Vicarious Victimization and Related Forms of Secondary Traumatization

by

Kelly E. Knight, Colter Ellis, Samuel T. Murphy, Heather Olson, Greer Wagner, Terra Dion, Rachel Gemar

• LAST MODIFIED: 26 April 2018
• DOI: 10.1093/obo/9780195396607-0242

Introduction

Vicarious victimization is a process that results from repeated empathetic engagement with populations who experience first-hand victimization, i.e., primary victimization. It can be thought of as an umbrella term to encompass a number of distinct but related forms of secondary trauma, including vicarious traumatization, secondary traumatic stress, compassion fatigue, trauma exposure response, burnout, moral distress, and counter-transference. The term vicarious victimization is intentionally used here, rather than those just listed, to emphasize an occupational hazard that operates, simultaneously, at two different levels. First, the term denotes the victimization that is indirectly transmitted from victim to victim service provider. Second, the term signifies the victimization that occurs in occupations that have, intentionally or unintentionally, ignored the hazardous consequences of empathetic engagement. Using the term may also help criminologists, victimologists, and criminal justice scholars and practitioners view this occupational hazard as relevant to their own work because, historically, it has been studied almost exclusively in the psychology, social work, and public heath fields. Vicarious victimization is likely a significant problem. It can impact the mental and physical health of victim service providers, exacerbate staff turnover and shortages in providers, and decrease the efficacy of service provision for victims. Addressing the process of vicarious victimization is challenging. Although important work is being done, definitional inconsistencies, conceptual complexities, methodological issues, and gaps in the research need to be addressed. Determining even the prevalence of vicarious victimization, alone, is difficult given research limitations such a poor generalizability and reliance on cross-sectional data. Likewise, although there is some research on the predictors of vicarious victimization, correlates like historical and primary trauma, as well as overlap in childhood and adult onset, make it difficult to tease apart specific symptoms and long-term outcomes. Evidence-based interventions are virtually non-existent but some strategies are discussed in the literature, generally, falling into two categories, individual-level self-care and organizational response. Tracking distal outcomes of service providers themselves, the agencies that employ them, and the populations they serve will be an important objective for future research. Note: Research reported in this submission was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number 5P20GM104417. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Definitions

As mentioned in the introduction, the term vicarious victimization can be thought of as an umbrella term used to encompass a number of distinct but related phenomena, including vicarious traumatization in Pearlman and Mac Ian 1995, secondary traumatic stress in Figley 1999, compassion fatigue in Figley 2002, trauma exposure response in van Dernoot Lipsky 2009, burnout in both Maslach and Jackson 1981 and Maslach, et al. 2001, moral distress in Jameton 1984, and counter-transference in Freud 1910. Vicarious victimization is largely an occupational hazard that occurs among victim service providers, defined here as professionals or volunteers who regularly work with victims. Burgess, et al. 2013 defines victims as individuals who have been “confronted, attacked, assaulted, or violated by a perceived predator, resulting in serious short-term, as well as long-term, physical and/or mental injuries” (p. 10). Victim service providers include but are not limited to child protective service workers; sexual and domestic violence advocates; criminal justice personnel such as law enforcement, attorneys, and correctional staff; mental, physical, and emergency healthcare providers, including doctors and nurses; teachers; and religious clergy. These providers often work with victims who have been affected by sexual assault, child maltreatment, intimate partner abuse, elder abuse, hate crimes, and other forms of violence, as well as economic crimes, public order crimes such as prostitution and drug use, accidents, natural disasters, and war and terrorism. Historically, there has been much debate over the use of certain terms and this has led to confusion and definitional inconsistences. For example, Pearlman and Mac Ian 1995 offers a definition of vicarious traumatization that focuses on the internal transformation that occurs within victim service providers, whereas Figley 1999 gives a definition of secondary traumatic stress that focuses more on the symptoms. Several other concepts, however, have stood out over time and can help provide a foundation for understanding vicarious victimization, as described in Newell, et al. 2016.

• Burgess, A., C. Regehr, and A. Roberts. 2013. Victimology: Theories and applications. Burlington, MA: Jones & Bartlett.

  In this introductory textbook about the field of victimology, the authors operationally define a victim as an individual who has sustained a serious injury via a confrontation, attack, assault, or violation by a perceived predator. The injury can be short-term, long-term, physical, or mental. Subsequent chapters describe the different forms of victimization (e.g., child abuse and neglect, intimate partner violence, and sexual assault).

• Figley, C. R. 1999. Compassion fatigue: Toward a new understanding of the costs of caring. In Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators. 2d ed. Edited by B. H. Stamm, 3–28. Baltimore: Sidran.

  In this book chapter, Figley defines secondary traumatic stress as the behaviors and emotions that result from knowing about a significant other’s traumatic experience. Figley describes the context in which secondary traumatic stress can arise and contrasts it with other related concepts to help provide conceptual clarity.

• Figley, C. R. 2002. Compassion fatigue: Psychotherapists’ chronic lack of self care. Journal of Clinical Psychology 58.11: 1433–1441.

  DOI: 10.1002/jclp.10090

  In this essay, Figley defines compassion fatigue as a state of tension and preoccupation associated with traumatized patients and discusses an etiological model linking empathetic ability and compassion fatigue.

• Freud, S. 1910. The future prospects of psycho-analytic therapy. In Essential papers on countertransference. Edited by B. Wolstein, 16–24. New York: New York Univ. Press.

  Freud first discusses counter-transference in this address given to the Second International Psycho-Analytical Congress at Nuremberg in 1910. Freud posits that counter-transference occurs in physicians as a result of the influence that patients have on their unconscious feelings and argues that physicians must recognize and overcome the process.

• Jameton, A. 1984. Nursing practice: The ethical issues. Englewood Cliffs, NJ: Prentice-Hall.

  Jameton, in his book on ethical issues in the nursing profession, begins a discussion around the issue of moral distress, which he argues arises when institutional constraints make it virtually impossible for nurses to follow what they know to be the right course of action.

• Maslach, C., and S. E. Jackson. 1981. The measurement of experienced burnout. Journal of Organizational Behavior 2.2: 99–113.

  DOI: 10.1002/job.4030020205

  In this seminal article, Maslach and Jackson define burnout as a syndrome of emotional exhaustion and cynicism prevalent among human service professionals. The authors designed and administered the Maslach Burnout Inventory to assess various aspects of burnout and initially showed that three subscales emerged, emotional exhaustion, depersonalization, and personal accomplishment.

• Maslach, C., W. B. Schaufeli, and M. P. Leiter. 2001. Job burnout. Annual Review of Psychology 52.1: 397–422.

  DOI: 10.1146/annurev.psych.52.1.397

  In a later review article building on twenty-five years of research, the authors define the three domains of burnout as exhaustion, cynicism, and inefficacy.

• Newell, J. M., D. Nelson-Gardell, and G. MacNeil. 2016. Clinician responses to client traumas: A chronological review of constructs and terminology. Trauma, Violence, & Abuse 17.3: 306–313.

  DOI: 10.1177/1524838015584365

  This article provides a useful visual timeline of the development of these and other related constructs, tracking a timespan from 1889 to 2014.

• Pearlman, L. A., and P. S. Mac Ian. 1995. Vicarious traumatization: An empirical study of the effects of trauma work on trauma therapists. Professional Psychology: Research and Practice 26.6: 558–565.

  DOI: 10.1037/0735-7028.26.6.558

  In this article, Pearlman and Mac Ian explore the effects of trauma therapy on therapists and expand on the term vicarious traumatization, which the authors initially proposed in 1990. Pearlman and Mac Ian argue that vicarious traumatization is a transformation that occurs within trauma workers as a consequence of empathetically engaging with clients.

• van Dernoot Lipsky, L. 2009. Trauma stewardship: An everyday guide to caring for self while caring for others. Oakland, CA: Berrett-Koehler.

  In this book, van Dernoot Lipsky introduces the term trauma exposure response to refer to the transformation that results from exposure to the suffering of others. This term is framed under the larger concept of trauma stewardship, which seeks to understand how victim service providers approach and are affected by their work.