BURNOUT, VICARIOUS TRAUMA, RESILIENCE, AND COPING OF AFRICAN
AMERICAN SOCIAL WORKERS
Nicole Richelle Ladner-Pace
B.A., California State University, Sacramento, 2008
PROJECT
Submitted in partial satisfaction of
the requirements for the degree of
MASTER OF SOCIAL WORK
at
CALIFORNIA STATE UNIVERSITY, SACRAMENTO
SPRING
2010
BURNOUT, VICARIOUS TRAUMA, RESILIENCE, AND COPING OF AFRICAN
AMERICAN SOCIAL WORKERS
A Project
by
Nicole Richelle Ladner-Pace
Approved by:
__________________________________, Committee Chair
Teiahsha Bankhead, Ph.D., L.C.S.W.
____________________________
Date
ii
Student: Nicole Richelle Ladner-Pace
I certify that this student has met the requirements for format contained in the University format
manual, and that this project is suitable for shelving in the Library and credit is to be awarded for
the Project.
_______________________________, Division Chair
Robin Carter, D.P.A., L.C.S.W.
Division of Social Work
iii
_______________________
Date
Abstract
of
BURNOUT, VICARIOUS TRAUMA, RESILIENCE, AND COPING OF AFRICAN
AMERICAN SOCIAL WORKERS
by
Nicole Richelle Ladner-Pace
African Americans are known to have a higher risk of health problems among ethnic groups
(Williams, 2002). They are overrepresented among those with mental health care challenges
when incomes are not controlled (Townes, Chavez-Korell, & Cunningham, 2009), and they are
less likely to seek mental health services (Obasi & Leong, 2009). Therefore, African Americans
as social workers may have an elevated risk for developing burnout and vicarious trauma. An
exploratory, cross-sectional study was conducted among 31 African American social work
practitioners and students to assess burnout and vicarious trauma, and to determine whether
resilience and coping may serve as protective factors. Respondents were recruited through faculty
social workers and MSW students at CSU Sacramento’s Social Work program. A selfadministered questionnaire involved thirty likert scale questions from both the Stamm’s (2009)
ProQOL Version 5 Survey to detect burnout, secondary traumatic stress, and compassion
satisfaction and the Africultural Coping Systems Inventory (ACSI) to measure the culturespecific coping strategies used by African Americans in stressful, day-to-day situations. A focus
group was also conducted. Salient findings included low potential for burnout and vicarious
trauma, high compassion satisfaction, resilience, high reliance on spiritual and collective methods
iv
of coping, and rare mention of personal intentions to pursue mental health services for self-care.
______________________________, Committee Chair
Teiahsha Bankhead, Ph.D., L.C.S.W.
______________________________
Date
v
ACKNOWLEDGMENTS
One of my favorite scriptures says, “But He knows the way that I take: when He has tried
me, I shall come forth as gold” (Job 23:10, KJV). As a full-time returning student, wife, parent,
and First Lady, I have truly been on a challenging journey these past “seven” years—a road of
various bumps and unexpected turns along the way; yet, I made it! And I am stronger and better
for the experience; by His Grace, I am refined like pure gold. Thank you to my Lord and Savior,
Jesus Christ, for showing me what he intended for my life and for being my “footprints in the
sand.” To my husband, my pastor, and friend, Glenn Pace, who has encouraged me, believed in
me, and prayed over me from the beginning: You asked me if I was ready for “the next level.”
You certainly have not disappointed. Thank you for your support. I love you! This victory is ours.
To my parents, Nathaniel and Sherlie Ladner: How blessed I am that you are my own! I love you
and thank you for always being right there. Shannon Janae: Remember the poem? Thank you,
Lil’ Sis, for your love, support, and sense of humor. Grandmother, Johnnie Mae Carter: Just like
you said, I can help my hubby in the church now! Thank you to all my relatives for your
encouragement; Mom Beatrice Pace and family; my young men, Brandon L. Thibodeaux and
Joshua and Mychal Pace; and my nephews, Lil’ Raymond and Bryce: Tee-Tee loves you. Time to
make up for lost times! Thank you to my church family for keeping me in prayer; my friends:
Johnnia, Adrienne, Rima, Aliyaah, Jeneen, and Sheree for always being there; to past counselors,
instructors, CSUS professors, and field supervisors who have shared their faith in my capabilities,
who have been true listeners, role models, and sources of inspiration: Thank you for believing in
me. To all those seeking higher education and those I will have the pleasure of serving: “Here I
am! I believe in you, here’s my hand.” To my social work peers, and all helpers of others, as we
continue to ‘carry this cross,’ let us be sure to take care of ourselves in the process.
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TABLE OF CONTENTS
Page
Acknowledgments.................................................................................................................... vi
List of Tables ............................................................................................................................ x
Chapter
1. INTRODUCTION ……………..………………………………………………………… 1
Background .................................................................................................................. 1
Social Work’s Code of Ethics ...................................................................................... 3
Professional Competence ............................................................................................. 4
Diversity and Cultural Competence ............................................................................. 5
Challenges Faced by African Americans ..................................................................... 6
Research Problem ........................................................................................................ 7
Purpose of the Study ................................................................................................... 7
Theoretical Frameworks .............................................................................................. 8
Definition of Terms ..................................................................................................... 9
Assumptions .............................................................................................................. 11
Justification ................................................................................................................ 11
Limitations ................................................................................................................ 12
2. LITERATURE REVIEW ................................................................................................. 13
Introduction................................................................................................................. 13
The Burnout Term ..................................................................................................... 14
Understanding Burnout in Modern Terms ................................................................. 15
Conceptualization of Burnout .................................................................................... 15
Burnout and Social Work........................................................................................... 17
Individual, Job, and Organizational Factors of Burnout ............................................ 19
Categories of Burnout Symptoms .............................................................................. 23
Demographics of Burnout .......................................................................................... 23
Stress in Human Services .......................................................................................... 25
Social Work Students and Stress ................................................................................ 27
Stress and African Americans……………….. ........................................................... 29
vii
Education and Training ............................................................................................. 31
Vicarious Trauma ..................................................................................................... 32
Background ................................................................................................................ 32
Constructivist Self-Development Theory .................................................................. 33
Disruptions and Manifestations of Vicarious Trauma on Therapists and Clients .... 34
Vicarious Trauma and Its Impact on Relationships ................................................... 36
Potential Impact of Vicarious Trauma on Professionals ............................................ 37
Impact of the Therapist’s Vicarious Traumatization on Clients ................................ 40
Empathy: A Promoting Factor of Burnout and Vicarious Trauma ............................ 41
Post Traumatic Stress Disorder.................................................................................. 44
Ethnicity and PTSD ................................................................................................... 45
Transference, Countertransference, and Projective Identification ............................. 46
Gender and Vicarious Traumatization ....................................................................... 48
Personal History of Trauma ....................................................................................... 49
Burnout, Vicarious Trauma, and Compassion Fatigue .............................................. 50
Occupational Studies ................................................................................................. 53
Resilience and Coping among African Americans .................................................... 58
Resilience Model ....................................................................................................... 59
Spirituality and Coping among African Americans ................................................... 60
Research Questions…. ................................................................................................ 69
3. METHODS ....................................................................................................................... 71
Introduction................................................................................................................ 71
Research Design ........................................................................................................ 71
Dependent Variables .................................................................................................. 72
Sampling Procedures and Data Collection Procedures .............................................. 72
Instrumentation .......................................................................................................... 74
Data Analysis Plan ..................................................................................................... 75
Human Subjects Protection ........................................................................................ 76
Subject Confidentiality .............................................................................................. 76
Voluntary Participation .............................................................................................. 77
4. FINDINGS ........................................................................................................................ 78
viii
Introduction................................................................................................................ 78
Demographics ............................................................................................................ 78
Professional Quality of Life Scale (ProQOL) Version 5 ........................................... 81
Burnout, Secondary Traumatic Stress, and Compassion Satisfaction ....................... 82
Summary of Overall Findings: Professional Quality of Life Scale (ProQOL) ......... 83
Africultural Coping Systems Inventory ..................................................................... 83
Summary of Overall Findings: Africultural Coping Systems Inventory ................... 92
Focus Group……………………………………………………………………… .... 92
Special Considerations .............................................................................................. 101
Summary of Overall Findings: ProQOL, ACSI, and Focus Group ......................... 103
Potential for Burnout, Vicarious Trauma (or STS), and Compassion Satisfaction . 103
Resilience ................................................................................................................. 103
Coping….................................................................................................................. 104
5. DISCUSSION ................................................................................................................. 105
Introduction.............................................................................................................. 105
Professional Quality of Life (ProQOL) .................................................................. 105
Africultural Coping Systems Inventory (ACSI) ..................................................... 106
Focus Group Discussion .......................................................................................... 107
Burnout .................................................................................................................... 107
Vicarious Trauma .................................................................................................... 109
Resiliency................................................................................................................. 111
Coping....................................................................................................................... 111
Summary .................................................................................................................. 112
Recommendations .................................................................................................... 113
Limitations of the Study .......................................................................................... 115
Implications for African American Social Workers ................................................ 115
Implications for Future Studies................................................................................ 116
Conclusion ............................................................................................................... 116
Appendix A. Consent Form Cover Page ............................................................................. 119
Appendix B. Consent Form………………………………………….................................. 120
ix
Appendix C. Survey ............................................................................................................. 121
Appendix D. Focus Group Interview ................................................................................... 124
References. ............................................................................................................................. 127
x
LIST OF TABLES
Page
1.
Table 1 Ability to Cope with Social Work-Related Stress…………………………… .80
2.
Table 2 Professional Quality of Life Scale (ProQOL)………………………………....82
3.
Table 3 Africultural Coping Systems Inventory Summary…………………………….84
4.
Table 4 Spiritual-Centered Coping……………………………………………………. 85
5.
Table 5 Collective Coping...............................................................................................87
6.
Table 6 Cognitive/Emotional Coping…………………………………………………. 89
7.
Table 7 Ritual-Centered Coping…………………………….…………… …………… 91
xi
1
Chapter 1
INTRODUCTION
Social work has been acknowledged in the literature as a “stressfully hazardous
profession” due to both the nature of the work it involves and the expectations placed on
professionals in their helping roles with clients (Gilbar, 1998, p. 39). For a student entering the
social work field with this understanding, the idea of pursuing this profession can be daunting.
The thought of high turnover in more challenging areas of social work due to high levels of stress
can also be discouraging to aspiring social workers and not promising for clients who need and
rely on their services. Without knowledge of the psychological impacts of working under
challenging workplace conditions, which may include difficult client behavior and vicarious
exposure to traumatic experiences, workers may feel a great degree of stress, may feel less
competent and ineffective, and may even decide to terminate their employment early. As a social
worker, it is not only important to be aware of the potential risks of burnout and vicarious trauma
on the job, but also the unique factors that serve to increase one’s capacity to maintain a personal
sense of wellbeing in order to perform well and remain in emotionally demanding careers.
Background
Burnout and vicarious trauma (also known as secondary traumatic stress) are popular
phenomena in the field of social work, both involving stress that is experienced by the human
service worker who is negatively impacted as a result of the nature of their jobs and interactions
with clients (Figley, 1995; Killian, 2008). Symptoms of burnout began to be noticed as early as
the 1970s when a psychoanalyst by the name of Herbert J. Freudenberger coined the term to
collectively label feelings of emotional exhaustion, loss of motivation, and decreased
commitment that he and other human service workers experienced (Maslach, Schaufeli, & Leiter,
2001). Initially, the term would describe the effects of chronic drug use; however, Freudenberger
2
(1974) would substitute the old understanding of the term for the psychological state of human
service volunteers in alternative health care agencies. Freudenberger (1975) described it as the
exhaustion experienced by a worker as a result of demands placed on one’s “energy, strength, and
resources” thereby promoting one’s ineffectiveness (p.1); and Freudenberger (1980) defined
burnout as “a state of fatigue or frustration brought about by devotion to a cause, way of life, or
relationship that failed to produce the expected reward (p. 13, as cited by Ben-Zur & Michael,
2007, p. 64). For example, this might often be the case of social workers who set out in their work
to improve the lives of their clients but are unsuccessful at doing so whether due to a lack of
needed resources to the client, limitations in the workplace, or incompetency. With time, the
experience of burnout has been perceived as a consequence of working with emotionally
demanding individuals (Kim & Stoner, 2008). By Maslach, et al., (2001), burnout is described as
involving three components: emotional exhaustion, depersonalization or cynicism towards one’s
job and or clients, and decreased feelings of effectiveness and personal accomplishment (Jenaro,
Flores, & Arias, 2007; Kim & Stoner, 2008; Martin & Schinke, 1998; Poulin & Walter, 1993;
Soderfeldt, Soderfeldt, & Warg, 1995).
The term “vicarious traumatization” originated with McCann and Pearlman (1990) in
their efforts to characterize what psychotherapists experience as the result of their interaction with
trauma survivors (Pearlman & Mac Ian, 1995). Vicarious traumatization is described as the result
of continuous empathic engagement with clients’ traumatic stories which may include childhood
sexual abuse, rape, assaults, physical and emotional abuse, the death of a loved one, the
witnessing and re-enactments of cruel behaviors among others, and such events as war or
genocide (Hesse, 2002; Pearlman & Mac Ian, 1995). According to Buchanan, Anderson,
Uhlemann, and Horwitz (2006), “compassion fatigue,” an alternate term for vicarious and
secondary trauma, (Buchanan, et al., 2006) was first coined by Joinson (1992) who studied
3
burnout in nurses working in emergency departments (Najjar, Davis, Beck-Coon, and
Doebbeling, 2009). It was Joinson’s belief that nurses potentially take on the traumatic stress of
their clients due to their caring and empathetic nature, their own symptoms often mimicking those
of the patients they assist (Najjar, et al., 2009).
Social Work’s Code of Ethics
Social work, according to the National Association of Social Workers (NASW) Code of
Ethics (1996), is based on work in which the wellbeing of the client comes first and foremost,
above one’s own self-interest. The NASW Code of Ethics (1996) states, “Social workers should
not allow their personal problems, psychological distress…or mental health difficulties to
interfere with their professional judgment and performance or to jeopardize the best interests of
people for whom they have a professional responsibility”(p. 23), they should “be alert to and
avoid conflicts of interest that interfere with the exercise of professional discretion and impartial
judgment,” and “…should not take unfair advantage of any professional relationship or exploit
others to further their personal, religious, political, or business interests” (p.9). This being said,
social workers must come into the helping relationship client-focused, self-aware of personal
issues, and clear-minded from personal sources of distress that could potentially impact the client.
Since the wellbeing of the client is first and foremost in social work, the upkeep of the human
service worker is also imperative since it is the interaction between them that will undoubtedly
have some impact on their mental and emotional health (Yin, 2004). Yin (2004) argues that
workers who are stressed or burned out can not adequately meet the needs of their clients.
Awareness of one’s self and knowledge of the threats to one’s psychological and
physiological wellbeing in the field of social work is imperative to provide help and not harm to
clients. Rothschild and Rand (2006) discuss the importance of the therapist making efforts to be
thoroughly familiar with one’s life history, past and present, and knowing one’s self well enough
4
that personal experiences and emotions do not become confused with or difficult to distinguish
from the experiences of one’s clients. According to Rothschild and Rand (2006), having this
awareness can ensure that professionals recognize the need for personal reflection and even
psychotherapy to gain and maintain clear thinking around their own unresolved issues. Not
having such awareness of one’s personal issues can be detrimental to a client’s wellbeing as well
as that of the therapist.
Burnout and vicarious trauma, therefore, are a threat to all social workers who are
professionally obligated to abide by Social Work’s Code of Ethics and employed to empower and
promote the wellbeing of others. Without knowledge that the potential for these experiences
await, how can one be prepared to suddenly handle them as competent and professional social
workers and MSW interns? Interns, according to Farber (1983), learn and become familiar with
their own unconscious psychological processes, motivations, and difficulties during their
education and training; and if not aware, they are in danger of overidentifying with clients,
doubting their own abilities to deal with related stress, never identifying the means that assist
them in coping, and questioning their own mental wellbeing (Farber, 1983). Furthermore, jobrelated stress deteriorates relationships between human service professionals and the clients with
whom they work (Einstat & Felner, 1983).
Professional Competence
Crucial to both the client and worker is the worker’s sense of competency, a common
goal among human service professionals (Cherniss, 1980; Einstat & Felner, 1983). The
professional must remain competent in the knowledge, training, and skills that help to achieve the
wellbeing of the specific client populations with whom they are engaging; and this can only occur
through appropriate and continued education, training, consultation, and supervision from others
who are also competent in the unique techniques and interventions which benefit specific
5
populations (NASW, 1996). Without competency, both service and the relationship between the
client and clinician can become toxic, and the possibility of doing more harm than good is made a
reality through unethical practice with clients.
Diversity and Cultural Competence
Professional literature, despite our pluralistic society, is still lacking sufficient research
that focuses on diversity—something that has been a concern since the 1900s, according to GuyWalls (nd). It was just in 1909 that the Black experience became a request for inclusion in the
social work curriculum, and since then, various researchers have continued to express concern
over the lack of effort in many social work programs to respond to the need for minority content
that is meaningful and raises people of color beyond marginal interest to practitioners and
educators (Guy-Walls, nd). The National Association of Social Workers (NASW) and Council of
Social Work Education (CSWE) have mandated the incorporation of diversity-related teachings
in all areas of practice within the Social Work profession (Guy-Walls, nd); however, Guy-Walls
(nd) asserts that the effectiveness of multicultural content in the education and training of
Bachelors and Masters level students has not been scientifically measured. Today, there is still a
deficiency of information found on the experiences of minority social workers and their minority
clients.
Cultural competence is said to involve a dual perspective that is important to the
communication and practice between social workers and vulnerable populations (Guy-Walls, nd);
and therefore, the inclusion of more research that equally examines the experiences and
observations of minority workers, as it does of predominant, European views, provides a more,
inclusive picture—a “dual” perspective—of social work and displays its value for diversity and
multiculturalism. Since minority social work professionals have been less discussed in current,
professional research, in the spirit of social work which embraces diversity and such things as
6
ethnographic interviewing –a technique used to gain understanding and appreciation for the
differences of others (CASCW, 2001), there is value in exploring the minority perspective.
Challenges Faced by African Americans
African Americans, as a minority group, are more vulnerable to serious health risks than
other ethnic groups (Obasi & Leong, 2009; Townes, Chavez-Korell, & Cunningham, 2009;
Utsey, Bolden, Lanier, & Williams, 2007; Utsey, Giesbrecht, Hook, & Stanard, 2008; Williams,
2003). And although there exists the possibility that some mental health professionals will have
themselves experienced similar traumatic events as their clients, which makes them more
vulnerable to vicarious traumatization (Buchanan, et al., 2006; Cornille & Meyers, 1999;
Cunningham, 2003; Hesse, 2002; Morran, 2008; Nelson-Gardell & Harris, 2003: Pearlman &
Saakvitne, 1995; Sprang, Clark, & Whitt-Woosley, 2007), African Americans have been found
less likely to pursue mental health care (Obasi & Leong, 2009; Townes, et al., 2009); face a
smaller pool of available professional, black counselors and therapists for their personal use
(Obasi & Leong, 2009; Townes, et al., 2009); and may not trust that other non-Black counselors
and therapists are culturally competent enough to assist them with their own emotional and
traumatic experiences (Obasi & Leong, 2009). Furthermore, Appleby (1998) discusses the
potential exploitation of black social workers who are hired by agencies to provided services for
clients of their own ethnic group. As a result, minimizing their professional responsibilities leads
to overall deprivation of skills, training, and opportunities for advancement which promotes
inequality, feelings of frustration and stress for African American workers (Appleby, 1998).
Overall then, it seems reasonable to believe that African American social workers face a triple
threat to their wellbeing when cultural factors are considered in addition to one’s potential for
burnout and vicarious trauma in social work professions. For that reason, mediators of burnout,
vicarious trauma, and cultural health risk factors are helpful and informative resources for
7
minority professionals in high stress, work environments or when facing traumatized clients in
session.
Research Problem
The Social Work profession upholds an explicit set of principles which includes its value
for diversity (NASW, Code of Ethics, 1996); yet the professional literature on minorities in social
work is often lacking (Guy-Walls, nd). In a high-stress profession as social work in which the
literature on stress and coping is expanding (Dziegielewski, Turnage, and Roest-Marti, 2004),
understanding cultural factors among minority workers that may mediate between their wellbeing
and psychological risks in the helping professions seem relevant for examination. This study
particularly explores the potential for psychological risks of burnout and vicarious trauma among
African Americans in social work who are themselves at higher risk for developing health
problems than any other ethnic group (Obasi & Leong, 2009; Townes, et al., 2009; Utsey,
Bolden, et al., 2007; Utsey, Giesbrecht, et al., 2008; Williams, 2003). Therefore, identifying
protective factors in the lives of African American social workers and students which help to
minimize stress and maintain wellbeing is crucial and appropriate for exploration.
Purpose of the Study
The researcher’s purpose for this study is to contribute to the knowledge base
regarding the potential for burnout and vicarious trauma among African American social workers
and MSW students. In doing so, the researcher hopes to expand the limited knowledge-base
regarding minority workers and their strengths, and highlight the importance of education,
training, and self-care against the psychological risks that may result in helping professions. The
researcher aims to inspire the implementation of new or introductory courses and workshops on
burnout and vicarious trauma which will prepare the student and professional for stressful, work-
8
related challenges. As well, the researcher hopes to inspire continued research into the cultural
experiences of all social workers from various minority backgrounds.
Theoretical Frameworks
Goldstein’s Ego Psychology of the Psychodynamic theory, (as cited by Payne, 2005), is
relevant to the burnout of African American social workers and the potential impact on their
clients. It involves the goal of managing relationships with others in a “consistent, rational
pattern,” a motivation to “explore, understand, and change their environment,” and social
competence, involving social transactions, which is impacted by the environment, social
structure, and culture (Payne, 2005, p. 85). “In a supportive work environment,” as stated by
Ospina-Kammerer & Dixon (2001), “…highly motivated professionals can reach their goals and
fulfill their expectations” (p. 87). The individual’s development of defense and coping
mechanisms may help limit the impact of environmental stressors, although not always in ways
that promote beneficial interactions with others; on the other hand, coping mechanisms tend to
promote positive interactions more efficiently (Payne, 2005).
Manning, Cornelius, and Okundaye (2004) discuss the importance of both the
Afrocentric Perspective and Ego Psychology in the African American community. Incorporating
the concepts of spirituality and moral development, the Afrocentric Perspective is perceived to
positively influence the development of African Americans in the way that it supports meaningful
religious images and beliefs, collective responsibility—in which members support and take
responsibility for each others’ wellbeing, and builds support systems through kin and extended
families. These protective influences “shield African Americans from the impact of racism and
oppression as well as mental and general health” (p. 232). Coping behaviors among African
Americans in difficult situations, which includes rituals in the management of stress, are best
understood through these perspectives (Utsey, Adams, & Bolden, 2000). The inner strengthening
9
of African American people, their strengths, adaptation, interpersonal relations, and mediators of
negative forces against their wellbeing are all represented herein (Manning, et al., 2004).
Together, the Afrocentric Perspective and Ego Psychology improve the functioning of African
Americans through their own cultural and individual strengths (Manning, et al., 2004). Cultural
and racial identification, self-concept, and worldview are improved, while negative behaviors and
self-blaming become less likely to occur (Manning, et al., 2004).
According to the resilience model proposed by Masten (1994, 2001, as cited by Utsey,
Bolden, et al., 2007), two conditions must be present for resilience to be recognized: a) the
existence of a significant threat or exposure to severe hardship (risk factors) and b) the realization
that one has positively adapted in the presence of that adversity (Utsey, Bolden, et al., 2007)
Definition of Terms

Burnout: Described as involving three components: emotional exhaustion,
depersonalization or cynicism towards one’s job and or clients, and decreased feelings of
effectiveness and personal accomplishment (Jenaro, et al., 2007; Kim & Stoner, 2008;
Martin & Schinke, 1998; Poulin & Walter, 1993; Soderfeldt, et al., 1995).

Vicarious Traumatization (VT): Conceptualized by McCann and Pearlman (1990) to
describe the secondary trauma experienced by human service professionals as they are
repeatedly exposed to the traumatic stories of their clients which may include such events
as childhood sexual abuse, rape, assaults, physical and emotional abuse, experiencing a
death, the witnessing and re-enactments of cruel behaviors among others, and such events
as war or genocide (Hesse, 2002; Pearlman & Mac Ian, 1995). It has also referred to by
other researchers as Compassion Fatigue (Bell, Kulkarni, & Dalton, 2003; Figley, 2000;
Killian, 2008; Najjar, et al., 2009; Sprang, et al., 2007).
10

Stress: Described as a natural consequence of working with people who have had
traumatizing experiences (Figley, 1995); a reaction to being under too much pressure
(Wilmot, 1988); and anything that disrupts one’s normal functioning, producing internal
strain or tension (Ben-Zur & Michael, 2007).

Resilience: Often defined as one’s ability to rise above adversities and adjust successfully
to varying situations, and the resilient individual is represented in research as “the
psychologically healthy person” (Scannapieco & Jackson, 1996, p. 190). Most definitions
of resilience involve the concept of one’s ability to overcome and adapt to challenging or
threatening experiences (Yin, 2004).

Coping: The utilization of resources among African Americans in the management of
stressors (Utsey, Giesbrecht, et al., 2008). Four common manners of coping are described
as: 1) cognitive/emotional, 2) spiritual, 3) collective and 4) ritualistic (Utsey, Bolden, et
al, 2007). Spirituality and religion have been found by numerous studies to play an
important role in the lives of African Americans and their ability to cope with challenging
situations (Constantine, et al, 2006; Laurence-Webb & Okundaye, 2007; Musgrave,
Allen, & Allen, 2002; Walker & Dixon, 2002; Sharp, 2006).

Religion and Spirituality: Religion and spirituality are well-known strengths of African
American culture (Holt, Clark, & Klem, 2007; Lawrence-Webb & Okundaye, 2007;
Manning, et al., 2004; Musgrave, et al., 2002; Walker & Dixon, 2002); and although
related, it is important to note that they should not be confused as equal concepts
(Musgrave, et al., 2002; Lawrence-Webb & Okundaye, 2007). Religion is defined by
Holt, et al., (2007) as being a structured system of explicit beliefs, practices, rituals, and
symbols. Spirituality refers to one’s being inspired by, or having some relationship or
belief in a higher power, a “Supreme Being,” and something greater than oneself
11
(Musgrave, et al., 2002, p. 557). It is the two together or separately, religion and/or
spirituality, that are believed to help individuals make sense of the world around them
and to cope with life experiences (Musgrave, et al., 2002).

Compassion Satisfaction: the pleasure one experiences as the result of being able to do
his/her job in a way that feels satisfying (Musa & Hamid, 2008).
Assumptions

Religion and spirituality are major strengths and means to coping among African
Americans in stressful situations.

Challenging life experiences of African Americans result in their overall resiliency and
ability to cope.

Psychological and physiological health risks are increased for African American social
workers who may experience burnout and/or vicarious trauma.

Because of the cultural and historical challenges of African Americans, as social workers,
they are likely to find challenging work with vulnerable clients more rewarding.
Justification
The Social Work profession will be benefited by the addition of relevant knowledge
regarding social worker burnout, vicarious traumatization, and the associated risks of each which
negatively impact both workers and clients. Cultural insight will be provided into the coping
resources and the resilience of African American social workers and MSW students which serve
to protect them from psychological harm, and which also upholds Social Work values and its
Code of Ethics in valuing diversity and recognizing strengths.
12
Limitations
This research study is not a longitudinal study nor does it include an analysis for a
representative sample of African American social workers across the United States. The study is
small in nature, observing only a small number of social work students and professionals within
Northern California and therefore, cannot be generalized to the larger population of African
American social workers. This study only serves to identify resilience and coping strategies
among African American social workers which help to mediate against the experiences of
burnout and vicarious trauma in the field and in social work careers. The researcher will discuss
implications for African Americans pursuing careers in social work and the potential for
managing stress, one’s sense of identity, and maintaining wellbeing among those in helping
professions which is vital for helpful services to clients.
13
Chapter 2
LITERATURE REVIEW
Introduction
Empirical studies regarding burnout among social workers are limited while the concept
of burnout has been well acknowledged as a common experience among human service
professionals (Ben-Zur & Michael, 2007; Gilbar, 1998; Jenaro, et al., 2007; Ospina-Kammerer &
Dixon, 2001; Soderfeldt, et al., 1995). Many studies increasingly examine and explain the various
factors associated with burnout—including occupational and individual characteristics, coping,
and prevention (Ben-Zur & Michael, 2007; Braithwaite, 2007; Jenaro et al., 2007; Martin &
Schinke, 1998; Ospina-Kammerer, et al., 2001; Perron, 2006; Soderfeldt, et al, 1995). In more
recent times, a growing concern has been established for the effects of trauma work on the human
service professional. Vicarious or Secondary Trauma (VT or ST), also referred to as Compassion
Fatigue (CF), is potentially experienced by workers who must regularly engage in and be exposed
to the traumatic experiences of clients (Bell, et al., 2003). Common knowledge regarding burnout,
and the expanding research on Vicarious Traumatization and Compassion Fatigue, warrant
exploration not only of those factors which are associated with each experience, but also an
examination of the resilience of human service professionals; as a result, professionals might gain
understanding into factors that help to buffer such experiences while protecting the psychological,
physiological, and emotional health of social workers, increasing the quality of service they
provide to clients, and promoting the longevity of social workers in their chosen careers (OspinaKammerer, & Dixon, 2001). For the purpose of this research, the researcher will review and
provide a description of burnout and Vicarious Traumatization concepts, explore and discuss
findings regarding the negative impacts that each has on workers and their clients, report on
additional risk, coping and resilience factors among African Americans that may help to mediate
14
between these experiences and their wellbeing as human service professionals and students.
Vicarious trauma and secondary traumatic stress are used interchangeably; and the phenomena of
compassion fatigue is also briefly discussed to distinguish between the differences and
similarities of each.
The Burnout Term
The initial use of the burnout term, as it relates to human services, is credited to a
psychoanalyst in the 1970s known as Freudenberger (Maslach, et al., 2001; Perron & Hiltz, 2006;
Soderfeldt, et al., 1995) who, through direct experience and observations of emotional
exhaustion, loss of motivation, and decreased commitment among himself and others, and
collectively referred to these experiences as “burnout” (Maslach, et al., 2001). In the 1970s,
Freudenberger (1974) substituted the original use of the word, which characterized the effects of
chronic drug abuse in the 1960s, for the psychological state of human service volunteers in
alternative health care agencies (Soderfeldt, et al., 1995). Freudenberger’s (1974) emphasis of the
term was on the psychology of the individual (as cited in Soderfeldt, et al., 1995); and burnout
was understood as the result of adverse reactions of workers to the human services workplace
(Soderfeldt, et al., 1995). These adverse reactions were believed to include physical and
emotional exhaustion (Martin & Schinke, 1998) as a result of their work with emotionally
demanding individuals (Kim & Stoner, 2008). Similarly, in the 1970s, job burnout was defined as
“a breakdown of psychological defenses that workers use to adapt and cope with intense jobrelated stressors” and “a syndrome in which a worker feels emotionally exhausted or fatigued,
withdrawn emotionally from clients, and perceives a diminution of achievements or
accomplishments” (Brohl, 2006, “Do I Have Burnout,” para. 1).
Freudenberger (1980) further defined burnout as “a state of fatigue or frustration brought
about by devotion to a cause, way of life, or relationship that failed to produce the expected
15
reward (p. 13, as cited by Ben-Zur & Michael, 2007, p. 64). For example, this might often be the
case of social workers who set out in their work to improve the lives of their clients but are
unsuccessful at doing so because of a lack of needed resources to the client, limitations in the
workplace, or incompetency. Maslach (1982) and other researchers who have followed interest in
burnout have promoted further insight into the concept by viewing it through a social,
psychological viewpoint; in this new perspective, attention is given to the environment’s impact
on the individual (Farber, 1983, as cited in Soderfeldt, et al., 1995) and to the numerous
definitions and descriptions of burnout that have continued to develop, aimed at providing a more
distinct understanding of what it entails.
Understanding Burnout in Modern Terms
More modernized definitions continue to be found for both burnout and stress in
professional literature. For example, Gilbar (1998) defines burnout as symptoms found in the
attitudes and behaviors of workers that either precede or indicate dysfunctional job performance
and as “physical and emotional exhaustion involving the development of negative self concept,
negative job attitudes, and a loss of feeling and concern for clients” (p. 40); Maslach, et al.,
(2001) have since defined burnout as “a psychological syndrome in response to chronic personal
stressors on the job” (p. 399); in the Social Work Dictionary (2003), it is defined as a general
term to describe feelings of apathy or anger among workers as a result of stress and frustration
while at work; and on the job, it has been perceived as involving stress, high workload, and lack
of coping resources (Winstanley & Whittington , 2002, as cited in Ben-Zur & Michael, 2007).
Conceptualization of Burnout
Burnout is conceptualized by Maslach, et al., (1981, 2001) as involving three
components: emotional exhaustion, depersonalization or cynicism towards one’s job and or
clients, and decreased feelings of effectiveness and personal accomplishment (Jenaro, et al., 2007;
16
Kim & Stoner, 2008; Martin & Schinke, 1998; Poulin & Walter, 1993; Soderfeldt, et al., 1995).
Emotional exhaustion involves the worker having run out of emotional and/or psychological
(Poulin & Walter, 1993) and physical (Kim & Stoner, 2008) resources. Depersonalization is the
negative and insensitive response of workers to their clients at which point they begin to detach
from clients, becoming emotionally distant, and objectifying their clients (Maslach, et al., 2001;
Poulin & Walter, 1993). The worker’s attitude toward clients becomes more negative as clients
are perceived as burdensome, workers become less caring and attentive to clients’ needs and
feelings, and this depersonalization of the client ultimately lessens the quality of service that the
client receives (Maslach, 1982). Decreased feelings of personal accomplishment, also referred to
as inefficacy (Maslach, et al., 2001) occur when the worker experiences feelings of incompetency
on the job, is unable to meet personal, work-related expectations, and when he or she has a
pessimistic view of work-related achievements (Kim & Stoner, 2008; Poulin & Walter, 1993).
Maslach, et al., (2001) explain that inefficacy sometimes appears to be the resulting role of either
exhaustion, depersonalization, or the combination of both and that depersonalization and
exhaustion hinder one’s sense of accomplishment, thereby impeding one’s ability to be effective
on the job. Emotional exhaustion has proven to be the condition most commonly associated with
burnout and gives significance to the study of burnout as it relates to the wellbeing, job
satisfaction (Arches, 1991; Kirk-Brown & Wallace, 2004; Lloyd, et al., 2002) performance,
turnover, and retention of human service workers (Kim & Stoner, 2008; Lloyd, et al., 2002;
Martin & Schinke, 1998; Maslach, et al., 2001; Poulin & Walter, 1993).
To make more comprehensible the process of burnout, Maslach (1982) describes a cycle
of burnout that involves the three components of emotional overload (emotional exhaustion),
depersonalization, and reduced personal accomplishment (inefficacy). The overwhelm felt by a
worker in dealing with the emotional demands of clients depletes his/her own emotional
17
resources leading to emotional exhaustion. Potentially, being emotionally exhausted may create
feelings of being unable to help or make a difference—also referred to as compassion fatigue
(Maslach, 1982). When a worker begins to feel unable to make a difference, the emotional strain
of working with clients may feel so great that detaching from them becomes a way of coping or
being more efficient on the job without succumbing to the emotional aspects of the job. This
detachment becomes the starting point of depersonalization in which the worker is self-protecting
against the emotionality of the work but in turn is causing the client to feel disregarded by the
worker who presents as indifferent. As the worker begins to recognize how negative his/her
feelings have become against those who need services, distress, guilt, and a sense of failure sets
in, leading to loss of self-esteem and even depression.
Burnout and Social Work
Burnout has been found to have a significant impact on both job performance, outcomes
in one’s health (Arches, 1991; Koeske & Koeske, 1989; Maslach, et al., 2001; Ospina-Kammerer
& Dixon, 2001), and on those who receive services (Kim & Stoner, 2008). Workers experiencing
high levels of work-related stress and dissatisfaction with their jobs and employers are likely to
be less committed, less productive, and less efficient (Maslach, et al., 2001); additionally,
employees may call in sick more often, consider leaving their careers, and actually leave their
agencies resulting in higher rates of employee turnover which negatively impacts clients’
experiences and the services they are provided (Kim & Stoner, 2008; Maslach, et al., 2001).
Braithwaite (2007) mentions the dynamic impact of stress upon workers in social care delivery as
a result of one’s job demands, control or autonomy, support, relationships, role at work, and
adjustments to change—stress-related factors that, without improvement, promote the potential
for work-related stress. According to Maslach, et al., (2001), the exhaustion component of
burnout is most associated with health-related problems, including the potential for substance
18
abuse and specific types of mental illness and dysfunction that are characterized by anxiety,
depression, and lowered self-esteem. Role stress, job autonomy, and the social support one
experiences are widely discussed as antecedents to burnout and turnover (Kim & Stoner, 2008).
A non-random, sample study by Ben-Zur and Michael (2007) examined burnout among
women and the differences between three care professions—social workers, psychologists and
nurses on work-stress appraisals, coping strategies and resources, social support at work, and
burnout indicators as well as the associations between them. Also having the role of caregivers in
the home, it was believed that women would be even more likely to experience burnout in the
workplace due to exhaustion—lacking energy and feeling worn out (Ben-Zur & Michael, 2007),
multiple roles and expectations, higher expectations placed upon them in the workplace, and
fewer rewards than their male counterparts. The study found few differences among the three
professions regarding the four psychological variables examined. The difference was small, only
3.5% of the variance, and non-significant in the regression analysis; and nurses and social
workers showed a higher score for depersonalization than psychologists. Depersonalization,
according to Ben-Zur and Michael (2007), is defined as having “a negative approach to others
and treating them as objects” (p. 64). The finding that exhaustion and depersonalization were
positively associated was the most significant finding. Workers who both perceived themselves as
having a sense of control over work-related challenges and had social support were less likely to
develop burnout and more likely to experience accomplishment. Without social support, workers
were found to be more likely for burnout, a significant finding. This study only accounted for
support at the workplace and did not measure potential support from family and friends. Ben-Zur
and Michael (2007) suggest future studies to include more representative samples of the care
professions to further explore the sources of appraisals that measure the perception of challenging
19
situations, one’s sense of control over them (challenge/control variables), and social supports and
their effects on workers’ well being.
Gilbar (1998) performed a study to determine whether a strong sense of coherence among
social workers was a coping strategy against burnout. Coherence is defined by Gilbar (1998) as a
decisive, cognitive and emotional perception and the degree to which one has a persistent belief
and confidence that the environment is predictable and that those things will most likely work out
for the best. One hundred and two social workers were interviewed; and a total of 81
participants—including 31 social workers in the field of physical illness, 21 in the field of mental
illness, and 29 in the field of the handicapped were contacted by Haifa University social work
students who administered to them two questionnaires including the Maslach Burnout Inventory
(MBI) and the Sense of Coherence (SOC) scale. The Sense of Coherence scale (SOC) measured
Comprehensibility: one’s perception that environments are predictable rather than unpredictable;
Manageability: belief that resources are controllable and he/she is capable of dealing with
demands, even if this “sense of control” is not of oneself but through faith of a higher power and
dependence on self and others; and Meaningfulness: one’s perception that his/her challenges,
despite their significance, are valuable and meaningful experiences to be challenged by rather
than disadvantaged (Gilbar, 1998). Strong coherence would mean that the worker saw their
challenges as worth facing; and a weak coherence would suggest participants experienced their
challenges as stressful. According to Gilbar (1998), this study confirmed the assumption that a
strong coherence among social workers leads to less burnout because these workers would be
more likely to identify their stressors and seek appropriate resources for their problems.
Individual, Job, and Organizational Factors of Burnout
Burnout is believed to be associated with individual traits of human service practitioners
and both job and organizational characteristics (Jenaro, et al., 2007; Kim & Stoner, 2008; Kirk-
20
Brown & Wallace, 2004; Lewandowski, 2003; Lloyd, et al., 2002; Martin & Schinke, 1998;
Maslach, et al., 2001; Poulin & Walter, 1993; Soderfeldt, et al., 1995). There have also been
research findings on the effects of client-interaction on the worker in relation to burnout (Poulin
& Walter; 1993, Soderfeldt, et al., 1995; Lloyd et al., 2002). Individual characteristics found to be
associated with burnout have included age and gender (Ben-Zur & Michael, 2007; Lewandowski,
2003; Poulin & Walter, 1993), level of experience or education (Soderfeldt, et al., 1995), one’s
own financial resources (Jenaro, et al., 2007), skills (Jenaro, et al., 2007; Lewandowski, 2003),
self-esteem (Ben-Zur & Michael, 2007; Lloyd, et. al., 2002; Poulin & Walter, 1993; Soderfeldt,
et. al., 1995), personal expectations regarding work-related issues (Lewandowski, 2003; Lloyd, et
al., 2002), perceived social support (Kim & Stoner, 2008) one’s own resilience, resources or
strengths utilized in coping with stressful situations (Jenaro, et al., 2007; Martin & Schinke,
1998), and the manner in which one views and responds to stress-related experiences (Martin &
Schinke, 1998); however, research supporting both clients’ impact on workers and individual
traits as predictors of burnout is more limited (Lloyd, et al., 2002), while job and organizational
characteristics in the research have been found more significant to the experiences of burnout
(Maslach, et al., 2001).
Among job and organizational factors found to be antecedents to burnout, popular
findings in the research include low work autonomy or lack of control on-the-job (Kim & Stoner,
2008; Maslach, et al., 2001; Poulin & Walter, 1993; Soderfelfdt, et al., 1995), low supervisory
support (Martin & Schinke, 1998; Poulin & Walter, 1993; Soderfeldt, et al., 1995) role ambiguity
(Ben-Zur & Michael, 2007; Kirk-Brown & Wallace, 2004; Lewandowski, 2003; Lloyd, et al.,
2002; Maslach, et al., 2001), role conflict (Ben-Zur & Michael, 2007; Kim & Stoner, 2008; KirkBrown & Wallace, 2004; Lloyd, et al., 2002; Maslach, et al., 2001; Poulin & Walter, 1993); low
salaries (Jenaro, et al., 2007; Soderfeldt, et al., 1995), lack of promotional opportunities (Brohl,
21
2006; Maslach, et al., 2001), and high levels of work-related stress as a result of job demands and
pressures experienced by workers (Lloyd, et al., 2002; Maslach, Schaufeli, Leiter, 2001).
According to Maslach, et al., (2001), examining the worker in relation to his or her environment,
including aspects of the job and organization as well as the emotions, motivations, and stress
responses of the workers, provides a broader understanding of how burnout may develop. More
recent knowledge, compiled by Maslach, et al., (2001), integrates individual and situational
factors into six areas of worklife—workload, control, reward, community, fairness, and values—
which they believe to be key organizational factors that predict burnout among workers.
The Lloyd, King, & Chenoweth (2002) study examined two factors: whether levels of
stress were greater for some social workers when compared to other health professionals, and
what factors promote stress and burnout among social workers. Several studies that examine the
impact of organizational structure and climate are cited by Lloyd, King, & Chenoweth (2002) and
include the Cushman et al. (1995), Collings & Murray (1996) Bradley & Sutherland (1995), and
the Balloch et al. (1998) studies. The Cushman et al. (1995) study revealed that lack of funding,
personnel shortages, high worker turnover rates, lack of linkages to other work resources,
attitudes of other health professionals, and working in a bureaucratic environment were identified
as stressors; the Collings & Murray (1996) study found pressures of planning and meeting workrelated goals was the most powerful predictor of overall stress among workers; and the Bradley &
Sutherland (1995) study examined occupational stress among 63 social workers and 73 home
aids, professional and support staff within a social services department in England. Findings
revealed that higher levels of stress were attributed to organizational structure and a climate of
low morale (as cited in Lloyd, King, & Chenoweth, 2002).
Finally, the Balloch et al. (1998) study (as cited in Lloyd, King, & Chenoweth, 2002)
22
found that conflicting demands on the job, expectations to do things not included in one’s job
description, inability to accomplish job-related responsibilities, and being unclear about job
expectations, goals, and objectives were the most frequently mentioned sources of personal stress
(as cited in Lloyd, King, & Chenoweth (2002). Balloch (1998) further explains role ambiguity—
uncertainty regarding the extent of one’s job and about the expectations of others which can
promote stress and result in job dissatisfaction, lack of self-confidence, a lowered sense of selfesteem, low motivation to work, and intention to leave the job (Sutherland & Cooper, 1990, as
cited by Lloyd, King, & Chenoweth, 2002). All of the mentioned studies helped to support their
conclusion that organizational structure and climate contribute to the burnout of social workers.
Protective factors against burnout, found by Lloyd, King, & Chenoweth (2002), were
supervision and teamwork, and forms of social support on the job. When social workers are able
to turn to their supervisors and co-workers for emotional and work-related support—including
emotional needs, assistance with casework, and developmental skills, lower levels of burnout,
work stress, and mental health problems are the outcome (Himle, et al., 1989, as cited in Lloyd,
King, &Chenoweth, 2002). In regards to comparisons of burnout between social workers and
other health professionals, lower levels of burnout were found among mental health workers than
of hospital or welfare social workers; however, findings in their research were not consistent in
this aspect.
Job satisfaction has also been found relevant to burnout. Martin & Schinke (1998)
surveyed 200 family/children and psychiatric workers of seven different social service
organizations using the Minnesota Satisfaction Questionnaire, the Maslach Burnout Inventory,
and the Staff Burnout Scale for Health Professionals. Findings revealed that 90% of both
family/children workers and psychiatrists reported overall satisfaction with their jobs; 57% of
psychiatric and 71% of family/children workers identified as moderately or severely burned out;
23
more than half of all workers were unsatisfied with their salaries; 43% of both groups were
unsatisfied with promotional opportunities; and only 5% of workers were satisfied with work life
(Martin & Schinke, 1998). Higher job satisfaction among workers was due to promotional
opportunities and the praise received from their employers—both negative correlates to burnout.
Categories of Burnout Symptoms
Kahill (1988), as cited by Figley (1995), identified five specific categories of burnout
symptoms, obtained from a comprehensive review of empirical research, which are experienced
by those workers who experience job stress (as cited in Figley, 1995); those symptoms, according
to Figley (1995), include Physical—fatigue and exhaustion, inability to achieve sleep, and
somatic problems which include headaches, gastrointestinal problems, colds, and flu; Emotional
—such as irritability, anxiety, depression, guilt, sense of helplessness; Behavioral—aggression,
callousness, pessimism, defensiveness, cynicism, substance abuse; Work-related—quitting the
job, poor work performance, absenteeism, tardiness, misuse of work breaks, thefts; and
Interpersonal—interaction with clients that is based more on obligation than genuine thought or
feeling, less focus and concentration of the client, withdrawal from clients and coworkers, and
dehumanizing or intellectualizing clients.
Demographics of Burnout
Overall, conclusions regarding the demographic characteristics of those who develop
burnout on the job have been fairly consistent with occasional exceptions (Maslach, 1982;
Maslach, et al., 2001). One of the most consistent findings has been that the younger in age are
likely to experience higher levels of burnout, and it is more prevalent in the earlier stages of one’s
career. In the helping professions, burnout has been found to occur in the first five years of one’s
career (Maslach, 1982) which, for instance, might include a population of new graduates. A
possible explanation is that these younger persons have less work experience, less wisdom, and
24
are not as mature or balanced as their elder peers. Also, burnout is least likely to occur among
those who have had post graduate training than among those who have not; and this group that
has had less post-graduate training was found to have the highest scores of depersonalization,
higher scores in emotional exhaustion, and lower scores in feelings of accomplishment (Maslach,
1982). Emotional exhaustion may be higher among those with higher education, possibly due to
higher expectations on the job that contribute to distress when personal expectations are not
satisfied (Maslach, 1982); this may also be due to a combination of greater responsibilities and
higher levels of job-related stress without having had the necessary training or education to
prepare themselves emotionally for such challenges faced on the job (Maslach, 1982).
Findings in regards to sex have not been as consistent or clear. The experiences of men
and women have been thought to be quite close, but men are often found to experience less
burnout than women and higher on cynicism while exhaustion appears to be more prevalent
among women, possibly due to stereotypical expectations of masculine and feminine roles; and
sometimes a distinction between their differences has been difficult to outline. Additionally,
males and females may often be employed in jobs that are thought to be dominated by their
gender—such as nurses being mostly female and more men being police officers (Maslach, 1982;
Maslach, et al., 2001).
Ethnicity has been far less studied. However, Maslach (1982) made several observations
regarding burnout factors among Asians, Whites, and Blacks. Asians and Whites share similar
experiences of burnout but Asians score higher for emotional exhaustion and depersonalization,
and lower on sense of accomplishment. The differences between Whites and Blacks were more
pronounced. Blacks were found to score lower on burnout overall, lower on emotional
exhaustion, and lower on depersonalization. Family and friendship networks, closer one-on-one
relationships, tendency to utilize emotional expression, experience with confrontation and
25
receiving personal feedback, resolution of conflicts, assertiveness, spontaneity, personal problems
and the hurt experienced from occurrences of discrimination and poverty are found to be factors
characteristic of the lifestyles of African Americans which make them more resilient in times of
distress or disappointment, according to Maslach (1982). And when all minorities are combined,
as compared to Whites, they have been found to score lower on emotional exhaustion and
depersonalization and, like that of Asians, less feelings of personal accomplishment (Maslach,
1982).
Burnout is less common among individuals who are married and more common among
singles than those divorced (Maslach, et al., 2001). Higher turnover might be seen among those
without families because there are fewer obligations to remain on the job since there may be no
family to support and fewer reasons to continue tolerating difficult work environments (Maslach,
1982). Those with families are more likely to stay on their jobs and their families serve as a
resource of emotional support, making workers less needy for approval on their jobs (Maslach,
1982). On the other hand, Freudenberger (1975) notes that relationships may suffer because one’s
personal or social life may be perceived as unsatisfactory, and the worker becomes more
dependent on experiencing gratification on the job; however, Freudenberger (1975) states that
being overly involved at work leads to overidentifying with one’s job, which leads to one’s “loss
of self” and the development of burnout.
Stress in Human Services
Stress, found to be a significant factor in human service careers (Appleby, 1998;
Cherniss, 1980; Einstat & Felner, 1983; Gellis & Kim, 2004), has been defined in numerous ways
in the professional literature. Wilmot (1998) defines stress not as the pressure that one
experiences but the reaction one has when facing excessive pressure. Manning’s (1998) concept
of stress involves the process of appraising events in one’s environment perceived to be stressful
26
and the resulting negative, psychological and physiological outcome on one’s health. And,
according to Manning (1998), an individual experiences impairment when he/she reaches
personal limitations as a result of the degree of stressful events which surpass one’s ability to
cope (Manning, 1998). Stress has been more recently defined as anything that disrupts the normal
functioning of a living being, producing internal strain or tension (Ben-Zur & Michael, 2007).
Sources of stress may vary for different human service professionals. According to
Deutsch (1984), various sources of stress found amongst psychotherapists have included
professional isolation and loneliness, feelings of grandiosity with assisting clients, overwhelming
responsibility, personal strain, doubts regarding one’s effectiveness, controlling one’s own
emotions during client sessions, consistent empathic interaction, and confusion regarding one’s
professional identity. Farber and Heifetz (1982), in a more recent study which examined stress
among psychotherapists, found that among their various potential sources of stress, “lack of
therapeutic success” was cited by 74% of subjects in their study and 57% believed “nonreciprocated attentiveness, giving and responsibility demanded by the therapeutic relationship”
were contributing factors to burnout (as cited in Deutsch, 1984, p. 834). Additional organizational
factors—including excessive workload, challenging work with clients, and organizational
politics—that were rated as significant stressors are also found by Farber (1979), according to
Deutsch (1984).
The outcome of job stress on workers’ health promises to be damaging without ways of
coping. Human service practitioners who experience chronic and prolonged stress at work are at
risk for chronic anxiety, psychosomatic illness, and various other emotional problems which can
undermine their ability to work effectively with clients (Lloyd, King, & Chenoweth, 2002); and
according to Gellis & Kim (2004), it may negatively impact one’s effectiveness, quality of life,
absenteeism, worker turnover, and productivity. Manning (1998) discusses stress and stress-
27
related impairment and provides several viewpoints: one’s vulnerability is as much a result of
unpredictable traumatic events outside of the workplace as they are from independent, daily
stresses; vulnerability may stem from having one’s own earlier traumatic experiences for which
treatment has not been obtained and, consequently, are re-lived as a result of environmental
stressors; and these environmental stressors, can trigger workers’ traumatic memories, potentially
leading to burnout among overworked staff whose colleagues are unaware of their exposure to
traumatic events. It is one’s own instincts in coping, as well as available support systems,
according to Manning (1998), that assist one in maintaining hardiness—described by Kamya
(2000) as one’s ability to manage and overcome challenges, while having a controlled and
committed nature, and perceiving oneself more as the controller of one’s destiny than a victim of
his/her circumstances; authenticity—an ability to remain true to one’s own personality, spirit,
character, and a worthiness of acceptance by others as defined in the Merriam-Webster
Dictionary, 11th ed. (2007); and finally, a positive belief system regarding life’s meaning (Kamya,
2000).
Social Work Students and Stress
Various studies that have been done on stress and coping of students in the helping
professions refer to those studying nursing, psychology, and mental health (Deutsch, 1984;
Dziegielewski, Turnage, and Roest-Marti, 2004). According to Dziegielewski, Turnage, and
Roest-Marti (2004), despite growing interests and professional literature on stress and coping—
especially in the helping professions where stress and burnout is evident—there has been very
little literature on stress among social work students whose clinical training combined with class
work and research makes them even more vulnerable to psychological distress. Students are not
only faced with their own developmental roles as individuals who are becoming young adults, but
they must take on numerous, new demands potentially causing role strain, role overload, and role
28
ambiguity which contribute to severe stress (Dziegielewski, Turnage, & Roest-Marti, 2004;
Home, 1997; Kamya, 2000). The responsibility of one’s job, caring for family, keeping up with
school, and taking on service demands while working with a variety of vulnerable populations
can be overwhelming for graduate students (Kamya, 2000). Such pressures may be especially
apparent for women since the expectations of them in society are to be the primary caregivers
while also enrolled as students, causing them to feel torn between multiple roles—student,
caregiver, or other obligations—and thereby promoting role strain and or stress (Home, 1997). It
is imperative not only to understand stress as it relates to students in the helping professions, but
to understand that without proper education, training, and interventions, social work students and
others in the helping professions will be more vulnerable to burnout as new professionals,
unaware of how stress impacts their careers and work environments, and unable to cope with
and/or prevent burnout.
Dziegielewski, Turnage, & Roest-Marti (2004) conducted research to examine changes in
responses of social work students after a 45-minute, stress management seminar on ways to better
handle stressful situations. The study utilized a pretest-posttest design involving a sample of 48
undergraduate students recruited as volunteers from three different course sections in their social
work program. The 45-minute seminar was conducted by an experienced, licensed clinical social
worker who provided a 2-page handout from which they discussed 4 topics: (1) understanding
and identifying personality styles and patterns of behavior, (2) learning about stress, (3) helping
students identify signs of stress in themselves and others, and (4) providing concrete measures—
such as cognitive restructuring, deep breathing, and relaxation training—for addressing stress
(Dziegielewski, et al., 2004). Students assigned to the experimental group showed a significant
improvement, showing a considerable decrease in their levels of stress and apprehension.
A survey study by Home (1997) examined relationships between stress, role strain,
29
perceived role demands, and perceived support of 443 women students of social work, nursing, or
adult education with family and job obligations at the same time. These women who are
pressured to maintain their responsibilities between family and the high expectations required of
them in school report feelings of being overloaded, having frequent role conflicts, and not having
enough support (Home, 1997). Those women who perceived themselves as having higher role
demands had more stress and role strain. According to Home (1997), stress is defined as the
distress one feels due to challenging life situations that deplete his or her ability to find solutions,
and role strain as the difficulty one feels when trying to maintain role demands—those that are
incompatible and simultaneous (role conflict), when time is insufficient to meet demands (role
overload), and one is preoccupied with one role while simultaneously performing another (role
contagion). As well, lower income women were also reported to have higher levels of stress. The
way one perceives family demands was a predictor of stress, and distance education and support
from family and friends proved to be mediating factors for stress. Role strain was predicted by
student-role demands—something thought to be valuable knowledge for educators (Home, 1997).
Stress and African Americans
African Americans as a group are known to be more at risk for environmental stressors,
such as racism and oppression, and stress-related diseases (Utsey, Adams, et al., 2000). African
American men have higher rates of morbidity, disability, and mortality compared to their white
counterparts and African Americans in general experience poorer health when compared to the
remainder of the U.S. population (Williams, 2002). Williams (2002) explains that a combination
of high job demands with little control, high levels of work output and lack of reward, low
occupational status, social isolation and poor diet promote elevated levels of stress which can lead
to harmful health behaviors such as impaired sleeping patterns, decreased physical activities,
increased substance use and food consumption, all which may lead to chronic diseases. Due to
30
cultural expectations, men and women tend to follow behavioral patterns that determine the
outcome of their health—men tending to engage in those that are more harmful (Williams, 2002).
In terms of coping with stress among African American men and women, the ways by
which they respond to it have further consequences to long-term health outcomes regarding
mental health, infectious diseases, and chronic diseases (Williams, 2002). In comparison to one
another, Williams (2002) shares that women are more exposed to stressful situations than men but
utilize coping strategies that are more effective than men, especially in terms of interpersonal
stress. Women are more likely than men to seek and receive similar degrees of social support for
stress among the same-sex, to be content with the support they receive, are more frequent
providers of support than men, and are more effective at providing support to others (Williams,
2002). On the other hand, Williams (2002) goes on to explain that women have been found to
experience depression and anxiety more than men as a result of internalizing their feelings,
whereas men externalize their emotions through outward behaviors such as alcohol or drug abuse
and antisocial behaviors (Williams, 2002). Recognizing stress as a major contributor to
developing unhealthy coping habits, which can and do include alcohol and substance use, is
critical. This research hopes to uncover some of the challenges and experiences that social work
presents and to explore how African American students and social workers manage to cope.
The NASW Workforce Study (Arrington, 2008) examined the various ways that social
workers cope with stress at work. A non-random survey was conducted with 3,653 respondents.
When reviewing the coping strategies for stress among racial and ethnic groups, 71% of African
Americans reported exercise as a strategy for coping with stress, more so than meditation (24%),
or therapy (15%). Equal numbers of men and women participants across all ethnicities (African
American/Black, Caucasian/White, Native American, Other Hispanic/Latino, Puerto Rican,
Chicano/Mexican American, Asian American, and Other) shared this view, with 72 % of women
31
and men equally choosing exercise as a coping strategy for stress. Overall, men (34%) were more
likely to choose meditation than women (29%). Meditation was the coping strategy most reported
by workers in mental health (35%) compared to health (27%) and child/welfare workers (24%).
Spiritual development was stated by participants as an “other” coping strategy for alleviating
stress. This study points out that African American professionals are utilizing coping strategies
outside the realm of spirituality and religion. Having an awareness of such coping resources, in
addition to proper education and training regarding health-related issues and stress-related factors
of social work can serve to improve the health outcomes of African American social workers.
Education and Training
Alpert and Paulson (1990) assert in their study that education and training in child sexual
abuse should be incorporated at graduate level studies while also acknowledging the finding that
such training will elicit strong emotional responses in trainees and others. Without formal training
in child sexual abuse, interns and their supervisors are less likely to recognize child sexual abuse
victims, the family dynamics that are associated with it, how to handle disclosures from their
clients regarding child sexual abuse, and they will be more likely to experience denial that it even
exists (Alpert & Paulson, 1990). Two courses, one a practicum, were provided to 20 students in
Psychology, education, health, nursing, and arts on the topic of child sex abuse. Hesitancy and
resistance were found to occur among the students. Alpert and Paulson explain that such program
development creates anxiety and resistance for a variety of possible reasons including that the
trainee may have had personal experience with sexual abuse, denial about the harsh reality of
child sexual abuse, feelings of incompetency with the subject and how to handle such concerns,
and the pressures of mandated reporting. Of the 20 graduate students in this study, 43% of those
in the sexual abuse course and 21% of those in the practicum course had experienced sexual
abuse, all of them whom reacted strongly to the courses’ content. Considerations for the sensitive
32
nature of the topic of sexual abuse to trainees, the resistance that it promotes among trainees, their
supervisors, parents, and staff, the need for people to understand and express their knowledge and
feelings about sexual abuse, as well as the consequences of a lack of education and training in this
area must be made (Alpert & Paulson, 1990).
Vicarious Trauma
In relation to burnout, a more recent interest in the helping professions has been the
harmful, psychological effects of clients’ trauma experiences on the therapists who work with
them (Cunningham, 2003; Cunningham, 1999; Hesse, 2002; Pearlman & Mc Ian, 1995). Such
efforts as working with survivors of the September 11th attacks, Hurricane Katrina, war, and
terrorism, or others who have survived childhood sexual abuse and domestic violence, repeatedly
expose workers to their clients’ stories and experiences of victimization making workers
vulnerable to the phenomena known as Vicarious or Secondary Traumatization (VT or ST), also
referred to by other researchers as Compassion Fatigue (Bell, et al., 2003; Figley, 2000; Killian,
2008; Najjar, et al., 2009; Sprang, Clark, & Whitt-Woosley, 2007). Those professionals working
mostly with sexual abuse clients, those who have personal histories of trauma, and those who
may be new to trauma work are thought to be most likely to experience vicarious trauma
(Cunningham, 2003).
Background
The term “vicarious traumatization” originated with McCann and Pearlman (1990) in
their efforts to characterize what psychotherapists experience as the result of their interaction with
trauma survivors (Pearlman & Mac Ian, 1995). Vicarious traumatization is described as the result
of continuous empathic engagement with clients’ traumatic stories which may include childhood
sexual abuse, rape, assaults, physical and emotional abuse, the death of a loved one, the
witnessing and re-enactments of cruel behaviors among others, and such events as war or
33
genocide (Hesse, 2002; Pearlman & Mac Ian, 1995). Trauma itself is understood as that which is
experienced by an individual as a result of actual or threatened death or harm caused to one’s self
or others and accompanying feelings of fear, helplessness, and horror (Hesse, 2002).
According to Buchanan, Anderson, Uhlemann, and Horwitz (2006), the term
“compassion fatigue” has been known to be substituted in place of vicarious and secondary
trauma. The term was first coined by Joinson (1992) who studied burnout in nurses working in
emergency departments (Najjar, et al., 2009). It was Joinson’s belief that nurses potentially take
on the traumatic stress of their clients due to their caring and empathetic nature, their own
symptoms often mimicking those of the patients they assist (Najjar, et al., 2009).
Bride (2007) discusses secondary traumatic stress, or vicarious traumatization, as the
natural consequence of the continual provision of services to traumatized clients during which
continual exposure to clients’ traumatic experiences takes place; and the human service
professional’s desire to both help and fulfill their own professional role in improving clients’
wellbeing, can add to their vulnerability. Cerney (1995) cites various studies acknowledging the
irrational expectations of therapists in their work with clients. Professionals whose work involves
an overload of abuse cases may intend to work with a high degree of efficiency and competence
in their work with every client; however, they may lack the training, knowledge, or resources
which help them to successfully meet the high demands of their work and, as a result, are
traumatized, both by their clients’ traumatic experiences and their inability to meet the needs of
their clients (Cerney, 1995).
Constructivist Self-Development Theory
Vicarious traumatization is based on constructivist self-development theory (CSDT)
(Black & Weinreich, 2001; McCann & Pearlman, 1990; Pearlman & Mac Ian, 1995; Pearlman &
Saakvitne, 1995). CSDT is said to involve a combination of self-psychology, object relations, and
34
social cognition theories, and it examines the ways that survivors of traumatic experiences are
impacted—including how they defend themselves, their resulting psychological needs, coping
styles, and the more prominent aspects of their traumatic experiences which determine their ways
of responding (Pearlman & Mac Ian, 1995). According to McCann & Pearlman (1990), how one
responds to trauma is based on a combination of life experiences and the developing self.
Influences that promote therapists’ vulnerability to vicarious trauma may involve their own
personal characteristics—such as personal trauma history, how one perceives the meaning of his
or her own traumatic experiences, one’s psychological style, the manner in which one interacts
with others, professional development, and current factors which promote stress and supports
(Pearlman & Mac Ian, 1995). Other influences may include client characteristics and the nature
of their experiences, stressful client behaviors, the work environment, and the socio-cultural
context (Pearlman & Mac Ian, 1995). Research has also found that the manner in which
individuals perceive their world can be disrupted and they may experience intrusive thoughts and
imagery as a result of their traumatic experiences (Black & Weinreich, 2000; Cerney, 1995;
Hesse, 2002; Pearlman & Mac Ian, 1995), a possible contributor to a therapist’s vicarious
traumatization.
Disruptions and Manifestations of Vicarious Trauma on Therapists and Clients
Various studies have noted findings amongst therapists of traumatized clients that
vicarious trauma causes disruptions in the therapist’s worldview (Feldman & Kaal, 2007;
Pearlman & Mac Ian, 1995; Pearlman & Saakvitne, 1995), beliefs or cognitive schemas
(Buchanan, et al., 2006; McCann & Pearlman, 1990; Pearlman & Mac Ian, 1995; Schauben and
Frazier,1995), relationships (Beaton & Murphy, 1995; Dutton & Rubinstein, 1995), spirituality
(Hesse, 2002; Pearlman & Saakvitne, 1995), identity or self-perception (Black & Weinrich, 2000;
Cerney, 1995; Feldman & Kaal, 2007; Figley, 2000; Hesse 2002; Pearlman & Saakvitne, 1995),
35
as well as vulnerability in their feelings of safety, trust, esteem, feelings of power or control, and
intimacy (Dutton & Rubinstein, 1995; Hesse, 2002; Pearlman & Saakvitne, 1995).
Worldview, “the way we understand the world,” which may be based on one’s personal
values, according to Pearlman and Saakvitne (1995), is equally impacted by trauma (p. 160).
Forced to acknowledge the violent and malicious acts that occur against human beings in society,
and in the world, one’s morals and beliefs about life and about the nature of human beings are
challenged, resulting in pessimistic attitudes and beliefs regarding the world (Pearlman &
Saakvitne, 1995). Feldman and Kaal (2007) use the assumptive worldview theory which proposes
that the natural beliefs people hold about the world, and from which they live by, give them a
sense of security and invulnerability which is shattered by a traumatic experience, resulting in
negative affect and posttraumatic symptoms.
Pearlman and Mac Ian (1995) mention a study regarding vicarious traumatization and
disrupted beliefs or schemas. Schauben and Frazier (1995) assessed 118 female psychologists and
30 female rape counselors for vicarious traumatization and found that disruptions in one’s beliefs
or schemas, with PTSD symptoms, and self-identification among workers as experiencing
vicarious traumatization was more likely when workers have higher caseloads of clients who
survived a traumatic experience. Steed and Downing (1998), as cited in Buchanan et al., (2006),
reported on 12 female trauma therapists who experienced increased disruptions to cognitive
schemas, increased vulnerability and self-protective strategies, and heightened mistrust and
suspicion of others as the result of working with survivors of sexual assault.
Black & Weinrich (2000) discuss how vicarious traumatization impact counselors’
beliefs and value systems, self-perceptions, and worldview; as well, the study examines the
effects of VT on interpersonal relationships and how it may be promoted by the counselor’s own
previous experiences of trauma. Findings, according to Black and Weinreich’s (2000) study
36
indicate that VT promotes increased identification conflicts that are potentially maintained over
time, including over-empathetically identifying with clients in the short or long term; VT can
promote isolation (or dissociation) in interpersonal relationships—whether professional or
domestic; the counselor can be both positively and negatively impacted as a result of their own
experiences of traumatization which resurface during trauma work with clients and how they
view themselves in professional and domestic contexts which is evidenced in how they identify
with significant others; counselors will revert to their long-established familial beliefs and value
systems rather than professional beliefs and values when confronted with the trauma of their
clients; trust becomes an important factor in appraising the world among counselors who
experience vicarious traumatization through their clients; and counselors will become
preoccupied with trauma-related issues that promote contradiction and difficulty for them in
regards to their own beliefs and values.
Vicarious Trauma and Its Impact on Relationships
Listening to the traumatic experiences of clients may create sensitivity in the trauma
worker who begins to compare similar experiences in his/her personal relationships (Dutton &
Rubinstein, 1995); and therapists’ relationships with clients and their own families, as well as
their perceptions of others in general, are negatively impacted as a result of vicarious
traumatization (Dutton & Rubinstein, 1995; Pearlman & Mac Ian (manuscript in preparation), as
cited by Pearlman & Saakvitne, 1995). Loss of esteem for others is one such example (Pearlman
& Saakvitne, 1995). Additional signs that vicarious traumatization may be impacting the
therapist’s relationships are social withdrawal, inability to tolerate a vast array of feelings that are
necessary for intimate relations, and a lack of enjoyment of entertainment (Pearlman &
Saakvitne, 1995). Feelings of alienation by peers and intimate others whom the worker feels
misunderstood by, or whom the worker feels may not believe or understand the stress and pain
37
involved in their jobs are also experienced by affected therapists (Dutton & Rubinstein, 1995).
Furthermore, there may be a tendency to draw closer to colleagues than to family which may
negatively impact one’s ability to interact with others in ways that are nurturing and in activities
that are outside the realm of work (Pearlman & Saakvitne, 1995.)
Potential Impact of Vicarious Trauma on Professionals
Overidentification may occur with the therapist who shares similar traumatic experiences
or backgrounds with clients (Cerney, 1995; Dutton & Rubinstein). According to Cerney (1995),
the therapist may become distraught from the client’s trauma and develop feelings of
responsibility for the client’s wellbeing. The therapist may feel an overwhelming sense of
helplessness or rage against the offender as a result of the client’s traumatic experience and feel a
need to rescue the client; as a result of the therapist’s distress, the client may react by sharing less
with the therapist (Hesse 2002) and even switch roles in the helping relationship in attempt to
protect the worker (Dutton & Rubinstein, 1995). The therapist who longs to satisfy personal,
unmet needs within the therapeutic relationship loses the ability to recognize his/her own personal
needs that mirror or relate to that of clients and loses focus of the client’s challenges and needs
(Pearlman & Saakvitne, 1995). In such instances as these, the potential for countertransference is
actualized in which therapists become distracted with personal traumatic experiences as they
relate to those of their clients, feeling such emotions as guilt or self-blame, fear, or helplessness
(Cerney, 1995; Dutton & Rubinstein, 1995). According to Dutton & Rubinstein (1995),
detachment from clients may occur if the therapist identifies with the victim’s perpetrator; and
dissociation may occur in response to recognizing similar characteristics between oneself and the
client and wanting to dissociate from them (Black & Weinrich, 2001). Therapists affected by
vicarious trauma may distance themselves from clients through the act of judging, labeling or
pathologizing the client’s response to their trauma, dissociate from clients during sessions,
38
become persistently late for client sessions, and may cancel clients’ appointments in an attempt to
protect themselves from vulnerability (Dutton & Rubinstein, 1995). Situations such as these lead
to ineffective practice by therapists who, as a result, further victimize already traumatized clients
(Dutton & Rubinstein, 1995; Hesse 2002).
Working with traumatized clients can create a vulnerable sense of identity in the therapist
who works with them. While the therapist may want to experience his/her identity as having a
sense of control or power over the experiences in their clients’ lives, it is instead necessary,
although a challenge, to remain as a catalyst for clients to gain understanding of their traumatic
experiences, rather than experiencing oneself as their rescuer (Hesse, 2002; Pearlman &
Saakvitne, 1995). One may begin to question his or her identity and experiences in terms of
gender roles, self esteem, and his or her past as well as the possibility of his or her own repressed
memories and feelings (Pearlman & Saakvitne, 1995). The gender of both client and perpetrator
may also contribute to the questioning of one’s identity.
Lost feelings of safety, trust, esteem, feelings of power or control, and intimacy, which
are all said to be included in one’s cognitive schema (Dutton & Rubinstein, 1995; Hesse, 2002;
Pearlman & Saakvitne, 1995), occur among trauma therapists and cause a change in one’s
behavior (Pearlman & Saakvitne, 1995). Hesse (2002) describes these various feelings of loss
among trauma therapists. Cynicism and suspicion of others results in response to learning of the
harmful acts of others and resulting feelings of distrust. Fear and a sense of helplessness occur
because of an inability to control events and maintain a sense of safety for themselves and others.
One feels a loss of independence due to one’s feelings of vulnerability. Loss of esteem for self
and others occurs, which may include instances in which the therapist questions his/her own self
worth; as a result of low self-esteem, the worker turns to numbing behaviors that may include
alcoholism, overeating, and overworking. An inability to experience intimacy results due to the
39
loss of faith in humanity and may even be unavailable to their own sense of need because they
have become consumed with the needs of their traumatized clients. Other challenges, according
to Hesse (2002) include an inability of the therapist to make sound judgments, to maintain insight
or be reflective regarding their therapeutic role with clients, and to maintain professional
boundaries by not overly obsessing with their clients’ trauma.
Pearlman and Saakvitne (1995) state that trauma therapists may experience disruptions
of their frame of reference which includes their sense of identities, worldviews, and their
spirituality. One’s spirituality, according to Pearlman and Saakvitne (1995), characterized as “a
sense of meaning for one’s life…hope and idealism… connection with others…and awareness of
one’s experience,” is made vulnerable, damaged, and/or eliminated as a result of vicarious
traumatization (p.161). Religion or lack thereof may be one’s resource to obtaining or
maintaining such experiences; and one’s sense of meaning and connection with others is seen as
imperative to maintaining psychological wellbeing—especially among those who have
experienced childhood sexual abuse (Pearlman & Saakvitne, 1995). It is the disruption of one’s
spirituality that Pearlman and Saakvitne (1995) note as being the most damaging effect of
vicarious traumatization, and the least explored, among survivors of trauma and the therapists
who work with them. One’s self-capacity—involving “inner or intrapersonal abilities” that permit
one to uphold an ongoing, reasonable, and affirmative sense of self and which are “critical for
self-soothing and affect tolerance,” according to Pearlman and Saakvitne (1995), are also
disrupted (p. 161). These self-capacities, according to Pearlman & Saakvitne (1995), involve
one’s ability to sustain positive self-judgment, adjust strong emotions, and preserve one’s internal
sense of relation with others. Without such knowledge and insight regarding client needs and selfawareness of the professional, therapists who experience vicarious traumatization with clients
40
may further threaten the wellbeing of their clients (Dutton & Rubinstein, 1995: Hesse, 2002;
Pearlman & Saakvitne, 1995).
Impact of the Therapist’s Vicarious Traumatization on Clients
The traumatized client suffers further harm and can be re-traumatized in various ways at
the hands of therapists who have been negatively impacted by vicarious trauma (Dutton &
Rubinstein, 1995: Hesse, 2002; Pearlman & Saakvitne, 1995). Such experiences may include
therapists avoiding discussion of a client’s experiences that promote strong or uncomfortable
emotions in themselves and even blaming the victim to protect themselves when experiencing
uncomfortable feelings from working with threatening, manipulative, or exploitative clients
(Hesse, 2002; Dutton & Rubinstein, 1995). Clients may be blamed or shamed by therapists who
feel their identity as competent therapists is challenged in the client-therapist relationship because
of feelings of ineffectiveness or the client bringing attention to the therapist’s own vulnerabilities;
and the therapist may be seeking the client’s praise in order to feel more competent as a therapist
(Hesse, 2002). Clients are unable to express themselves openly as a result of therapists who
overidentify with the client due to unresolved emotions and traumatizing experiences that are
similar to those of the perpetrators (Hesse, 2002). In such cases, according to Hesse (2002), the
client limits how much he/she shares with the therapist and therefore never has a full opportunity
to explore and work through their trauma. Therapists may be biased towards their own worldview
and cause clients to feel unable to fully convey their own beliefs and feelings, limiting their
ability to heal (Hesse, 2002). Clients may desire to emulate their therapist whose own self-image
or self-esteem is damaged from a traumatic experience, but this is never recognized by the
impacted therapist and therefore never explored; workers may lose the ability to remain
empathetic and maintain healthy boundaries with clients; the therapist may become
argumentative and emotionally unavailable; clients may be overmedicated or over-hospitalized;
41
therapists may fail to utilize helpful referral sources due to their own mistrust of others;
inappropriate treatment methods may be used by the therapist to maintain the therapist’s sense of
control and that minimize the therapist’s own discomfort (Hesse, 2002). It has even been found
that empathizing, or having an empathetic nature, with traumatized clients can result in the
psychological harm of the therapist which in turn leads to such adverse, and injurious, client
experiences (Feldman & Kaal, 2007; Figley, 1995; Figley, 2000; Killian, 2008; Miller, Stiff, &
Ellis, 1988; Rothschild, 2006; Sprang, et al, 2007).
Empathy: A Promoting Factor of Burnout and Vicarious Trauma
Social workers, counselors, and other human service professionals have been known to
have an empathetic nature which is often the promoting factor in their choice of career as
professional “helpers” (Figley, 1995). Various researchers have discussed empathy as a factor
that impacts both the professional’s likelihood of experiencing burnout (Miller, et al., 1988;
Rothschild, 2006) and vicarious traumatization (Feldman & Kaal, 2007; Figley, 1995; Figley,
2000; Killian, 2008; Sprang, et al, 2007). Described as both a valuable and necessary tool for
effective work with clients and a threat to the well-being of therapists, Rothschild (2006)
describes the benefits and disadvantages of empathy in working with clients. “Empathy allows us
to relate to those in our care, to have a sense of what they are feeling…put their experiences into
perspective, understanding how they are being affected by the incidents we are trying to mediate”
(Rothschild, 2006, p. 10); and when suffering from, what Rothschild refers to as, “unconscious
empathy,” such phenomena as “unmanageable countertransference, projective identification,
compassion fatigue, vicarious traumatization, and burnout may take place (Rothschild, 2006, p.
11). Miller, et al., (1998) similarly describe empathy as one of the personality characteristics of
human service professionals who are motivated in their roles of helping others in distress which
makes them more likely to experience burnout. A therapist’s experience of a traumatic event,
42
unresolved trauma, and/or listening to children’s trauma has proven to be an additional cause of
vicarious traumatization among professionals (Figley, 1995).
As a more cognitive component in addition to affective response, empathy involves
understanding and sympathizing with clients but feeling personal distress as the result of their
emotions (Feldman and Kaal, 2007). Also described as a multidimensional concept, empathy
includes the dimensions of emotional contagion and empathic concern (Miller, et al., 1988). In
response to clients’ actual or anticipated emotional expressions, workers may display emotional
contagion as they mirror similar client reactions (Miller, et al., 1988) which may include facial,
vocal, or bodily postures (Feldman & Kaal, 2007). Empathic concern, according to Miller, et al.,
(1998), involves a general concern and consideration for the client’s wellbeing but does not have
the element of paralleling the client’s reactions.
The Miller, et al., (1988) study, examined the relationship between burnout, empathy, and
communication among human service professionals and found that caregivers and support staff
displayed equal levels in the area of empathic concern, while support staff displayed higher levels
of emotional contagion. Miller, et al., (1988) explain the necessity of “detached concern,” a term
invented by Lief and Fox (1963), in which professionals have the ability to distance themselves
from their clients in order to remain objective about the troubles they experience. Miller, et al.,
(1988) cite Maslach’s (1982) declaration that maintaining concern and emotional distance
simultaneously is important for quality care to clients; however, Maslach (1982) states that the
vicarious experience of a worker as a result of helping his or her client will promote his or her
emotional exhaustion, a factor of burnout (Miller, et al., 1988). In terms of burnout, caregivers
and support staff felt similarly in terms of emotional exhaustion and depersonalization, according
to Miller, et al., (1988) study, but caregivers did experience a greater sense of personal
accomplishment; and communicative responsiveness—the worker’s ability to communicate
43
assertively in ways that are received well by their clients, which helps to build rapport and
promote clients’ compliance to treatment—impacts the worker’s perceived accomplishment on
the job, a potential safeguard against burnout (Miller, et al., 1988). In examining potential
changes in secondary victims’ worldview as compared to that of non-victims, Feldman and Kaal
(2007) examined responses among 65 male and female, undergraduate participants and did not
find correlation between vicarious trauma and negative assumptive worldview; however, they did
find that empathy and emotional contagion are key factors in vicarious traumatization, giving
credence to empathy as a factor of vicarious traumatization (Feldman and Kaal, 2007; Pearlman
& Mac Ian, 1995).
Killian (2008) explains how the professional’s inner experience is negatively transformed
as a result of their empathic engagement with clients who have experienced traumatic events. The
stress involved in regularly listening to clients’ traumatic stories can result in acute distress over
time for the worker as the trauma experience is transferred to the professional over continual
exposure (Killian, 2008); and over this continued exposure to their clients’ traumatic stories,
human service professionals become vulnerable to emotional disruption in which they experience
similar symptoms as their clients, as though they themselves have also experienced the traumatic
event of the client (Bride, 2007). In the therapist’s effort to empathize with the client, he or she
develops psychological distress having become an indirect victim of the clients’ trauma (Bride,
2007). As a result of this secondary victimization, the human service professional develops
symptoms of Post Traumatic Stress Disorder (PTSD)—a diagnosis initially given to war veterans
as a result of their traumatic experiences in combat, in which intrusive, avoidant, and
hyperarousal symptoms occur (Bride, 2007; Figley 1999; McGruder-Johnson, Davidson, Gleaves,
Stock, & Finch, 2000).
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Post Traumatic Stress Disorder
Killian (2008) defines PTSD as “an adjustment disorder that may develop as a result of
exposure to an extraordinary stressful event or series of events” which may include anxiety,
startle responses, fatigue, sleep disturbances, intrusive thoughts, difficulty concentrating, and
difficulty controlling anger (p. 33). Hesse (2002) maintains that individuals who experience
traumatic events are at risk for PTSD which commonly involves intrusive thoughts (flashbacks or
nightmares), avoidance (one’s attempt to deny or reduce exposure to situations or people who
may cause a person to experience painful emotions), and hyperarousal (physiological signs of
hypervigilance or increased startle response), all which are defined more comprehensively in the
DSM-IV (Hesse, 2002).
The American Psychiatric Association Diagnostic and Statistical Manual of Mental
Disorders (2000) more thoroughly describes the symptomology of PTSD and the ways in which it
may be experienced. Intrusive imagery may evolve in the form of recurrent distressing dreams or
recollections of the traumatic event. Hallucinations or flashbacks (dissociative states in which the
person relives the traumatic experience as though the event is occurring in the present moment)
may result; and such flashbacks may be accompanied by prolonged distress and heightened
arousal in the event that something triggers or instantly reminds the person of a traumatic event.
The person makes deliberate efforts to avoid any thing, person, or situation that is a reminder of
the trauma they experienced and may experience both an inability to recall important aspects of
their traumatic experiences and a lack of responsiveness to people and situations in the world
around them. Thirdly, symptoms of anxiety or increased arousal, which develop only after the
traumatic event takes place, results in one’s development of hypervigilance and an inability to
sleep, control anger, concentrate, and complete tasks.
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Ethnicity and PTSD
According to research, ethnic minority groups may experience higher rates of
posttraumatic symptomology (McGruder-Johnson, Davidson, Gleaves, Stock, & Finch, 2000).
McGruder-Johnson, et al., (2000) discuss several studies which examine relationships between
ethnicity, gender, PTSD symptoms, level, and frequency of exposure to violence among African
American, Hispanic Americans, and European Americans. While the research cautions that its
studies do not directly assess secondary trauma and to interpret findings with caution, its findings
are still noteworthy regarding interpersonal violence among African Americans. In examining
African American, Hispanic, and European American combat groups, maladjustment was higher
among minorities, who were found to also have more marital problems, experiences with
substance abuse, and more physical health problems; African Americans and Hispanics had
higher reports of violent crime exposure than Europeans; African American veterans showed
significantly higher symptoms of PTSD than both Hispanics and Europeans when compared
across similar levels of combat. Norris (1992) explored PTSD symptomology as it related to
lifetime and current distress among African American and European civilians whose community
experienced a variety of traumatic events (as cited in McGruder-Johnson et al., 2000). African
Americans, again, showed higher rates of PTSD symptoms even though Europeans showed
higher rates of lifetime exposure to traumatic experiences including physical assault and tragic
death.
McGruder-Johnson et al., (2000) provides a variety of assumptions regarding the reason
for higher rates of PTSD symptomology found among African American subjects: 1) Living in
hostile social environments, perhaps characterized by racism, 2) severity of traumatic
experiences, having fewer financial resources to recuperate from them, and high exposures to
hostility, prejudice, and neglect which may increase vulnerability to the development of trauma-
46
related symptoms, and 3) increased vulnerability due to the combination of ethnic status and
traumatic experience. In the interpretation of these findings and assumptions, however, it was
noted that secondary trauma was not assessed, although supported in its discussion, and that the
probabilities of developing PTSD will differ according to one’s degree of exposure to traumatic
events and the type of trauma that is experienced (Kessler et al., 1995, as cited in McGruderJohnson, et al., 2000). The McGruder-Johnson et al., (2000) study is limited in relation to this
observation. The vulnerability of African Americans as a result of such risk factors seems to be
heightened as therapists who potentially face transference, countertransference, and projective
identification with clients (Cerney, 1995; Hesse, 2007; Pearlman & Saakvitne, 1995; Rothschild,
2006).
Transference, Countertransference, and Projective Identification
Potential occurrences of transference, countertransference, projective identification, and
identification during therapeutic sessions are believed to make therapists more vulnerable to
vicarious traumatization (Cerney, 1995; Hesse, 2007; Pearlman & Saakvitne, 1995; Rothschild,
2006). Cerney (1995) discusses these concepts and their impact in session with professionals and
their clients. Therapists experience transference when their clients project feelings from their past
relationships onto the therapist (Rothschild, 2006). For example, a client might react to the
therapist as though he/she is one of the abusers who have caused them harm; as a result, therapists
may unconsciously take on a negative sense of self, experiencing feelings of pain, anger, or guilt
feelings as if they themselves have been harmed. These therapists potentially take on similar
psychological symptoms of their clients or perceive themselves as further harming their clients
because of their client’s negative or accusatory reactions towards them.
Countertransference is thought of in terms of worker characteristics, involving the
reactions of therapists toward clients which results from their own, unresolved personal conflicts
47
(Cunningham, 2003; Figley 1995; Nelson-Gardell & Harris, 2003; Rothschild, 2006).
Countertransference involves the past experiences of both the therapist and the client and “can be
positive or negative, healthy or unhealthy, or a benefit or deficit to the relationship” (Kohut,
1981, as cited by Rothschild, 2006, p. 19). Therapists may experience their own distortions in
session, unknowingly responding to their clients’ transference towards them (Figley, 1995).
Figley (1995) cites the definition of countertransference by Corey (1991) which states that in the
process of countertransference, the therapist sees him or herself in their clients, overidentifying
with them, and even attempting to meet their own needs through them. Figley (1995) suggests an
importance in recognizing countertransference reactions not only as a result of their clients’
transference, but as the result of various sources of stress, past or present, whether from the
client’s or therapist’s experience. An overprotective nature of therapists toward their clients
because of their knowledge regarding clients’ traumatic experiences is one manner in which
countertransference might be experienced among therapists (Cerney, 1995). Therapists who
experience counter-transference may over or underestimate the trauma experienced by their
clients and have difficulty coping with their own sense of self.
Projective identification is an additional factor that may surface in practice with clients
and have a negative impact on the client-worker relationship and on their wellbeing (Cerney,
1995; Rothschild, 2006). Cerney (1995), conceptualizes projective identification as “a group of
fantasies and accompanied object relations having to do with the ridding of the self of unwanted
aspects of the self; the depositing of those unwanted ‘parts’ into another person; and the
‘recovery’ of a modified version of what was extended” (Ogden, 1979, as cited by Cerney, 1995,
p. 136). Projective identification involves the lashing out of clients towards their therapists as a
result of the clients’ vulnerabilities, and the therapist internalizing this treatment and similarly
lashing out towards their clients in return. The therapist’s self perception is threatened by this
48
negative interaction with the client and perceives him or herself as having undesirable attributes
which they place onto the client in self-defense. Both the therapist and the client are equally
harmed. Finally, identification with clients, according to Cerney (1995), involves an equal sharing
in the client’s traumatic emotions of rage and wanting revenge against the source of their trauma.
In this instance, the therapist is only intensifying the clients traumatic emotions and the progress
and necessity of working through those emotions is less likely to be accomplished (Cerney,
1995).
Gender and Vicarious Traumatization
Research shows that gender may make one more or less likely to experience vicarious
traumatization and to experience it differently (Cerney, 1995; Cornille & Meyers, 1999; Figley,
1995; Sprang, et al., 2007). According to Cerney (1995), women therapists may experience more
fear or vulnerability as a result of their clients’ experiences which cause them to become
overprotective, while men may become overprotective of female clients, experiencing a sense of
guilt; in both such instances, countertransference is taking place and promotes their vulnerability
to vicarious trauma. In McGruder-Johnson, et al.’s (2000) study, the prevalence of PTSD
symptoms, a hallmark of vicarious traumatization, is claimed as having higher rates among
women who are exposed to interpersonal violence than men, despite the finding that men
participants reported more exposures to traumatic events; and overall, women, were more likely
than men to develop PTSD symptoms after exposure to a traumatic incident (McGruder-Johnson,
et al., 2000). Similarly, the prevalence of PTSD was found to be higher among female therapists
(Kassam-Adams (1995), female soldier mortuary workers (McCarrol, et al., 1983), and female
police officers (Martin, et al., 1986) than their male counterparts (Cornille & Meyers, 1999).
49
Personal History of Trauma
Various researchers have discussed and found that workers who have had their own
personal experiences of traumatizing events are more vulnerable to vicarious traumatization or
secondary trauma (Buchanan, et al., 2006; Cornille & Meyers, 1999; Cunningham, 2003; Hesse,
2002; Morran, 2008; Nelson-Gardell & Harris, 2003: Pearlman & Saakvitne, 1995; Sprang,
Clark, & Whitt-Woosley, 2007), while Schauben and Frazier (1995, cited by Buchanan, et al.,
2006) has suggested the contrary. Pearlman and Saakvitne (1995) suggest that a therapist whose
client has experienced a similar traumatic event as him or herself, is reminded of his or her own
personal, traumatic experience which causes the therapist to re-experience his or her own pain.
Countertransference may result in therapy, lessening the chances for successful treatment of the
client and potentially harming the therapist’s self-esteem and professional characteristics
(Pearlman & Saakvitne, 1995). Cornille and Meyers’ (1999) research mentions a variety of
studies which support the claim of increased vulnerability to vicarious traumatization among
human service practitioners as a result of their own personal, traumatic histories. Disaster workers
(Moran & Britton, 1994), mental health and law enforcement (Follette et al., (1994) were among
those found to have higher and more severe levels of STS symptoms as the result of having a
personal traumatic history (as cited in Cornille and Meyers, 1999). Morran (2008) noted
resonances among female workers who worked with male perpetrators of abuse. While not asked,
these women, through personal expressions, revealed concerns of their own experiences with
abuse and the impact these experiences continue to have on their relationships—whether to
remain in or terminate them, and their perceptions of past partners. Trust and hesitancy about
future relationships was an occurring theme. Personal history appears, in more studies than not, to
impact the therapist’s vulnerability to developing vicarious trauma.
In Buchanan, Anderson, Uhlemann, and Horwitz’ (2006) study, two thirds (61%) of
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mental health professionals were found to have experienced emotional or psychological abuse
with more than half (53%) reporting the events as traumatizing; more than 40% experienced
accidental disasters of which one third of respondents experienced as traumatizing; one third
experienced child sexual abuse of which 28% experienced as traumatizing; one third experienced
domestic violence of which one quarter felt they had been traumatized; one fifth experienced
childhood physical abuse, or a robbery or mugging of which 18% found the physical abuse
traumatizing and the robbery or mugging, 13%; fourteen had experienced rape as an adult of
which all reported being traumatized; thirteen experienced a natural disaster of which 7% found
traumatizing; and while one third of respondents considered critical illness, a family-related or
sudden death to be traumatizing events, only 3% of them found their experiences to be
traumatizing. Overall, thirty-two percent of respondents believed that their traumatic experiences
continued to significantly impact their lives, with almost half of them (47%) utilizing personal
therapy to cope. The majority of respondents felt their core beliefs had changed regarding
themselves and the world; more than half felt traumatized by their client’s experiences; and close
to one half felt that their witnessing and participation in the reenactment of their clients’ traumatic
experiences personally traumatized them. Overall, the Buchanan, et al. (2006) study found that
approximately one third of their respondents reported current feelings of secondary traumatic
stress. However, Buchanan et al., (2006) suggests that more research is necessary to make clear
whether the personal trauma history of workers has any influence on their development of
secondary traumatic stress symptoms.
Burnout, Vicarious Trauma, and Compassion Fatigue
It is important to note that there are similar, yet very distinct features between burnout,
vicarious trauma, and compassion fatigue (Conrad & Kellar-Guenther, 2006; Cunningham, 2003;
Feldman & Kaal; 2007; Figley, 2000; Killian, 2008; Najjar, et al., 2009; Nelson-Gardell & Harris,
51
2003; Sprang, et al., 2007). In professional literature, burnout has been correlated with
organizational factors, job characteristics, and policies which promote prolonged job stress
among human service professionals (Cunningham, 2003; Deutsch, 1984), causing a negative shift
in their attitudinal and behavioral responses to stress (Cherniss, 1980). Burnout involves the
gradual process of emotional exhaustion that worsens from such combined factors as job strain,
“erosion of idealism,” one’s feelings of nonachievement on the job, and an accrual of client
contact that is of an intense nature (Figley, 1995, pp. 11-12). Burnout, as suggested by Pearlman
and Saakvitne (1995) occurs in relation to high stress and low rewards among human service
professionals and in situations in which minimal goals and work-related satisfaction are difficult
to obtain; in contrast to vicarious traumatization, burnout is not based on interaction with one’s
clients and the situations that may occur between them (Pearlman & Saakvitne, 1995). Burnout
may occur regardless of the type of client population being served and in response to stressors in
the work environment, whereas vicarious trauma results from the direct experience of listening to
traumatic material from clients (Nelson-Gardell & Harris, 2003).
Burnout and vicarious trauma both negatively impact the well being of professionals and
the service they provide to clients (Killian, 2008), but McCann and Pearlman (1989, as cited by
Figley, 1995) suggest that vicarious traumatization is a type of stress that results from an
accumulation of memories regarding clients’ traumatic experiences which impact and are
impacted by the therapists’ own perspectives of the world. The danger in vicarious traumatization
is that its effects are accumulative and more permanent, impacting the professional’s work habits
as well as his or her personal life (Pearlman & Saakvitne, 1995). Similarly to burnout, vicarious
traumatization shares the organizational factors of workload, social support, and work
environment which are associated with job stress (Killian, 2008).
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Before discussing compassion fatigue (or secondary traumatic stress), it is helpful to
understand the meaning of “compassion” in a social work context. Compassion is defined as “a
feeling of sympathy leading to a desire to help others who experience suffering or hardship”
(Barker, 2003, p. 86). Compassion fatigue is said to be a form of burnout resulting from empathic
identification in which the professional perceives similarities between him or herself and the
client, whether positive or negative (Weinrich, 1989, as cited by Figley, 2000). Those
professionals who work with the traumatized are most susceptible to develop compassion fatigue
(Figley, 1995). In contrast to burnout, compassion fatigue can develop suddenly without warning
(Conrad, et al., 2006; Figley, 1995). Accompanied by a sense of helplessness, confusion, and a
sense of isolation from supporters; lacks a real origin of symptoms; and its recovery rate is faster
than that of burnout (Conrad et al., 2006; Figley, 1995). Both burnout and compassion fatigue
promote feelings of helplessness, loneliness, anxiety, and depression (Conrad, et al., 2006). Also,
it is important to note that, unlike burnout, a single exposure to a traumatic event can result in the
development of compassion fatigue (Conrad, et al. 2006). Unlike vicarious traumatization,
compassion fatigue is characterized by observable symptoms, rather than a framework that
involves one’s symptoms, and the ability to adapt and find meaning (Pearlman & Saakvitne,
1995). The term “compassion fatigue” is often used interchangeably with that of “secondary
traumatic stress” and is favored among nurses, emergency workers, and other professionals who
experience its symptoms in their work (Figley, 1995; Sprang, et al., 2007), perhaps because it is
thought of as being less stigmatizing (Sprang, et al., 2007). Vicarious trauma and compassion
fatigue have more to do with psychological effects experienced by the worker as a result of
prolonged exposure to his or her clients’ traumatic experiences (Killian, 2008; Sprang, et al.,
2007). Unlike vicarious traumatization, burnout and stress develop independently from trauma
and have not been found to have direct relation to trauma work with clients (Bell, et al., 2003).
53
Occupational Studies
Among the various studies that have explored burnout and vicarious trauma, the
phenomema of compassion satisfaction has also become an interest (Conrad, 2006; Musa-Hamid,
2008; Stamm, 2005). Despite potential for the negative affects of burnout and vicarious trauma
among workers, Conrad (2006) reveals that compassion satisfaction may be experienced among
workers with vulnerable clients. Compassion satisfaction is defined by Stamm (2005) as the
pleasure one experiences from the ability to perform one’s job well (as cited in Musa-Hamid,
2008). In Conrad’s (2006) study, the risk of compassion fatigue and burnout, the potential for
compassion satisfaction, and the relationship between them were examined among child
protection workers in Colorado. Participants included 363 child protection caseworkers and
supervisors, of which 89.8% (n=326) were female averaging at least 8 years on the job. 76%
(n=276) of participants were caseworkers, 7.7% (n=28) were supervisors, and 15.2% (n=55)
marked themselves as other. Participants were found to have higher rates of compassion fatigue
than for burnout and good potential for compassion satisfaction. Conrad (2006) noted that the
higher rate of compassion fatigue was explained by the stressful nature of CPS work found to
cause distress among workers, a factor of secondary traumatic stress, and the possibility that
workers may have developed compassion fatigue from other sources of personal trauma or in a
helping relationship previous to their current positions. Lower risk for burnout may have been
that those workers who were aware that they had developed burnout quit their positions or
because many participants showed high potential for compassion satisfaction. Higher levels of
compassion satisfaction than burnout was explained to be the result of one’s feeling or belief of
having a purpose in or being called to do such types of challenging work. Combined with feelings
of confidence in one’s ability and effectiveness on the job, workers may choose to remain on their
jobs (Conrad, 2006).
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Similar to CPS workers, domestic violence workers can also be negatively impacted by
the experience of vicarious traumatization. A study on vicarious trauma and secondary
victimization by Morran (2008) examined the emotional consequences experienced by male and
female professionals who worked in domestic violence perpetrator programs in the UK. Of 30
practitioners, 16 probation officers and 14 psychotherapists, social workers, and women’s support
workers—all experienced in domestic violence work, completed questionnaires asking about their
experiences of engaging with domestic violence offenders. All respondents were white, and 12
were women. Unfortunately, this study was not inclusive of Black and other ethnic minority
experiences. Findings of the Morran (2008) study found that workers experienced their jobs as
both challenging and draining. Their personal views about men, relationships, the world, and their
self-perceptions were all impacted. In all aspects of living, workers experienced increased
challenges with personal awareness of power and control issues, as popularly studied by McCann
and Pearlman (1990); persistent distortions occurred in their perception of men in which female
workers especially became overly fixated with issues regarding power, control and abusiveness in
general life, workplace relations, with family and friends, and personal relationships (Morran,
2008). Morran (2008) describes how these women became overly suspect and defensive against
abusive and disrespectful actions and attitudes towards and about women that they would
regularly observe in everyday life. As well, according to Morran (2008), their views on intimacy
as well as their intimate relationships were impacted as a result of their heightened awareness of
abuse, some reporting the concern for whether they themselves had become abusive in their
reactions towards their own partners. Workers experienced a range of complex emotions
including anger, rage, hate, loathing, and fear as a result of working with male offenders. Women
felt more exposed and vulnerable in their work, their personal world more questionable as being
safe and reliable as they developed a heightened vulnerability in their work with male offenders.
55
Male workers tended to feel more aware of the abusive and oppressive nature of male behavior
and began analyzing the behaviors of themselves and their male colleagues, friends, and family
members, questioning and relating to characteristics they felt were potentially shared with male
offenders. Moreover, male workers began to view men differently, perceiving male offenders as
both threatening and vulnerable (Morran, 2008).
Mental health workers, who may experience a variety of client populations, share with
other professionals specializing in traumatized populations a vulnerability to vicarious trauma (or
secondary traumatic stress), with outside factors further contributing to their susceptibility.
Buchanan, et al., (2006) surveyed environmental factors in the workplace and client
characteristics associated with trauma therapists’ experiences of secondary traumatic stress,
current levels of traumatic stress symptoms, and self-report ratings on experiencing secondary
traumatic stress among 280 Canadian mental health professions. 235 respondents were female,
and 45 were male. Racial and ethnic backgrounds were not specified. On a 5-point Likert-type
scale from very little stress (1) to extremely stressful (5), one third of participants (30.15%)
reported personal life stress in the 4 or 5 category range, eight percent reported their personal
lives as extremely stressful, and 37% reported moderate stress. Hence, it is important to note the
vulnerability of workers to being affected not only by the challenges of client work, but also by
the challenges and stressors in their personal lives. As workers are further confronted and forced
to deal with stressful work and interactions in the company of traumatized clients, their wellbeing
is continually threatened.
Strong emotional reactions, such as anger, anxiety, and trust as well as denial,
minimization, and projection—various aspects of cognitive distortion, may be commonly
experienced among many of those who work with victims of sexual trauma, making this field of
work a concern to both the wellbeing of sexual abuse workers and the professionalism they
56
maintain with clients (Way, Vandeusen, Martin, Applegate, & Jandle, 2004). Way, et al. (2004)
discuss and compare the negative effects experienced between those who work with sexual
trauma victims and workers who treat offenders, stating that while workers may be effected
differently depending on whether they are providing services to the survivor or the perpetrator,
there is much similarity in the experience of vicarious traumatization when it exists among these
two categories of workers. Among the effects of vicarious trauma, named by Way, et al., (2004),
are disrupted cognitive schemas (Pearlman & Mac Ian, 1995; Rich, 1997), intrusive imagery
(Kassam-Adams, 1999; Pearlman & Mac Ian, 1995; Rich, 1997; Steed & Bicknell, 2001; Steed &
Downing, 1998), avoidance symptoms (Kassam-Adams, 1999; Steed & Bicknell, 2001),
decreased sense of personal safety and safety of significant others (Jackson et al., 1997; Rich,
1997), hypervigilance around strangers (Jackson et al., 1997; Steed & Bicknell, 2001), difficulties
with trust and intimate relationships (Pearlman & Mac Ian, 1995; Rich, 1997), self-esteem issues
(Pearlman & Mac Ian, 1995), increased cynicism, depressed mood, discouragement, disruptions
in sexuality, and increased substance use (Rich, 1997, as cited by Way, et al., 2004, pp. 51-52).
Schauben and Frazier (1995) wanted to ascertain the effects of working with sexual
assault victims on counselors. Two hundred and twenty respondents including women
psychologists and sexual violence counselors completed questionnaires; however, only 148
responses (118 psychologists and 30 sexual violence counselors) could be analyzed due to
copying errors of 68 questionnaires. Male counselors were not used in the sample assessment
because they were too few (n = 4). Ninety-eight (98%) of respondents were Caucasian. Schauben
and Frazier (1995) found that the percentage of post traumatic stress symptoms was higher among
counselors with more trauma survivors in their caseloads. Self-reported symptoms of secondary
trauma and disrupted beliefs were also found to occur among these counselors and others—none
of whose symptoms resulted as a consequence of their own personal traumatic experiences, as
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believed among some researchers (Buchanan et al., 2006; Schauben & Frazier 1995). Loss of
trust due to disrupted belief systems and anger towards their clients’ perpetrators were found to
be the consequences of these counselors in working with survivors of sexual violence.
Those who provide care to cancer patients are similarly not immune to the negative
psychological impact of working with vulnerable clients (Najjar, 2009; Simon, Pryce, Roff, &
Klemmack, 2005). Simon, et al., (2005) discusses a study by Supple-Diaz and Mattison (1992)
which examines secondary traumatic stress among oncology workers; the study found that both
secondary traumatic stress and burnout existed among oncology workers and that compassion
satisfaction moderated burnout and secondary traumatic stress; however, the relationship between
compassion satisfaction and burnout was stronger. Satisfaction with work was associated with
lower burnout; secondary traumatic stress was more related to one’s empathic engagement with
clients; and secondary traumatic stress was likely to promote burnout and dissatisfaction with
work (Simon, et al., 2005).
A study by Najjar, et al., (2009) aimed to assess whether compassion fatigue existed
among cancer-care providers. As a result of working with cancer patients who workers perceive
as suffering and in pain, these workers may experience feelings of failure and ineffectiveness
during instances of client death (Najjar, et al, 2009). And workers who feel inadequately trained
to assist cancer patients with their emotional needs are at an increased risk for developing burnout
(Najjar, et al, 2009). In addition to a discussion of the relationship between compassion fatigue
and burnout among nurses, and the finding that found that oncology workers do experience both
compassion fatigue and burnout, Najjar, et al., (2009) also suggests that the experience of
compassion fatigue results in the inability of workers to remain empathetic in their work with
clients and their families. Further, compassion fatigue was found to also impact the work
environment, decrease productivity of workers, increase the number of sick days, and contribute
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to higher turnover (Najjar, et al., 2009). In light of the many risks faced by workers who are on
the front lines of helping vulnerable populations, it is useful to identify such factors—whether
worker characteristics, traits, experiences, and/or strengths that may protect them from these
harmful experiences and thereby promote worker wellbeing.
Resilience and Coping among African Americans
Resilience is defined as one’s “ability to overcome adversities and adapt successfully to
varying situations,” and its research has been found to focus on “the psychologically healthy
person” (Scannapieco & Jackson, 1996, p. 190). Jenaro, et al. (2007) defines resilience as a
“psychological endurance” or “hardiness” that makes it possible for one to resist the negative
effects of stress by way of problem-focused coping (p. 81). Turner (2001) discusses how
resilience involves an innate strength or natural capability of achieving mental health, and that
one is directly able to access this resource; as well, the individual has the ability to survive
environmental risks and trauma during childhood and yet develop a sense of wellbeing (p. 441).
Resilience is an important concept when discussing how various populations are able to cope with
stress and trauma, but it is also a significant factor in examining the health of workers who
experience daily stress on their jobs. Yin (2004) uses the term “worker resilience” to describe the
ability of workers to recover from the daily stresses they experience on high risk jobs—those that
involve a high degree of stress, frustration, job demands and expectations, such as that of CPS
workers (Yin, 2004). Most definitions of resilience involve the concept of one’s ability to
overcome and adapt to challenging or threatening experiences (Yin, 2004).
From times of slavery, African Americans have demonstrated their resilience under
difficult, trying circumstances and conditions (Marbley, nd; Utsey, Giesbrecht, et al., 2008).
Resources to African Americans have included family and “indigenous systems” which include
“schools, churches, community organizations…fraternities, social clubs, age and sex peer
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groups,…and small businesses…” in the African American community (Marbley, nd, p. 10).
According to Marbley (nd.), the African American family itself has survived much of its struggle
due to the support of such indigenous systems which provide support, protection, and a resource
for building social bonds that promote their mental and physical health as African Americans.
Kinship and extended families have also been deemed a protective factor in the African American
community which also promotes resilience (Scannapieco & Jackson, 1996; Utsey, Giesbrecht, et
al., 2008).
Resilience Model
According to the resilience model proposed by Masten (1994, 2001, as cited by Utsey,
Bolden, et al., (2007), two conditions must be present for resilience to be recognized: a) the
existence of a significant threat or exposure to severe hardship (risk factors) and b) the realization
that one has positively adapted in the presence of that adversity (Utsey, Bolden, et al., 2007).
According to Utsey, Bolden, et al. (2007), exposure to a victim of a violent crime, such as that of
human service workers with traumatized clients, constitutes such a risk factor; and multiple risk
factors have been found to correlate strongly with poor social, psychological, and health
outcomes (Utsey, Bolden, et al. (2007). Protective factors, on the contrary, have included
cognitive ability and disposition, family functioning, and social support (Utsey, Bolden, et al.,
2007).
Utsey, Bolden, et al., (2007) note that in order to understand the factors that predict risk
and resilience in African Americans, there must be “an appreciation of the cultural beliefs,
behaviors, and practices” that are exclusive to African Americans—including a worldview that is
based in such things as “a strong spiritual/religious belief system, extended familial and fictive
kinship bonds, a collective social orientation, and affective expressiveness” (p. 77) among other
factors (Utsey, Giesbrecht, et al., 2008). Both history and research have shown the resiliency of
60
African Americans and that effective coping strategies and positive adaptive outcomes during
times of risk and adversity have often been the result of their cultural beliefs, behaviors, and
practices which are helpful resources in times of stress and hardship (Scannapieco & Jackson,
1996; Utsey, Bolden, et al., 2007).
Turner (2001) mentions one study by Werner and Smith (1982) that examined resiliency
among 698 children from backgrounds of poverty, stress, and neglect who were followed into
their adulthood. It was found that two-thirds of these children became well-functioning adults,
and Werner and Smith concluded, according to Turner (2001), that “at each stage in an
individual’s development there is a shifting balance between factors that heighten vulnerability
and protective factors that enhance resilience” (p. 442). Knowing these protective factors makes it
possible to distinguish individuals who may more easily develop resilience. Turner (2001) goes
on to mention various characteristics found, by various studies, to contribute to one’s resiliency: a
sense of humor; a sense of direction or mission; one’s ability to attain independence; selfefficacy—one’s belief that he/she is able to complete various tasks and control the outcome of
one’s experiences (Turner, 2001; Werner, 1985, as cited by Turner, 2001) (or self-esteem and
initiative); and having a talent or skill. Among such requirements that promote resiliency is also
the ability to carry ongoing relationships with other adults who have an affirmative nature
(Turner, 2001). The concept of resilience is popularly found in literature and research regarding
African American culture and coping experiences (Holt, et al., 2007; Jenkins, 2005; Marbley, nd;
Mattis, 2002; Utsey, Bolden, et al, 2007; Utsey, Giesbrecht, et al., 2008; Yin, 2004)
Spirituality and Coping among African Americans
Coping resources among African Americans have included a variety of factors that
include optimism and ego resilience, social support, collective identity, racial pride, and
religiosity at times when African Americans are faced with stressors (Utsey, Giesbrecht, et al.,
61
2008). Utsey, Bolden, et al (2007) explain four manners of coping that are common among many
African Americans: 1) cognitive/emotional—the individual regulates emotional response to a
situation according to perceived degree of threat; 2) spiritual coping—beliefs about God or a
higher power provide a basis from which the individual can manage and recuperate from
hardships, and grow in resilience that gives way to optimism in one’s challenges; 3) collective—
the family and friends are depended on as resources for coping; and 4) ritual—similar to spiritual
coping but utilizing spiritual practices which provide structure to cultural and spiritual beliefs.
Spirituality and religion have been found by numerous studies to play an important role in the
lives of African Americans and their ability to cope with challenging situations (Boyd-Franklin,
2003; Constantine, Miville, Warren, Gainor, & Lewis-Coles, 2006; Laurence-Webb & Okundaye,
2007; Musgrave, et tal., 2002; Walker & Dixon, 2002; Sharp, 2006).
Laurence-Webb & Okundaye (2007) conducted a qualitative study, using two focus
groups to examine values and beliefs regarding religion and spirituality among 19 African
American kinship caregivers between the ages of 40 and 70. As a result, Laurence-Webb &
Okundaye (2007) found that these women caregivers, despite the sacrifices and hardships they
faced in caring for their disabled grandchildren, did so to fulfill a historical, religious, family
responsibility and sharing a faith that God would strengthen them and see them through their
challenges. According to Laurence-Webb & Okundaye (2007), these challenges were seen as
God’s lessons for them; and faith, determination, and spirituality were the coping skills they
utilized to maintain a positive attitude despite their difficulties. The following were findings in
relation to the study: (1) a strong reliance on and belief in God, God’s omnipresence, and belief in
God’s power and love to guide them in their daily struggles, (2) belief that God could alter the
life or the worst of others who surrender to Him, (3) the need to care for themselves physically,
emotionally and spiritually if they are to be effective helpers in the lives of others, (4) the use of
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spirituality and negotiation in coping with the unresponsiveness of various social institutions, (5)
faith, determination, and sense of connectedness to a higher entity in coping with negative
circumstances in their lives—utilizing prayer as a means to maintain their relationship with God
and to experience emotional and physical healing, (6) the belief in the utility of their religion and
a responsibility to care for others outside of the home and into the larger community in order to
enhance the lives of others, and a belief that God is in control of their challenges and can help
them overcome, and (7) the need to rear their children along with them in their spiritual beliefs to
provide them better guidance and perhaps pave a better direction for them than their biological
parents may have experienced. In this study, it is clear that religion and spirituality have a clear
purpose in the lives of these African American caregivers, their relationships, and their capacity
to cope with life challenges. Laurence-Webb & Okundaye (2007) state that these caregivers
“refused to give up on difficult challenges,” “…embraced prayer as a means of keeping a
relationship with God,” and “their faith was a source of emotional and physical healing” (p.112).
Finally, these African American caregivers shared the belief that their spirituality “is to be used to
improve and enhance the lives of others” beyond their homes…revealing their ability to find
meaning and purpose similarly mentioned by Gilbar (1998) and Constantine, et al. (2006).
Constantine, et al. (2006) mentions several other studies which examine religious and
spiritual elements, coping, and “meaning making” among African American women (p. 229).
A qualitative study by Mattis (2006) reported that “religion and/or spirituality enabled
participants to recognize their life purpose or destiny; additionally, other researchers mentioned
(Mattis, et al., 2000) found that religion and spirituality can influence their work participation and
behaviors and that “African American’s spiritual beliefs, values, and practices serve as a vital
basis for understanding thoughts, feelings, experiences, and behaviors related to their career
development” (Constantine, et al., 2006, p. 229). It is suggested that counseling professionals
63
expand their knowledge about the experiences of African American students on college campuses
and how these experiences relate to their career development (Constantine, et al, 2006).
The religious and spiritual experiences among African American students have in fact
been explored (Constantine et al, 2006; Walker & Dixon, 2002). Constantine et al, (2006) studied
the associations among religion, spirituality, and career development by interviewing a sample of
12 African American undergraduate students and found that religion and spirituality were
important influences in the career development of African American college students.
Participants believed it was important to help or serve others through their work or vocation; that
their purpose in life was being fulfilled through their choice of career; and that spiritual and
religious activities—such as prayer, bible reading, and attending church—were activities for them
that could potentially alleviate stress related to school and their careers. Lastly, they believed that
their religion or spirituality provided “important opportunities for quiet reflection and connecting
with a Higher Power” (p.237). Because the sample size of this study was small, non-random,
chosen from a specific university, and did not account for such variables as socioeconomic status,
generalizability would not be feasible. Suggestions for future research involve the examination of
“both cohort and longitudinal effects of religion and spirituality on the career development of
African American college students” in a variety of college campuses, including experiences of
non-Christian students (Constantine, et al., 2006, p. 238).
A study by Morano and King (2005) examined whether the religiosity—involving the
incorporation of religious coping by use of such resources as prayer, one’s faith in God, and
religion—had a mediating effect on care giving strain among 384 diverse, Alzheimer’s disease
caregivers. Caregiver strain is described by Morano and King (2005) as a term that may also
replace the concept of “burden” and encompasses all the potential negative consequences
involved in caring for a disabled adult—including such conditions as emotional, physical, and
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psychological distress; loss of time from work and personal life; financial drain; and especially
depression which causes the greatest risk to these workers. The participants of the study, mostly
women, 74%, included 147 White, 113 Hispanic, and 88 African American women. White
caregivers had the lowest mean regarding religiosity, 12%, while African American caregivers
had the highest mean, 17.7%, and the Hispanic caregivers had the second highest rate, 16.8%.
The study found that its White caregivers had the highest levels of depression, while both
Hispanic and African Americans—those reporting higher levels of religiosity, had lower levels of
depression. Additionally, religiosity was found to be an important protective factor among these
caregivers.
Csiernik and Adams (2002) completed a study to examine the impact of stress on
spirituality, and of spirituality on ameliorating workplace stress. Various qualitative studies which
include that of Neal (2000), cited by Csiernik and Adams (2002), provide evidence that
spirituality is in fact a vital factor in dealing with stress in the workplace and has the potential to
positively impact physical, psychological, social, intellectual and spiritual health. The study
included 154 participants who completed and turned in questionnaires which measured the impact
of workplace stress on their spirituality and the degree to which their spirituality helped minimize
their work-related stress. A positive correlation was found (r=.523, 00.1 significance level)
supporting that individuals who believed their spirituality lessened their workplace stress tended
to have higher scores regarding spiritual wellbeing compared to those who did not perceive their
spirituality as positively impacting their work-related stress. Among participants who perceived
themselves as more spiritual, spirituality was found to decrease their perceptions of workplace
stressors and contribute to their wellbeing and positive perceptions regarding the healthiness of
their organizations-whether the organizations involved related health risks or not.
A study performed by Kamya (2000) examined the relationship between hardiness,
65
spiritual well-being, and self-esteem among social work students. Kobasa (1979) introduced the
concept of hardiness and defined it as “one’s ability to handle and manage problems or
difficulties” (as cited in Kamya, 2000, p. 232). Kamya (2000) explains hardiness further by
describing it as one’ ability to view hardships and evolving life experiences as challenges and
having an inner sense of control over such circumstances rather than a feeling of vulnerability.
Spiritual well-being is described by Kamya (2000) as involving a “personal satisfaction with
one’s relationship with a higher being, and one’s sense of meaning and purpose in life” (p. 232).
And finally, self-esteem, according to Kamya (2000), has been found to be a key factor in
positively coping with stress and helpful in managing challenges over which one may have little
control. A study mentioned by Kamya (2002), performed by Martin and Carlson (1988), provides
evidence of a potential relationship between reduced incidences of disease and risk factors and an
improved quality of life among those whose lifestyles are integrated with spirituality; as well,
according to a Martin and Carlson (1988) study, their handling of stress and personal challenges
are made easier by their sense of spirituality (as cited in Kamya, 2002). One hundred and five
master’s-level social work students who completed a minimum of one-year in the program
completed a self-administered questionnaire distributed to them before watching a presentation
on burnout by social workers who had been in the field for a minimum of five years. The
questionnaire measured hardiness, spiritual well-being, and self-esteem. The study did not,
however, measure the impact of religious affiliation with the student’s responses, and their
answers may have been influenced by the preceding presentation on burnout. Nevertheless, the
study found a positive relationship between hardiness, spiritual well-being, and self-esteem
among social work students and supports earlier findings of relationships between spiritual wellbeing, psychological well-being, and relational well-being (Kamya, 2000). Those students who
scored higher in self-esteem had greater internal strengths to tolerate stress (Kamya, 2000).
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Moberg (2005) mentions various studies which discuss findings on the impact
of spirituality and religion on life satisfaction, psychosocial well-being and both physical and
mental health. Spirituality is discussed as having importance to human well-being, potential to
improve the effectiveness of clinical social work and all of the services provided in health and
human service professions (Moberg, 2005). The earliest study which served to examine
religiosity involved surveying 219 participants whose personal adjustment in old age was
positively impacted by their religious activities and beliefs—a factor not observed among those
who lacked religious membership (Moberg, 2005).
A second study mentioned by Moberg (2005) include that of in-depth interviews of
older adults in nursing homes and independent living whose religion and spirituality helped them
find and respond to meanings through the use of actions and symbols, reframe experiences,
transcend losses and suffering, establish intimacy with God and others, and find hope
(MacKinlay, 2001, as cited in Moberg, 2005). A third study mentioned by Moberg (2005)
examines the relationship between religious/spiritual coping and psychological distress among
127 informal caregivers to community-residing disabled elders. The study found that threefourths of the caregivers who used religious or spiritual means of coping had more positive
relationships with their clients, experienced less depression, and less mental strain than the
remaining caregivers. A fourth study, Miltiades and Pruchno (2002), compared Black and White
caregiving mothers whose parents have developmental disabilities and found that religious coping
was a positive source of satisfaction; also, Black mothers—although they had higher levels of
religious and caregiving satisfaction—were found to experience higher caregiving burdens. Poor
health among these mothers resulted in a need for the services being provided by churches and
faith-based organizations (as cited in Moberg, 2005). A fifth study, (Palmore, et al., 1985),
revealed that happiness, feelings of usefulness and personal adjustment were associated with
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religious activities and attitudes—bible reading, and beliefs about future life as well as ideas
regarding death)—among religious widows which aided their emotional stability (as cited in
Moberg, 2005).
Finally, two studies mentioned by Moberg (2005) examined the benefits of
prayer and provide evidence of its positive impact on clients’ well-being. One of these studies,
Byrd (1988), in a double-blind clinical trial, examined the effects of intercessory prayer on 192
coronary patients. The patients were randomly selected for a treatment group and compared to a
control group of similar patients. The study showed that the outcomes of those who received
prayer measured better on six of the 26 health variables assessed upon their admission and
release, and that their overall severity of symptoms was better than those who did not receive
prayer (Moberg, 2005). A second study, measured the outcome of similar coronary patients who
used private, self-prayer against those patients who did not; similarly, these patients had better
psychological outcomes a year after the surgery than those who did not pray, which supported the
conclusion that the use of private prayer alone, aside from general religiosity, predicted
hopefulness and healthier affect in cardiac care patients (Moberg, 2005).
Moberg (2005) further adds that the well-being of service providers who work to prevent
problems are also benefited by their access to or assistance from religious communities or
congregations. Emotional calm through prayer and meditation, the pleasure one may experience
from attending worship, the nurturing and assistance of clergy, a place of social support,
intergenerational contact, and the encouragement of health-related behaviors, as well as a gained
sense of life’s meaning may all contribute to an individual’s well-being and make the religious
institution a place that contributes to one’s health (Moberg, 2005).
A study by Chatters, Taylor, and Lincoln (1999) examined the social demographic
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correlates of religious participation among African Americans. Organizational (religious service
attendance), non-organizational (frequency of prayer, reading religious materials,
watching/listening to religious programming), and subjective (spiritual comfort and support,
importance of religious or spiritual beliefs, and the importance of religion) religious participation
were the dependent variables of the study. The study found high levels of religious participation
among African Americans. Thirty-eight percent of blacks read religious materials, 35.9% watch
religious broadcasts at least once a week, 8 out of 10 felt strongly about their religious beliefs,
and about half (43.6%) “almost always” sought spiritual comfort through religion. Further, the
study found that 52.3% of blacks attended religious services at least two to three times per month
(Chatters, et al., 1999).
The relationship between sociodemographic factors and religious involvement was more
complex. Chatters, et al., (1999) found positive relationships between age and high levels of
religious involvement. Age was found to positively impact almost every indicator of religious
participation; women were found to be more involved in religious participation than men—
potentially explained by the differences in social roles of women and men in their families, work,
and other networks as well as psychological traits; those with higher levels of education had
higher levels of participation in religious services, and those of lower incomes and educational
levels were more likely to watch or listen to religious programming in lieu of reading religious
materials. From previous research studies, Chatters, et al., (1999) make assumptions regarding the
relationship between income and subjective religious participation, stating that the likelihood of
persons of higher incomes having options beyond subjective religious practices for coping with
personal problems; whereas those of lower income have less resources and turn to religion as a
coping method that helps them to reframe their challenges, distract them from their problems, or
lessen the degree of stress that results from them (Chatters, et al, 1999).
69
Research Questions
Given the various research findings, and the lack of material presented on burnout and
vicarious trauma in educational programs, much is left to be considered in the wellbeing of
African American social workers and MSW students. While there is the very real potential for all
social workers to develop burnout and vicarious trauma in various fields of social work with
various, traumatized client populations, the harmful effects of burnout and vicarious trauma may
prove especially harmful among African Americans who suffer from disproportionate health
risks, disproportionate use of psychological services in times of distress (Obasi & Leong, 2009;
Townes, Chavez-Korell, & Cunningham, 2009), and cultural mistrust (Obasi & Leong, 2009).
For such reasons, it is important to recognize various coping and resilience factors that may help
to mediate the negative psychological and physiological effects of burnout and vicarious trauma
on the health of African American social workers and MSW students and simultaneously prevent
the harmful impact that these experiences carry over onto their clients and relationships. This
study will 1) assess whether there are symptoms of burnout or vicarious trauma currently present
among participants, 2) examine coping strategies and factors of resiliency, 3) and seek to
understand from their perspectives as African Americans how their ethnic identity, background,
and cultural practices may be impacted by, or play a role in, their experiences on the job and with
clients. African Americans have been found to have lower levels of life satisfaction and happiness
than that of their White counterparts, and not just as a result of socioeconomic status (Turner,
2001). As this research will utilize the B. Hudnall Stamm’s (2009) Professional Quality of Life
Scale (ProQOL) Version 5 survey, in addition to identifying potential burnout and vicarious
trauma among participants, it will also 4) identify potential for what is known as compassion
satisfaction among participants—“the sense of reward, efficacy, and competence one feels in
one’s role as a helping professional” (Killian, 2008, p. 33). Overall, this study aims to examine
70
the potential challenges that exist for African Americans who seek careers in social work, to
highlight the importance of appropriate self-care, and explore the unique coping factors,
experiences, and even risk factors of African Americans that may contribute to their resilience in
times of distress and impact the wellbeing of their clients.
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Chapter 3
METHODS
Introduction
The purpose of this research study is to explore the potential for burnout and vicarious
trauma (secondary traumatic stress) among professional African American social workers and
MSW students who provide services to vulnerable client populations. The role of resiliency in
coping in stressful situations will also be explored. The study will also examine how the quality
of services provided to clients may be impacted. The researcher hopes to provide multicultural
insight that will further contribute to the competence of all social workers regarding cultural
values and strengths of this minority group, shed light on the challenges to be faced by African
Americans who seek careers in social work, further highlight the need of appropriate self-care,
and explore the unique coping factors and experiences of African Americans that may contribute
to their resilience in times of distress, and impact the wellbeing of their clients.
Research Design
For this purpose, the research design is an exploratory, cross-sectional study for the
purpose of gaining insight into the current, professional experiences of African American social
workers, a concept less studied. Exploratory studies are considered appropriate when the subject
being researched is somewhat new and under-studied and when more familiarity with the topic is
desired (Rubin & Babbie, 2008). Cross-sectional designs may have exploratory purposes, as well
as descriptive or explanatory purposes; and they are used to examine phenomenon by collecting
data at one point in time. Qualitative and quantitative data will be collected. A focus group in
which 20 open-ended questions to be asked will be utilized. Snowball sampling will be utilized in
obtaining participants who will also provide additional referrals of African American social
workers upon the researcher’s request.
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This study will 1) assess whether there are symptoms of burnout or vicarious trauma
currently present among participants, 2) examine coping strategies and factors of resiliency, 3)
seek to understand from their perspectives as African Americans how their ethnic identity,
background, and cultural practices may be impacted by, or play a role in, their experiences on the
job and with clients, and 4) identify potential for compassion satisfaction among participants.
Dependent Variables
The dependent variables are burnout and vicarious trauma in African American Social
Workers and MSW students. Burnout is conceptualized by Maslach & Jackson (1981) as chronic
stress that results from the continual interactions between workers and their clients whose
problems promote fear, anger, embarrassment, and despair in the worker-client relationship and
which are difficult to remedy and lead to emotional drain. Emotional exhaustion,
depersonalization, and a decreased sense of personal accomplishment are features of burnout
experienced by the worker. Emotional exhaustion occurs when workers feel emotionally depleted
and unable to give of themselves on an emotional level; depersonalization sets in when workers
become cynical of their clients, holding negative attitudes and feelings about them as though they
are worthy of their problems; and workers who might otherwise experience a sense of personal
accomplishment, based on the success they have with their clients, instead feel negative and
dissatisfied with themselves and their jobs (Maslach & Jackson, 1981).
Sampling Procedures and Data Collection Procedures
To conduct this study, the researcher recruited 60 African American research participants
from diverse fields of social work. Participants were recruited through the personal contacts of
this researcher at CSU Sacramento’s Social Work program, including faculty social workers and
MSW students. Criteria for inclusion were African American social workers and MSW students.
Criteria for exclusion were non-African American social workers.
73
For the data collection procedure, a self-administered questionnaire for quantitative data
was utilized. The survey includes three sections with a combined total of sixty-nine questions.
The first nine questions include demographic information. Thirty likert scale questions, from
Stamm’s (2009) ProQOL Version 5 Survey designed to detect compassion satisfaction, burnout,
and secondary traumatic stress, are utilized and have been successfully tested for validity and
reliability (Stamm, 2009). An additional 30 items will come from the Africultural Coping
Systems Inventory (ACSI)—a thirty-item, self-report, likert scale measure of the culture-specific
coping strategies used by African Americans in stressful, day-to-day situations. The ACSI has
also been successfully tested for validity and reliability (Utsey, Adams, et al., 2000; Utsey,
Brown, & Bolden, 2004).
The researcher will inform participants of the opportunity to participate in this study and
to be informed of the study’s results. The researcher will hand out consent forms to be signed by
those who would like to participate. After participants have signed the consent forms, they will be
collected by the researcher and placed into a specified envelope for “completed consent forms,”
separate from surveys. Survey questionnaires will be handed out to those who would like to
participate. After completion of the surveys, the researcher will collect and store them in a
marked envelope specified for “completed surveys,” separate from the consent forms.
Participants will then be recruited to participate in a follow-up focus group in early January 2010.
The researcher will reserve a study room in the CSU Sacramento library. Finally, a focus group
will be conducted during which 20 open-ended questions developed by the researcher will be
utilized to obtain additional, qualitative information in relation to the survey. These questions will
involve the participants’ self-evaluation of personal and work-related emotions, thoughts,
strengths and challenges, and coping styles. Focus group data will be collected by way of the
researcher’s handwritten notes and voice recorder.
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Instrumentation
The instrument to be used in this research is a three-part, self-report survey including
nine demographic questions designed by the researcher, B. Hudnall Stamm’s (2009) Professional
Quality of Life Scale (ProQOL) Version 5 survey and the Africultural Coping Systems Inventory
(Utsey, Adams, et al., 2000; Utsey, Brown, et al., 2004). A focus group was designed to respond
to twenty open-ended questions designed by the researcher to obtain qualitative data from
participants. Stamm’s (2009) ProQOL survey includes thirty likert scale questions designed to
detect compassion satisfaction, burnout, and secondary traumatic stress and is stated to have good
to excellent reliability. For the Compassion Satisfaction scale, the alpha reliability is α = .88
(n=1130); for burnout, α = .75 (n = 976); and Compassion Fatigue is α = .81 (n = 1135). No
single item adds to or subtracts from the overall scale quality and the standard errors are minimal:
CS. 22, BO .21, and STS .20, which indicates small error interference. Close to half of published
studies on compassion fatigue, secondary traumatic stress, and vicarious traumatization have
utilized the ProQOL instrument or an earlier version of it (Stamm, 2009). Each of the three scales
measure a separate construct. The Compassion Fatigue inter-scale is separate. Correlations show
a 2% shared variance (r = -.23; co-σ = 5%; n = 1187) for Secondary traumatic Stress and 5 %
shared variance (r = .-.14; co-σ = 2%; n= 1187) for burnout. The scales for STS and Burnout have
a shared variance which reflects the distress that is characteristic of both conditions, and their
shared variance is 34% (r = .58; co- σ = 34%; n = 1187). Despite their differences, both scales
measure negative affect; and the STS scale, unlike that of the burnout scale, is the only scale that
measures fear (Stamm, 2009).
The Africultural Coping Systems Inventory (ACSI) is also a thirty-item, self-report, likert
scale measure of the culture-specific coping strategies used by African Americans in stressful,
day-to-day situations which has also been successfully tested for validity and reliability (Utsey,
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Adams, et al., 2000; Utsey, Brown, et al., 2004). The ACSI was conceptualized by an Africancentered philosophical framework; and it was developed in response to Eurocentric coping
measures that did not adequately represent the unique life experiences and history of African
Americans and their culture-specific coping strategies. Instead, the ACSI was based only on the
general ideas of problem-focused coping in which the individual aims to manage or regulate the
stressful situation, or emotion-focused coping in which the individual regulates his/her emotional
response to a stressor (Utsey, Adams, et al., 2000). The act of venting as a technique to minimize
one’s stress would be one such example of emotion-focused coping (Utsey, Adams, et al., 2000).
Spirituality, harmony, balance, a collective group orientation, and the emphasis on rituals are
reflected by the ACSI (Utsey, Adams, et al., 2000). The ACSI is comprised of four subscales:
Cognitive/Emotional Debriefing (11 items); Spiritual-Centered Coping (8 items); CollectiveCentered Coping (8 items); and Ritual-Centered Coping (3 items) (Utsey, Brown, et al., 2004). In
completing the ACSI, participants are asked to recall a stressful event that occurred over the past
week, briefly describe the situation, and then, using a 4-point likert scale measure, (0=did not use,
1=used a little, 2 =used a lot, 3=used a great deal) rate the coping techniques they used during
that stressful situation (Utsey, Brown, et al., 2004). Cronbach’s alpha coefficients for the ASCI
subscales have been found to range from .71 to .82 (Utsey, Adams, et al, 2000) and from .83 to
.87 (Constantine, Wilton, Gainor & Lewis, 2003, as cited by Utsey, Brown, et al., 2004). Through
an exploratory analysis and CFA, the model was found to be most efficient for representing the
unique coping factors of African Americans (Utsey, Brown, et al., 2004). The demographics,
ProQOL, and ACSI items were combined as one self-report measure totaling 69 questions, and
the focus group was conducted separately.
Data Analysis Plan
Preparation for the data analysis will begin after all questionnaires have been completed
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by participants and collected by the researcher. Each questionnaire packet will be reviewed and
coded for data entry by the researcher. The researcher will enter the data which will be analyzed
by the use of SPSS and Excel software. Data analysis will involve chi-square analysis in the
exploration of potential burnout, vicarious trauma, compassion satisfaction, coping methods, and
resiliency among participants. Focus group data collected will be analyzed for thematic content.
The researcher will look for, identify, and count the occurrences of major themes that arise in the
participants’ responses. The researcher will obtain an outside observer to review and analyze
thematic content for the purpose of interrater reliability.
Human Subjects Protection
The Protocol for the Protection of Human Subjects was submitted in the Fall of 2009 and
approved by the Division of Social Work as exempt research posing minimal risk. The study was
found to be “minimal risk” as it asks for participants to rate themselves emotionally,
psychologically, and professionally, which may involve sharing thoughts of a personal or private
nature, or personal recollection of experiences that may result in an emotional response to stress,
sensitivity, or discomfort for some participants. For their protection and safety, all participants
received a referral sheet of mental health services, and participants were informed that they were
free to discontinue participation at any time should they feel the need to do so.
Subject Confidentiality
This study is confidential. The questionnaires included a cover letter explaining
confidentiality standards as well as risks and benefits associated with participation in the research.
For the protection of subjects’ rights to privacy and safety, the names of participants were kept
separately from the surveys in a specified envelope for “completed consent forms” and stored
separately from surveys. Survey questionnaires were distributed to potential participants.
Individuals were informed that they could withdraw from participation at any time and for any
77
reason. Participants were asked to place their completed surveys face-down in a specified box at
the front of the room once they were completed. After completion of all the surveys, the
researcher collected and stored surveys in a marked envelope specified for “completed surveys.”
The surveys were kept separately from the consent forms. The researcher kept all data obtained
from participants in a locked file cabinet at her home office for safe storage during and after data
analysis. Only the researcher and the researcher’s advisor had access to the data; and all data will
be shredded after graduation. During the focus group, participants were instructed to use first
names only or a fictitious name if they chose to protect their identity.
Voluntary Participation
The researcher explained the purpose of the research study to potential participants and
invited them to take part in contributing to the research study. Individuals were informed that they
had the right to withdraw from participation at any time and for any reason and that no
inducements were being offered in exchange for their participation. At this time, consent forms
were passed out to be signed by those choosing to participate voluntarily.
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Chapter 4
FINDINGS
Introduction
Out of sixty possible respondents, the researcher recruited a total of thirty one African
American social work professionals and MSW students who completed the surveys for this
research study. Respondents were obtained through the personal contacts of this researcher at
CSU Sacramento’s Social Work program, including faculty social workers and MSWII students.
A self-administered questionnaire for quantitative data was utilized and it included a total of
sixty-nine questions. The first nine questions included demographic information followed by
thirty likert scale questions to detect burnout, vicarious trauma (secondary traumatic stress), and
compassion fatigue and thirty likert scale questions to measure culture-specific coping methods of
African Americans. A focus group of eight respondents from this study was also conducted to
obtain qualitative data on their experiences as African American social workers and MSW
students. The overall findings are demonstrated below.
Demographics
Age. Respondents’ ages ranged between 20 and 60 years. Of the thirty respondents, 20%
were 20-29 years old (N=6); 33.3% between 30-39 years old (N=10); 33.3% between 40-49 years
old (N=10); 10% between 50-59 years old (N=3); and 3.3% were 60 years of age or older (N=1).
One respondent was missing. The majority of respondents, 66.6%, were between the ages of 30
and 49 (N=20).
Gender. The majority of respondents, 87.1% (N=27), were female. Males comprised
12.9% of respondents (N=4).
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Level of Education. In terms of respondents’ level of education, 60% were MSWII
students (N=18), and 40% were professionals (N=12) of which two (6.7%) were licensed. One
respondent was missing.
Marital Status. Regarding the marital status of respondents, 41.4% were married or had a
partner (N=12); 37.9% were single (N=11); 17.2% were divorced (N=5); and 3.4% were either a
widow or widower (N=1).
Raising Children. Nineteen respondents (61.3%) reported raising children (N=19).
Twelve respondents (38.7%) reported not raising children (N=12).
Populations served. Respondents reported providing services to a variety of vulnerable
populations. Eighteen respondents (58.1%) worked with child abuse and neglect cases; eleven
respondents (35.5%) worked with sexual assault cases; thirteen respondents (41.9%) worked with
domestic violence cases; four respondents (12.9%) worked with elderly abuse cases; eight
respondents (25.8%) worked with the homeless population; ten respondents (32.3%) worked with
the disabled; four respondents (12.9%) worked with cases that involved racism and/or
discrimination; one respondent (3.2%) provided services to those experiencing sex-trafficking;
eleven respondents (35.5%) worked in drug abuse; two respondents (6.4%) worked in oncology
or medical services; and 8 respondents (25.8%) reported provided services in the “Other”
category. Child abuse/neglect cases and domestic violence cases were most reported as a service
provided by respondents. More than one third of respondents provided services in sexual assault
(N=11), and more than one-third of respondents provided services with drug abuse cases (N=11),
resulting in child abuse/neglect, sexual assault, and drug abuse service provision being the most
popularly reported services among respondents.
Years providing services to vulnerable populations. In terms of the number of years
respondents have provided services to vulnerable populations, 29% of respondents had provided
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services for 0-2 years (N=9); 9.7% had provided services for 3-5 years (N=3); 22.6% have
provided services for 6-8 years (N=7); 16.1% had provided services for 9-11 years (N=5); 3.2%
had provided services for 12-14 years (N=1); 9.7% had provided services for 15-17 years (N=3);
and 9.7% had provided services for 21 years or more (N=3).
How Often One Considers a Career Change. Regarding the rate of considering changing
one’s career, 20% reported they had never considered changing (N=6); 26.7% reported they
rarely considered changing (N=8); 20% reported they had sometimes considered changing (N=6);
16.7% reported they have often considered changing (N=5); 6.7% reported they had considered
changing most of the time (N=2); and 10% reported they consider changing careers all the time
(N=3). One respondent was missing. It is striking that more than one-third of respondents
(33.4%) reported considering a career change often, most of the time, or all the time.
Table 1
Ability to Cope with Social Work-Related Stress
Frequency
Valid %
Somewhat Capable
5
16.1%
Naturally Capable
21
67.7%
Exceptionally Capable
4
12.9%
Not Sure If Capable
1
3.2%
Total
31
100%
Table 1 demonstrates respondents’ beliefs regarding their ability to cope with Social
Work-related stress. Two-thirds of respondents (67.7%) believed they were “naturally capable” of
coping with social work related stress (N=21); five respondents (16.1%) felt somewhat capable of
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coping with social work-related stress; four respondents (12.9%) felt exceptionally capable of
coping with social work-related stress; and only one respondent (3.2%) felt not sure if capable of
coping with social work-related stress.
Professional Quality of Life Scale (ProQOL) Version 5
B. Hudnall Stamm’s (2009) Professional Quality of Life Scale (ProQOL) Version 5
survey was used with respondents to detect burnout, secondary traumatic stress, and compassion
satisfaction among respondents. The survey included thirty likert scale questions and has been
stated as having good to excellent reliability. Alpha reliability for burnout is α = .75 (n = 976);
Compassion Fatigue is α = .81 (n=1135); and Compassion Satisfaction is α = .88 (n = 1130).
Each of the three scales measures a separate construct. Both the burnout and STS scales reflect
distress and measure negative affect while the STS scale is the only scale that measures fear.
Stamm (2009) refers to burnout and secondary traumatic stress as factors of compassion
fatigue. According to Stamm (2009), burnout is described as involving hopelessness, difficulties
on the job, feelings of inefficacy and that one’s efforts make no difference; as well, it is said to
involve high workloads and unsupportive work environments (Stamm, 2009). Secondary
traumatic stress involves being exposed to the traumatic or stressful situation of others, and its
symptoms may involve fear, insomnia, and avoidance (Stamm, 2009); and finally, compassion
satisfaction involves the positive feelings generated from feeling able to do one’s job well
(Stamm, 2009). The results for respondents’ scores of burnout, secondary traumatic stress, and
compassion satisfaction are displayed in Table 2 below.
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Burnout, Secondary Traumatic Stress, and Compassion Satisfaction
Table 2
Professional Quality of Life Scale (ProQOL)
Scores
Burnout (BO)
Secondary Traumatic
Stress (STS)
Compassion
Satisfaction (CS)
Low (0-22)
20
Valid
%
67%
Average (23-41)
10
33%
13
46%
28
90.3%
High Level (42+)
0
0
0
0
3
9.7%
Total
30
100%
28
100%
31
100%
Frequency
Frequency
Valid %
Frequency
15
54%
0
Valid
%
0
Burnout. Table 2 above reveals the scoring for burnout among thirty respondents. One
score was missing. A score of 22 or less represents low burnout among respondents, a score
between 23 and 41 represents average burnout, and a score of 42 or more represents high burnout.
Twenty respondents (67%) scored between 13 and 22 revealing low levels of burnout. Ten
respondents (33%) scored between 23 and 35 revealing average levels of burnout. The minimum,
overall score for burnout among respondents in this study was 13 and the maximum score was 35.
The overall, average score for respondents was 20.6667, revealing low burnout.
Secondary Traumatic Stress (STS). Table 2 above also reveals the scoring for Secondary
Traumatic Stress among twenty eight respondents. Three scores were missing. A score of 22 or
less reveals low STS; between 23 and 41 reveals average STS; and a score of 42 or more reveals
high STS. Fifteen respondents (54%) scored between 14 and 22 revealing low levels of STS.
Thirteen respondents (46%) scored between 23 and 32 revealing average levels of STS. The
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minimum score was 14 among all respondents and the maximum score was 32. The average,
overall score for STS among all respondents was 21.4286 revealing low STS.
Compassion Satisfaction (CS). Table 2 above similarly displays the scoring for
compassion satisfaction among thirty one respondents. A score of 22 or less reveals low CS;
between 23 and 41 reveals average CS; and a score of 42 or more reveals high CS. Twenty eight
respondents (90%) scored between 24 and 41 revealing average CS. Three respondents (9.7%)
scored high for CS. The minimum score for CS among respondents was 24, and the maximum
score was 44. The average score for CS among respondents was 34.0323 revealing average to
high CS. The finding of such low, almost non existent levels of burnout and secondary trauma as
compared to higher levels of compassion satisfaction among respondents is worthy of noting.
Summary of Overall Findings: Professional Quality of Life Scale (ProQOL)
Overall, scores for the Professional Quality of Life scale reveal low to average burnout,
with 67% of respondents in the low range and 33% of respondents in the average range. Low to
average secondary traumatic stress was found, with 54% of respondents in the low range, and
46% in the average range. Compassion satisfaction was found to be in the average to high range
among respondents, with 90.3% in the average range and 9.7% in the high range.
Africultural Coping Systems Inventory
To measure the culture-specific coping methods used by African Americans in stressful,
day-to-day situations, the Africultural Coping Systems Inventory (ACSI) was used. The survey is
comprised of thirty self report, likert scale questions. The ACSI is comprised of four subscales:
Cognitive/Emotional Debriefing (11 items); Spiritual-Centered Coping (8 items); CollectiveCentered Coping (8 items); and Ritual Centered Coping (3 items). The ACSI reflects spirituality,
harmony, balance, a collective group orientation, and the emphasis on rituals. In completing the
ASCI, it directs respondents to recall a stressful event that occurred over the past week, briefly
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describe it, and rate the coping techniques they used during that stressful situation using a 4-point
likert scale measure (0=did not use, 1=used a little, 2=used a lot, 3=used a great deal). The
following table represents overall respondents’ scores on the four ACSI subscales.
Table 3
Africultural Coping Systems Inventory Summary
ACSI Scores Summary
Coping Subscales
Range
Mean
Spiritual-Centered Coping
0-31
1.84
Collective Coping
0-3
1.71
Cognitive/Emotional Debriefing
0-3
1.45
Ritual-Centered Coping
0-3
0.46
Table 3 represents the overall summary of respondents’ scores on the four ACSI scale.
As demonstrated, the Spiritual-Centered Coping subscale was found to be the highest reported
subscale involving the strategies used by respondents in coping with a stressful situation. The
mean score for Spiritual-Centered Coping was 1.84. A description of the Spiritual-Centered and
remaining subscales (Collective Coping, Cognitive/Emotional, and Ritual-Centered) are further
presented below.
Spiritual-Centered Coping is said to involve more of the African American personality
which is connected to one’s spirituality and Creator (Utsey, Adams, et al., 2000). The SpiritualCentered subscale includes eight items which describe the spiritual methods used by respondents
as a way of coping with a stressful situation. Of all the four subscales, the most reported methods
1
Africultural coping: To what extent participants used certain strategies to deal with
everyday, stressful situations. 0: Does not apply / did not use, 1: Used a little, 2: Used a lot, 3:
Used a great deal.
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in coping with a stressful situation, specified by respondents as method they used a lot or a great
deal, were found in the Spiritual-Centered Coping subscale. The results for the ACSI are
presented below in order of most to least significant in terms of the highest reported coping
methods by respondents as a way of coping.
Table 4
Spiritual-Centered Coping
Spiritual-Centered Coping
Coping Subscale
Coping Scores
Did not use/
Used a Lot/
Used a
Great Deal
Little
Valid
N
%
N
%
Total
%
Left matter in God’s hands.
4
13.0%
27
87.1%
31
100%
Prayed things would work themselves out.
4
13.0%
27
87.1%
31
100%
Went to church (or other religious meeting) to
10
33.3%
20
66.7%
30
100%
11
35.5%
20
64.5 %
31
100%
13
42.9
18
58.1 %
31
100%
get help from the group
Read a scripture from the bible (or similar book)
for comfort and/or guidance.
Asked for blessings from a religious or spiritual
person.
%
Sung a song to yourself to help reduce the stress.
15
48.4%
16
51.6%
31
100%
Asked someone to pray for you.
16
51.6%
15
48.4%
31
100%
Read passage from a daily meditation book.
20
64.5%
11
35.5%
31
100%
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Table 4 above, for Spiritual-Centered Coping, represents those coping methods most
reported in this subscale. One score was missing. Twenty seven respondents (87.1%) reported
leaving matters “in God’s hands” as a coping method used a lot or a great deal in coping with a
stressful situation; twenty-seven respondents (87.1%) similarly reported “praying that things
would work themselves out” as a coping method used a lot or a great deal in coping with a
stressful situation; and twenty respondents (64.6%) reported that attending church to get help or
support from the group and reading bible scriptures for comfort and guidance were coping
methods used a lot or a great deal in coping with a stressful situation. The coping method least
reported among respondents was reading a passage from a daily meditation book; twenty
respondents (64.5%) reported that reading a passage from a daily meditation book was a coping
method they did not use or used a little in coping with a stressful situation. The second, most-used
coping methods were found in the Collective Coping Subscale which includes eight items and is
discussed next.
Collective Coping is described by Utsey, Adams, et al., (2000) as involving the cultural
value system of African Americans which values collective involvement over that of
individuality. The following represents the highest reported Collective coping methods of
respondents in coping with a stressful situation.
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Table 5
Collective Coping
Collective Coping
Coping Subscale
Coping Scores
Did not use/
Used a Lot/
Used a Little
Great Deal
Valid
N
%
N
%
Total
%
7
22.6%
24
77.4%
31
100%
10
32.3%
21
67.7%
31
100%
14
45.2%
17
54.9 %
31
100%
Helped others with their problems.
14
45.2%
17
54.9 %
31
100%
Remembered what a parent (or other relative)
15
48.4%
16
51.6%
31
100%
16
51.6%
15
48.4%
31
100%
17
54.8 %
14
45.2 %
31
100%
20
64.5%
11
35.5%
31
100%
Shared feelings with a friend or family
member.
Sought emotional support from friends and
family.
Sought advice how to handle the situation from
an older person in your family or community.
once said about dealing with these kinds of
situations.
Thought of all the struggles Black people have
had to endure, which gave you strength to deal
with the situation.
Got a group of family or friends together to
help with the problem.
Asked for suggestions on how to deal with the
situation during a meeting of my organization
or club.
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Table 5 above represents the highest reported coping methods of the Collective Coping
Subscale. Twenty-four respondents (77.4%) reported sharing feelings with a friend or family
member a lot or a great deal to cope with a stressful situation; twenty one respondents (67.7%)
reported seeking emotional support from friends or family members a lot or a great deal to cope
with a stressful situation; seventeen respondents (54.9%) reported that seeking advice on how to
handle the situation from an older person in his/her family or community was a coping method
they used a lot or a great deal to cope with a stressful situation; and seventeen respondents
(54.9%) reported that helping others with their problems was a coping method they used a lot or a
great deal to cope with a stressful situation. The least used coping method of the CollectiveCoping subscale items was that of asking suggestions on how to deal with a situation during
one’s organizational or club meeting; twenty respondents (64.5%) reported that asking
suggestions on how to deal with a situation during one’s organizational or club meeting was a
coping method they did not use or used a little. The next subscale, Cognitive/Emotional Coping,
includes the third most reported coping methods reported among respondents.
The Cognitive/Emotional Coping subscale consists of eleven items. Cognitive/Emotional
Coping is described by Utsey, Adams, et al., (2000) as involving one’s adaptive process to
environmental stressors developed during times of slavery and times of racial oppression among
African Americans. The following represents the eleven Cognitive/Emotional coping methods
rated by each respondent as a way of coping with a stressful situation. The results for the highest
reported Cognitive/Emotional Coping methods are reported below.
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Table 6
Cognitive/Emotional Coping
Cognitive/Emotional Debriefing
Coping Subscale
Coping Scores
Did not use/
Used a Lot/
Used a Little
Great Deal
N
%
N
%
Total
Valid %
10
32.2%
21
67.8%
31
100%
11
35.5%
20
64.5%
31
100%
Hoped that things would get better with time.
13
41.9%
18
58.1%
31
100%
Spent more time than usual doing things with
13
41.9%
18
58.1%
31
100%
13
41.9%
18
58.1%
31
100%
Tried to remove yourself from the situation.
15
48.4%
16
51.6%
31
100%
Found yourself watching more comedy shows on
15
48.4%
16
51.6%
31
100%
18
58.1%
13
41.9%
31
100%
Got dressed up in my best clothing.
20
64.5%
11
35.5%
31
100%
Tried to convince yourself that it was not that
23
74.2%
8
25.8%
31
100%
27
87.1%
4
12.9%
31
100%
Attended a social event to reduce stress caused by
the situation.
Sought out people you thought would make you
laugh.
friends and family.
To keep from dealing with the situation, you
found other things to keep you busy.
television.
Spent more time than usual doing group
activities.
bad.
Tried to forget about the situation.
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The third most-reported coping methods in dealing with a stressful situation are from the
Cognitive/Emotional Coping subscale, shown above in Table 6. Twenty one respondents (67.8%)
reported attending a social event to reduce stress as a coping method they used a lot or a great
deal to cope with a stressful situation; similarly, twenty respondents (64.5%) also reported that
seeking out people who would make them laugh was a coping method they used a lot or a great
deal to cope with a stressful situation; and eighteen respondents (58.1%) reported that 1) hoping
things would get better with time, 2) spending more time doing things with family and friends,
and 3) to keep from dealing with the situation, they found other things to keep busy were coping
methods they used a lot or a great deal to cope with a stressful situation. The least reported coping
method from the Cognitive/Emotional subscale was “I tried to forget about the situation”;
fourteen respondents (45.2%) reported that trying to forget about the situation was a coping
method they did not use or used a little in coping with a stressful situation. The least reported
coping methods are next, belonging to the Ritual-Centered Coping subscale.
Ritual-Centered Coping involves the practicing of rituals in acknowledgement of one’s
ancestors, celebration of events, and in connection with one’s religion (Utsey, Adams, et al.,
2000). The following represents the three Ritual-Centered coping methods rated by each
respondent as a way of coping with a stressful situation.
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Table 7
Ritual-Centered Coping
Ritual-Centered Coping
Coping Subscale
Coping Scores
Did not use/
Used a Lot/
Used a
Great Deal
Little
Used a cross or other object for its special
N
%
N
%
Total
Valid %
22
71.0%
9
29.1%
31
100%
27
87.1%
4
13.0%
31
100%
29
93.6%
2
6.4 %
31
100%
powers in dealing with the problem.
Burned incense for strength or guidance in
dealing with the problem.
Lit a candle for strength or guidance in dealing
with the problem.
Above, Table 7 demonstrates the three coping methods belonging to the Ritual-Centered
Coping subscale. These coping methods were also the least used among all coping subscales.
Twenty-nine respondents (93.6%) reported that lighting a candle for strength or guidance was a
coping method they did not use or used a little in coping with a stressful situation; twenty-seven
respondents (87.1%) reported that burning incense for strength or guidance was a coping method
they did not use or used a little to cope with a stressful situation; and twenty-two respondents
(71%) reported that using a cross or other special object for its special powers was a coping
method they did not use or used a little to cope with a stressful situation. Within this subscale,
however, using a cross was most significant among the three Ritual-Centered coping methods.
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Summary of Overall Findings: Africultural Coping Systems Inventory
Spiritual-Centered Coping contained the most reported coping methods of respondents;
prayer, “leaving things in God’s hands,” and attending church were most reported as used a great
deal in coping with stressful situations among all subscales; this clearly reveals a strong sense of
spirituality and belief in God or a Higher Power among these respondents. Attending church and
reading bible scriptures were also popular methods of coping among respondents. It is interesting
that support for coping with a stressful situation is sought after at church but not as much in one’s
organizational or club meeting. Cognitive Emotional Coping methods most reported included
attending social events, utilizing one’s sense of hope, and seeking laughter amongst others; these
were reported among those coping methods that were used a great deal among respondents.
Collective Coping subscale involved the second-most highly reported coping methods among
respondents—sharing feelings with friend or family member, emotional support from friends or
family members, and advice from someone older in family or community—reveal the
importance of social relationships, emotional support, and resources for receiving direction and
advice in coping with stressful situations. And the Ritual-Centered Coping methods were the least
used among all four subscales, evidenced by the high percentages of respondents who reported no
or little use.
This section concludes the qualitative findings for the ProQOL (burnout, secondary
traumatic stress, and compassion satisfaction) and the ACSI (coping strategies). The following
section will report qualitative findings recorded from the focus group.
Focus Group
Eight African American social work professionals and MSW students between the ages
of 20-60 were involved in the focus group. Five of the respondents were MSWII students four
females and one male; and three were female social work professionals with MSW degrees.
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Respondents were obtained through snowball sampling and had all completed the survey for this
study. Subjects come from various areas of social work involving child welfare and school social
work, mental health, and criminal justice. The details found within this focus group are related to
various themes within the areas of interest. This area highlights the experiences and beliefs of this
group of African American social workers and MSW students. How their experiences and beliefs
may contribute to, or be impacted by, experiences of burnout and vicarious trauma (or secondary
traumatic stress) and the factors that may promote their wellbeing are found here. Responses
revealed the well-intentions of African American workers as well as stress-related factors relevant
to the risks of burnout and vicarious traumatization. The results are presented below.
The Meaning of “Helping Profession” to African Americans. Being in a “helping
profession” was defined as an opportunity to be a positive representation of black workers and
advocates; to be leaders and receive validation as professionals; and to improve life conditions
and services for all vulnerable populations and especially for their African American clients.
According to respondents, they felt obligated to better the lives of other African Americans and
believed that doing so was simply a part of their identity as African Americans. “It’s a part of
who we are,” stated one respondent. “We are just doing what we like (the act of helping),” said
another. “It’s a necessity,” another stated, “…giving back to the community, and our people as a
whole, because they are in (challenging) situations and need help from someone who can relate.”
Respondents believed their chosen social work careers are the result of wanting work that is
meaningful to them, which promotes their sense of cultural pride and tradition in helping others in
need, and which provides them opportunities to work against racism, biases, prejudices, and
discrimination, something they understand and have experienced along with many of their
minority clients.
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Extent of Education and Training about Work-Related Risk Factors in Social Work.
Respondents felt they had not been adequately prepared by their educational experience to work
confidently with specific populations. For example, working with the elderly, families, and
culturally diverse clients were not areas where respondents felt most competent as a result of their
education and training. Understanding policy work—specifically, how to promote change,
specific training regarding difficult issues and client behaviors, and how to protect and care for
oneself when dealing with such challenges were areas respondents felt less equipped to handle.
Respondents shared that education and life experiences had most informed them of the potential
risk-factors that come with careers in social work and felt their education and training on areas of
personal risk were minimal. Respondents stated they would have liked more education and
training in terms of self-care than what they actually experienced. “Not enough education and
training…we hear the need for self-care a lot but not enough about how to avoid burnout,” said
one respondent. Another respondent stated, “I’ve had one full day, an 8 hour training, on how to
avoid and de-escalate client behaviors when a client gets upset.” And a third respondent shared
that her personal experiences with trauma and death are what she feels have most educated her for
client challenges in social work.
Stressful Client Populations. The client populations most referred to as involving
challenging work included child welfare, youth, and mental health populations which respondents
believed to involve transference and countertransference experiences as well as verbal abuse from
some clients, an experience that was described as “totaling on [one’s] psyche.” However,
respondents agreed more that it is less of the client populations they serve that create stress on
their jobs and internships but, more so, the result of environmental factors in the workplace such
as administration issues and functions perceived as ineffective. Various mental health agencies
were described as mistreating, restraining, and controlling clients under conditions felt to be less
95
than humane. “Staff are more the issue than clients. They lead you to feel burned out…staff
should be on the same page (agreeing on client and agency matters).” Another respondent stated,
“Clients have never been a problem…it’s always the workers. Most clients want to be
helped…We chose them…we are here to work with their problems.”
Personal Impact of Client Work on the Workers. When respondents were asked about the
manner in which working with their clients has impacted them personally, respondents shared
belief that they had been impacted in positive ways; however, evidence of changes in their
worldviews, ideologies, vulnerabilities and the development of cynicism were apparent.
Respondents believed that working with clients had helped them to recognize personal strengths,
become more compassionate, and to gain important skills such as understanding more about
crime and abuse and managing counter-transference. However, respondents shared a change in
their ways of viewing the world. One respondent stated, “You learn the world isn’t what it seems.
You can’t take it all at face value.” A second respondent stated having the realization that “people
are flawed, so the world is flawed.” A third respondent shared, “your views of people change and
you have to remember that agency workers and difficult clients do not represent the entire
population.” Respondents agreed that their ways of viewing people had become more cynical,
and that they had become more vulnerable and suspicious of others. “I’m more suspicious and
cautious,” stated one respondent. “I have to always think twice about my impression of others,”
said another. A third shared, “I pay more attention to people’s behaviors.” The downside of their
working with clients has included a negative impact on personal relationships, decreased feelings
of personal accomplishment and inefficacy, emotional exhaustion, and cynicism—all factors
related to burnout. One respondent stated, “Working in mental health desensitized me to people in
my personal life who were in need of help.” Another revealed that client work “is taxing, and it
drains your optimism and drive.” The respondent went on to say:
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“You experience discouragement and negativity…and it impacts your self-perception
when problems (client issues) become overwhelming. You want to be gung-ho in efforts
to help them, but there are too many barriers. You feel a diminished sense of ability to
make a difference.”
Another worker revealed that during her work with mental health clients, she felt emotionally
abused by them, felt like she was unable to make a difference, and walked away from the job as a
result of the stress. She stated, “I wanted to help but didn’t feel like I was making a difference, so
it was no point in me being there.”
Maintaining Professional Boundaries. Respondents reported that maintaining
professional boundaries with clients is often challenging. “The goal is to not act like a family
member and still provide good services,” said one respondent. Another added that the stipulation
that there be no physical contact with clients is often difficult when knowing that a simple hug
might be beneficial for some clients: “I’m still working on that (maintaining professional
boundaries)! It’s ridiculous that you can’t have physical contact when considering what some
clients are going through. It seems very cold.” Additionally, it was believed important to
respondents that they not side with clients even though their experiences may be familiar or
justifiable for doing so. Attempts to remain neutral with clients while still demonstrating
sensitivity to client issues, enforcing rules, and being competent in one’s skills were expressed as
important to maintaining their boundaries with clients. Relying on one’s strength from, and belief
in, a higher power was also stated as helpful in not overstepping one’s roles.
Efficacy in One’s Work with Clients. Respondents stated feeling most effective when
reflecting on and using their ethics-based training in decision-making, when meeting work
expectations, and upon noticing desirable client outcomes. One respondent noted feeling most
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effective when personal effort in working with a client produces a positive difference in the
client’s behavior that otherwise may not have taken place.
Feeling Rewarded. Respondents reported feeling valued and rewarded at their jobs and
internships based on their clients’ reactions and responses to them and when told they are
appreciated by management at their jobs. One worker who worked with teens shared that feelings
of reward come from working with teens who “make it clear if a worker is welcomed or not” and
“when invited into their circle of trust.”
Productivity on the Job. Respondents reported feeling most productive on the job as a
result of their personal feelings of satisfaction with the services they provide to clients and
feelings of competence that result from witnessing their clients change because of the
respondents’ services. Respondents felt they didn’t need to see drastic and immediate changes
with clients in order to feel productive. Just being able to provide vulnerable clients with needed
resources and advocate for their clients was said to feel productive.
Power and Autonomy in the Workplace. Although allowed a certain degree of power and
autonomy in relation to their specific job responsibilities and expectations, respondents believed
their power and autonomy in the workplace were limited. Respondents felt they were allowed to
use creativity and decision-making in some areas, while yet confined by agency rules. One
worker stated, “There is definitely a ceiling….You always get to a place where you have to have
approval to go forward.”
Desired Changes in the Workplace. Agency policies and politics which negatively impact
client services as well as large client caseloads were among the changes most desired by
respondents in the workplace. One respondent stressed, “It’s frustrating wanting to accomplish
certain types of services for clients but can’t because you have to know someone, even though it’s
about the clients. “It’s a waste” not being able “to effect change,” stated another. A third
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respondent who had a caseload of 300 clients shared the difficulty in treating client cases
individually, “It’s hard to separate client cases and treat them independently. “A reduction in the
number of clients…” would allow more time to be spent “one-on-one” with clients.
Future Career Goals. Respondents did not see themselves remaining in the same work
positions and responsibilities over the next 5 to 10 years. Respondents hoped to be involved in
macro/policy work and as supervisors within the agencies they will be working for. Respondents
believed it was in macro/policy work that they could best make a difference in the lives of clients,
especially with youth, blacks, and minorities in general. “If I don’t have a voice to make change, I
have to do something different,” stated one respondent. Some respondents hoped to run their own
agencies. Another respondent added, “just talking about change is not enough.”
Perceived Supports in the Prevention of Health and Job-Related Risks. With the
knowledge that African Americans are more vulnerable than other groups for physiological and
psychological risk factors, the need for improved self-care was important to respondents. Better
health care, diet, exercise, healthy relationships and support from significant others, and more
educational resources—including job-related support or workshops—regarding the potential risks
involved in a social work career for the worker and about self-care were important.
In terms of favorable resources currently used among African American social workers
and students in managing their wellbeing, respondents reported the use of spiritual practices—
such as prayer and gospel music, spending time with family and friends, and taking more time for
self-care and leisure activities.
Resilience: Strengths and/or Vulnerabilities. A variety of issues were believed to make
African American social workers more and less vulnerable in their social work careers.
Familiarity with and pride regarding one’s cultural history among respondents was perceived as
both a strength and weakness—providing both a source of motivation and inspiration among
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African American social workers and students but also a sense of invincibility. African American
social workers were self-perceived to take on more challenges than what may be considered as
healthy or necessary.
Respondents tended to define African Americans as “strong,” “more resilient,” and
“more empathetic” due to historical, cultural challenges and personal experiences; one worker
stated, “We are more resilient because of where we’ve been…and our personal experiences make
us stronger.” Another stated, “We choose to work in the trenches or on the frontlines and are less
inclined to go for the less stressful jobs because we want to make a difference.” A third worker
professed that African Americans have “a history of carrying the cross” and have learned to
manage and handle a multitude of life challenges which causes the burden of taking on too much.
Respondents believed they are drawn to more difficult work, likely to do more than what
is reasonable without taking better care of themselves; as a result, they feel more vulnerable to
burnout and illness. “Although we can be considered strong (as African Americans), it does not
mean that we don’t also need emotional healing and comfort,” stated one respondent. Another
shared, “We have to know that it’s OK to seek out counseling. We work harder.”
Finally, as social workers, respondents viewed themselves as being “assigned tougher
clients” and stressed again the experience of their agencies to assist those clients who are also
African American. Respondents related that the potential for having experienced similar
challenges as their clients poses a risk for burnout and vicarious traumatization; however, they
felt that the manner in which they have dealt with their own challenges might make them more
capable of handling similar issues of their clients.
Overall, African American social workers and students felt their strengths included their
education—the knowledge and skills they had gained in addition to their personal knowledge and
life experience; being able to build rapport and be good listeners; and their sensitivity and ability
100
to better empathize with clients. “I have gained knowledge about different cultures and social
classes, so as not to disrespect or put down clients but be able to validate their experiences.” A
second respondent stated that she was less judgmental with clients as a result of her experience as
a client. “I hated feeling judged,” she said. Respondents reported their beliefs that being able to
build rapport with others, being good listeners, and being sensitive and empathetic to others were
innate strengths they possessed or aspects of their character that have developed over time.
Coping Styles. Respondents shared similar thoughts regarding their coping styles.
Turning to family, friends, and coworkers when dealing with stressful work-related issues were
commonly expressed as ways of coping. The use of religious or spiritual practices was also
common. One respondent said excitedly that she relied “heavily on prayer.” Another shared that
she leaves difficult situations “in God’s hands…” seeing challenges as between herself and God,
knowing that “healing would come in time.” One respondent shared an experience of one of her
young female clients, stating “it broke my heart.” In dealing with her client’s challenges, the
respondent shared that, at first, she cried; and afterwards, she talked out her feelings with a loved
one and turned to prayer in order to cope. Rational thinking—reasoning through one’s challenges
while reflecting on similar experiences of others who endured hardships was also mentioned. “I
thought about our history (as African Americans) and felt a duty to follow through with the work
we do on behalf of those in our past. When I compare my own challenges to those of others,
things are not so bad,” according to one respondent. Another respondent shared her personal use
of therapy after dealing with a client’s death on her job; as well, she turned to her coworkers,
friends, and prayer to cope. Support of family, friends, and coworkers, and the use of religious
and spiritual coping proved most immediate to the needs of respondents in coping with difficult
client issues. Only one respondent mentioned or commented on the use of personal therapy.
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Special Considerations
Unique Stressors to African American Social Workers. According to respondents, they
experience several unique stressors as the result of being African American social workers—
brought on by agency and client expectations, ethnic stereotypes and perceptions, and racial
experiences. Respondents described the pressures and feelings of obligation involved in meeting
the needs and expectations of clients who request black or minority workers because they feel
they will be best understood by a worker who is similar to them. Respondents similarly described
the pressure and obligation to be an advocate on behalf of clients whose agencies lack cultural
knowledge regarding their ethnic clients’ cultural experiences. “You become the spokesperson for
all black people, expected to know everything about who you are helping,” says one respondent.
Stress was also expressed as the result of agencies’ expectations to specifically assist African
American and minority clients. One respondent referred to herself as having been considered a
“special skills” person and goes on to give an example of how she has been made to feel on the
job by non-black agency staff: “You’re black,” she says, “I need you over here. Help me with this
(black) client.”
Being stereotyped by agencies who may not appreciate cultural /ethnic hair and fashion is
a “big stressor” according to respondents. Respondents stated feeling preoccupied with meeting
“professional” standards at their agencies in regards to appearance, as some agencies
predominantly staffed by non-black workers may not be familiar with ethnic styles of hair and
dress, what respondents referred to as their “cultural presentation.”
One’s image in the black community and among those they assist was also relevant to
respondents’ concerns. One respondent shared her challenge with having “jumped the fence,”
starting out as a client and now “being on the other side,” as the social worker: “…and no one
likes workers.” She stated having a “let’s help one another” spirit and ideology, but is limited and
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pressured by agency policies and regulations to not overstep professional boundaries as well as by
clients who may perceive her as not doing enough on their behalf. Respondents agreed they want
to uphold a positive image in their communities as well as among their non-black clients and
coworkers. “It is important to me how I’m seen by my community and to not have a negative
image.” One respondent described the additional pressure of working with older whites who are
sometimes skeptical about her abilities and status as a student: “Race and age are issues,” she
said.
The Impact of Culture on Client Work. Respondents believed strongly that they are more
empathetic and understanding of clients as a result of their cultural and life experiences. “We can
put ourselves in others’ shoes,” said one respondent. However, in relation to this, respondents
agreed on the need for maintaining their professional boundaries which they believed would
prevent the potential for transference and countertransference with their clients. Respondents
understood the idea that transference might occur when they, as workers, remind clients of people
in their personal lives. Because of their sense of culture, respondents believed they can “get too
friendly with clients,” but have to remember they are “still mandated reporters.”
Respondents reported being cautious of their experiences with other racial groups and felt
that it “is important to be a good experience” if they are only “one of the few blacks [other group
members] may have encountered.” Respondents hoped to work in a manner that undermines the
negative stereotypes they feel are placed on African Americans and social workers. According to
respondents, both, being too familiar with one’s own ideas of his or her African American culture
may cause some workers to feel biased towards their African American clients or, on the other
hand, cause them to become more pessimistic about them. Nevertheless, although African
American respondents believe they may at times relate to African American clients’ experiences,
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they have the realization with non-black clients that they are “bound by common experience”
rather than race.
Summary of Overall Findings: ProQOL, ACSI, and Focus Group
Among respondents, child abuse/neglect, sexual assault, and drug abuse service provision
were the most popularly reported services among respondents. A noteworthy finding is that more
than two-thirds of respondents (67.7%) felt they were naturally capable of coping with Social
Work-related stress which coincides with the focus group findings, noted earlier, that respondents
felt their strengths were innate or that their strengths have naturally developed over the years. It is
interesting that more than one-third of respondents (33.4%) reported considering a career change
often, most of the time, or all the time which matches respondent’s concerns in the focus group
about wanting work that is more fulfilling and in which they could better promote change in the
lives of their clients. It is fascinating to note that burnout has been found to take place within the
first five years of one’s career which potentially places more than one-third (38.7%) of
respondents in this research study at risk for burnout (Maslach, 1982).
Potential for Burnout, Vicarious Trauma (or STS), and Compassion Satisfaction.
Important findings were low to average burnout and vicarious trauma among
respondents. Burnout scored low among 67% of respondents and average among 33% of
respondents. Secondary traumatic stress scored low among 54% of respondents and average
among 46% of respondents. Average to high compassion satisfaction was found among
respondents with 90.3% of respondents scoring in the average range and 9.7% scoring high.
Resilience
Evidence of resilience among respondents surfaced in the focus group discussion as
respondents shared having once been vulnerable clients and/or on the receiving end of social
work services. As well, respondents discussed how the familiarity of struggles related to their
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cultural group which include racism, prejudice, and discrimination, serve as a source of
motivation, strength, and encouragement.
Coping
Spiritual and Collective Coping methods proved most significant among respondents and
among the four subscales; a high dependence on one’s spirituality, involving God and prayer, and
looking to others for support, guidance, and emotional comfort are highlighted. When asked
about ways of coping currently utilized or planned for the future, spiritual coping, time with
friends and family, as well as reasoning through one’s thoughts were mentioned; it is significant
that there was rare mention, only one respondent, of pursuing mental health care as an optional or
additional way of coping with personal or work-related stress.
This section provided findings for the quantitative (ProQOL and ACSI) and qualitative
(focus group) findings. A discussion about the overall findings will be provided Chapter 5.
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Chapter 5
DISCUSSION
Introduction
This researcher utilized a 60 question self-report survey involving thirty questions from
Stamm’s (2009) Professional Quality of Life to detect compassion satisfaction, burnout, and
secondary traumatic stress (vicarious trauma), and the Africultural Coping Systems Inventory
which is used to measure the culture-specific coping strategies used by African Americans in
stressful, day-to-day situations (Utsey, Adams, et al., 2000). A focus group of 8 people was also
conducted. Goals of the research study included: 1) to assess whether there are symptoms of
burnout or vicarious trauma currently present among participants, 2) examine coping strategies
and factors of resiliency, 3) seek to understand from their perspectives as African Americans how
their ethnic identity, background, and cultural practices may be impacted by, or play a role in,
their experiences on the job and with clients, and 4) identify potential for what is known as
compassion satisfaction among participants. Important findings were low potential for burnout
and vicarious trauma; high compassion satisfaction; resilience; reliance on spirituality and
collective support as a means of coping; and rare mention of personal intentions to pursue mental
health care. These findings are discussed below.
Professional Quality of Life (ProQOL)
Results from the ProQOL Version 5 (Stamm, 2009), utilized to measure potential for
burnout, secondary trauma, and compassion satisfaction among respondents, revealed low
burnout among 67% of respondents and average burnout among 33% of respondents. Results for
secondary traumatic stress were in the low range among 54% of respondents and the average
range among 46% of respondents. And average to high scores of compassion satisfaction were
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found among respondents with 90.3% of them scoring in the average range and 9.7% scoring in
the high range.
These African American social workers were more likely to feel a sense of satisfaction
with the work they provide in helping others than to feel burned out; this is reflected by the
67.7% of respondents who reported feeling “naturally capable” of dealing with social workrelated stress. This makes the finding interesting that a combined total of 33.4% of respondents
considered a career change often, most of the time, or all the time—showing the potential for
early job turnover among respondents. The concern would be that their changing over would be
the result of job exploration or a different focus in their work interests and not the result of stress.
But in this case, respondents may perceive the challenges they face within their agencies and with
clients as temporary, lessening their potential for burnout.
Africultural Coping Systems Inventory (ACSI)
The ACSI was utilized to measure the ways in which respondents chose to cope during
stressful, everyday situations. The scale is divided into four subscales: Cognitive/Emotional
Coping, Spiritual Coping, Collective Coping, and Ritual Coping. The ACSI measured the ways in
which respondents chose to cope along four subscales. Results indicated that among the four
coping subscales, Spiritual Coping was most utilized among respondents. Spirituality and religion
have been a vital source and reason for hope, strength, guidance, faith, healing, support,
community, and will to survive among Africans and African Americans in times previous to,
during, and since slavery; and they are natural aspects of life and individuality which continue to
characterize their belief systems and values (Laurence-Webb & Okundaye, 2007).
In the results of this study, the belief of, and dependence on, something higher than
themselves is clear among participants, particularly in the overwhelming percentage of those who
responded that leaving their stressful situation “in God’s hands” was a coping method they used a
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great deal. This reveals the ability of these respondents to relinquish some of the emotional
pressure involved in their work to a Higher Power believed to be in control of the situation; this
belief system is beneficial in that it avoids self-expectations that are too high or unachievable and
which negatively impact one’s self-esteem and sense of self-efficacy. The low response to
reading “a passage from a daily meditation book” reflects similar findings of the NASW
Workforce Study (2008) that meditation and personal therapy are less used. This may reveal a
lack of awareness or disinterest in meditational resources as useful self-care methods.
Focus Group Discussion
The following section discusses findings from the focus group regarding burnout,
vicarious trauma, resilience, and coping.
Burnout
Findings from the focus group reflect research findings pertaining to various related
factors of burnout. Respondents acknowledged the difficult experiences often involved in
working with vulnerable populations and within their workplaces or internships. Among the
various factors mentioned, ineffective agency functioning, limited power and autonomy, negative
attitudes of one’s job, lack of support (Braithwaite, 2007; Soderfeldt, Soderfeldt & Warg, 1995),
stringent agency rules or regulations (Soderfeldt, Soderfeldt & Warg, 1995), large caseloads
(Schauben & Frazier, 1995), and difficulty with fellow workers (Ben-Zur & Michael, 2007; Kim
& Stoner, 2008) are or have been the experiences of these respondents. The willingness to share
these experiences may be due to perceptions of the group as a supportive environment in which
these African American respondents could share personal and collective experiences. In terms of
mental health and wellbeing, without appropriate education, training, and self-care, and with
continued experiences of factors that promote burnout and vicarious trauma, respondents could
face a triple threat when considering their potential for higher health risks in general.
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Respondents gave prideful references to their statuses in social work, feeling a sense of
duty to vulnerable clients; they perceived themselves as natural caregivers—a task that in itself
has been known to be associated with stress (Ben-Zur & Michael, 2007; Home, 1997).
Respondents expressed feeling a responsibility in assisting others who are vulnerable, especially
African American clients whose betterment they hoped to contribute to. This collective goal was
perceived as a part, and expectation of, their African American culture and identity as suggested
by Lawrence-Webb & Okundaye (2007). Being able to carry out these goals among vulnerable
populations was perceived as a source of personal accomplishment (Himley, Jayaratne, & Chess,
1987) for these respondents. However, various occasions when positive changes are slow to take
effect, despite the efforts of the worker, may allow for this sense of personal accomplishment to
become stalled. Respondents shared occasional decreased feelings of personal accomplishment, a
major element of burnout mentioned by Maslach, Schaufeli, and Leiter (2001); it is important to
note that such feelings may result in negative self-perceptions, feelings of inadequacy, and lack of
efficacy (Kim & Stoner, 2008; Poulin & Walter, 1993) in addition to emotional exhaustion, also
relative to burnout and present in the experiences shared among respondents.
Additional factors of burnout were respondents’ feelings of having been educated or
trained insufficiently (Maslach, 1982) regarding self-care techniques, difficult client challenges
and issues in the work environment (Alpert & Paulson, 1990; Maslach, 1982; Pearlman &
Saakvitne, 1995); such challenges among workers are known to promote job turnover (Maslach,
1982). Respondents felt that their education in these areas were minimal rather than throughout
their educational training.
Respondents of this research study, while feeling inefficient to handle specific client
challenges, and while expecting to see positive change in and for their clients, may be more at
risk for burnout as they push themselves to meet high self-expectations, and those of their clients
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and workplaces. Feelings of reward (Maslach, Leiter, & Schaufeli, 2001) and productivity for
some respondents were based on the reactions and desired praise of the client (Deutsch, 1984;
Hesse, 2002), supervisors, or agency which may similarly impact one’s feelings of efficacy
(Maslach, Schaufeli, & Leiter, 2001; Turner, 2001), self-esteem (Ben-Zur & Michael, 2007;
Lloyd, King, & Chenoweth, 2002; Maslach, 1982), and one’s feelings of competence and selfperception as a professional (Cerney, 1995). While such experiences may not be exclusive to
African American social workers, African American social workers are expected to have such
experiences simultaneously to a range of life challenges already faced—for example, having less
positive health outcomes (Utsey, Adams, et al., 2000) and experiencing the effects of racism and
discrimination which may be ongoing, and even traumatic, stressors in themselves (Bryant-Davis
& Ocampo, 2005).
Meanwhile, respondents in this research study, even if only to explore other interests,
expressed looking forward to a change from their current work with clients as a way of seeking
more satisfaction than what they have experienced in the direct-service role, as mentioned by
Rapoport (1960). This may be likely among MSWII respondents who may still be somewhat new
to the profession. Respondents shared their desires to change over from client work to being more
involved in policy and supervision where they might have more control, power, and autonomy
within their agencies to create change at the client-level.
Vicarious Trauma
As with factors of burnout, factors of vicarious trauma also surfaced during the focus
group discussion. Respondents described ways in which their perceptions of people and the world
have changed as a result of their work with vulnerable clients. Experiences of suspicion
(Buchanan, et al., 2006; Hesse, 2002), vulnerability (Buchanan, et al., 2006), desensitization
towards people in their own relationships (Pearlman & Saakvitne, 1995), and self-esteem issues
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(Rich, 1997; Way, et al., 2004) were mentioned. Nevertheless, low outcomes of vicarious trauma
were found among respondents which may be due to having worked in a particular field for
shorter amounts of time, minimal exposure to trauma victims, lack of self-care strategies, and
having the support of family, friends, or coworkers (Way, et al., 2004).
Empathizing with clients or having an empathetic nature, as described among
respondents about themselves, involves placing one’s self in the position of their clients in order
to better understand their experiences (Lawrence-Webb & Okundaye, 2007). According to these
respondents, the struggles African Americans have faced have caused them to feel familiar with
the trials and emotional experiences of others. Specific focus group questions addressed the
viewpoints of respondents as African Americans social workers. Their responses gave further
insight into their empathetic qualities and that they believed this was a result of their cultural
history as African Americans. However, having an empathetic nature is a factor of vicarious
trauma as it is of burnout (Feldman & Kaal, 2007; Killian, 2008; Way, et al, 2004). As indicated
by the findings of low burnout and vicarious trauma among respondents in this research study, it
is this empathetic nature, described by Killian (2008), which likely promotes their desire of
helping others (Figley, 1995). This is further revealed by the finding that all respondents scored
within the average range (90.3%) or high range (9.7%) of compassion satisfaction, a marked
contrast from that of burnout and secondary traumatic stress.
Respondents felt that their own life experiences were among factors responsible for
preparing them for their work with clients. However, having experienced one’s own trauma or
sharing similar experiences as one’s clients may promote further risk of vicarious traumatization
(Cerney, 1995; Dutton & Rubinstein). Challenges with healthy boundaries, also relative to
transference and countertransference (Hesse, 2002), were also a concern among respondents.
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Resiliency
Evidence of resiliency, which is described as involving the existence or exposure to a
significant threat or hardship and one’s realization of having survived that hardship (Utsey,
Bolden, et al., 2007), emerged from several respondents in the group. Respondents discussed
themselves as once being vulnerable, users and/or clients of social work services, and now “being
on the other side” in the position of helper. This demonstrates the resiliency model defined by
Masten (1994, 2001) by two conditions: the exposure to personal hardship and the realization of
adapting in spite of it (Utsey, Bolden, et al., 2007).
Coping
In terms of coping with stress, respondents believed that better self-care, healthy,
supportive relationships with family, friends, and coworkers, and educational opportunities would
be helpful in maintaining their wellbeing. Lawrence-Webb & Okundaye (2007) gives mention to
such supports as being beneficial to workers. Among the coping resources currently practiced
among respondents, spending time with, and utilizing the support of, family and friends as well as
spirituality—an important cultural strength—were named as important resources by Utsey,
Adams, et al., (2000). What was rarely mentioned among respondents in this research study was
the current or planned use of therapy as needed in coping with personal or job-related stress.
Obasi-Leong (2009) and Townes, Chavez-Korell, and Cunningham (2009) point out that African
Americans are less likely to consider the use of counseling, experiencing stigma (Obasi-Leong,
2009) or apprehension about services provided by White counselors who dominate various
systems and may be racially biased, providing services that do not incorporate the client’s cultural
(Townes, Chavez-Korell, and Cunningham, 2009). Consequently, those who may not have easy
access to the support of their families, friends, or coworkers, as culturally expected, and who
choose to forego personal therapy for stress and personal challenges may be likely to internalize
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difficult experiences and related anxiety or strain and adopt unhealthy coping behaviors
(Maslach, Schaufeli, & Leiter 2001; Williams, nd).
Summary
In summary, this study did not find that respondents have burnout or vicarious trauma,
only that various factors for such were present. The resilience and coping methods of these
African American social workers appear to be factors which protect against burnout or vicarious
trauma and that promote wellbeing and compassion satisfaction. Respondents expressed their
choice of social work as being a part of their identity and purpose which displays a sense of pride
in their culture and history as African Americans. Despite the presence of factors related to
burnout and vicarious trauma which surfaced in the focus group discussion, overall scores were
low for burnout and vicarious trauma (secondary traumatic stress). The period of time in their
jobs and internships, a lack of exposure to client trauma, or their resilience and/or coping styles
may have protected, and may continue to protect, respondents from the psychological stress of
their duties as social workers. Therefore, self-care, coping styles, and proper education and
training on the risks of such things as exposure to traumatic client stories, transference and
counter-transference, high client case loads and a variety of difficult working conditions are
relevant and vital to their wellbeing.
Compassion satisfaction was not only found among respondents but they scored higher in
compassion satisfaction than either burnout or vicarious trauma. The higher percentage of
compassion satisfaction than that of burnout and secondary traumatic stress may demonstrate the
potential for African Americans to experience more satisfaction in their social work careers and
therefore be less impacted by psychological risks. Spirituality, cultural values, collective support,
and relationships were found in this research to be strengths and served as preferred resources for
coping with stressful situations among these African American respondents.
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It is important to recognize, however, that respondents may still develop burnout at a later
time in their careers with continued exposure to stressful workplace factors and/or vicarious
trauma with repeated exposure to the traumatic experiences of one’s clients. Social workers are
more susceptible to compassion fatigue which can develop suddenly, even after a single exposure
to a client’s traumatic experience (Conrad, et al. 2006). With this said, respondents have not
necessarily escaped from harm’s way. For that reason, it is important to consider that cultural
factors, personal familiarity with client experiences, specific coping methods, and resilience may
not be enough for all social workers to ward themselves completely of psychological risks—and
that, in some ways, these factors may promote further risk among them. Strong cultural identities
and ideologies may be negatively impacted over time as workers and students encounter the
gamut of traumatic client and workplace experiences that do not coincide with their personal
beliefs and values. For this reason, African Americans may still be more susceptible to burnout
when personal expectations are difficult to meet (Figley, 1995) and vicarious trauma when one’s
ideologies and worldview are impacted (Feldman & Kaal, 2007; Pearlman & Mac Ian, 1995;
Pearlman & Saakvitne, 1995).
Recommendations
Social work educators and agencies would do well to ensure that all social workers enter
their careers with the knowledge, skills, and realistic expectations that help to promote
satisfaction in their work. This would help to retain workers on their jobs longer and ensure that
turnover is more the result of decisions to explore career possibilities and not the result of stress,
burnout, and vicarious traumatization among workers. An educational focus on risk factors and
strengths among specific cultural groups will promote multi-cultural competency as well as selfreflection and help to further prevention against risk factors. Providing workers and student
interns with mindfulness-based trauma prevention programs, discussed by Berceli & Napoli
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(2006), will specifically help towards prevention against vicarious trauma. Mindfulness
meditation training, according to Berceli & Napoli (2006), assists in the regulation of emotions by
increasing awareness, flexibility, and adaptability to one’s emotions and encouraging acceptance
rather than avoidance or suppression of thoughts (Berceli & Napoli, 2006). Providing more
advancement opportunities among workers for supervisory positions may help to promote selfesteem and self-efficacy among workers. Dass-Brailsford (2007) discusses the benefits that
supervision can bring to workers, describing it as an opportunity to educate, provide support, and
detect burnout, vicarious trauma, and countertransference, and that it has the potential to lessen
unintentional shaming of workers; in the provision of such supervision, the quality of the
therapeutic relationship with clients is also safeguarded (Dass-Brailsford, 2007). And finally, the
incorporation of spiritual coping must be acknowledged and integrated into the therapeutic
process with African Americans who rely on their spirituality; doing so will lessen the potential
for resistance or a diminished sense of trust among those who seek mental health services (BoydFranklin, 2003).
This being said, the responsibility of preserving social worker wellbeing can not be
placed on them alone. Resources must be put in place for social work students and professionals
to obtain. Agencies, supervisors, and educational institutions should each be held accountable in
promoting the wellbeing of their workers and students. Maintaining low outcomes of burnout and
vicarious trauma, as found among respondents in this research study, means maintaining high
compassion satisfaction—a goal for the worker, the educator, and the employer. Promoting the
resilience of African American social workers through the Afrocentric and Ego Psychology
frameworks is likely to benefit their satisfaction in the workplace and the service outcomes of
their clients.
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Among those who teach and hire African American social workers, it is also true that an
awareness is needed of the traumatizing effect of various forms of racism that continue to occur
overtly and covertly (Bryant-Davis & Ocampo, 2005). These may include the actions of some
agencies to place the responsibility of minority clients solely on minority workers. In the
adequate provision of educational and training experiences, the wellbeing of workers is protected,
longevity in difficult job positions is promoted, and agencies are not only better informed but they
secure for their clients appropriately trained and more competent workers who are capable of
providing effective services. As a result, more positive outcomes are made possible for the
wellbeing of clients and the success of their agencies.
Limitations of the Study
The low scores for burnout and secondary traumatic stress may have been the result of
self-report measures which may impact the reliability of responses provided (Utsey, Adams, et
al., 2000). As a result of this condition, burnout and vicarious trauma may appear less existent
than what may actually be present among respondents, and reliability may be weak. The small
sample size of this study requires caution in interpreting the results and cannot be generalized to
the larger population of African American social workers.
Implications for African American Social Workers
This research study highlights the importance of self-exploration regarding cultural
practices and beliefs of African American social workers. Education on the skills necessary to
counteract the risks of vicarious trauma is also necessary. The need for self-care and coping
strategies are vital to the wellbeing of workers and students, as well as in the quality of service to
one’s clients. Literature suggests that the African American culture values the collective which
reflects their fulfillment in helping others. It is important that African American social workers be
mindful of risk factors that increase their vulnerability to personal harm without appropriate self-
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care. Dass-Brailsford (2007) suggests using supervision as a self-care strategy in dealing with
stress-promoting factors in one’s work; the suggestion is made that workers should “choose a
supervisor who understands them, whom they feel they can trust, and with whom they can
develop an alliance” (Dass-Brailsford, 2007, p.297). Additionally, as a minority group that is
more at risk for health challenges than any other racial group (Griffith, Neighbors, & Johnson,
2009; Williams, 2002), African American social workers must, as should all others working in
helping professions, be especially encouraged to pursue mental health services as needed.
Implications for Future Studies
Future studies might involve utilizing a larger, more representative sample of the
population of African American social workers across the United States with better potential for
generalization to the larger population. Additionally, a longitudinal study would be beneficial in
determining whether any changes in burnout and vicarious trauma symptoms take place over an
extended period of time among respondents. Directly exploring respondents’ personal and family
histories of illness might assist in determining whether a correlation exists between types of
illnesses and higher rates of burnout and vicarious trauma. Finally, a more direct exploration of
respondents’ cultural beliefs, feelings, and intentions regarding the personal use of mental health
services is needed. Educators, employers, and social workers must be aware of the potential
barriers to, and benefits of, encouraging the use of mental health services among minority
professionals. Highlighting and expanding on such findings among all ethnic groups in social
work will bring attention to additional risk factors, promote awareness of protective factors, and
illustrate how cultural factors among social workers may impact their clients.
Conclusion
This research study was aimed at detecting potential for burnout and vicarious trauma
(secondary traumatic stress), factors of resiliency, methods of coping, and potential for
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compassion satisfaction among African American social workers. It was also the goal of this
researcher to explore the perspectives of African Americans in social work to highlight their
strengths and beliefs regarding their ethnic identity, life experiences, and how cultural practices
may impact, or play a role in, their experiences on the job and with clients. According to the
results of this research study among African American social workers, resilience, compassion
satisfaction, and both spiritual and collective coping served as protective factors which likely
decrease the impact of, or vulnerability to, burnout and vicarious trauma which in turn promotes a
positive experience among their clients.
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APPENDICES
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APPENDIX A
Consent Form Cover Page
African American Social Workers and MSW students:
The purpose of this research study is to explore the experiences of African American social
workers in the workplace and with clients, and the role that resiliency may play in coping with
stressful situations.
Participation in this study is voluntary, and there will be no inducements offered for participating.
However, your participation is considered valuable in contributing to the research on African
American experiences in Social Work and would be greatly appreciated.
The content of the questions requires participants to recall personal and work-related experiences
that may promote stress, to rate themselves emotionally, psychologically, and professionally, and
reflect on personal ways of coping. Such thoughts may elicit psychological reactions and/or
discomfort (such as with stress or guilt) for some participants. If this should be the case for you,
you may skip questions or end your participation at any time and for any reason. For your
protection, safety, and convenience, you will receive a referral sheet of mental health services.
Thank you for your time and participation.
Nicole Ladner-Pace
MSWII, CSU Sacramento
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APPENDIX B
Consent Form
Dear African American Social Workers:
My name is Nicole Ladner-Pace. I am a graduate student in the MSW Program at California
State University, Sacramento. I am currently working on my master’s project and would greatly
appreciate your help. The purpose of this research study is to examine the risk for burnout and
vicarious trauma, and the role of resilience in coping among African American social workers
and MSW students.
Your involvement in this research project is voluntary. Your participation will involve reading
and responding to a survey of questions about job-related experiences and personal coping
strategies. This will take approximately one hour of your time. Additionally, if you agree to be
contacted, you may be asked to participate in a focus group discussion on these topics. You may
skip questions if you feel uncomfortable or stop your participation at any time, for any reason. If
after your participation in the survey and/or focus group you wish to seek support, you may
contact the CSUS Center for Counseling and Diagnostic Services at 916-278-6252 or
Psychological Counseling Services at (916) 278-6416. You will also be given a list of additional
counseling service referrals for your convenience.
You will not receive any compensation for participating in this study. The results of the research
project may be published, but your name will not be used. Consent forms will be stored
separately from completed questionnaires to protect participants’ confidentiality. Information that
is recorded and transcribed from the focus group will be stored in a separate file at the
researcher’s home office and destroyed after graduation.
The results of this research will be available after May 2010. If you would like to see a copy of
the results, or if you have any questions or concerns regarding this project or your participation,
you may contact me at (510) 295-7990 or by email: Nrichellepace@sbcglobal.net. For specific
inquiries or concerns pertaining to this study and/or your participation, you may also contact my
advisor, Dr. Teiahsha Bankhead at (916) 278-7177 or by email: bankhead@csus.edu.
Again, your participation in this research study is entirely voluntary. By signing below, you are
indicating that you have read this consent form it in its entirety and that you are agreeing to
participate in this project. Please keep a copy of this letter for your records. Thank you, and your
participation is greatly appreciated.
______________________________________
Signature of Participant
_________________________
Date
For focus group participants (please check one).
I agree to be audio recorded:
Yes
No
Not Applicable
121
APPENDIX C
Survey
Part I.
Instructions: Please circle the answer that is most true for you.
1. Age:
1= 20-29
2. Gender:
2= 30-39
1= Male
3. Level of Education:
5= PhD
3= 40-49
2= Female
1= MSWI
4= 50-59
3= Transgendered
2= MSWII
4= Refused
3= MSW
4. Marital Status: 1= Married/Partner 2= Single 3= Divorced
5. Are you raising children?
5= 60 and older
1= Yes
4= LCSW
4= Widow/Widower
2= No
6. What types of client experiences do you currently provide counseling for? (Circle all
that apply)
1= Child Abuse/Neglect
2= Sexual Assault
4= Elderly Abuse
5= Homelessness
7= Racism/Discrimination
10=Drug Abuse
3= Domestic Violence
6= Disabilities
8= War Trauma
11= Oncology/Medical
9= Sex-Trafficking
12= Other
7. How many years have you provided direct services to vulnerable populations?
Years: 1= 0-2
5= 12-14
2= 3-5
3= 6-8
4= 9-11
6= 15-17
7= 18-20
8= 21 or more
8. How often have you considered changing your job due to stress or difficult working
conditions?
1= Never Have
2= Rarely Have
3= Sometimes Have
4= Often Have
5= Most of the Time Have
6= All the Time Have
9. How capable do you feel in your current ability to cope with Social Work-related
stress?
1= Not Capable At All
2= Somewhat Capable
3= Naturally Capable
4= Exceptionally Capable
5= Not Sure If I’m Capable
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Survey
The following survey of 60 questions is designed to explore your self-perceptions, feelings, and
experiences as they relate to your job (Part II), and the coping strategies you generally use in
stressful, day-to-day situations (Part III).
Part II.
Instructions: Consider each of the following questions in regards to you and your present work
experiences. Select the number that most closely reflects how often you have had these
experiences on the job or at your internship in the last 30 days.
1 = Never,
2 = Rarely,
3 = Sometimes, 4 = Often,
5 = Very Often.
_____ 1. I am happy.
_____ 2. I am preoccupied with more than one person I help.
_____ 3. I get satisfaction from being able to help people.
_____ 4. I feel connected to others.
_____ 5. I jump or am startled by unexpected sounds.
_____ 6. I feel invigorated after working with those I help.
_____ 7. I find it difficult to separate my personal life from my life as a social worker.
_____ 8. I am not as productive at work because I am losing sleep over traumatic experiences of
a person I help.
_____ 9. I think I might have been affected by the traumatic stress of those I help.
_____ 10. I feel trapped by my job as a social worker.
_____ 11. Because of my helping, I have felt “on edge” about various things.
_____ 12. I like my work as a social worker.
_____ 13. I feel depressed because of the traumatic experiences of the people I help.
_____ 14. I feel as though I am experiencing the trauma of someone I have helped.
_____ 15. I have beliefs that sustain me.
_____ 16. I am pleased with how I am able to keep up with social work techniques and protocols.
_____ 17. I am the person I always wanted to be.
_____ 18. My work makes me feel satisfied.
_____ 19. I feel worn out because of my work as a social worker.
_____ 20. I have happy thoughts and feelings about those I help and how I could help them.
_____ 21. I feel overwhelmed because my case (work) load seems endless.
_____ 22. I believe I can make a difference through my work.
_____ 23. I avoid certain activities or situations because they remind me of frightening
experiences of the people I help.
_____ 24. I am proud of what I can do to help.
_____ 25. As a result of my helping, I have intrusive, frightening thoughts.
_____ 26. I feel “bogged down” by the system.
_____ 27. I have thoughts that I am a success as a social worker.
_____ 28. I can’t recall important parts of my work with trauma victims.
_____ 29. I am a very caring person.
_____ 30. I am happy that I chose to do this work.
(B. Hudnall Stamm, 2009. Professional Quality of Life: Compassion Satisfaction and Fatigue
Version 5 (ProQol).
123
Survey
Part III.
Instructions: Now, consider the strategies you utilize in coping with stressful, day-to-day
situations. Recall a stressful situation that occurred within the past month. Rate each coping
strategy by indicating whether you used it to cope with the stressful situation.
0 = Did not use,
1 = Used a little,
2 = Used a lot, 3 = Used a great deal.
_____ 1. I prayed that things would work themselves out.
_____ 2. I got a group of family or friends together to help with the problem.
_____ 3. I shared my feelings with a friend or family member.
_____ 4. I remembered what a parent (or other relative) once said about dealing with these kinds
of situations.
_____ 5. I tried to forget about the situation.
_____ 6. I went to church (or other religious meeting) to get help or support from the group.
_____ 7. I thought of all the struggles Black people have had to endure and it gave me strength to
deal with the situation.
_____ 8. To keep from dealing with the situation, I found other things to keep me busy.
_____ 9. I sought advice about how to handle the situation from an older person in my family or
community.
_____ 10. I read a scripture from the bible (or similar book) for comfort and/or guidance.
_____ 11. I asked for suggestions on how to deal with the situation during a meeting of my
organization or club.
_____ 12. I tried to convince myself that it was not that bad.
_____ 13. I asked someone to pray for me.
_____ 14. I spent more time than usual doing group activities.
_____ 15. I hoped that things would get better with time.
_____ 16. I read a passage from a daily meditation book.
_____ 17. I spent more time than usual doing more things with friends and family.
_____ 18. I tried to remove myself from the situation.
_____ 19. I sought out people I thought would make me laugh.
_____ 20. I got dressed up in my best clothing.
_____ 21. I asked for blessings from a spiritual or religious person.
_____ 22. I helped others with their problems.
_____ 23. I lit a candle for strength or guidance in dealing with the problem.
_____ 24. I sought emotional support from family and friends.
_____ 25. I burned incense for strength or guidance in dealing with the problem.
_____ 26. I attended a social event (dance, party, movie) to reduce stress caused by the situation.
_____ 27. I sung a song to myself to help reduce the stress.
_____ 28. I used a cross or other object for its special powers in dealing with the problem.
_____ 29. I found myself watching more comedy shows on television.
_____ 30. I left matter in God’s hands.
(Utsey, Adams, & Bolden. 2000. Africultural Coping Systems Inventory (AFCI).
124
APPENDIX D
Focus Group Interview
1. What was your personal motivation, influence, or inspiration for choosing the
social work profession?
2. What has been most helpful in preparing you for human service work with
vulnerable populations? Please explain.
3. What does being in a “helping profession” mean for you as an African American?
(Probe: Is there any cultural significance in choosing this type of career, e.g.,
tradition, obligation, etc?)
4. Of the vulnerable client populations you have worked with, with which
population/s have you experienced the work as most stressful and why?
5. Where do you see yourselves professionally—5, 10, and 15 years from now? Do
you plan to remain in the same type of position you are in at your present job or
internship today? Why or why not?
6. When do you feel MOST productive on your job or internship?
7. When do you feel MOST effective with a client?
8. In what ways do you feel valued and rewarded on your job or internship?
9. If you could improve the experiences you have at your workplace or internship,
what would you most want to change?
10. What types of power and autonomy do you experience in your career or field
placement, and how clear are you about your specific roles?
125
11. How has the work that you do with your clients affected you personally—(Probe:
1) your personal thoughts and emotions, 2) self-perception—personally and
professionally, 3) relationships, and 4) observations of clients and others, 5) the
world, and 6) life in general?)
12. What types of experiences do you feel your social work education has prepared
you LEAST for? (Probe: To what extent have you received education and training
regarding work-related risk factors for human service professionals?
13. Recall the stressful event you reflected on to complete the “Coping” section of the
research survey, or another stressful event you may have experienced since
completing the survey. This event can be a life or work-related event. If you feel
comfortable in doing so, provide a brief description of the stressful event and the
specific method of coping you utilized to get through or rise above it.
14. Do you feel you experience any unique stressors as African American social
workers and MSW students? (Probe: Have you ever experienced racism or
discrimination in the workplace by clients or other professionals within or outside
of your agency? If so, in what way has the experience impacted you as a
professional or as a student?)
15. Have you ever felt that unique expectations were placed upon you at the
workplace or internship as a result of your African American ethnicity? Please
explain.
126
16. In what ways do you feel African American social workers or MSW students may
be more or less vulnerable to burnout and vicarious trauma than other social
workers or students of a different ethnic background?
17. African Americans, in general, are known to be at greater risk for certain health
challenges than other racial groups. Social work is known as a stressful
occupation that is mentally and emotionally challenging due to the many demands
placed on social workers and their involvement with difficult client behaviors or
challenges. What supports do you feel are necessary to African American social
workers and MSW students to prevent further health and job-related risks?
18. In the field of Social Work, students and professionals are often reminded of the
importance of personal boundaries and “taking care” of oneself. 1) In what ways
do you practice professional boundaries with clients and within your agencies?
And 2) what favorable resources do you 1) most utilize now, and 2) plan to utilize
in the future, to maintain your sense of wellbeing?
19. In what ways, if any, do you believe your cultural experience as an African
American impacts the work to be done with your clients—whether African
American, other minority, or White?
20. As an African American social worker or MSW student, what specific strengths
do you believe you bring to your work with vulnerable clients?
127
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