress (STS), and burnout. The present study examined the concurrent validity between the STS subscale on the Professional Quality of Life (ProQoL) scale and the Secondary Traumatic Stress Scale (STSS). Furthermore, the relationships between compassion satisfaction (CS) and burnout were investigated. Participants were recruited using a comprehensive web search of agencies across the United States that employed victim advocates, a subtype of helping professionals that are understudied. A list of possible agencies ( N = 75) was generated, and each agency was sent an email about the study. In total, 132 victim advocates provided data for these analyses. Findings revealed positive correlations between the STS subscale on the ProQoL and the STSS. In addition, a negative correlation was found between burnout and CS. Two-level hierarchical multiple regression analyses demonstrated that burnout accounted for 47.3% of the variance in STS, and CS contributed an additional 3.9%. Furthermore, burnout accounted 45.8% of the variance in VT, whereas CS contributed an additional 0.6%, indicating that burnout is a strong predictor of VT and STS, but CS may serve as a protective factor against experiencing both. Prevention and intervention efforts should target reducing burnout to combat these psychological sequelae and increasing CS.
The Deferred Action for Childhood Arrivals (DACA) executive order intended to protect undocumented youth from deportation and mitigate the negative impact of their undocumented status. Using qualitative methods, eight DACA recipients were interviewed. Participants were primarily females, ranged in age from 19 and 27 years old, and had immigrated from Mexico. Our findings revealed that as participants grew up, they experienced a sense of liminality, or "non-belonging"; however, upon receiving DACA status, these feelings of liminality were temporarily abated. Problematically, as our participants encountered the limitations of DACA, their feelings of liminality returned. While DACA increases access to education, health care, and legal system participation, it only temporarily mitigates the impact of having an undocumented status. The ramifications of the sense of liminality that occur with being undocumented is discussed and policy reforms in areas of federal and state educational policy and immigration policy are suggested.
Secondary traumatic stress (STS) is a pattern of psychological symptoms that approximates the symptoms of posttraumatic stress disorder (PTSD) and occurs in professionals who are exposed to individuals who have experienced trauma. While victim advocates are frontline health professionals who are trained to support victims of crime and interpersonal violence and are at risk for developing STS, they have been largely neglected in the extant literature on STS. The STS Scale (STSS) is a 17-item self-report questionnaire utilized to assess frequency of symptoms of intrusion, avoidance, and arousal, specifically related to providing services to victims of trauma. The purpose of this study was to investigate the psychometric properties of the STSS with a sample of victim advocates ( N = 135) using confirmatory factor analysis (CFA). Results indicated that both a single-factor model and three-factor model were equivalent. This study represents a first attempt to validate a measure of STS among victim advocates, a unique and understudied population who are at risk for developing STS given their work with individuals who have experienced interpersonal violence. Establishing effective, easy to administer, and efficient measures of STS is important given that this population encounters secondary trauma on a regular basis in the context of their job. While additional theoretical work regarding the construct of STS is needed, the STSS did demonstrate high reliability with this population and thus can be used as part of the assessment of STS among victim advocates.
Vicarious trauma is referred to as the detrimental change in the manner that professionals understand and interpret material, as a result of exposure to second-hand traumatic material (McCann & Pearlman [1990] Journal of Traumatic Stress, 3:131). According to Aparicio et al. (Health & Social Work, 2013, 38:199), vicarious trauma comprises both affective and cognitive components and, while it is distinct from posttraumatic stress disorder (PTSD), it is associated with similar symptoms, including re-experiencing and avoiding traumatic material and experiencing depressed mood. The purpose of this study was to analyse the psychometric properties of the Victim Trauma Scale (VTS) and provide additional support, supplementing the findings of Aparicio et al. (2013), but instead using victim advocates as participants (n = 142). The survey was open between February 2016 and February 2017. More than 96% of participants were in paid employment positions, as more than 80% reporting working 40 or more hours a week. Aparicio et al. (2013) found that the VTS was two-dimensional (affective and cognitive); however, after examining the goodness of fit of the two-factor model using a confirmatory factor analysis (CFA) approach, this study concluded that the two-dimensional model was not a good fit. Due to the poor goodness of fit of the two-factor model and the post hoc EFA resulting in a one-factor model, our data do not support the findings of Aparicio et al. (2013). Further, the findings suggest the VTS is an acceptable measure of vicarious trauma, as demonstrated by the high internal consistency and the single-factor loading.
Mental health disparities directly tie to structural racism. Digital mental health (DMH), the use of technologies to deliver services, have been touted as a way to expand access to care and reduce disparities. However, many DMH fail to mitigate the persistent disparities associated with structural racism that impact delivery (e.g., costs, dependable internet access)–and may even exacerbate them. Human-centered design (HCD) may be uniquely poised to design and test interventions alongside, rather than “for,” marginalized individuals. In employing HCD methodologies, developers may proceed with a vested interest in understanding and establishing empathy with users and their needs, behaviors, environments, and constraints. As such, HCD used to mindfully address structural racism in behavioral health care may address shortcomings of prior interventions that have neglected to elevate the voices of marginalized individuals. We argue that a paradigm shift in behavioral health services research is critically needed–one that embraces HCD as a key methodological framework for developing and evaluating interventions with marginalized communities, to ultimately promote more accessible, useful, and equitable care. The current commentary illustrates practical examples of the use of HCD methodologies to develop and evaluate DMH designed with marginalized populations, while also highlighting its limitations and need for even greater inclusivity. Following this, calls to action to learn from and improve upon HCD methodologies will be detailed. Acknowledging potential limitations of current design practices, methodologies must ultimately engage representative voices beyond research participation and invest in their active role as compensated and true collaborators to intervention design.
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