Geriatric Mental Health Disaster and Emergency Preparedness

106 Geriatric Mental Health Disaster and Emergency Preparedness
THE INFLUENCE OF PRACTITIONER
TRAUMA ON SERVICE DELIVERY
Rothschild (2006) provides examples of practitioners who have been affected
by vicarious trauma through the interaction of client experiences
on their own histories. The emotional foundations of these experiences
are frequently related to profound human suffering, loss, and distress.
These personal, family, and/or community histories have shaped practitioners
and their practice. It is the authors’ view that these experiences will
overtly, as well as unconsciously, influence the work of practitioners in the
development and delivery of services in emergencies and disasters.
The violence inherent in disasters violates boundaries. When practitioners
work alongside or with communities involved in civil emergencies,
merely listening to the survivors’ stories may reawaken their own early
trauma or their community’s history of trauma. The transference of practitioners
will have an impact on attitudes and values across teams and disciplines,
both nationally and internationally, and on the processes of service
development and delivery. In the same way, this transference will influence
individual and community responses to those who aim to offer help and
support.
Warren, Lee, and Saunders (2003) and Herman (1992), among others,
identify the effects on practitioners who work with people and communities
involved in traumatic events. There is also an extensive literature
on the development of unconscious organizational defenses that enable
practitioners to deal with the painful nature of much that human service
provision entails (Huffington, Armstrong, Halton, Hoyle, & Pooley, 2004;
Hughes & Pengelly, 1997; Obholzer & Roberts, 1994). Since violence and
loss are associated with civil emergencies and disasters, it is likely that practitioners,
their teams, and organizations will have developed effective defenses
to the anxiety evoked by their teamwork. If these defenses impede
effective service delivery, however, it can be detrimental to the well-being
of individuals and the community (Hughes & Pengelly; Obholzer & Roberts).
Herman (p. 141) states in relation to therapists who work with traumatized
people:
The therapist’s adverse reactions, unless understood and contained, also
predictably lead to disruptions in the therapeutic alliance with patients and
to confl ict with professional colleagues. Therapists who work with traumatised
people require an ongoing support system to deal with these intense