Societies rely on first responders to save lives. What happens when the wellbeing of these crisis workers is compromised by daily exposure to crisis and trauma? This chapter describes a developed and tested arts-based intervention aimed at mitigating the trauma response through positive resource reinforcement. Specifically designed to be used in a non-clinical setting, the intervention features the drawing of a mandala capturing images and symbols of safety and was tested to ascertain the efficacy of its ability to increase positive affect, decrease negative affect, and reinforce connections to positive resources in participants.
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Emergency and crisis workers are our everyday heroes. They pull out us out of our darkest, scariest moments. We owe them depths of gratitude. Yet what happens when pieces of that dark and scary moment stay with these heroes? Not a day goes by that professional and volunteer crisis workers do not respond to a traumatizing event. While crisis workers are trained and prepared for the highly charged environment of emergency response, exposure to the events has significant impact on emotional and psychological well-being. Many suggestions of self-care activities are offered, but rarely do these provide immediate relief from the burgeoning emotions experienced during the event. Cumulative exposure and layering of empathetic response to traumatic events lead crisis workers to form maladaptive coping mechanisms, advancing the natural stress response to deepen into a disrupted belief system and vicarious trauma. Symptoms of vicarious trauma echo those of post-traumatic stress disorder (PTSD), having the potential to render crisis workers ineffective in their duties and creating one more victim of the disaster. By developing an arts based method for preventing vicarious trauma, this study seeks to add to the existing body of literature and best practices related to trauma disorder prevention.
Common to all groups of first responders is that, following a traumatic event, they will be among the first present at trauma sites and often the very first to attend to the victims. A look at the literature, however, shows that the first responder group as a whole is much less studied than victims of the same events that they attend. (Kleim & Westphal, 2011, p. 17)
Statistics specifically related to vicarious trauma in crisis workers are not readily available. Instead, the literature provides statistics on PTSD symptoms in crisis workers. It is unclear though, whether these symptoms are the result of direct exposure to the trauma experience or interaction with the trauma victims and aftermath of the crisis. As the symptoms of vicarious trauma and PTSD present similarly, statistics on PTSD in crisis workers may still provide insight into the depth of the problem and validation for further research.
Research examining symptoms of posttraumatic stress disorder (PTSD) in Chinese crisis workers found significantly higher rates of burnout and PTSD symptoms in the crisis workers than in nonclinical professions. Among these crisis workers exposed to traumatic events, 26% of the research participants demonstrated symptoms of PTSD. (Shakespeare-Finch, 2011) A specific study on Australian firefighters found 7% with severe levels of PTSD and an overwhelming 68% with moderate levels. Twenty-one percent (21%) of Japanese crisis workers reported with symptoms of PTSD due to their work following earthquakes, typhoons, and volcano eruptions (Kleim & Westphal, 2011). New Zealand studies found that 30% of paramedics and 46% of police officers exhibited moderate to high levels of PTSD symptoms (Regehr, 2001). The most recent study in the United States (US) indicates that of the 84% who have experienced a traumatic event, 34% go on to be diagnosed with a mental health disorder. Ten percent (10%) of US crisis workers are diagnosed with PTSD. While significantly lower than other countries, many cite negative repercussions in the workplace as a reason to avoid diagnosis and treatment (University of Phoenix, 2017).
Despite these alarming statistics, a larger volume of literature about emotional and psychological responses to trauma is written about the primary victim. Emotional and psychological impairments in crisis workers correlate to high personal and public costs. Maladaptive coping mechanisms adversely affect the ability to serve trauma victims. Considering the pervasiveness of emotional and psychological impairments in crisis workers, it is of critical importance to develop interventions based on an understanding of the risks that contribute to stress reactions and traumatic disorders (Kleim & Westphal, 2011, p. 21).