Winblad Neal E, Changaris Michael, Stein Phyllis K
Private Pracitce Truama and Developmental Trauma Specialist, Pleasanton, CA, United States.
Health Psychology Department, Integrated Health Psychology Training Program, The Wright Institute, Berkeley, CA, United States.
Front Neurosci. 2018 Feb 16;12:70. doi: 10.3389/fnins.2018.00070. eCollection 2018.
Individuals who treat trauma are at significant risk of vicarious traumatization and burnout. Somatic Experiencing® (SE®) is a resiliency-focused trauma treatment modality designed to address autonomic nervous system (ANS) dysregulation and its impacted physical health and mental health symptoms e.g., anxiety, depression, post-traumatic stress disorder, migraines, fibromyalgia, and chronic fatigue, etc. The SE® training supports the development of clinical skills to reduce physical health/mental health symptoms as well as increase clinician resilience. Individuals who display resilience often have increased experiences of well-being (quality of life) and decreased levels of self-reported psychological symptoms. Greater resilience could mitigate the risks to providers and the clients they treat. This within-groups, longitudinal study assessed students ( = 18) over the course of a 3-year SE® practitioner training. This training focuses on increased ANS, physical, and emotional regulation skills. The convenience of a web-based survey allowed for: measures of a general quality of life (WHOQOL-BREF), psychological symptoms, somatic, anxiety, and depressive symptoms (PHQ-SADS), as well as a measure of early life exposure to adversity (CDC/Kaiser Permanente ACE Score Calculator Questionnaire). The clinician survey was conducted yearly for 3 years. Future studies would do well to also include laboratory-based objective measures of ANS functioning. ANOVA with repeated measures showed that there were significant reductions in anxiety symptoms (GAD7, < 0.001) and somatization symptoms (PHQ15, < 0.001). Health-related quality of life (a measure of physical well-being) and social quality of life (a measure of interpersonal well-being) both increased significantly (Health QoL = 0.028; Social QoL = 0.046). Results suggest that professionals attending the 3-year SE® training course experience a significant improvement in self-reported measures associated with resiliency including: quality of life (well-being) and psychological symptoms (anxiety and somatization). Our results support the importance of future research in a larger sample and support the exploration, cross-sectionally and prospectively, of the relationship of clinician resiliency and changes in clinician resiliency with SE® training and clinical outcomes. These data have implications for other professions at risk of exposure to vicarious trauma (VT) including nurses, medical providers, and paramedics.
治疗创伤的个体面临替代性创伤和职业倦怠的重大风险。体感疗法（SE®）是一种以恢复力为重点的创伤治疗方法，旨在解决自主神经系统（ANS）失调及其对身体健康和心理健康症状的影响，例如焦虑、抑郁、创伤后应激障碍、偏头痛、纤维肌痛和慢性疲劳等。SE®培训有助于培养临床技能，以减轻身体健康/心理健康症状，并提高临床医生的恢复力。表现出恢复力的个体通常幸福感体验增加（生活质量），自我报告的心理症状水平降低。更强的恢复力可以降低提供者及其治疗的客户所面临的风险。这项组内纵向研究在为期3年的SE®从业者培训过程中对18名学生进行了评估。该培训侧重于提高自主神经系统、身体和情绪调节技能。基于网络调查的便利性使得能够进行以下测量：一般生活质量（世界卫生组织生活质量简表，WHOQOL-BREF）、心理症状、躯体、焦虑和抑郁症状（患者健康问卷-躯体焦虑抑郁量表，PHQ-SADS），以及早年生活中接触逆境的测量（疾病控制与预防中心/凯撒医疗集团不良童年经历评分计算器问卷）。临床医生调查连续3年每年进行一次。未来的研究最好还纳入基于实验室的自主神经系统功能客观测量。重复测量方差分析表明，焦虑症状（广泛性焦虑障碍量表，GAD7，P<0.001）和躯体化症状（患者健康问卷15项，PHQ15，P<0.001）有显著降低。与健康相关的生活质量（身体健康的一项测量指标）和社会生活质量（人际幸福感的一项测量指标）均显著提高（健康生活质量，P = 0.028；社会生活质量，P = 0.046）。结果表明，参加为期3年SE®培训课程的专业人员在与恢复力相关的自我报告测量方面有显著改善，包括：生活质量（幸福感）和心理症状（焦虑和躯体化）。我们的结果支持在更大样本中进行未来研究的重要性，并支持从横断面和前瞻性角度探索临床医生恢复力以及临床医生恢复力的变化与SE®培训和临床结果之间的关系。这些数据对其他面临替代性创伤（VT）风险的职业有启示意义，包括护士、医疗服务提供者和护理人员。
