Too tired to care? The psychological effects of working with trauma.

This quantitative and qualitative longitudinal study was designed to examine the effects on caregivers working therapeutically with seriously traumatized people. The participants were 13 healthcare workers seconded into a trauma and recovery team (TRT) set up to help those traumatized by the Omagh bombing on 15 August 1998. Quantitative data were collected using the Compassion Satisfaction/Fatigue Test and the Life Status Review Questionnaire. Qualitative data regarding positive and negative aspects of working with traumatized individuals, as well as caregiver's experience leaving the TRT, were gathered using open-ended questions contained in the final data set. These questionnaires were completed at four points in time: August 1998, December 1998, August 1999 and February 2001. Ethical approval for the study was gained from the Sperrin Lakeland Trust research committee. Analysis of the quantitative data indicated that levels of compassion fatigue and burnout increased, respectively, from 18.85 to 34.46 and 22.38 to 29.69 over the first year. Levels of compassion satisfaction decreased from 87.62 to 80.15, while levels of satisfaction with life (53.85 to 40.38) and life status (11.23 to 5.62) also decreased. Findings also demonstrated that compassion satisfaction is possibly a protective factor against compassion fatigue and burnout, in that caregivers with high compassion satisfaction scores were less likely to have corresponding high compassion fatigue and burnout scores. Findings from the qualitative data generated, revealed that team spirit and camaraderie, along with the satisfaction of seeing clients recover, were the most positive aspects of working in the team. Media interest, coping with and containing anger shown by bereaved relatives and dealing with the content of client's stories were the most negative. Themes to emerge from leaving the team included lack of understanding and support from non-trauma managers and an underestimation of the impact on caregivers of finishing in the team. Strategies that were found to be beneficial in helping to alleviate the negative effects of working with trauma were also elicited. This research has implications for practice, management and education.