Defense Date


Document Type


Degree Name

Doctor of Philosophy


Clinical Psychology

First Advisor

Scott Vrana, Ph.D.


Vicarious traumatization (VT) describes the gradual, transformative shifts in internal experience that occur as a result of cumulative exposure to clients’ trauma material. VT is thought to develop in the therapist due to empathic engagement with clients, resulting in profound disruptions in frame of reference. Because VT is conceptualized as a condition that develops due to frequent exposure to clients’ traumatic material, a rapidly emerging body of theoretical literature suggests that clinicians can safeguard against VT by maintaining a more balanced workload (i.e., a caseload of clients with a variety of presenting problems) and limiting the number of trauma cases. However, the quantitative research base on VT is limited and has been plagued by several methodological shortcomings, most notably the lack of comparison groups of non-trauma clinicians. As such, a primary aim of the present study was to characterize the prevalence and severity of VT among one group of clinicians treating predominantly traumatized populations, and one group providing treatment for a wider variety of presenting issues. Further, a secondary aim of this project was to identify both therapist-level and occupational-level contributors to VT. In our cross-sectional, online survey study of 114 generalist mental health providers (Mage = 33.36, 75.4% female, 88.6% Caucasian) and 107 trauma clinicians (Mage = 42.66, 81.3% female, 86.9% Caucasian) recruited from various professional organizations, levels of VT were low and not significantly different between the two provider groups. Risk factors for VT included fewer years of experience, having a greater personal history of trauma, and a personal distress empathy style. Protective factors included a perspective-taking empathy style, problem-focused and emotion-focused coping styles, and high-quality supervision. When the VT construct was examined alongside similar (but conceptually different) occupational stress constructs of secondary traumatic stress and burnout, there was a high degree of overlap, indicating that VT may not be a distinct phenomenon or unique to working with trauma clients. Results suggest that claims about the deleterious effects of trauma therapy are likely overstated, thereby refuting the original conceptualization of VT. Future research directions and implications for prevention and intervention are discussed.


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