Saturday, 15 January 2005 - 2:00 PM

This presentation is part of: Workforce Issues in Social Work

Exploring Vicarious Traumatization in Oncology Health Professionals

Cancer has profound physical and psychosocial effects upon persons living with cancer and upon their families. Social workers, nurses, and oncologists each play a different but important role in helping cancer patients and their families bear the burden of the experience of a life-threatening illness. As a result of the high level of emotional intensity involved in working with those who have cancer, social workers, nurses, and doctors are seen to be at risk for experiencing “vicarious traumatization,” also called compassion fatigue and secondary traumatic stress. Vicarious traumatization, a concept borrowed from the trauma literature, is a process by which a clinician experiences alterations in her/his personal and professional life as a result of empathic connection with trauma survivors. The concept of vicarious traumatization provides a systematic way of exploring, defining, and describing the deleterious effects on the clinician that result from working with persons experiencing trauma. Although there is good reason to believe that the concept of vicarious traumatization can be applied to those working with cancer patients and their families, the scant empirical research that has looked at this has not necessarily demonstrated this to be the case. So, what possible explanations can there be for this perplexing phenomenon?

This exploratory, cross-sectional study of oncology social workers, physicians, and nurses, and utilizes both quantitative and qualitative measures. Quantitative research methods were used to enhance the understanding of vicarious traumatization in oncology work in the aggregate. 187 social workers, doctors and nurses responded to a survey about their work with oncology patients, including their emotional reaction to the work. In-depth, semi-structured interviews were conducted with 21 clinicians currently working in oncology (7 from each profession) to enhance the understanding of clinicians’ personal experiences of vicarious traumatization and, more generally, of working in oncology. Additionally, 4 clinicians who left oncology work (one physician, one nurse, and two social workers) were interviewed to further enhance the depth of understanding of what it is like to work in oncology by understanding the factors that caused these clinicians to leave this work.

Interestingly, the results of the quantitative portion of this study support the empirical conclusions in the literature, i.e., that vicarious traumatization does not appear to occur in oncology health care professionals. On the other hand, the qualitative results present a much more complex picture of how professionals experience their work in oncology, including their varied vicarious experiences of trauma. Qualitative data suggest that although the nature of vicarious trauma is transient, it has occurred at some point in many of these professional’s oncology careers. Clinicians reported the following factors that help them to continue doing the emotionally intense work they do: working on a well-functioning team, the rewards of the work, formal coping mechanisms (generally provided at workplace), and informal coping mechanisms, which they engage in both at work and outside of work. Additionally, it is clear from this research that measures of vicarious trauma do not capture the longitudinal nature of clinicians' experiences of this phenomenon.

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