Vicarious Post-Traumatic Growth Among Service Providers Working with Syrian Refugees in Istanbul, Turkey

Background and Purpose: Turkey continues to host the world’s largest number of Syrian refugees at over 3.6 million registered individuals. Service providers working with these refugees often hear stories of trauma and despair. Although a psychological “cost of caring” has been associated with the cumulative engagement with traumatized individuals, vicarious posttraumatic growth (VPTG) – or positive growth – has also been reported. VPTG is the psychological growth among service providers who work with traumatized individuals, where increased levels of sensitivity, compassion, insight, tolerance, empathy, and spirituality have been reported.

To contribute to literature in this understudied area, we examined: the 1) frequency of traumas disclosed to a sample of service providers working with Syrian refugees; 2) the prevalence of moderate/high VPTG (and the five VPTG subscales) among service providers; and 3) predictors associated with VPTG.

Methods: We recruited a sample of 104 service providers from agencies that provided psychosocial services to Syrian refugees throughout Istanbul, Turkey. Participants were recruited on a rolling basis to generate a convenience sample. VPTG was measured through a modified version of the Post Traumatic Growth Inventory (PTGI). We employed multivariable regression analysis to assess associations between years of experience in profession, being a direct or indirect service provider, organizational support, supervision frequency, perceived social support (from friends, family, and significant others), and VPTG.

Results: Service providers ranged from 20 to 47 years, with a mean age of 29 years (SD=5). Half (50%) were male and half were female. Almost half (48.1%) reported that the majority of their clients disclosed traumatic experiences to them, with war/terrorism/political violence (77.9%), traumatic grief/separation (65.4%), and serious accident/illness (62.5%) being the most frequent traumas disclosed. Almost half (48.5%) of service providers presented with moderate/high levels of VPTG, with moderate/high growth reported among the five VPTG subscales: Appreciation for Life (64.4%); Personal Strength (59.6%); New Possibilities (56.7%); Spiritual Change (46.2%); and Relating to Others (35.0%).

Service providers with higher levels of perceived organizational support (aOR:1.08, 95% CI:1.00,1.16) and higher levels of perceived social support (aOR:1.05, 95% CI:1.01,1.10) were associated with a greater likelihood of moderate/high VPTG. We did not find any significant multivariable associations between years of experience in profession, being a direct or indirect service provider, supervision frequency, and VPTG.

Conclusions and Implications: Despite the frequency of traumatic experiences disclosed by Syrian refugees, the prevalence of VPTG highlights that service providers can make meaning and positive growth by working with traumatized individuals. The prevalence of VPTG does not indicate the absence of negative consequences (i.e., vicarious traumatic stress and secondary traumatic stress) but suggests that service providers may experience both positive and negative consequences by working with traumatized individuals. In addition to the wellbeing of the refugees, a focus on the wellbeing of service providers is needed during humanitarian crises. Organizations may benefit from enhancing institutional support and highlighting the importance of social support in fostering VPTG amongst service providers.