Saturday, 15 January 2005 - 8:00 AM

This presentation is part of: The Difficulty of Disclosure: Issues Related to Disclosing Trauma, Abuse and Victimization

Trauma and Disclosure in Emergency Responders

Purpose: It is now recognized that rescue workers who are exposed to mutilated bodies, mass destruction and life threatening situations may become hidden victims of disaster. Symptoms described in the research literature include recurrent dreams, feelings of detachment, dissociation, anger, irritability, depression, memory or concentration impairment, somatic disturbances, alcohol and substance use and re-experiencing of symptoms when exposed to trauma stimuli (McFarlane & Yehuda, 1996; Regehr & Bober, 2004). Of the multiple factors which influence severity and duration of symptoms, support from within the emergency service organization has repeatedly been shown to be highly predictive (Leffler and Dembert, 1998; Weiss et al., 1995; Marmar, et al, 1999). Yet the culture of emergency organizations frequently does not encourage the disclosure of trauma response.

Method: This paper presents the results of a mixed method study examining trauma response among emergency responders, organizational supports and the influence of organizational culture on disclosure and support seeking. 208 police officers, paramedics and firefighters completed quantitative surveys identifying trauma exposure, level of traumatic stress and depression symptoms and social supports. A subsample of 48 emergency responders participated in indepth interviews further probing their trauma experiences, social supports within the emergency organization and organizational culture factors that encouraged or discouraged trauma disclosure. Triangulation of the data sources and member checking with emergency responders throughout the process of research development and data analysis increased the reliability and validity of results.

Results: While results varied between types of service, consistent with the findings of other studies, levels of trauma exposure and traumatic stress symptoms were high among these emergency responders (Alexander & Klein, 2001; Galea, et al, 2002). Perceived social support from the organization in terms of colleagues, management and union, was significantly associated with traumatic stress and depression scores. Of particular concern was the finding that perceived levels of social support diminished and symptom levels increased with years of service. Qualitative findings revealed that while changes have occurred within emergency organizations in recent years, nevertheless, traumatic response was not generally accepted and disclosure was not encouraged by management or colleagues. Those who expressed distress were often ostracized and viewed as not suitable for the job. While the experience was not universal, lack of organizational support was experienced as a major disappointment, stressor and concern for many of those participating in the qualitative component.

Implications for Policy and Practice: In recent years social workers and other mental health practitioners have been engaged in the development and application of group based and individual treatments to address the impact of workplace trauma. The findings of this study would suggest that without organizationally based interventions aimed at creating a healthier workplace environment that is supportive of workers in distress, the value of individual and group interventions will be compromised.

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