Relations of Resilience and Personal Meaning with Vicarious Traumatization in Psychotherapists

44 JELENA ŽELESKOV-ĐORIć, VLADIMIR HEDRIH & PREDRAG ĐORIć

relations of resilience and Personal Meaning with Vicarious traumatization in Psychotherapists

Jelena Želeskov-Đorić, Vladimir Hedrih & Predrag Đorić

abstract

This study investigated the relationship between resilience, personal meaning and vicarious traumatization in a sample of trauma therapists (N=68). Participants completed ARP (Adversity Response Profile), PMP (Personal Meaning Profile) and TABS (Trauma and Attachment Belief Scale). The results showed that both personal meaning and resilience level are negatively related to the vicarious traumatization level of a therapist. Personal meaning was found to mediate the relationship between resilience and vicarious traumatization. On the level of subscales, personal meaning of relationships with others was the sole most important predictor of resilience.

Keywords: personal meaning, vicarious traumatization, resilience, psychotherapists

Die Beziehung von robustheit und persönlicher Bedeutung mit stellvertretenden traumatisierungen in der Therapeutin Zusammenfassung

Diese Studie untersucht die Beziehung zwischen Robustheit, persönlicher Bedeutung und indirekter oder stellvertretender Traumatisierung in einer Auswahl von TraumatherapeutInnnen (N=68). Die Teilnehmenden füllten ARP, PMP und TABS Fragebogen aus. Die Resultate zeigten, dass beide, die persönliche Bedeutung und die Robustheits-Ebene, zur indirekten, unmittelbaren Traumatisierungshöhe der Therapeutin negativ bezogen sind. Weiter wurde gefunden, dass die persönliche Bedeutung, die Beziehung zwischen Robustheit und stellvertretende Traumatisierung schlichtet. Auf der Unterskala-Höhe der persönlichen Bedeutung der Beziehung mit anderen, war die einzige wichtigste Wirkungsvariable, die der Robustheit

Schlüsselwörter: Persönliche Bedeutung, stellvertretende Traumatisierung

résilience et sens individuel dans le contexte de traumatismes délégués au psychothérapeute résumé

Dans cette étude, nous étudions les rapports entre résilience, sens personnel et traumatisme délégué dans un échantillon de thérapeutes spécialisés dans le traitement de traumatismes (N=68). Les participants ont rempli l’ARP (Adversity Response Profile), le PMP (Personal Meaning Profile) et le TABS (Trauma and Attachment Belief Scale). Les résultats ont montré que le sens personnel et le niveau de résilience sont négativement associés à la manière International Journal of Psychotherapy: 2012, Vol. 16, No. 3, pp. 44-55: ISSN 1356-9082© Author and European Association of Psychotherapy (IJP): Reprints and permissions: www.ijp.org.uk

45RELATIONS OF RESILIENCE AND PERSONAL MEANING WITH VICARIOUS

dont le thérapeute gère le traumatisme qu’il assume. Le sens personnel est utilisé comme intermédiaire dans la relation entre la résilience et les traumatismes assumés à titre de ‘vicaire’. Concernant les échelles secondaires, la capacité à attribuer un sens aux relations avec les autres est l’unique facteur permettant de prédire la capacité de résilience.

Mots-clés : sens personnel, traumatisme délégué, résilience, psychothérapeutes

Связь между устойчивостью терапевтов, их личностными смыслами и викарной травматизацией Резюме

В данном исследовании изучались отношения между устойчивостью, личностными смыслами и викарной травматизацией терапевтов, работающих с травмой (общее количество участников исследования – 68 человек). Участники заполняли следующие опросники: Профиль реакции на неприятности (ARP – Adversity Response Profile), Профиль личностных смыслов (PMP – Personal Meaning Profile), а также Травма и шкала Привязанности и Убеждений (TABS – Trauma and Attachment Belief Scale). Результаты показали отрицательную зависимость между личностными смыслами и уровнем устойчивости терапевтов и уровнем их викарной травматизации. Наиболее важным прогностическим параметром устойчивости терапевтов к травматизации является подшкала личностных смыслов взаимодействия с другими людьми.

Ключевые слова: личностный смысл, викарная травматизация, устойчивость, психотерапевты

*

Introduction

Vicarious traumatization is a very important concept in therapeutic process. Studies suggested that being exposed to descriptions of traumatic events while treating clients can lead to a form of traumatization in therapists, manifested in symptoms similar to those of PTSD, including feelings of helplessness and isolation, intrusive and avoidant symptoms, and physiological arousal (Smith et al., 2000). There are several explanations for the development of such symptoms in therapists. Concepts of vicarious traumatization (VT), secondary traumatic stress (STS), compassion fatigue (CF) and secondary traumatic stress disorder (STSD) are most widely used concepts to explain what is happening to the therapists through working with trauma victims. Vicarious traumatization is a transformation of therapist’s experience, resulting from empathic engagement with survivor clients and exposure to their material (McCann & Pearlman, 1989; 1995; Pearlman & Saakvitne, 1995). Secondary traumatic stress is a natural consequence of a relationship between two people (the traumatized individual and the person close to the traumatized), not limited to the therapeutic relationship, but found in most close relationships (Figley, 1995). Compassion fatigue is defined as a syndrome resulting specifically from empathizing with people who are experiencing suffering and pain (Figley, 1995), and secondary traumatic stress disorder is a syndrome of symptoms nearly identical to PTSD, except that knowledge about traumatizing events experienced by a significant other is associated with a set of STSD symptoms, and PTSD symptoms are directly connected to the person experiencing primary traumatic stressors (Figley, 1995). All these concepts are very important in therapeutic work, but many of the studies examined the effects of vicarious trauma on therapists (Herman, 1992; Kassam-Adams, 1994; McCann


& Pearlman, 1995; Munroe, 1990; Schauben & Frazier, 1995). The results indicated that vicarious trauma could have influence on the therapeutical alliance, conflicts with colleagues and the destruction of therapist’s borders. Baranowsky (2002) found that therapists could make their intervention hasty as a consequence of vicarious trauma. Due to the importance of vicarious trauma, it is necessary that therapists take care about themselves and be aware when something changes in their thinking and feeling (Saakvitne & Pearlman, 1996). They suggest that effects of vicarious traumatization are modifiable and that transformation of VT could be done by paying attention to stress inherent to the psychotherapists work, and also by building resilience and strategies that induce meaning into psychotherapists lives (Saakvitne & Pearlman, 1996). Another construct highly convergent to VT is burnout. Burnout is a state of feeling emotionally exhausted and disconnected from other people, and lacking a sense of accomplishment from one’s work (Maslach, 1982), but is more related to certain aspects of work environment and is not specific for working with traumatized clients. Devilly, Wright, & Varker (2009) reported high correlations between VT, STS and burnout, and found that all of these constructs predicted therapist distress. Deighton, Gurris & Traue (2007) suggested that, due to the properties of trauma therapists work, burnout and VT may be one and the same thing for this specific group.

A number of researchers used the Trauma and Attachment Belief Scale (TABS; Pearlman, 2003) as a measure of vicarious traumatization. Schauben and Frazier (1995) used TABS to assess the effects of vicarious trauma on female sexual violence counselors. They found that counselors who had a higher percentage of trauma survivors in their caseloads obtained higher TABS ratings, but also more PTSD symptoms, and more vicarious trauma then the others in the study. Another study conducted by Pearlman and Mac Ian (1995) used TABS to measure vicarious trauma in 188 trauma therapists and suggested that therapists with personal trauma history had higher TABS scores then others in the study. Brady, Guy, Poelstra, and Brokaw (1999) examined the relationship between vicarious traumatization (assessed by TABS) and spirituality in female psychotherapists. TABS was also used as a measure of vicarious traumatization in Cunningham’s (1997) research with social workers, Lobel’s (1997) research with therapists working with women raped in adulthood and Walton’s (1997) research with trauma therapists.

Available stress research suggests that adaptation to trauma is linked to resilience (Yehuda, 1998). Resilience has been described as an individual capacity for maintenance, recovery or improvement in mental health during life challenges, individual capacity for transforming and change (Lifton, 1993) and successful adaptation following exposure to stressful life events (Werner & Smith, 1992). According to research literature, resilience is an important factor for work performance, and well-being of mental health care workers (Benard, 1996; Benard, 1997; Erikson, 1963; Krovetz, 1999; Werner & Smith, 1992). In spite of this, review of the literature has not yielded any studies investigating relations between resilience and vicarious traumatization.

The present study examined resilience as operationalized by the Adversity Response Profile (ARP) developed by Paul Stoltz (2000), where resilience is defined as a capacity of a person to overcome difficult life situations and adversity, and to become stronger and prepared for future life events. According to Stoltz’s (1997) research there are three categories of people who represent the varying abilities of individuals to cope with adversity. The first is the “Quitter” who chooses not to deal with adversity. The second type of person is the “Camper”, who takes on the challenge of life until the ascent becomes too difficult or they decide that they have reached their definition of “success”. The third type of person is the “Climber”, who does not allow obstacles to get in their way. Climbers are described as “persistent, tenacious,


and resilient” (Stoltz, 1997, p.19). In this study, we were interested in the relationship between resilience, as measured by AQ, and the four resilience sub-dimensions (referred to as CORE), and vicarious traumatization, operationalized by TABS in psychotherapists.

Saakvitne and Pearlman (1996) suggested that personal meaning is another factor that may have an important role in transforming VT among therapists. They reported that “making of meaning is the opposite of the erosion and negation of meaning that results from vicarious traumatization” (Saakvitne & Pearlman, 1996, p. 73). Some other researchers showed that personal meaning could be significant in mental health, life satisfaction (Erikson, 1982; Ledbetter, Smith & Vosler-Hunter, 1991; Ryff, 1989) and psychological well-being (zika & Chamberlain, 1992). Concept of meaning is conceptualized in a number of different ways. For example, Wong (2000) argued that there is always meaning and purpose to our existence, and that meaning allows individuals to generate a value system, which provides an understanding of both how we live and why we live. Baumeister (1991) suggests that meaning consists of shared beliefs about the possible connections among relationships, events and things, and Maslow (1954) found that meaning is experienced by self-actualized individuals who are devoted to a cause beyond themselves. A key figure in the development of existential therapy and founder of logotherapy, Frankl (1984) argued that meaning seeking and fulfilment is our greatest purpose in life. Wong (1998) defines personal meaning as “an individually constructed, culturally based cognitive system that influences an individual’s choice of activities and goals, and endows life with a sense of purpose, personal worth, and fulfilment.”

In our study, personal meaning is operationalized by Personal Meaning Profile (PMP, Wong, 1998). Up to date, this measure was used in a number of studies – Pan et al. (2008) conducted a study on 667 mainland Chinese postgraduates studying in Hong Kong and Australia and reported personal meaning to be related with acculturation and to mediate the relationship between acculturative stress and positive affect. Hope (2006) found personal meaning to be related to well-being and STS on a sample of caregivers.

The goal of the current study was to investigate the relationship between resilience and personal meaning on one side and vicarious traumatization on the other, in psychotherapists. Based on the available research data, we expected personal meaning and resilience to be negatively related to vicarious traumatization in psychotherapists.

Method

Participants

The participants were psychotherapists from Europe holding European Certificate for Psychotherapy and working with PTSD clients. A sample of 68 therapists – 48 women and 20 men participated in a study: 46 therapists were from Serbia and 22 were from Germany, Austria, UK and France. All therapists have been working with clients with PTSD for 13 years on average.

Measures

General information. Respondents were asked about their psychotherapeutical orientation and about the length of time they have been working with clients with PTSD.

Resilience. The Adversity Response Profile (ARP; Stoltz, 2000) was used to measure resilience. The ARP is a self-report measure consisting of fourteen scenarios, ten of which


are scored. Each scenario is followed by four questions, answered on 5-point scale. Each of the four answers is an indicator of a separate of the four resilience subdimensions: Control, Ownership, Reach and Endurance (CORE). Scores on each scale of ARP can range from 10 to 50. Control (C) assesses the degree of control people perceive to have over adverse situations when they occur. Ownership (O) describes the extent to which people believe that they can improve their situations and take responsibility for improving it even if it was caused by influences beyond their control. Reach (R) describes the degree to which a person perceives good or bad events to reach into other areas of one’s life. Endurance (E) assesses one’s perceptions of lasting affects of events and their consequences. Sum of the four scores represents the overall resilience measure called the Adversity Quotient (AQ). In a study by Stoltz (2000), internal consistency for the four subscales and the overall score ranged from 0,77 to 0,86. The same study showed that correlations between ARP subscales, although substantial were always lower than the scales’ reliability coefficients, thus indicating that subscales indeed measure different aspects of resilience.

Personal Meaning. To measure personal meaning, the Personal Meaning Profile (PMP) developed by Wong (1998) was used. The purpose of the questionnaire is to measure a person’s perception of personal meaning in his or her life. It consists of 57 items and uses a 7 point self report scale. Items are organized in seven content-related groups, forming seven subscales: achievement, relationship, religion, self-transcendence, self-acceptance, intimacy, and fair treatment. Lang (1994) reported that Total PMP was positively correlated with Ellison’s (1981) Spiritual Well-being (r = .64) and Rekel and Wong’s (1984) Perceived Well-being scale, r = .29 p < .05. Rekel and Wong (1984) reported an overall Cronbach’s alpha coefficient of .93 and coefficients ranging from 54 to .91 for subscales. Cronbach’s alpha value reported by Giesbrecht (1997) for PMP scale was .93, and subscale alpha coefficients ranged from .61 to .82.

Vicarious traumatization. Vicarious traumatization was assessed using the Trauma and Attachment Belief Scale (TABS; Pearlman, 2003). The TABS is a self report questionnaire intended to measure disruption in beliefs about self and others which arise from psychological trauma or from vicarious exposure to trauma material, through psychotherapy or other helping relationship. Specifically, the scale measures disrupted cognitive schemes, related to self or others, in the five psychological need areas – safety, trust, esteem, intimacy, and control. Within each need area, separate sets of items tap into beliefs about oneself and beliefs about others, yielding ten subscale scores and a total score. TABS is comprised of 84 items on a 6-point scale, asking the respondent to rate the extent to which each statement matches his or her own beliefs. The TABS contains the following ten subscales: self-safety, other-safety, self-trust, other-trust, self-esteem, other-esteem, self-intimacy, other-intimacy, self-control and other-control. A number of studies yielded support for the validity of the TABS as a measure of vicarious traumatization (Brady, Guy, Poelstra & Brokaw, 1999; Cunningham, 1997; Galloucis, 1995; Lobel, 1997; Pearlman & Saakvitne, 1995; Walton, 1997).

results

First, we examined the descriptive statistics of the sample on the measures used. The results are shown in Table 1.


table 1. Means, SDs and ranges of the sample on the measures used in the study

Vicarious Traumatization – TABS Personal Meaning – PMP Resilience – ARPScale Mean SD Range* Scale Mean SD Range* Scale Mean SD Range*TABS overall score

181.80 25.72 132-245

PMP overall score

310.45 30.08 230-385

ARP overall score

149.94 15.40 111-194

Self-Safety

26.52 5.50 16-38 Achievement 92.62 8.11 75-109 Control 35.71 4.89 26-49

Other-Safety

19.54 3.75 9-27 Relationship 51.04 5.27 41-63 Ownership 38.31 5.08 26-50

Self-Trust

18.10 3.27 10-26 Religion 43.11 11.35 11-62 Reach 37.40 4.85 26-48

Other-Trust

19.71 3.55 13-30 Self-transedence

42.05 6.17 26-53 Endurance 38.23 4.60 27-49

Self-Esteem

17.85 4.04 9-28 Self-acceptance

32.78 4.37 20-42

Other-Esteem

17.17 3.84 8-25 Intimacy 29.02 3.88 19-35

Self-Intimacy

15.78 4.14 7-31 Fair tretment 19.80 3.16 9-27

Other-Intimacy

14.90 3.65 8-28

Self-Control

17.67 4.04 8-23

Other-Control

14.52 3.31 8-23

*(min-max)

Relative to vicarious traumatization measures, if we compare the results of our sample with the US norms provided by Pearlman (2003), we can see that the mean overall TABS score of our sample is very close to the mean score of the nonclinical standardization sample used to create US TABS norms. Mean t score of our sample, obtained by using these norms is 50, which is the defined average of t scale (raw scores corresponding to t score 50 in Pearlman sample are 181-184). Compared to the sample of US trauma therapists from the same study, our sample has substantially higher mean overall TABS score – mean t score of the US trauma therapist sample was 44, while mean t score of our sample is 50.

Relative to resilience measures, compared to results of Stoltz (2000), our sample has lower means on control and ownership and higher on reach and endurance, while overall score is a close match (149.94 on our sample – 150.5 reported by Stoltz, 2000).

Next, we explored the internal consistency measures of scales used on our sample. The results are shown in Table 2.

The results show that general scores on all three tests, i.e. measures of vicarious traumarization, personal meaning and resilience have good internal consistency. On the other hand, when subscales are considered, we can see that all vicarious traumatization scales show unacceptably low internal consistency levels on our sample, while internal consistency of PMP scales is mostly adequate. For this reason, in further analyses we will use PMP subscales, but only the general measure of vicarious traumatization. Internal consistency measures of all resilience scales are adequate.


table 2. Internal consistency measures of the scales used in the study

Vicarious Traumatization – TABS Personal Meaning – PMP Resilience – ARP

Scale Cronbach’s alpha Scale Cronbach’s

alpha Scale Cronbach’s alpha

TABS overall score .888 PMP overall score .929 ARP overall score .80Self-Safety .565 Achievement .866 Control .77

Other-Safety .480 Relationship .849 Ownership .76Self-Trust .383 Religion .891 Reach .77

Other-Trust .471 Self-transedence .799 Endurance .78Self-Esteem .549 Self-acceptance .660

Other-Esteem .622 Intimacy .664Self-Intimacy .645 Fair tretment .561

Other-Intimacy .626Self-Control .549

Other Control .491

Having in mind that the main goal of our study was exploration into relations of vicarious traumatization of psychotherapists with resilience and personal meaning, we calculated correlations between these variables. We also examined correlations between vicarious traumatization and various variables we considered using as possible controls. These data are given in Table 3:

table 3. Correlations of vicarious traumatization with personal meaning, resilience, their subscales and possible control variables

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 171 TABS -2 PMP overall

score -.34 -

3 Achievement -.25 .80 -4 Relationship -.42 .72 .72 -5 Religion -.16 .58 .17 .19 -6 Self-

transedence -.34 .82 .70 .62 .42 -

7 Self-acceptance -.27 .69 .53 .44 .24 .45 -

8 Intimacy -.18 .64 .53 .43 .14 .40 .63 -9 Fair tretment -.32 .63 .42 .49 .20 .42 .59 .47 -

10 Resilience overall score -.25 .49 .47 .47 .17 .41 .47 .42 .34 -

11 Control -.30 .38 .35 .35 .07 .40 .50 .32 .23 .70 -12 Ownership -.22 .45 .51 .51 .03 .49 .29 .27 .33 .71 .55 -13 Reach -.09 .25 .26 .21 .08 .12 .38 .32 .20 .77 .39 .29 -14 Endurance -.02 .32 .24 .23 .25 .21 .34 .24 .20 .77 .36 .30 .76 -15 Gender -.09 -.10 -.13 -.09 -.06 -.18 -.05 .04 .04 -.15 -.22 -.33 .08 -.05 -16 Age .02 .12 -.01 -.08 .19 .07 .16 .02 .28 -.09 -.11 .08 -.19 -.13 -.33 -17 Length of

therapeutic education in years

.12 .10 -.07 -.13 .31 .03 .09 -.05 -.02 -.09 -.07 -.03 -.17 -.12 -.21 .46 -

18 Work experience in years

-.06 .08 .05 .03 -.04 .06 .13 .10 .37 .05 -.06 .19 -.04 .03 -.19 .72 -.13

* All correlations higher than .23 are statistically significant at the .05 level, and are presented in bold.


We can see from the data that general scores of both personal meaning and resilience have statistically significant negative correlations with vicarious traumatization. However, that is not the case with all of their subscales. When personal meaning is considered, all save two subscales correlate with vicarious traumatization, whereas the correlation of only one resilience subscale with vicarious traumatization is high enough to be significant. None of the potential control variables have statistically significant correlations with vicarious traumatization. The same is the case when relations between these potential control variables and both resilience and personal meaning are considered. We should also point out the moderate correlation between resilience and personal meaning overall scores.

Next, we tried to build regression models for predicting vicarious traumatization level based on personal meaning and resilience. First, we built a regression model for predicting vicarious traumatization based on overall scores of personal meaning and resilience, and after we explored the predictive value of resilience and personal meaning sub-dimensions for the same purpose. The results are shown in Table 4:

table 4. Linear regression model for predicting vicarious traumatization from resilience and personal meaning

Independent variables

Standardized coefficients (Beta)

Significance zero order correlation

Partial correlation

Resilience .007 .955 -.204 .007Personal meaning -.406 .003 -.402 -.354

Dependent variable: Vicarious traumatization, R = .402, R square = .162, Adjusted R square = .137, sig.=.003. Statistically significant predictors are given in bold. All predictors were entered at once.

We can see from the results that although both predictors have statistically significant zero order correlations with vicarious traumatization, variance explained by resilience is the same variance that is also responsible for the correlation with personal meaning. For this reason, although both personal meaning and resilience were entered into the model, correlation between the prediction function and vicarious traumatization is the same as its zero order correlation with personal meaning.

When personal meaning and resilience subscales were used as predictors of vicarious traumatization, the only statistically significant predictor of vicarious traumatization was personal meaning of relationships with other people (relationship subscale, stepwise linear regression was used, beta = -.455, sig.beta< .001, R = .455, R2 = .207, Adj. R2 = .195, sig. < .001)

Although other subscales have significant zero order correlations with vicarious traumatization, this is again mostly the same variance that is explained by personal meaning of relationships with others.

These results pointed to the possible existence of a mediation relationship between the examined variables. For this reason we tested a mediation effect model in which we proposed that personal meaning (overall score) mediates the relationship between resilience and vicarious traumatization. For testing this model we used the Sobel test (Baron & Kenny, 1986) and a bootstrap procedure (Preacher & Hayes, 2004, 2008). The results confirmed that personal meaning mediates the relationship between resilience and vicarious traumatization (Sobel test statistic = -2.64, p = .008; indirect effect estimate = – .35, s.e. = .15, z = 2.60, p = .009). Test results also showed that an opposite model – that resilience mediates the relationship between personal meaning and vicarious traumatization, does not hold. We also tested a model in which the personal meaning subscale relationships with others was


entered as a mediator, and results also showed a statistically significant but somewhat lower mediation effect (indirect effect estimate = -.30, s.e. = .12, z = -2.55, p = .01).

Discussion

If we look at the presented data we can see that there are two main results of this study. The first main result is that vicarious traumatization is related both to the level of resilience, and level of personal meanings. As expected, both correlations are negative. Wiebe (2001) reported a similar result about a negative correlation between personal meaning and vicarious traumatization ( – .35 , p < .01).

The second main result is the finding that personal meaning mediates the relationship between resilience and vicarious traumatization. If we look at the data from the level of subscales, we can see that the only significant predictor of vicarious traumatization is the personal meaning subscale relationship with others. This scale includes items like: “I am altruistic and helpful”, “I care about other people”, “I am trusted by others” etc.

Although zero order correlations of most of personal meaning subscales with vicarious traumatization are statistically significant, as is the correlation of resilience control subscale, after considering the variance accounted for by personal meaning of relationships with others, independent contributions of all other subscales become nonsignificant. This also applies to resilience subscales. Personal meaning of relationships with others is much more important predictor of vicarious traumatizations than all of the other variables considered taken together. Also, as is the case with the overall personal meaning score, a mediation model proposing that the relationship subscale moderates the relation between resilience and vicarious traumatization also holds.

Relative to the external validity of the study, we must note that one possible limitation is the sample size and therapists belonging mostly to humanistic and psychodynamic orientations in psychotherapy. Results also showed that psychotherapists in our sample, regardless of nationality/country they are from, had a higher level of vicarious traumatization as measured by TABS, then the reference sample of US trauma therapists. On the other hand, average TABS score of our sample, was in line with the average score of the Pearlman’s (2003) nonclinical population sample. One possibility for these results could be that European psychotherapists worked with PTSD patients more often than with other types of trauma clients, due to recent wars in the Balkans and the sequential outflow of large numbers of refugees and other participants in those events. Another possible explanation may be that European psychotherapist system of continual education, which includes supervision, puts less focus on vicarious traumatization of psychotherapists. On the other hand, descriptive characteristics of the other measures obtained on our sample were in line with those obtained on reference samples, and that is also the case with internal consistency and resilience scale interrelations. All of this suggests, that although the sample used in the study structurally differs from the general population of psychotherapists, statistical/psychometrical data obtained on the measures support the validity of the results.

Having all this in mind, we can say that these results strongly support the hypothesis proposed by other researchers (eg. Pearlman, 1996) that personal meaning is an important mediator of vicarious traumatization level. This is even more so, if we take into account the fact that no significant relation between vicarious traumatization and any of the control variables was found. Vicarious traumatization does not seem to change with the duration of exposure to traumatic contents (years of therapeutic experience, years of working experience), nor is it related to age or gender, but it does change with the level of personal


meaning one finds in relationships with others. The finding that personal meaning mediates the relationship between resilience and vicarious traumatization implies that in order to reduce vicarious traumatization levels of therapists it would be much more effective to develop prevention programs aimed at developing personal meanings, especially personal meanings of relationships with others than on developing strategies for coping stress, or at least that stress coping programs should be supplemented with elements aimed at developing personal meanings.

Conclusion

Our results show that vicarious traumatization level of therapists in our sample is negatively related to both resilience and personal meanings. Personal meaning mediates the relationship between resilience and vicarious traumatization. When subscales are considered the level of personal meaning of relationships with others was found to be the sole most important covariate of the vicarious traumatization level, accounting for more variance then all the other variables taken together and making their individual contributions to the total amount of vicarious traumatization variance explained non-significant. Results also supported a model postulating that personal meanings of relationships with others mediates the relationship between resilience and vicarious traumatization.

acknowledgement

This research was partly supported by a research grant from the Ministry of Education and Science of the Republic of Serbia within the framework of the 179002 scientific research project, led by Vladimir Hedrih, Ph.D.

authors:

Jelena Želeskov-Đorić, PhD, Research assisstant, Gestalt psychotherapist, EAGTInstitute for Criminological and Sociological Research, BelgradeHome adress: Dr Ivana Ribara 53/11, 11000 – Belgrade, SerbiaE-mail: [email protected] activity: Psychological research and psychotherapy

Vladimir Hedrih, PhD, Assistant professorDepartment of Psychology, Faculty of Philosophy, University of NišE-mail: [email protected], [email protected] Main activities : Psychological research

Predrag Đorić, MD, Msc, Vascular surgeonInstitute for Cardiovascular Deseases, Belgrade Dr Ivana Ribara 53/11, E-mail: [email protected] Main activities: Research and vascular surgery

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Relations of Resilience and Personal Meaning with Vicarious Traumatization in Psychotherapists