Rape Crisis Counseling: Trauma Contagion and Supervision

Background: Helpers, who repeatedly hear survivors’ stories, may suffer the transfer of trauma symptoms from the traumatized and come to evidence similar PTSD symptoms called secondary traumatic stress disorder (McCann & Pearlman, 1990). These symptoms include recollection of trauma events, re-experiencing, detachment, difficulties in concentrating and sleeping (Figley, 1995). Rape crisis centers in Israel provide assistance to victims via 24/7 hot line calls, meetings and accompanying through medical, psychological, and legal procedures. Staff are trained for three months before starting their position. Staff helping rape survivors can be emotionally overwhelmed and at risk of trauma-transmission, effecting their personal lives negatively or positively (Zoellner & Maerker, 2006). Therefore, rape centers support their staff with professional supervision. 

Purpose: The study evaluates two hypotheses:

1. Increased staff exposure to victims’ trauma will be associated with increased supervision necessary to combat the potential secondary traumatizing effects of the helping effort. 

2. Supervision will mediate the negative effects of secondary traumatization, reducing its impact.

Methods: 106 staffers-women in seven of nine rape crisis centers in Israel completed anonymous questionnaires documenting their work and trauma experiences. Trauma-exposure was defined by staff’s number of victim-contact hours and their assessment of the traumas-severity they heard; supervision was assessed by the number of hours they received. In addition, participants responded to questions on related to potential secondary traumatization assessed by the degree of sexual intimacy experienced in their relationships (Hershlag, 1984), and their Secondary Trauma Scale (Motta e al., 2004) scores. Both measures are commonly used and validated in Hebrew. Four potential non-job confounders were also assessed: personal abuse history, education, anger management skill, and posttraumatic growth--as most staff had previously experienced some form of trauma.

Data were analyzed using univariate descriptive statistics. Hypotheses were evaluated in fully recursive path analyses via OLS regression where supervision time was regressed on client-exposure-time, severity-of-exposure and the four confounders. The staff-secondary trauma criteria were then regressed on all these variables including supervision time.

Results:Participants’ mean age was 43.4 years; 58% were married, 26% single, 13% divorced; and 3% widowed. 81% had a college degree or more. 18.9% reported being exposed to victims-trauma at a minimal level, 54.7% moderate and 26.4% extreme. 43.4% were abused at some time in their lives.  

All path equations were significant. After taking confounding variables into account, job exposure to victims’ trauma was significantly associated with increases in supervision time    (b=.34, p=.002). Supervision time fully mediated the relationship between duration of exposure to victims’ trauma and staff’s secondary trauma reports such that increased supervision was associated with degrading sexual intimacy ( b= -.47; p=.032) and increased Secondary Trauma Scale scores (b=6.16; p=.004) after taking into account staff’s education level, history of abuse, anger management skill, and posttraumatic growth scores.

Conclusions and Implications for Practice: The study results raise concern about staffer mental health in that the supervision effect exacerbated the secondary trauma impacts. The study suggests a need for documenting the nature of the supervision and considering different types of supervision methods.