Exploring Factors that Influence the Impact of Indirect Exposure to Trauma

Whittenbury, Kate (2025) Exploring Factors that Influence the Impact of Indirect Exposure to Trauma. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Helping professionals are indirectly exposed to trauma through learning about their clients’ experiences. This type of exposure has been linked to the onset of post-traumatic stress symptoms and adverse changes in beliefs about self, others, and the world. These negative reactions have been associated with a reduction in quality of care provided by professionals, high absenteeism, sick leave and a desire to leave the profession. Despite the prevalence of these issues, not all professionals experience these issues, suggesting factors beyond exposure may influence the onset of personal distress post-exposure. Previous research has aimed to identify these risk factors, although have consisted of conflicting findings and some factors are left unexplored. Consequently, this thesis was designed to shed light on what might influence reactions to indirect trauma to adversity with the aim of protecting professionals, maintain their wellbeing and allow them to continue working effectively in their occupations. Through a mixed-methods approach, the author explored the complexities of indirect exposure to trauma. The author began with a qualitative inquiry delving into helping professionals’ perceptions of factors contributing to distress and potential protective strategies. In subsequent experimental studies the impact of exposure type, a pre-exposure stressor, and cognitive interventions on distress levels was examined. Experimental findings indicated comparable levels of distress across different trauma stimuli modalities (video vs. transcript) and pre-exposure stress states. Furthermore, individual characteristics appeared to exert a more substantial influence on responses to indirect trauma exposure than the experimental manipulations designed to mitigate its impact. Through these investigations, a further understanding of factors (e.g., empathy, characteristics of traumata) which may lead professionals to experience personal distress in trauma work is provided. The findings in this thesis call for a holistic understanding and exploration of the experience of indirect trauma when working as a health professional, as the culmination of factors is argued to lead professionals to experience distress. Additionally, a focus on how professionals can be protected is needed, such as restructuring beliefs associated with trauma work to be more adaptive, and tailoring self-care methods to an individual, rather than the current generic self-care methods recommended.