Vicarious Trauma in a Group of Inner-City Family Physicians
Vicarious Trauma in a Group of Inner-City Family Physicians
Background: Vicarious trauma is an understudied phenomenon among Canadian family physicians.
Objective: This phenomenological study set out to explore the experiences of a group of inner-city family physicians caring for women using illicit drugs.
Methods: Ten family physicians working in Toronto and Ottawa, Canada, participated in in-depth interviews. The data were analyzed using an iterative and interpretive process.
Results: The first major theme emerging from the data analysis was the emotional impact of the work. Participants shared the challenges, sorrows, and joys they experienced as they struggled to care for their patients. The sub-themes identified were as follows: tragedy and death, difficult behaviors, and isolation from mainstream medical community. The second major theme identified was coping strategies. Participants were open, thoughtful, and eloquent as they reflected on the three primary coping strategies reported: adaptation and evolution of practice style, teamwork, and modification of expectations.
Conclusions: Participants, narratives of loss, grief, and compassion were consistent with vicarious trauma and therefore participants risked developing compassion fatigue—a specific form of burnout. These are new and important findings. Further research exploring vicarious trauma as a possible contributor to burnout among family physicians is warranted.
There is an emotional cost to caring. Listening to patients' narratives of traumatic events can provoke intense emotions such as profound sadness, helplessness, frustration, and anger. This emotional response is often termed vicarious trauma (VT). By engaging in empathic relationships with patients, helping professionals such as family physicians undergo a transformation in their inner experiences that impacts emotions and cognitive patterns. Far from being pathologic, VT is a normal part of any caring professional's emotional response. Just as trauma symptoms are a normal response to a traumatic event, VT is a normal response to working with traumatized patients. Identification of VT is important because if left unchecked, it can lead to a specific form of burnout often referred to as compassion fatigue (CF). Although VT is a normal part of the work, CF is not inevitable and can be prevented.
This qualitative study set out to explore the phenomenon of VT in a group of inner-city family physicians caring for a patient population known to experience high levels of trauma: women using illicit drugs. Although there has been much research exploring VT and CF in non-physicians caring for similar populations, little literature was found to explore these phenomena in family physicians. This is a surprising gap in the literature because VT is known to contribute to burnout in non-physicians, and burnout is common among Canadian family physicians. It is, therefore, worth understanding the possible contribution of VT to the high rates of burnout among family physicians, making this an area deserving of study.
Abstract and Introduction
Abstract
Background: Vicarious trauma is an understudied phenomenon among Canadian family physicians.
Objective: This phenomenological study set out to explore the experiences of a group of inner-city family physicians caring for women using illicit drugs.
Methods: Ten family physicians working in Toronto and Ottawa, Canada, participated in in-depth interviews. The data were analyzed using an iterative and interpretive process.
Results: The first major theme emerging from the data analysis was the emotional impact of the work. Participants shared the challenges, sorrows, and joys they experienced as they struggled to care for their patients. The sub-themes identified were as follows: tragedy and death, difficult behaviors, and isolation from mainstream medical community. The second major theme identified was coping strategies. Participants were open, thoughtful, and eloquent as they reflected on the three primary coping strategies reported: adaptation and evolution of practice style, teamwork, and modification of expectations.
Conclusions: Participants, narratives of loss, grief, and compassion were consistent with vicarious trauma and therefore participants risked developing compassion fatigue—a specific form of burnout. These are new and important findings. Further research exploring vicarious trauma as a possible contributor to burnout among family physicians is warranted.
Introduction
There is an emotional cost to caring. Listening to patients' narratives of traumatic events can provoke intense emotions such as profound sadness, helplessness, frustration, and anger. This emotional response is often termed vicarious trauma (VT). By engaging in empathic relationships with patients, helping professionals such as family physicians undergo a transformation in their inner experiences that impacts emotions and cognitive patterns. Far from being pathologic, VT is a normal part of any caring professional's emotional response. Just as trauma symptoms are a normal response to a traumatic event, VT is a normal response to working with traumatized patients. Identification of VT is important because if left unchecked, it can lead to a specific form of burnout often referred to as compassion fatigue (CF). Although VT is a normal part of the work, CF is not inevitable and can be prevented.
This qualitative study set out to explore the phenomenon of VT in a group of inner-city family physicians caring for a patient population known to experience high levels of trauma: women using illicit drugs. Although there has been much research exploring VT and CF in non-physicians caring for similar populations, little literature was found to explore these phenomena in family physicians. This is a surprising gap in the literature because VT is known to contribute to burnout in non-physicians, and burnout is common among Canadian family physicians. It is, therefore, worth understanding the possible contribution of VT to the high rates of burnout among family physicians, making this an area deserving of study.
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