Interventions and Strategies Several authors describe techniques or informal STS interventions. Although rigorous research on these approaches has not yet been conducted, Sprang et al.’s (2018) workgroup proposed comprehensive STS intervention guidelines, comprised of universal/primary prevention on an organizational level, selective/secondary prevention, or indicated/ tertiary prevention and clinical treatment for those with STS symptoms. Interventions include guidance for maximizing safety and minimizing unwanted exposure to traumatic stressors, psychoeducation about posttraumatic stress symptoms, and education about reducing risk factors and enhancing protective factors to prevent expectable acute posttraumatic stress reactions from becoming chronic impairments. From these principles, Miller and Sprang (2017)
recently developed
a manualized program called Components for Enhancing Clinician Engagement and Reducing Trauma (CE-CERT), which provides a standardized option for STS intervention.
In light of the paucity of empirical guidance, I propose several STS management strategies based on the experiences of hundreds of trauma therapists I have supervised during a quarter-century of trauma-focused work. These strategies are intended as basic self-care tools and are not intended as a comprehensive intervention approach. To promote self- reflection, the strategies are presented as questions play therapists can use to evaluate their self-care practices.
Physical Well-Being 1. Do you work through meals, tolerate unquenched thirst, or hold your bladder because you do not take time at work to care for your own basic needs? Many play therapists who would not deny a child a drink of water or a bathroom break, regularly inhibit themselves from satisfying these necessities. Be as compassionate toward your body’s basic needs for nutrition, hydration, sleep, and bathroom breaks as you are to children’s needs.
2. Do you feel physically safe traveling to/from and at work? Creating a physiological fear responses. If your work environment involves elevated risk of physical harm, proactively take all available actions to enhance physical safety (e.g., install security lights, walk in groups to automobiles, ensure workplace emergency systems are functional and that you know how to use them, or develop a buddy system for situations in which you have safety concerns).
chaos, or beauty? When your work environment contains pleasant and comfortable surroundings, you and your clients are visually reminded that beauty continues to exist in the world despite pain and suffering. message you wish to impart.
Psychoeducation and Monitoring of STS 4. Do you recognize the normalcy of STS reactions? Empathic, emotionally attuned trauma therapists commonly experience sadness, distress, or concern related to children’s traumatic experiences.
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This is expected and typical
rather
than a sign of
inadequacy or
unprofessionalism. Play therapists who experience prolonged or intense reactions should consider seeking professional support (e.g., mental health services, consultation, or peer support), but sporadic and transient STS reactions characterize most play therapists’ work.
5. Can you accurately rate your level of STS? It can be helpful to use an assessment tool to monitor your STS level. The Professional Quality of Life Scale (ProQOL; Stamm, 2010) is the most widely used scale for STS and related concerns. It is available online at no cost.
CognitiveStrategies 6. Are your thoughts helpful or unhelpful? examine the veracity and helpfulness of your work-related thoughts: • Examine your expectations to be sure that they are reasonable and within your control to achieve. For example, focus on providing high-quality treatment to a child and family rather than attempting to alter aspects of a child’s environment you have little or no power to change (e.g., a family’s socio-economic status).
• Be aware of cognitive bias. Your increased awareness of child abuse does not mean that it occurs with any greater frequency than it did before you were aware of
it. Recognize that play
therapists are often exposed to skewed samples of traumatized children. Moreover, surviving trauma does not sentence children survivors, including many play therapy and trauma experts, who have transformed their traumatic experiences into opportunities for posttraumatic growth.
• Remain cognizant of the boundary between your own and your clients’ experiences. During sessions, therapists share an empathic connection with clients. Afterward, it is important to relinquish clients’ experiences and emotions in order to reclaim and remain fully present in your own life. Ruminating on clients’ experiences is the conclusion of each work day remind yourself that your clients’ experiences are not your experiences, and refocus yourself on your own emotions, thoughts, activities, and loved ones.
BehavioralStrategies 7. Do you balance suffering and joy? During the past week, how many minutes have you focused on traumatic material compared to the amount of time you have engaged in highly pleasant activities? If the balance tilts heavily toward trauma, increase the time you spend in joyful experiences to establish a more sustainable ratio. Scheduling short breaks to focus on a non-work related, pleasant experience or thought also can help play therapists retain a sense of balance throughout the work day.
8. Do you unnecessarily expose yourself to traumatic events in the media? Given play therapists’ level of trauma exposure at work, reducing extracurricular exposure through news broadcasts, movies, books, and
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