Helping the Helpers

For mental health workers empathy is an essential aspect of good help. This is also a source for compassion fatigue, vicarious traumatisation or secondary traumatic stress (STS). Early recognition and awareness is crucial to be resilient to these symptoms. Awareness of this is important for workers in areas of conflict and disaster, and in extreme environments such as these, people may be more vulnerable to secondary traumatisation. We also know that professionals under this kind of stress may be at risk to perform less efficiently and not perform as they would normally do. Even large organizations that have the resources and knowledge about this particular kind of stress may have reduced capacity to deal with or take care of the affected personnel. As for local helpers, there may often not be any support or resources at all to deal with this. We hope these links will be useful for all persons engaged in this kind of important but heavy work.

Helping the Helpers – what kind of problems are they facing?
Tools, information, guidelines etc for Helping the Helpers
Vicarious resilience
Organisations and sites

Helping the Helpers – what kind of problems are they facing?

The helpers in disaster and catastrophes are trying to solve problems sometimes too overwhelming. They are also just human beings, and although they haven`t went through those catastrophes by themselves, they have to cope with lots of horrible stories and impressions. That of course leaves marks on them, and sometimes they also develop severe psychological problems. Here we have collected a selection of articles high lightening some of these topics.

  • Compassion Fatigue, Secondary PTSD, Vicarious PTSD, Differences - You tube video
    In this webcast Frank Ochberg explains the differences between Compassion Fatigue, Secondary PTSD, burn out, and Caregiver Burden.
  • Compassion Fatigue: An Introduction
    A clinical overview on Compassion Fatigue and Secondary Traumatic Stress. We find the description of symptoms, and discussion of some studies. References to books on that topics, and some websites. – Charles Figley Ph.D., Florida State Univ. Traumatology Inst.
  • Resources for Survivors and Caregivers
    The organization “Gift from Within” is a non-profit organization, dedicated to help those who suffer of PTSD, and those who care for traumatized individuals. Under this link you find some articles on compassion fatigue and burnout, together with related topics. – GFW, 2010.
  • When Helping Hurts
    This short article (2 p.) presents an overview on the psychological consequences helpers in disaster are suffering of. – Frank Ochberg, M.D.
  • The Importance of Helping the Helper
    The article provides with an overview over the problems and psychological consequences helpers are facing, by taking care of clients in very difficult and almost catastrophic situations, with focus on social workers in Child Welfare. – Roger Friedman, in Trauma and Child Welfare, 2002.
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Tools, information, guidelines etc for Helping the Helpers

  • Guidelines for the prevention and management of vicarious trauma among researchers of sexual and intimate partner violence
    These guidelines outline recommendations for the prevention of, and response to, vicarious trauma in researchers working in the field of sexual and intimate partner violence but can also be of use and relevance to those researching other sensitive topics including other forms of gender based violence. -Sexual Violence Research Initiative (SVRI).
  • Stress Management in Disasters
    This workbook (26 p) describes the SMID concept (Stress Management in Disasters in the Caribbean), a “comprehensive, peer-driven, multi-component stress management program which is administered on a volunteer basis and was designed to prevent and to mitigate the psychological dysfunction which exposure to traumatic situations like disasters may cause in emergency response personnel. The program is based on the principles of crisis intervention and critical incident stress management and it is not intended to take the place of professional therapy”. Quite useful. - The Pan American Health Organization/WHO, Cyralene P. Bryce 2001
  • Insights into the Concepts of Stress
    This workbook (80 p) is together with the workbook mentioned above, to describe the SMID concept. Both workbooks were designed to provide the basic training material for persons who will provide help for the helpers. Quite useful. - The Pan American Health Organization/WHO, Cyralene P. Bryce 2001
  • United Nations Stress Management
    UN Peacekeeping 2015
    “Many of today's peace-keepers must confront intense, traumatic and even life-threatening situations which may induce serious and prolonged levels of stress. Therefore, stress management training has become an increasingly important factor in the adequate preparation and training of United Nations peace-keepers. This document has been created to provide a basic framework for professional stress management trainers. - The United Nations Department of Peace-keeping, New York, 1995.
  • Caring for volunteers
    The IFRC Psychosocial Centre´s new "Caring for Volunteers, a Psychosocial Support Toolkit," will help National Societies not only prepare volunteers but also support them during and after disasters, conflicts and other dramatic events. The toolkit contains practical tools for preparing for and handling crises, as well as for peer support and communication. In addition, there is a chapter on how to monitor and evaluate volunteers' efforts. Some of the tools can be printed out for managers in the field and for volunteers.
  • Manual on human rights monitoring – trauma and self care
    Vicarious trauma refers to the negative reactions that can occur when hearing about someone else’s traumatic experiences. Human rights defenders and officers are at risk of vicarious trauma when they interview victims of human rights violations and hear stories of their suffering.
  • Secondary Traumatic Stress
    Each year more than 10 million children in the United States endure the trauma of abuse, violence, natural disasters, and other adverse events. These experiences can give rise to significant emotional and behavioural problems that can profoundly disrupt the children’s lives and bring them in contact with child-serving systems. For therapists, child welfare workers, case managers, and other helping professionals involved in the care of traumatized children and their families, the essential act of listening to trauma stories may take an emotional toll that compromises professional functioning and diminishes quality of life.
  • Managing Stress in the Field
    An IFRC Psychosocial Centre (2009) leaflet designed for delegates and field workers before, during and after their mission. Its aim is to help them to recognize, prevent and reduce stress in situations of complex humanitarian disaster.
  • Helping the Helpers – Acute Stress
    The Headington Institute has published some very god learning- and training materials, This education module/booklet (177 p) tries to help mental health professionals to better understand stressors, dangers, development of acute stress reactions, assessment tools etc. along with suggestions for treatment. Very useful. – Headington Institute,
  • Understanding and coping with traumatic stress / eLearning
    Headington Inst provides professional helpers with a quite good eLearning module. – Headington Inst 2010.
  • Helping the helpers - Community based psychological support
    It has been acknowledged that support programmes cannot afford to focus on the affected people alone. Helpers and other people exposed to emotional stress can themselves enter a state of crisis as a result of their work. This is especially so for young and inexperienced helpers. These facts have strong implications for the Red Cross - Red Crescent Movement, where a significant part of the volunteer force consists of young people.
  • Online Training Programs
    The Headington Institute provides also some other very good online training courses to download/do online.
    On this site you`ll find:
  • Psychological First Aid - Trainer Manual
    This represents an manual to help professional health workers to set up a workshop to help helpers with psychological problems after disaster. - University of Nebraska, policy center
  • Managing stress in humanitarian workers
    The organization provides here with some “guidelines for good practice”, with 8 principles defining how the helpers should be guided and supported. – Antares Foundation 2012
  • Professional Quality of Life Test
    This test (version 5, aug 2009) provides with material to estimate the impact, the possible burnout or compassion fatigue in the helpers in disaster. – Professional Quality of Life/ Beth Hudnall Stamm et al. 2010.
  • The Concise ProQOL Manual 2009
    The background material and statistics in a manual (55 p.) for the ProQOL test mentioned above. – Beth Hudnall Stamm, 2009.
  • Module 6 Helping the helpers
    Community-based psychological support.MHPSS.Net
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Vicarious resilience

“As with vicarious trauma, awareness is a key factor in vicarious resilience because when we know such an experience exists we are more likely to recognize and benefit from it. Vicarious resilience specifically recognizes the value of observing resilience in our trauma-survivor clients. This is not only noticing positive dimensions of trauma work, although that is important. It’s how bearing witness to our clients’ resilience can change how we are, not just as therapists, but as persons in our own lives, dealing with our own sorrows and challenges."

David Gangsei, a clinical psychologist who has worked for 30 years in the field of rehabilitation for torture survivors -

  • Vicarious Resilience: A New Concept in Work With Those Who Survive Trauma
    Pilar Hernalndez, David Gangsei, David Engstrøm 2007
    This study explores the formulation of a new concept: vicarious resilience. It addresses the question of how psychotherapists who work with survivors of political violence or kidnapping are affected by their clients’ stories of resilience. It focuses on the psychotherapists’ interpretations of their clients’ stories, and how they make sense of the impact that these stories have had on their lives. In semistructured interviews, 12 psychotherapists who work with victims of political violence and kidnapping were interviewed about their perceptions of their clients’ overcoming of adversity. A phenomenological analysis of the transcripts was used to describe the themes that speak about the effects of witnessing how clients cope constructively with adversity. These themes are discussed to advance the concept of vicarious resilience and how it can contribute to sustaining and empowering trauma therapists (pdf,15 pages).
  • Vicarious Trauma, Vicarious Resilience and Self-Care
    David Gangsei
    This essay examines the phenomenon of vicarious trauma, its impact on those who work with traumatized clients and the importance of self-care.
  • Exploring the impact of Trauma on Therapists: Vicarious Resilience and related concepts in training
    Pilar Hernalndez, David Gangsei, David Engstrøm 2010
    An integrative training framework articulating multiple perspectives on the impact of trauma work is offered with a training/supervision exercise to address the complex and systemic relationships that affect therapists in both positive and negative manners. The concepts of vicarious trauma, vicarious resilience, compassion fatigue, resilience, posttraumatic growth, altruism born of suffering, and reciprocity are reviewed. The paper highlights the importance of vicarious resilience as a dimension of experience that counteracts the normally occurring fatiguing processes that trauma therapists experience.
  • Vicarious traumatization and vicarious resilience: an exploration of therapists’ experiences conducting individual therapy of refugee clients
    Megan C. Welsh 2014
    The purpose of this qualitative, descriptive study was to explore clinicians’ experience of vicarious traumatization and/or vicarious resilience in working with refugee clients in order to gain a better understanding of vicarious trauma and the ways in which clinicians are effected by vicarious trauma. A second purpose of this study was to determine whether or not clinicians experience vicarious resilience in working with this client population, and what, if any, impact the vicarious resilience has on the clinician’s treatment modalities, practice style, and personal life.
  • Vicarious Trauma and Resilience
    NetCE 2016
    The purpose of this course is to expand health and mental health professionals' abilities to identify and understand countertransference reactions common in work with trauma survivors, the causes and signs of burnout and compassion fatigue, and factors contributing to vicarious trauma and resilience.

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Organisations and sites

  • Green Cross
    The Green Cross is an international, humanitarian assistance organization, non-profit corporation comprised of trained traumatologists and compassion fatigue service providers. The organization is oriented to helping people in crisis following traumatic events.
  • Gift from Within
    The organization “Gift from Within” is an online, non-profit organization, dedicated to help those who suffer of PTSD, and those who care for traumatized individuals. Founded by a non-clinician, supported and carried also by clinicians.
  • Centre for Humanitarian Psychology
    Via training and information targets this organization to stabilize psychosocial skills for “more efficient aid workers”. Some information is free, some (f.e. e-learning) has to be purchased.
  • Headington Institute
    This institute was established in 2001, it provides a collaborative network of mental health professionals offering a variety of services to humanitarian workers. The aim is to provide psychological and spiritual support for humanitarian relief and development workers worldwide. It offers training programs/also e-learning, counseling, debriefing etc.
  • Antares Foundation
    This is a non-profit organization, its mission is to improve the quality of management and staff support and care in humanitarian and developmental organizations.
  • Professional Quality of Life
    This website gives some overview and help in case of compassion fatigue, burnout and related topics. Created by dedicated people working as psychologists, historians and in other fields.
  • The Mental Health & Psychosocial Network
    MHPSS Network is a growing global platform for connecting people, networks and organizations, for sharing resources and for building knowledge related to mental health and psychosocial support both in emergency settings and in situations of chronic hardship
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