University of Sheffield, Sheffield, UK.
University of Nottingham, Nottingham, UK.
Clin Psychol Psychother. 2017 Sep;24(5):1059-1068. doi: 10.1002/cpp.2068. Epub 2017 Jan 25.
The study investigated the relationship between exposure to trauma work and well-being (general psychological distress, trauma symptoms, and disrupted beliefs) in trainee clinical psychologists. It also assessed the contribution of individual and situational factors to well-being.
A Web-based survey was employed.
The survey comprised the General Health Questionnaire, Secondary Traumatic Stress Scale, Trauma and Attachment Belief Scale, Trauma Screening Questionnaire, and specific questions about exposure to trauma work and other individual and situational factors. The link to the online survey was sent via email to trainee clinical psychologists attending courses throughout the UK RESULTS: Five hundred sixty-four trainee clinical psychologists participated. Most trainees had a caseload of one to two trauma cases in the previous 6 months; the most common trauma being sexual abuse. Exposure to trauma work was not related to general psychological distress or disrupted beliefs but was a significant predictor of trauma symptoms. Situational factors contributed to the variance in trauma symptoms; level of stress of clinical work and quality of trauma training were significant predictors of trauma symptoms. Individual and situational factors were also found to be significant predictors of general psychological distress and disrupted beliefs.
This study provides support for secondary traumatic stress but lacks evidence to support belief changes in vicarious traumatization or a relationship between exposure to trauma work and general psychological distress. The measurement and validity of vicarious traumatization is discussed along with clinical, theoretical implications, and suggestions for future research.
Secondary traumatic stress is a potential risk for trainee clinical psychologists. Training courses should (a) focus on quality of trauma training as it may be protective; (b) advocate coping strategies to reduce stress of clinical work, as the level of stress of clinical work may contribute to trauma symptoms.
Exposure to trauma work only uniquely explained a small proportion of variance in trauma symptoms. The study was cross-sectional in nature therefore cannot imply causality.
本研究调查了创伤工作暴露与受训临床心理学家的幸福感（一般心理困扰、创伤症状和信念紊乱）之间的关系。它还评估了个体和情境因素对幸福感的贡献。
采用基于网络的调查。
该调查包括一般健康问卷、二次创伤应激量表、创伤和依恋信念量表、创伤筛查问卷，以及关于创伤工作暴露和其他个体和情境因素的具体问题。通过电子邮件向参加英国各地课程的受训临床心理学家发送了在线调查的链接。
564 名受训临床心理学家参与了研究。大多数受训者在过去 6 个月中只有 1-2 例创伤案例；最常见的创伤是性虐待。创伤工作暴露与一般心理困扰或信念紊乱无关，但却是创伤症状的重要预测因素。情境因素对创伤症状的变化有贡献；临床工作压力水平和创伤培训质量是创伤症状的重要预测因素。个体和情境因素也被发现是一般心理困扰和信念紊乱的重要预测因素。
本研究为二次创伤应激提供了支持，但缺乏证据支持替代性创伤中的信念变化或创伤工作暴露与一般心理困扰之间的关系。还讨论了替代性创伤的测量和有效性，以及临床、理论意义，并提出了未来研究的建议。
二次创伤应激是受训临床心理学家的潜在风险。培训课程应（a）关注创伤培训的质量，因为它可能具有保护作用；（b）倡导应对策略以减轻临床工作压力，因为临床工作压力水平可能会导致创伤症状。
创伤工作暴露仅能独特地解释创伤症状变异的一小部分。该研究是横断面的，因此不能暗示因果关系。
