ABSTRACT
Since the 1970s, professional publications in the field of mental health, emergency services, and disaster management have abounded with reports and studies on the effects of trauma intervention on the responders. During the 1980s and 1990s, much of that literature focused on the psychological effects of trauma exposure among first responders–firefighters, police officers, and emergency medical personnel. Simultaneously, as the number of natural and technological disasters was on the rise, studies of the effects of large-scale disaster events on both the victims and the disaster responders increased. Wee and Myers (1998) reviewed some of the literature related to these two populations. In 1995, Figley and his contributing authors provided a groundbreaking exploration and focus on those professionals who provide therapy to victims of trauma: crisis workers, trauma counselors, nurses, physicians, and other caregivers who become victims themselves of secondary traumatic stress disorder (STS) or compassion fatigue. A very small number of studies have further narrowed the focus of research to examine the psychological 182impacts of providing mental health counseling to the specialized context of large-scale disasters (Bartone, Ursano, Wright, & Ingraham, 1989; Berah, Jones, & Valent, 1984; Frederick, 1977; Hodgkinson & Shepherd, 1994; Raphael, Singh, Bradbury, & Lambert, 1984; Wee & Meyers, 1997; Winget & Umbenhauer, 1982). Wee and Myers (1998) studied the psychological impact of disaster mental health work on the counselors from Project Heartland, who provided treatment and supportive mental health services to the victims of the Oklahoma City bombing. Most significant among their findings were the following:
Counselors were psychologically affected by their work, whether or not they personally experienced the bomb blast.
Of the counselors surveyed, 64.7% exhibited some degree of severity for posttraumatic stress disorder (PTSD) as measured by the Frederick Reaction Index (FRI).
Additionally, 44.1% of counselors exhibited “caseness” (considered a case or positive risk based on scores at or above the 90th percentile for non-patient norms) on the SCL-90-R Global Severity Index score or two-dimensional T-scores greater than or equal to a T-score of 63.
Nearly three-quarters (73.5%) of counselors were rated as being at moderate risk (23.5%), high risk (29.4%), or extremely high risk (20.6%) for compassion fatigue, as measured by the Compassion Fatigue Self Test for Psychotherapists (Figley, 1995).
Also, 76.5% of counselors were rated as being at moderate risk (35.3%), high risk (26.5%), or extremely high risk (14.7%) for burnout, using the same Compassion Fatigue Self Test.
Over half (52.9%) of the counselors evaluated disaster mental health work as more stressful than other jobs they had experienced.
Longer duration of work providing counseling services to disaster victims was significantly related to higher mean distress scores.
Certain categories of counselors had levels of distress higher that their coworkers, including administrators of the counseling program, males, and ethnic groups other than Caucasian.
