The effects of vicarious traumatization on clinical workers who work with the survivors of the great Hanshin-Awaji (Kobe) earthquake (Japan).

摘要

The purpose of the study was to explore systematically the ways in which working with the survivors of the Great Hanshin-Awaji (Kobe) Earthquake affect the psychosocial well-being of clinical workers, including social workers and clinical psychologists. The concept and theoretical framework of vicarious traumatization were intensively reviewed to encompass not only the psychological symptoms but also broad effects, such as workers' identity issues and their frame of reference. Clinical workers were selected as the study population because they were the primary group of professionals who provided clinical services as well as outreach programs for the Kobe survivors. To accomplish this purpose, a qualitative research method was applied in this study. A self-administered questionnaire was also employed to capture the mental health status as well as coping strategies among clinical workers. In-depth face-to-face interviews were conducted with a total of 23 subjects. The qualitative analysis delineated a variety of categories related to vicarious traumatization. These are: "conflict of role expectation through feelings of guilt," "identification reaction to survivors," "fluctuation of identity as a clinical worker," "reconstruction of perspective on supports," "changes in human relations," and "returning to spirituality." Practical and policy implications were discussed, focusing on the necessity of the following: (1) establishing a solid care system for guilt feelings, (2) creating a legitimated supervision system, (3) reconstructing values in support of natural disaster victims, (4) understanding of the cultural impact, and (5) making accommodations for spiritual care. Future research implications were also summarized as the need for survey research as well as cross-cultural studies to grasp more detail in the psychosocial state among these practitioners.