This study examined how caregivers' biased perceptions of ability to help traumatized patients relates to the caregivers' secondary traumatic stress (STS). There is reason to believe that caregivers overestimate their ability to help and underestimate their vulnerability to develop STS, but it is unclear how such unrealistic optimism relates to STS. The results show that Israeli caregivers working with terror victims believed that their ability to help traumatic patients is superior to their peers' while their likelihood to be negatively affected by such treatment is lower. Beyond the impact of the number of patients treated and caregivers' experience, unrealistic optimism was positively correlated to caregivers' STS. Theoretical and practical implications for those working with traumatized patients are discussed. In a world filled with conflict and terror, an increasing number of individuals are traumatized and both seek and need help to cope with their gruesome experiences. Unfortunately, the impact of a traumatic experience goes beyond those who experience it themselves. Helping traumatic patients bear their pain and reconstruct their shattered reality comes at considerable costs for treating caregivers. Caregivers working with traumatized patients often experience compassion fatigue or, more generally, secondary traumatic stress (STS). STS is manifested in symptoms similar to those of post-traumatic stress disorder (PTSD) including fear, difficulty sleeping, recurringimages of traumatic experience, and cognitive and behavioral avoidance of trauma reminders (Boscarino, Figley, & Adams, 2004; Figley, 1995). Listening to the stories of traumatized patients, helping them bear their pain, and attempting to reconstruct their shattered reality extracts a personal price from caregivers (Pearlman & Saakvitne, 1995). The transfer of trauma from victims to their immediate social environment creates what Basham (2008) referred to as a new front, calling for special awareness to these exposed groups. Therapists working with survivors of the September 11, 2001, World Trade Center attack (Boscarino et al., 2004; Creamer & Liddle, 2005; Eidelson, D'Alessio, & Eidelson, 2003), as well as the 1995 Oklahoma City Federal Building bombing (Wee & Myers, 2002) suffered from high levels of STS. High STS levels were also found among social workers working in Israeli hospitals sharing the patients' war reality (Lev-Wiesel, Goldblatt, Eizikovits, & Admi, 2008). In recent years, awareness of the impact of trauma treatment on caregivers is growing rapidly. Social workers engaged in direct practice with traumatic patients of domestic and politically related violence have experienced symptoms of STS (Bride, 2007). Caregivers who tend not to work thoroughly through the traumatic events with their patients and advocate that perspective have been found to demonstrate high STS levels (Deighton, Gurris, & Traue, 2007). Among the situational characteristics that (negatively) correlate with lay trauma counselors' STS are the level of their program coordination, perceived social support, and the program director's commitment. On the chronic personality level, self-efficacy and sense of coherence have been negatively correlated with STS levels (Ortlepp & Friedman, 2002). Exploring factors that correlate with STS manifestation is of high importance, as it may contribute to mapping potential STS risk factors. The current study focuses on one prominent factor: the extent to which the caregiver's perceived ability to help is accurate or, instead, is biased in an optimistic, self-serving manner. As far as we know, ours is the first study to look directly at this relationship between unrealistic optimism and STS. It addresses questions such as the following: Do caregivers who treat traumatized patients perceive their ability to help patients recover as superior to the ability of peers with similar experience? Do they feel less vulnerable than their peers to suffering from the negative consequences of trauma treatment? Are these biased perceptions associated with lower levels of STS, as positive illusions theories might suggest? Or are these biased perceptions associated with higher levels of STS, as suggested by theories considering the individual as a naïve scientist? To answer these and related questions, we used a cross-sectional design to survey Israeli caregivers working with traumatized victims of war and terror. These caregivers are typically called to hospitals in a mass-casualty event to provide psychological first aid (Gagin, Cohen, & Peled-Avram, 2005). Many of these caregivers work with multiple helping systems (e.g., social security, welfare) simultaneously (Woodrow & Ginsberg, 1997), and face difficulties creating a sense of safe environment for their patients (Shalvi & Luzzatto, 2006). Thus, apart from a theoretical contribution concerning the relationship between unrealistic optimism and STS, the current study also highlights practical implications for a particularly important and vulnerable group of caregivers.
- positive illusions