vicarious trauma aaron heffernan lcsw toni rivera-joachin bs, msbm © children’s hospital of...

Vicarious Trauma

Aaron Heffernan LCSW

Toni Rivera-Joachin BS, MSBM

© Children’s Hospital of Wisconsin. All rights reserved.

Objectives• Understand trauma

• Learn the signs and symptoms of vicarious trauma

• Identify strategies for self-care to prevent vicarious trauma and burnout

• Share Hip Hop Therapy as a way to build resilience.


Project Ujima• Project Ujima is a nationally

recognized community program of Children’s Hospital of WI—Community Services that serves youth and adult victims of crime and interpersonal violence

• “UJIMA” is the 3rd principle of Kwanzaa meaning “collective work and responsibility” used to create the tag line “working together to make things right”

• Longest and most comprehensive program of it’s type in the US


What is Trauma?

• A stressful experience or event that shatters a person’s sense of security leaves a person feeling vulnerable and helpless

• Can be physical, emotional and psychological


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Can you recognize a “traumatized” individual?


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Adverse Childhood Experiences (ACE) Study

• The ACE Score is used to assess the total amount of stress during childhood and has demonstrated that as the number of ACE increase, the risk for health conditions increases exponentially.

• 17,000 children medically followed into adulthood to measure exposure to adverse childhood experiences and traumatic stressors.

• The short- and long-term outcomes of these childhood exposures include a multitude of health and social problems


Sample ACE Questions• Were your parents ever divorced or separated?• Did an adult or person 5 years older than you touch

your body in a sexual way?• Did a family member go to prison?• Did a parent/adult make you afraid that you may be

physically hurt?• Did you often feel that no one loved you or you were

not special?• Did you often feel like you didn’t have enough food to

eat, had to wear dirty clothes and had no one to protect you?


Some of the conditions...

• Alcoholism and alcohol abuse

• Chronic obstructive pulmonary disease (COPD)

• Depression

• Fetal death

• Health-related quality of life

• Illicit drug use

• Ischemic heart disease (IHD)

• Liver disease © Children’s Hospital of Wisconsin. All rights reserved.

Some of the conditions...

• Risk for intimate partner violence

• Multiple sexual partners

• Sexually transmitted diseases (STDs)

• Smoking

• Suicide attempts

• Unintended pregnancies

• Early initiation of smoking

• Early initiation of sexual activity

• Adolescent pregnancy © Children’s Hospital of Wisconsin. All rights reserved.

Key Findings.....

Almost two-thirds of ACE study participants reported at least one ACE, and more than one of five reported three or more ACE.

What does this mean?


Implications?• Almost everyone experiences trauma and/or

adverse childhood experiences.

• Research identified that the body does “withhold” trauma

• No everyone will exhibit negative consequences of trauma.

• Most people who are in helping professions usually are working through their personal trauma history by supporting others.


What does trauma look like in violently injured youth?

• Poor school performance• Disinterest in regular activities• Nightmares, flashbacks or day dreaming• Aggressive or withdrawn• Exaggerated violent behavior• Hypervigliance/Paranoia• Poor self-esteem and self concept

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How to support traumatized people

• Approach with genuine respect, patience• Understand that they will move at their own pace

on their road to recovery• Normalize the distress they feel• Give them the sign they should look for so they can

identify when they need additional assistance• Create a safety plan• Teach coping strategies• Encourage them to return to normal routines• Give positive experiences so they will seek help in

the future© Children’s Hospital of Wisconsin. All rights reserved.

Ways to provide support when someone is crisis

• Emotional support: comments that support and encourage someone’s ideas

• Advice: direct, specific suggestions, direction on what to do

• Guidance: offer different point of view or different way of thinking about a problem or experience


What happens to people who work with traumatized

people over time?


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What is vicarious trauma?

Vicarious trauma is the process of change that happens because

you care about other people who have been hurt, and feel

committed or responsible to help them. Over time this process can

lead to changes in your psychological, physical, and

spiritual well-being.

Heddington Institute


President Obama after Newtown shooting

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What is vicarious trauma?

• Manifests differently in each person—we all process emotions differently

• Effects intensify with repeated interactions overtime

• Can be pervasive—effects various parts of an individuals life including their emotions, relationships and how they see the world


Signs of vicarious trauma

• Feeling vulnerable

• Distrust

• Changed view of the world

• Changes in eating, sleeping, activity level, interactions with others

• Hypervigliance and/or paranoia © Children’s Hospital of Wisconsin. All rights reserved.

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How to prevent vicarious trauma

• Awareness and self reflection

• Create and maintain a work life balance

• Build meaningful connections with colleagues to debrief feelings and experiences

• Identify personal boundaries

• Practice self-care techniques© Children’s Hospital of Wisconsin. All rights reserved.

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Self-care examples

• Hobbies and/or special interests

• Taking time for self

• Relaxation techniques: massage, meditation, deep breathing

• Establishing firm boundaries

• “Turn-off” when not working


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Activity: Your turn....

There is a “Self Care Plan” at your table.

Take a few moments and reflect on ways to spend time on you!

Anyone want to share?


Key Takeaways

• It is important to be aware of the challenges of working with traumatized individuals

• Working with traumatized individuals for a long time, can have affects on your health

• Important to understand your boundaries so you can identify when you are on “burn-out”

• Identify your self care practices


Project Ujima“Working together to make things right”

Contact Information:Toni K. Rivera-Joachin, MSBM

Project Ujima Manager

414-292-4006

Email: [email protected]

www.projectujima.org

Referral Line: 414-266-2557

vicarious trauma aaron heffernan lcsw toni rivera-joachin bs, msbm © children’s hospital of...

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