Caring for the Healers
Fostering Healthcare Providers’ Post-traumatic Growth in Disaster Areas: Proposed Additional Core Competencies in Trauma-Impact Management

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ABSTRACT

Disaster planning has traditionally focused on the concrete needs of the impacted population. This article looks at the impact of direct and indirect trauma exposure as it affects healthcare providers responding to a region-wide natural disaster and discusses trauma management via the incorporation of self-care techniques. It also explores post-traumatic growth as a potential benefit arising from trauma exposure. We propose that preventative and post-traumatic interventions be added to disaster planning. We further propose that the governing bodies that oversee the training of healthcare providers add training in post-traumatic interventions, including training in and support of self-care interventions to prevent and/or mitigate the effects of secondary traumatic stress. We suggest that they also provide training in Mind–Body Medicine Skills, a promising intervention that addresses symptoms of secondary traumatic stress and promotes post-traumatic growth.

Section snippets

Wounded Healers

“Long ago, in ancient Greece, the great hero god Heracles was invited to the cave of the centaur Pholos. Chiron, a wise and beneficent centaur and a great master of healing, was also present. As a token of appreciation and hospitality, Heracles brought a flask of heady wine to the gathering. The rich, fragrant liquid attracted other centaurs who, unaccustomed to wine, became drunk and then began to fight. In the ensuing melee Chiron was struck in the knee by an arrow shot by Heracles …

Trauma Exposure and Healthcare

The ability to disrupt or simply threaten groups of individuals, entire populations, and institutions through war, conventional terrorism, bioterrorism, natural disasters, man-made technological disasters, or other large-scale traumatic events has transformed the fields of traumatology, public health, public and military policy, medical training, health administration, and disaster preparedness. Our tendency is to prioritize and address tangible deficiencies in structure, procedures, or

Vicarious Traumatization Following Hurricane Katrina

During and after Hurricanes Katrina and Rita, medical personnel across the Gulf Coast region in general, and New Orleans especially, struggled to provide healthcare to a frightened population while adapting to critical shortages in staff and medicines as well as basic supplies, including food and water. Healthcare workers who sought counseling services following Hurricanes Katrina and Rita struggled with a confluence of emotions. They expressed deep anger at the failures of many systems upon

Post-traumatic Growth

From a resilience-model perspective, what are often neglected, if not unrecognized, are the many potentially positive factors that can arise within the individual after surviving a disaster. The scientific concept of resilience within trauma dates back to the 1960s. Caplan20 stated that a fundamental assumption in crisis theory is the potential for growth from a negative life experience. Since the publication of Caplan’s work, a growing number of contemporary theorists and clinicians have made

Looking Ahead: Mitigation and Preparedness

Successful strategies that foster and support posttraumatic growth and resiliency among healthcare providers consider STS as an unavoidable side effect of working with trauma.25 Primary, secondary, and tertiary strategies for reducing STS can fall under 3 categories:

  • Those aimed at the individual practitioner, both personally and professionally;

  • Those aimed at the organization;

  • Those aimed at the systems of care and policy.

For trauma-impact management to be effective, it must be recognized and

Conclusions

Healthcare providers, by the nature of their work, are called upon to assist traumatized victims. STS is an unavoidable consequence of trauma and disaster work. In addition to the indirect exposure to trauma characteristic of STS, providers assisting in mass disasters may be directly traumatized themselves. However, disasters, like other traumas, harbor within themselves the seeds of growth and positive change. There is increasing interest in this potential for posttraumatic growth and the ways

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