OhioCanDo4Kids

How to Maintain Emotional Health When Working with Trauma

By Joy D. Osofsky, Frank W. Putnam, and Judge Cindy S. Lederman

ABSTRACT

Vicarious traumatization, compassion fatigue, or secondary traumatization refers to the cumulative effect of working with survivors of traumatic life events as part of everyday work. Although this issue has been acknowledged and addressed among professionals such as police officers and medical professionals, it has been discussed less among juvenile and family court judges who also experience secondary traumatic stress. In fact, in one recent study, a majority of judges reported one or more symptoms of secondary traumatization. This article describes the common signs and symptoms of secondary trauma, job-related factors that contribute to secondary trauma among judges, and the potential negative impact on organizational performance. The authors conclude with specific recommendations tailored for juvenile and family court judges.

The Ohio Department of Mental Health (ODMH) Maternal Depression Project was originally developed by Dr. Amy Heneghan at Case Western Reserve University in late 2004 and transferred in July 2006 to Dr. Frank Putnam at Cincinnati Children’s Hospital after Dr. Heneghan left Ohio for San Francisco.

The project consists of two main components: 1) a maternal depression awareness training for health professionals serving mothers and children; and 2) a project to evaluate the feasibility of large scale screening for maternal depression by Help Me Grow workers in 17 counties in Ohio.

Sexual Abuse Longitudinal Study Summary (August, 2006)

Overview
Eighty four females were referred by child protective service agencies within six months after the disclosure of childhood sexual abuse along with 82 non-abused matched comparison females. This relatively large and racially diverse sample was interviewed three times in childhood (approximately once per year for three consecutive years), twice in adolescence, and most recently, when the sample is embarking on the tasks of young-adulthood (i.e., emancipation from parents, formation of identity, romantic partner selection, reproductive decisions, initiation of career, transition to motherhood). Findings from this longitudinal study have provided some of the most definitive evidence for the unique ways in which childhood sexual abuse impacts on the bio-psych-social development of females across distinct developmental stages.Approximately 45 peer-reviewed journal articles have been generated from this longitudinal study reporting on a host of behavioral, psychological, and physiological effects in both childhood and adolescence. In general, results from our study show that there are striking differences between sexual abuse victims and girls on a “normal” developmental course when taking into account possible confounds. While there are several identifiers of resilience in the lives of these women, there is also disturbing evidence that survivors of childhood sexual abuse continue to suffer throughout development. This suffering may manifest acutely, in childhood, immediately following the disclosure of abuse, or may emerge or be revisited later in life as developmentally salient issues reminiscent of the abuse surface or resurface.

Explanation of Dissociation
Dissociation is defined as a disruption in the usually integrative functions of consciousness, memory, identity and/or perception (DSM-IV-TR, page 519). Clinical research has consistently found that a high level of dissociation is significantly associated with major psychopathology. In some instances, this takes the form of a DSM-defined dissociative disorder. In other instances, the dissociation is associated with another DSM diagnosis such as Posttraumatic Stress Disorder, Somatization Disorder, Borderline Personality Disorder or Acute Stress Disorder. High levels of dissociation have also been repeatedly found to be associated with antecedent experiences of trauma and life-threatening experiences. It is important to screen for dissociation in psychiatric patients and traumatized individuals as the presence of a high level may inform clinical care as well as help to identify an unrecognized dissociative disorder which requires specialized treatment.