Abstract
D. Litt. et Phil.
This research focuses on the development of a short term action centered clinical personological treatment programme for adult emergency rescue workers who developed secondary traumatic stress disorder (STSD)/compassion fatigue and co-morbid symptoms of burnout as a result of exposure to critical incidents. A programme, comprising three sessions, was developed incorporating previously tested cognitive behavioural techniques with clinical personological theory as well as newly developed behavioural techniques tailored to the cross cultural South African context.
The need for the study arose out of the lack of scientific validated data regarding the treatment of STSD/compassion fatigue among emergency rescue workers as well as the need for a cost-effective treatment programme that would address the serious need of emergency rescue workers in South Africa who for the most part need to make do without any employee wellbeing programmes.
The effects of STSD/compassion fatigue are often as debilitating as that of PTSD. It hampers the sufferer unable to operate as well as they previously did. As a result they may present with lower productivity at work as well as various psycho-social problems and be at risk of substance abuse. This ultimately has a negative impact on the victims of trauma they are responsible for rescuing.
Various theoretical models are discussed on the etiology of STSD/compassion fatigue, including the constructivist development al theory by McCann and Pearlman (1990) as well as Valent’s (2003) bio-social theory on survival strategies.
Treatment approaches are investigated and critiqued, including, the accelerated recovery program (ARP) as developed by Gentry, Baranowsky and Dunning (2003) under the direction of Figley (2003) for the treatment and prevention of compassion fatigue, critical incident stress debriefing as first formally described by Mitchell in 1983 for the treatment of acute traumatic stress reactions, as well as Saakvitne and Pearlman’s (1992) constructivist self-developmental treatment program for vicarious traumatization, based on the constructivist self development al theory developed by McCann and Pearlman (1990).
The theories and therapies underlying the intervention programme include various cognitive behavioural and personological principles to offer a person specific practical solutions for their personality type and psychological needs. The hypotheses were formulated with regard to significant improvement of symptoms of STSD/compassion fatigue as result of the intervention programme. The co-morbid symptoms of burnout are also evaluated for a decrease, without significantly reducing their capacity for compassion satisfaction.
A test re- test quasi-experimental analysis with two independent groups was required, in order to determine whether there will be a statistically meaning full reduction in the prevalence of symptoms of secondary traumatic stress disorder (STSD)/compassion fatigue and the co-morbid symptoms of burnout amongst emergency rescue staff who had been instructed in an Action Centred Personological Treatment Plan.
In an effort to attain spatial and temporal control a sample population was selected with a cluster sampling method from the greater Gauteng emergency rescue staff. They included paramedics, fire fighters and ambulance staff. The specific municipality had been incorporated into a greater Gauteng metropolis in the past two years. Potential subjects for both the experimental and control group were obtained through drawing personnel files, using random sampling. A sample of 17 participants was included in the intervention group and 17 participants were included in a non-intervention group. This was representative of 80% of the total population group of emergency rescue staff in this particular municipality.
Existing psychometric assessment instruments were utilised to generate data for the experimental analysis. The measurement instruments included, the Millon inventory of personality styles (MIPS) to customise a cognitive behavioural treatment programme, the Compassion fatigue and satisfaction questionnaire to verify symptoms of STSD/compassion fatigue and burnout, and the British Columbia burnout questionnaire to confirm symptoms of burnout. The quantitative data was supported by information gathered from a clinical social history questionnaire. This information was used as part of the discussion of the results as a means to enhance the former descriptive results.
The action centred personological treatment programme proved to be effective in the treatment of symptoms of STSD/compassion fatigue and burnout without significantly reducing the candidates’ potential for compassion satisfaction.