As you know, as a therapist you are ethically mandated to ensure that you
take measures to care for yourself. However, as you will see, the therapist care
of self can be quite enmeshed between client issues and agency policies and procedures.
I know some will not agree with my actions and assessment of the situation, but
I feel it beneficial, for the purposes of this article, to provide an accurate
description of my perceptions at the time.
Ive been the sole batterers
intervention counselor at my agency (covering two counties) for over four years.
Many events have led up to the insidious appearance of what I now know is Vicarious
Trauma. I had all the symptoms and was taking numerous medications to try and
cope with what I thought was the result of something inherently wrong with me.
I battled feelings of shame, doubt, and intermittent suicidal wishes.
Determine What Can Be Done
Being a therapist teaching men to take
responsibility for their violence, I didnt want to blame anyone.
Yet, I saw where changes could be made once I started looking into the phenomenon
and continually ran into information regarding the types of environments that
are conducive to the development of this disorder. Not only did I need to change
some things personally, but also I needed some changes from my employer. So, I
wrote a professional and detailed letter explaining the vicarious trauma symptoms
I was experiencing. My letter noted the research supporting vicarious trauma as
a real phenomenon. I attached documentation of both prevention and intervention
actions an organization can take to address the very real occurrence of Vicarious
Trauma among employees in the helping professions.
From my research I
discovered several solutions to vicarious trauma. These solutions included: flexible
schedules, adequate pay and leave, support of professional development, availability
of non-trauma related work and supervision that is collaborative and not authoritarian.
The most hurtful aspect of this situation is that I asked for help, but my request
was only met with what I felt was judgment and blame by supervision. I expressed
a desire for the letter to open a line of communication aimed at problem solving.
Unfortunately, my supervisor became deeply offended by the truth and responded
punitively. Does this sound familiar to you? On a scale of 1-10, how would you
rate the support you currently receive from supervision?
Experiencing Both Victim and Perpetrator Trauma
In my employers
written response to my plea for help she stated, If you were doing your
job right you wouldnt be having these symptoms. She further stated
that because I work with the men who cause the trauma I am not exposed
to trauma and therefore my problems couldnt possibly be related to my job.
I explained to her that, in my opinion, I listen to more trauma than the victims
counselor. I talk to both the victims and perpetrators. I contact victims to get
a history of abuse; they call me when hes re-offended or theyre afraid
he will; and they call to check on progress and sometimes go into details about
the abuse history again. In addition, I contact victims randomly to see if theres
any continued abuse. More significant than this, however, is that these men, of
course, were not born to batter! In my experience, most of them have endured horrific
abuse and abandonment or witnessed such. As you know, they batter for power and
control, yes. But on a deeper level, they batter to obtain love. Through
my years on the job, I have accumulated many hours of listening to these accounts.
I explained to my supervisor that in order to empathize with a person I believe
I have to feel what they feel. She wanted to know why these trauma
symptoms didnt happen sooner if thats the case. I explained that its
probably due to the fact that 80% of my clients at that time were court ordered
after abusing a child. When I told my supervisor I had a three- and a half-year-old
son, I was told that the problem was I just didnt have good enough boundaries.
My employer simply refused to accept that my experience of vicarious trauma was
occurring and was valid.
Repercussion of Vicarious Trauma Reporting
My trauma became worse during the meeting wherein my employer gave
me her written reply and an official review that contained the information I just
described. She informed me that I was now on probation because of an event that
had happened the previous day. I felt that my claims of experiencing vicarious
trauma had caused my boss to treat me differently and unfairly.
are the events that happened on the previous day. One of my clients (who as a
child had been kidnapped at the age of three, kept from his mother for a month,
probably molested, injected with drugs, and experienced severe corporal punishment)
and his wife had a violent fight. They filed protective orders against one another.
When they came in to see me, they were in the process of dismissing these POs
and desperately wanted help. I felt strongly that he needed immediate psychiatric
intervention. He asked me to explain to his wife the what, where, how, when and
why because he was confused and a bit disoriented. I asked her if she wanted to
come in, if she felt safe, and she was adamant that she did. Because I allowed
these individuals to violate a protective order I was written up; however, both
my supervisor and I had violated a protective order in the past.
the meeting, my supervisor demanded to see certain files. One of the files requested
involved a victim I had been treating for two years. Even though I deal with the
batterer, I treated the victim due to a case overload of the victims counselor.
The victim is now 19, the primary abuser is her mother, and at this time she was
four months pregnant. The file was incomplete, I had not kept up on the charting,
and due to the extreme mistrustfulness of the client, I didnt keep extensive
notes. The point being
I also was written up for incomplete files. Sadly
I was ordered to terminate her as a client or to transfer her to the victims
counselor. This was in direct violation of my ethical standards to not abandon
my clients. I was told to never talk to any victim. My supervisor then informed
me that I would no longer be able to make up any time on the weekends, that if
I could not get my forty hours in per week I would not only have my pay docked,
but I would be reduced to part-time status, lose all my benefits, and not have
an opportunity to become full-time again.
I was completely devastated by my employers lack of understanding, could
not stop crying. I was hyperventilating, and just wanted to go home and recover.
She stated that if I left I would not have a job, that I needed to just go and
put some cold water on my face. Even now as I recall these events I become nauseous.
My response to my employer followed the course of Stockholm Syndrome in that the
next day I came in apologizing for hurting her feelings, thanking her for helping
me, and apologizing for being so awful at my job. My employer had also suggested
that perhaps I shouldnt be a therapist because of my claims of trauma.
There were a few things that my employer did which made
a significant difference. There were things that I did that also helped. In response
to my letter, she agreed to hire a part-time male counselor to co-facilitate the
treatment groups and provide an opportunity to case-manage with a peer. Another
action taken by my employer was to bring in a special guest speaker to the following
staff meeting (held once per month). The guest speaker volunteered on a regular
basis at the numerous fund-raising activities and she is a licensed spiritual
counselor and Riki practitioner. She came and talked about stress management.
The speakers focus was on aromatherapy, massage therapy, and meditation.
Her spiritual practices are similar to my own and the workshop she facilitated
reconnected me to this valuable aspect of self-care.
I believe my supervisor
was at least willing to accept that the working environment was stressful. My
employer also followed through with hiring a very competent, amiable, laid-back,
and experienced therapist to co-facilitate my treatment groups. At this point
my anxiety and intrusive thought symptoms had become so bad that I was unable
to confront the men in these groups. Luckily most of them had been there so long
they knew how I would normally have responded. So when I would just shake my head
at some victim blaming or sexist remark, one group member would inevitably verbalize
my non-verbal communication accurately, or one would say, Youre gonna
let him get away with saying that?!
Also, once I had a co-facilitator
I felt safe. Up until this point also I was leaving the building by myself at
night in a rural community with no lighting. I began having mild panic attacks
at this point because I was certain that the odds were against me; I had never
been accosted, but I felt it was only a matter of time given the number of men
I tended to alienate on a daily basis. Having that other person to share the charting
with after each group has also allowed me to stay on top of client records. In
addition, being able to case-manage each client has allowed me to feel more confident
in the decisions I make, and less vulnerable to complaints or allegations of inappropriate
Sources of Prevention to Prevent Trauma for the Worker
Actions that I took that helped me regain a sense of sanity included returning
to a spiritual foundation. Nothing radical, I simply began replacing negative
and self-defeating thoughts with thoughts of faith. I began to choose on a daily
basis to detach emotionally from the abuse of my boss and focus on my belief that
God always has, and always will, provide. I set new priorities. I stopped stressing
over being on time and started enjoying my son and patiently helping him to make
the right choices, even if that meant I would be late. I began dreaming about
what to do instead of work at the agency and became excited knowing that I CAN
do other things. I may not play the political games of social service work very
well, but I know that I am an excellent therapist, conduct excellent psychological
evaluations, and I am loyal (perhaps to a fault). I try to do the right thing,
even if its not the PC thing.
Ultimately I had to really practice
what I preach; that is, I had to accept that the only thing I have control over
is me, my thoughts, my beliefs, and my actions. Most importantly, I had to realize
that I am not trapped. I can leave, I can find a new job or start my own practice,
and I can take care of myself as a priority. The ironic reality is that as a therapist
I am ethically mandated to ensure that I take measures to care for myself first
and foremost; however, the working environment sends the message that I can only
do so on my employers terms and if I cant complete the self-care outside
of the walls placed around me, then Im out of luck. Its not their
problem. Ive learned that my best protection against vicarious trauma is
to not let others invalidate me, to not buy into the belief that you keep your
job at all costs [even over your family and health], and to remember what truly
---Danielle Balletto, LPC, LBP A licensed professional counselor
(LPC) and a licensed behavioral practitioner (LBP) in the State of Oklahoma. A
graduate of The University of Tulsa. Graduated Magna Cum Laude with a Bachelors
in 1996 and graduated with a Masters in Clinical Psychology in 1998. Batterers
counselor working with offenders and severely mentally ill for eleven years. Currently
working on a Doctorate in Criminal Justice through Capella University.
Reflection Exercise #4
The preceding section was about the vicarious
trauma that can result from working with batterers. Write three case study examples
regarding how you might use the content of this section in your practice.
Peer-Reviewed Journal Article References:
DelTosta, J. E., Ellis, M. V., & McNamara, M. L. (2019). Trainee vicarious traumatization: Examining supervisory working alliance and trainee empathy. Training and Education in Professional Psychology, 13(4), 300–306.
Nissen-Lie, H. A., Orlinsky, D. E., & Rønnestad, M. H. (2021). The emotionally burdened psychotherapist: Personal and situational risk factors. Professional Psychology: Research and Practice.
Sprang, G., Ford, J., Kerig, P., & Bride, B. (2019). Defining secondary traumatic stress and developing targeted assessments and interventions: Lessons learned from research and leading experts. Traumatology, 25(2), 72–81.
Online Continuing Education QUESTION
What solutions did Balletto provide for vicarious trauma? Record the
letter of the correct answer the .