Vicarious trauma in therapists: a meta-ethnographic review

Background: Hearing about trauma can leave a mark on an individual, leading to a significant change in worldview that shatters their existing beliefs and is pervasive across view of self, other and the world. Individuals present with a range of symptoms that mimic post-traumatic stress disorder although the symptoms are less severe. Despite this, some individuals can experience growth through an enriched understanding of self and other. This altered perspective enables individuals to respond in ways that promote growth and positivity in their own lives. Aims: The aim of this review was to synthesise existing qualitative literature exploring how therapists experience working with trauma survivors. Method: A systematic literature search found 16 studies which were selected for review following the application of inclusion/exclusion criteria and quality appraisal. Noblit and Hare's (1988) approach to meta-ethnography was followed. Results: The themes identified outline a cognitive model of vicarious trauma whereby therapists presented with cognitive, emotional, physiological and behavioural 'symptoms' due to marked changes in schemata following repeated exposure to trauma. The literature suggests that therapists experience growth and development alongside vicarious trauma through witnessing clients' resilience and growth. Conclusion: This meta-ethnographic review suggests that the impact of working with trauma is profound and complex for therapists bearing witness to their client's pain and concurrently, their growth.