title: Secondary Traumatic Stress and Vicarious Posttraumatic Growth in New Zealand Clinical Psychologists: The Consequences of Working with Traumatised Clients

authors: Stapleton, Madeleine

subjects: Secondary traumatic stress

abstract: Clinical psychologists who provide trauma treatment are vicariously exposed to their clients’ traumatic experiences. The responsibility of clinical psychologists to practise both effectively and safely makes assessing the negative and positive psychological consequences of vicarious exposure to trauma imperative. If provisions are not put in place to prevent the negative psychological consequences and facilitate the positive psychological consequences, then detrimental outcomes may arise for the clinician, their clients, and the organisation that they work for.
The present study was designed to assess the experience of secondary traumatic stress (STS) and vicarious posttraumatic growth (VPTG) in clinical psychologists who work with traumatised clients in New Zealand. The purpose of this study was to identify the factors that were related to these phenomena, including the level of vicarious exposure to trauma (years working as a clinical psychologist, hours per week working with traumatised clients, and percentage of traumatised clients on caseload), posttraumatic cognitions, secondary trauma self-efficacy (STSE), perceived social support, and engagement in self-care activities.
Seventy-two clinical psychologists completed the online survey. Significant relationships were found between the main variables in this study: STS correlated positively with posttraumatic cognitions and VPTG correlated positively with self-care. Non-hypothesised significant relationships were also found. Posttraumatic cognitions correlated significantly with hours per week working with traumatised clients, STSE, perceived social support, and self-care. Additionally, self-care correlated significantly with perceived social support.
The results of this study suggest that clinical psychologists who experience more posttraumatic cognitions following vicarious exposure to trauma may be more likely to experience STS. The results also suggest that those clinical psychologists who engage in more self-care activities may be more likely to experience VPTG. As the majority of the proposed hypotheses were not supported, it appears that the factors thought to be related to STS and VPTG may not be as pertinent as previous research indicates. Overall, the results suggest that there may be other factors not explored in this study that may influence the experience of STS and VPTG.
As discrepant results were found in this study, future research should continue to investigate the factors that are related to STS and VPTG in clinical psychologists. Investigation into the ways in which posttraumatic cognitions following vicarious exposure to trauma can be prevented, or reduced, would also be beneficial, as would investigation into the specific self-care activities that are related to VPTG. Future research could also investigate the barriers that may prevent clinical psychologists from engaging in self-care.
Taken together, this study provides insight into the factors that are related to STS and VPTG, and importantly, identifies how STS may be prevented and VPTG may be facilitated.

text: Secondary Traumatic Stress and Vicarious Posttraumatic Growth in New Zealand Clinical Psychologists: The Consequences of Working with Traumatised Clients Clinical psychologists who provide trauma treatment are vicariously exposed to their clients’ traumatic experiences. The responsibility of clinical psychologists to practise both effectively and safely makes assessing the negative and positive psychological consequences of vicarious exposure to trauma imperative. If provisions are not put in place to prevent the negative psychological consequences and facilitate the positive psychological consequences, then detrimental outcomes may arise for the clinician, their clients, and the organisation that they work for.
The present study was designed to assess the experience of secondary traumatic stress (STS) and vicarious posttraumatic growth (VPTG) in clinical psychologists who work with traumatised clients in New Zealand. The purpose of this study was to identify the factors that were related to these phenomena, including the level of vicarious exposure to trauma (years working as a clinical psychologist, hours per week working with traumatised clients, and percentage of traumatised clients on caseload), posttraumatic cognitions, secondary trauma self-efficacy (STSE), perceived social support, and engagement in self-care activities.
Seventy-two clinical psychologists completed the online survey. Significant relationships were found between the main variables in this study: STS correlated positively with posttraumatic cognitions and VPTG correlated positively with self-care. Non-hypothesised significant relationships were also found. Posttraumatic cognitions correlated significantly with hours per week working with traumatised clients, STSE, perceived social support, and self-care. Additionally, self-care correlated significantly with perceived social support.
The results of this study suggest that clinical psychologists who experience more posttraumatic cognitions following vicarious exposure to trauma may be more likely to experience STS. The results also suggest that those clinical psychologists who engage in more self-care activities may be more likely to experience VPTG. As the majority of the proposed hypotheses were not supported, it appears that the factors thought to be related to STS and VPTG may not be as pertinent as previous research indicates. Overall, the results suggest that there may be other factors not explored in this study that may influence the experience of STS and VPTG.
As discrepant results were found in this study, future research should continue to investigate the factors that are related to STS and VPTG in clinical psychologists. Investigation into the ways in which posttraumatic cognitions following vicarious exposure to trauma can be prevented, or reduced, would also be beneficial, as would investigation into the specific self-care activities that are related to VPTG. Future research could also investigate the barriers that may prevent clinical psychologists from engaging in self-care.
Taken together, this study provides insight into the factors that are related to STS and VPTG, and importantly, identifies how STS may be prevented and VPTG may be facilitated.

year: 2017

title: Impact of Concomitant Surgical Atrial Fibrillation Ablation in Patients Undergoing Aortic Valve Replacement

authors: Yoo, Jae Suk

subjects: Science & Technology

abstract: Background: The clinical benefit of concomitant atrial fibrillation (AF) ablation at the time of aortic valve replacement (AVR) is uncertain.
Methods and Results: A total of 124 patients with AF who underwent AVR with (n=50) or without (n=74) a concomitant maze procedure, between 2000 and 2011, were evaluated. There were no significant differences in early postoperative outcomes. During a median clinical follow-up of 18.1 months (interquartile range: 6.9–47.8 months), 19 late deaths (15.3%) and 33 valve-related complications (26.6%) occurred, but the differences between groups were not statistically significant. Major event-free survival at 5 years was 60.9±9.9% vs. 57.0±10.3% (P=0.41). After adjustment, the maze group demonstrated similar risks for major adverse cardiac events (hazard ratio, 1.18; 95% confidence interval, 0.56–2.49; P=0.67). However, the rate of sinus rhythm restoration at 4 years was significantly higher in the maze group (80.6% vs. 3.6%, P<0.001). Left atrial dimension was smaller (46.9 vs. 50.4mm, P=0.017), and the ejection fraction was higher (60.6% vs. 58.0%, P=0.059) in the maze group. The rate of postoperative anticoagulation was also lower in the maze group (53.1% vs. 89.2%, P<0.001).
Conclusions: Concomitant AF ablation in patients undergoing AVR resulted in increased sinus rhythm restoration, better echocardiographic results, and decreased anticoagulation requirement, without increasing surgical morbidity or mortality.

text: Impact of Concomitant Surgical Atrial Fibrillation Ablation in Patients Undergoing Aortic Valve Replacement Background: The clinical benefit of concomitant atrial fibrillation (AF) ablation at the time of aortic valve replacement (AVR) is uncertain.
Methods and Results: A total of 124 patients with AF who underwent AVR with (n=50) or without (n=74) a concomitant maze procedure, between 2000 and 2011, were evaluated. There were no significant differences in early postoperative outcomes. During a median clinical follow-up of 18.1 months (interquartile range: 6.9–47.8 months), 19 late deaths (15.3%) and 33 valve-related complications (26.6%) occurred, but the differences between groups were not statistically significant. Major event-free survival at 5 years was 60.9±9.9% vs. 57.0±10.3% (P=0.41). After adjustment, the maze group demonstrated similar risks for major adverse cardiac events (hazard ratio, 1.18; 95% confidence interval, 0.56–2.49; P=0.67). However, the rate of sinus rhythm restoration at 4 years was significantly higher in the maze group (80.6% vs. 3.6%, P<0.001). Left atrial dimension was smaller (46.9 vs. 50.4mm, P=0.017), and the ejection fraction was higher (60.6% vs. 58.0%, P=0.059) in the maze group. The rate of postoperative anticoagulation was also lower in the maze group (53.1% vs. 89.2%, P<0.001).
Conclusions: Concomitant AF ablation in patients undergoing AVR resulted in increased sinus rhythm restoration, better echocardiographic results, and decreased anticoagulation requirement, without increasing surgical morbidity or mortality.

year: 2014-06

title: Reo Rua Pukapuka Pikitia: Whānau drawing on their community cultural wealth to create strategies for developing Te Reo Rangatira

authors: Brouwer, Jacqui

abstract: The use of Te Reo Māori in Early Childhood Education in Aotearoa New Zealand is mandated in the ECE curriculum. Research shows that picturebooks are powerful tools in language learning, but there is a lack of research concerning the use of bilingual picturebooks by whānau to support Māori language learning in a New Zealand kindergarten. This research presents findings from a 4-week programme in which five whānau members were introduced to several types of dual language picturebooks (Reo Rua Pukapuka Pikitia, RRPP) in a Puna Pukapuka Pikitia (PPP). Whānau explored RRPP and suggested how they could bring Reo Rangatira from RRPP into their homes to support language learning. Their suggestions aligned with Ellis’s principles of effective language teaching (Ellis, 2010) including the development of formulaic phrases, following the ways in which tamariki naturally learn language, encouraging opportunities for tamariki to speak and listen, as well as having interactions linked to RRPP.

text: Reo Rua Pukapuka Pikitia: Whānau drawing on their community cultural wealth to create strategies for developing Te Reo Rangatira The use of Te Reo Māori in Early Childhood Education in Aotearoa New Zealand is mandated in the ECE curriculum. Research shows that picturebooks are powerful tools in language learning, but there is a lack of research concerning the use of bilingual picturebooks by whānau to support Māori language learning in a New Zealand kindergarten. This research presents findings from a 4-week programme in which five whānau members were introduced to several types of dual language picturebooks (Reo Rua Pukapuka Pikitia, RRPP) in a Puna Pukapuka Pikitia (PPP). Whānau explored RRPP and suggested how they could bring Reo Rangatira from RRPP into their homes to support language learning. Their suggestions aligned with Ellis’s principles of effective language teaching (Ellis, 2010) including the development of formulaic phrases, following the ways in which tamariki naturally learn language, encouraging opportunities for tamariki to speak and listen, as well as having interactions linked to RRPP.

year: 2023