A Scoping Review of Vicarious Trauma Training for Service Providers Working with People Who Have Experienced Traumatic Events

Background & Purpose
The term vicarious trauma (VT), which may be known as compassion fatigue or secondary trauma, refers to significant, indirect experiences of distress resulting from empathic engagement with clients who experienced traumatic events. Thus, social workers who aid traumatized individuals may experience VT. In turn, VT can impair service quality and social workers’ personal mental health. Although effective VT training for social workers may aid in preventing VT, little information is available concerning the development and implementation of VT trainings for service providers from any profession, including social work. To help advance evidence development in this area, we reviewed existing interventions aimed at addressing VT among service providers who work with traumatized clients.

Method
Given the heterogeneity and limited nature of existing studies, we undertook a scoping review (Arksey & O’Malley, 2005). Searches of electronic databases were conducted to identify studies published in peer-reviewed journals, with no date restrictions. Three independent reviewers screened articles. Over 1,315 citations were reviewed, and 157 full-text reports were reviewed. During the full-text screening, 138 articles were excluded as they were not intervention studies, were non-empirical studies, and/or did not address VT directly.

Results
A total of 27 studies were included in the review. The majority of studies were conducted with health care professionals in medical settings (n=17) in the U.S. (n=16). VT interventions were delivered as psychoeducational programs (n=14), mindfulness-focused programs (n=8), and other types of programs such as recreational activities (n=5). Only one study used a randomized design, while other studies applied quasi-experimental designs (n=15) and non-experimental designs such as qualitative studies (n=6). Most studies (n=14) measured compassion fatigue as a key outcome using three subconstructs: 1) compassion satisfaction, 2) burnout, and 3) secondary traumatic stress (i.e., using the Professional Quality of Life scale). While overall study outcomes trended positively, findings were also mixed.

Conclusions and Implications
This review determined that VT interventions have been mainly implemented in health care settings with health care professionals. Considering that service providers, including social workers, in violence and trauma service settings may also experience high rates of VT, increased attention should be given to interventions for service providers in diverse settings, and especially those that serve violence victims (e.g., in domestic violence shelters, rape crisis centers). Notably, the majority of programs reviewed had similar approaches, including education and awareness of VT and a focus on coping strategies (e.g., mindfulness practice). However, the nature of VT experienced by service providers might differ depending on the service setting (e.g., palliative care or domestic violence programs). Accordingly, future research should consider tailored strategies for different VT types. Although our review found some promise in VT training, most studies involved short sessions, were designed as non-randomized control trials, and used brief follow-up assessments. Thus, our review underscores the need for social work researchers to lead the development and testing of VT interventions using rigorous research designs, aimed at a diverse groups of service providers, and based on the identification of unique VT experiences across service settings.