SUPPORTING THE SUPPORTER: EXPLORING WELL-BEING IN THE FACE OF VICARIOUS TRAUMA by VICTOR JUN HYUNG LEE Bachelor of Social Work, University of British Columbia, 2017 Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of MASTER OF ARTS IN COUNSELLING PSYCHOLOGY in the FACULTY OF GRADUATE STUDIES TRINITY WESTERN UNIVERSITY November 2021 © Victor Jun Hyung Lee, 2021 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA The following committee members attest to the successful completion of this thesis Marvin McDonald, PhD Darae Lee, MSW Teresa Puvimanasinghe, PhD Thesis Supervisor Second Reader External Examiner ii WELL-BEING IN THE FACE OF VICARIOUS TRAUMA iii ABSTRACT (ENGLISH & KOREAN HANGUL) Helping professionals working with clients who have lived through trauma often carry with them a risk of vicarious traumatization (VT) as well as the potential for vicarious posttraumatic growth (VPTG). The vicarious impacts of trauma have been explored among diverse helping practitioners but VPTG studies among refugee workers has been scarce. This thematic narrative study explored how service providers are personally thriving because of working with refugees. Six helpers and the researcher co-constructed narratives about how their work with refugee trauma survivors has cultivated personal growth and well-being. Qualitative results showed that VPTG as an alternative narrative to VT was personally empowering for refugee workers in the face of refugee clients’ trauma. Results further revealed that mutual relationships and allyship color sustainable growth at the heart of VPTG. These findings on refugee workers in Canada have important implications for service providers’ well-being, service quality, policy, and refugee clients’ health. Keywords: refugees, vicarious trauma, vicarious posttraumatic growth, well-being WELL-BEING IN THE FACE OF VICARIOUS TRAUMA iv 트라우마로 고통받는 사람들과 일하는 전문가들은 대리외상증후군만이아니라 대리외상후 성장의 가능성도 있다. 직접적 트라우마에 노출된 사람들을 돕는 직업군들이 겪는 현상, 즉 대리적 (간접적) 외상 에 노출되어있는 다양한 직업군들에 대한 연구는 활발히 진행되어 왔다. 그러나 난민들을 돕는 난민 전문가들이 겪을 수있는 대리외상후 성장에 대한 연구는 매우 제한적이었다. 본 정성적 연구는 주제적 이야기 분석을 통해서 어떻게 캐나다 난민들과 일하는 전문가들이 개인적으로 성장하는지에 대해 연구했다. 본 연구자는 온라인으로 진행된 반 구조화 인터뷰를 통해서 비영리 단체에서 속한 여섯명의 난민전문 사례관리사들의 난민들과 일하는 과정에서 느끼는 성장과 웰빙에 대해 대화형식으로 인터뷰를 진행했다. 그 결과 다음과 같은 주제들이 도출 되었다: 캐나다 이민 시스템에 대한 좌절감, 무력감과 절망감, 난민들과의 사례관리자간의 정신적 구별, 긍정적 힘과 에너지의 주고 받기, 무조건적 자기수용등이다. 이러한 주제들은 외상후스트레스를 가진 다양한 난민들과 일하는것은 대부분 대리외상증후군으로 귀결된다는 이야기에 반함을 의미한다. 연구에 참여한 몇몇 난민 전문사례관리사들은 대리외상후 성장에대한 대화를 나누는 것을 대리외상화만에 집중하는 대화보다 더 큰 의미를 느꼈다. 난민들과 일하는 전문가들에 대한 연구가 다른 상담분야보다 상대적으로 빈약함을 비추어 볼때 본 연구의 이러한 결과들은 그들에 대한 안녕, 서비스의 질, 관련 정책 그리고 무엇보다 난민클라이언트들의 삶과 관련해 중요한 의미를 갖고있다. 키워드: 난민, 대리외상증후군, 대리외상후 성장, 웰빙 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA v TABLE OF CONTENTS ABSTRACT (ENGLISH & KOREAN HANGUL) ...................................................................... iii TABLE OF CONTENTS ................................................................................................................ v LIST OF TABLES ......................................................................................................................... ix LIST OF FIGURES ........................................................................................................................ x CHAPTER 1: INTRODUCTION ................................................................................................... 1 CHAPTER 2: LITERATURE REVIEW ........................................................................................ 7 CSDT Model of Vicarious Traumatization......................................................................... 7 Methodological & Conceptual Challenges ......................................................................... 9 Existing Methodological Challenges .................................................................... 11 Evidence for Vicarious Traumatization ............................................................................ 12 Vicarious Traumatization: Quantitative Inquiry ................................................... 12 Exposure to Trauma .............................................................................................. 15 Vicarious Traumatization: Qualitative Inquiry ..................................................... 16 Evidence of Vicarious Traumatization for Settlement Workers ........................... 17 Risk Factors and Protective Factors ...................................................................... 18 Movement towards Flourishing ............................................................................ 20 Alternative Narratives of Trauma Work ........................................................................... 20 Transition towards Growth and Resilience ........................................................... 21 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA vi Vicarious Posttraumatic Growth: Initial Studies .................................................. 22 Vicarious Posttraumatic Growth: Further Evidence ............................................. 24 Purpose of Current Study .................................................................................................. 26 CHAPTER 3: METHODOLOGY ................................................................................................ 29 Research Design................................................................................................................ 29 Research Paradigm Assumptions .......................................................................... 29 Rationale for the Narrative Approach as Methodology ........................................ 32 Conceptual Thinking for Thematic Analysis ........................................................ 35 Participants and Recruitment ............................................................................................ 37 Sampling and Data Collection .......................................................................................... 39 Data Analytical Strategy ................................................................................................... 42 Transcription as Interpretation .............................................................................. 42 Applying the Thematic Analysis .......................................................................... 43 Rigour and Quality ............................................................................................................ 46 Reflexivity............................................................................................................. 47 Interrogating Assumptions. ....................................................................... 47 Research Journal. ...................................................................................... 48 My Relationship with the Topic of Research. .......................................... 49 Disconfirming Evidence ....................................................................................... 52 Collaboration with Research Participants ............................................................. 53 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA vii Collaboration with Research Team ....................................................................... 53 Ethical Considerations ...................................................................................................... 54 CHAPTER 4: RESULTS .............................................................................................................. 56 Vicarious Traumatization (VT)......................................................................................... 57 Frustration with the System .................................................................................. 57 Identification with Helplessness and Hopelessness .............................................. 60 Vicarious Posttraumatic Growth ....................................................................................... 62 Organizational Support ......................................................................................... 62 Self-Care Strategies .............................................................................................. 64 Detecting and Meeting Clients’ Needs within Our Capacity................................ 66 Differentiation of Self from Clients ...................................................................... 67 Factors Hindering VPTG ...................................................................................... 69 Unconditional Self-Acceptance ............................................................................ 70 Postecstatic Growth .......................................................................................................... 72 Empowering and Being Empowered .................................................................... 72 Facilitating Self-Sustainability.............................................................................. 74 Intersectional Allyship and Sense of Privileges.................................................... 75 Changing the Narrative Through Research Participation ..................................... 77 Integrative Summary of Results........................................................................................ 78 CHAPTER 5 DISCUSSION ......................................................................................................... 83 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA viii Summary of Rationale and Research Question ................................................................ 83 Contribution to Literature ................................................................................................. 84 Relevance to VT Literature ................................................................................... 84 Relevance to VPTG Literature.............................................................................. 86 Relational Shaping of Growth. ................................................................. 87 Implications for the Study: Supporting the Supporters..................................................... 91 Policy Recommendations...................................................................................... 92 Dissemination of Findings During the Next Phases of COVID-19 Pandemic ..... 95 Strengths, Limitations, and Future Directions for Research ............................................. 96 Conclusion ........................................................................................................................ 98 REFERENCES ........................................................................................................................... 100 APPENDIX A: Glossary............................................................................................................. 115 APPENDIX B: Background Questionnaire ............................................................................... 118 APPENDIX C: Professional Quality of Life Scale (PROQOL) ................................................ 119 APPENDIX D: First Interview Protocol.................................................................................... 120 APPENDIX E: Second Interview Protocol................................................................................ 121 APPENDIX F: Informed Consent Form .................................................................................... 122 APPENDIX G: Debriefing Form ............................................................................................... 124 APPENDIX H: Resource Sheet ................................................................................................. 125 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA ix LIST OF TABLES Table 1 Participants’ Backgrounds ............................................................................................... 38 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA x LIST OF FIGURES Figure 1 Processes of Vicarious Traumatization ........................................................................... 9 Figure 2 Thematic Map: Vicarious Impact of Working with Refugees ...................................... 78 Figure 3 Core Processes of Relational Shaping of Growth Model .............................................. 88 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA xi ACKNOWLEDGEMENTS To the members of our research team, especially Dr. McDonald: It is difficult to put the overall experience of ending our journey together into words. Through this research, we may have come close as a group to embodying relational shaping of growth. Thank you for your encouragements, patience, and kindness; they helped me cultivate competence as a novice qualitative researcher. To my family and friends: The end of my journey to this project has become even more meaningful thanks to each and every one of you folks. Mom and dad, we have come a long way and I am grateful to have both of you bear witness to this achievement. Chloe, thank you very much for believing in me and giving me priceless advice. Your passion and appreciation for aesthetics complemented the research with much-needed visual rhetorics. To Chris, Linus, and Susan, and many more colleagues, thank you for your loving friendship and timely support. And to the key informants (Gina, Darae, and Meheret) and the participants: MM, BM, LMB, AS, RA, and JSB: Thank you for your willingness to trust me with your stories during this unique time. It has been my privilege to bear witness to your experiences of thriving and healing in collaboration with our clients. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA CHAPTER 1: INTRODUCTION This research project concerns service providers caring for newcomers to Canada who have lived through refugee-related trauma and challenges of resettlement and settlement (see Appendix A: Glossary). Specifically, the project aims to explore how these service providers communicate about vicarious trauma (VT) and the ways in which they resist or reinterpret it. While the primary frameworks for conceptualizing the negative effects that practitioners experience have been amply documented in the literature, the positive effects have not received adequate attention. At the heart of this qualitative thesis lie the narratives of settlement workers who share their lived experiences walking alongside Canadian immigrants with multiple needs, particularly refugees and asylum seekers. The number of refugees and asylum seekers who are forcibly displaced as a result of conflict, poverty, violence, and human rights abuses is constantly increasing worldwide. They often suffer from the aftermath of the traumatic experiences such as injury, rape, torture, and concentration camp experiences. For Canada, the response to the humanitarian crisis in Syria (i.e., Operation Syrian Refugees) resulted in a large increase in the acceptance rate for refugees including Syrians (Immigration, Refugees and Citizenship Canada, 2019a). According to the UN's refugee agency (The Office of the United Nations High Commissioner for Refugees; 2018), Canada resettled the largest number of refugees out of 25 countries in 2018. Given the ongoing influx of refugees, more research needs to be done to understand the psychological impacts of working with these people. Investigation on this topic can promote service quality, service providers’ well-being, and refugee clients’ successful settlement (Puvimanasinghe et al., 2015). 1 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 2 Since the early 1990s, there has been a persistent discussion in the psychological literature about adverse effects of trauma work on helpers who work with traumatized individuals. Figley (1995), one of the founding investigators of the phenomenon, referred to it as the “cost of caring” (p. 7). According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the diagnostic criteria for posttraumatic stress disorder (PTSD) recognizes that one could make themselves vulnerable to symptoms of PTSD simply by learning about traumatic events experienced by a family member or a close friend (5th ed.; DSM-5, American Psychiatric Association, 2013; Figley was using the fourth edition of the DSM, which formulates this point in a similar fashion). Partially overlapping concepts such as compassion fatigue (CF), vicarious trauma (VT), secondary traumatic stress (STS), and burnout have shaped this costly caring narrative, resulting in common advice to helping professionals to be aware of how debilitating trauma work can be on their personal and professional lives. In light of helping relationships, the same narrative warns helping professionals that walking alongside and experiencing the pain of others could take a heavy toll on one’s emotions, cognition, memories, self-esteem, identity, and worldview (Figley, 1995). In the past, several studies have assessed specific groups of helping professionals for VT. The groups that have been studied frequently include therapists (Follette et al., 1994; Iliffe & Steed, 2000; Pearlman & Mac Ian, 1995), firefighters (Brown et al., 2002), social work clinicians (Cunningham, 2003), and ambulance workers (Clohessy & Ehlers, 1999). Another group of helping professionals regularly exposed to traumatic material is settlement workers. Settlement worker is a general occupational category that refers to those who help immigrants with multiple needs and barriers, understand immigrants’ rights and responsibilities, and offer diverse resources to help with resettlement (Ontario Council of WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 3 Agencies Serving Immigrants, 2020). The central pillars of their work include a) documentation support (e.g., assistance with processes of application); b) provision of information and orientation (e.g., education, housing, employment, community connections, etc.); c) service bridging (e.g., making referrals to other professionals, informing clients of external resources), d) client advocacy (i.e., speaking to other service providers/government ministries on behalf of their clients), and e) emotional support (Immigration, Refugees and Citizenship Canada, 2019b). In fact, the services settlement workers provide overlap to a large extent with those provided by social workers in support of Canadian-born citizens with needs (except for psychological counselling). In this project, I recruited a group of Canadian settlement workers focusing on caring for refugees and asylum seekers who have lived through trauma. As many settlement workers incorporate culturally relevant practices, they listen empathically to their clients’ narratives of pre-migration trauma and post-migration stressors (Chan et al., 2016). For the most part, the adverse psychological impacts of working with the refugee survivors of trauma seem to run parallel to the narrative of vicarious traumatization. Indeed, a small number of researchers documented that service providers supporting refugee populations have reported experiencing VT (e.g., Barrington & Shakespeare-Finch, 2013; Puvimanasinghe et al., 2015). Consider the comments from several settlement workers participating in Puvimanasinghe et al.’s (2015) study, representing the symptoms of VT through their narrative: …what they [asylum seekers] want is the visa. And I can’t do anything about that… And this thing of wanting to give someone a hug and say, “of course come here; come and live in my house”. So… feeling like a heart connection with clients; but not being able to do what they really want … So that definitely; the helplessness is something I have struggled with. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 4 … It’s much harder … when you got children of your own. [Earlier] people could talk to me about anything. Now… it’s not easy … So when a mother says her child died of asthma because she did not know he had asthma ... I think “my God, I have a child that age”. The identification with that is so much. So you can defend against that and just not listen, and the person feels that you don’t care about the child … I care, I do care. Those are the hardest things I think (p. 758) These narratives arguably reveal the negative effects of trauma work on participants’ personal and professional lives. For almost all participants of the study, bearing witness to their clients’ traumatic material—pre-migration trauma and post-migration stressors—has impacted them to such an extent that they commonly take in some of their clients’ emotional pain (Puvimanasinghe et al., 2015). The participants exhibited the signs of what researchers referred to as vicarious trauma narratives, including frustration at the seemingly uncaring and unjust immigration system, a sense of helplessness for not being able to resolve clients’ immediate needs, and identifying with their clients’ predicaments (Chan et al., 2016; Figley, 1995). On the other hand, the positive psychological impacts of working with traumatized people have also surfaced in the recent literature. These impacts are described in various ways as vicarious post-traumatic growth or VPTG (Arnold et al., 2005), vicarious resilience or VR (Hernandez et al., 2007), and adversarial growth or AG (Linley & Joseph, 2007). A small number of studies (e.g., Arnold et al., 2005; Hernandez et al., 2007; Linley & Joseph, 2007) have attested to these alternative narratives, reporting that, in fact, it is through their work that trauma practitioners are able to experience positive change and growth. Such narratives are closely associated with how we understand the relationship between hope and despair. Contrary to some theorists who described hope and despair as antonyms and put them on opposite sides of a WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 5 spectrum (Campbell, 1987), other theorists suggested that hope and despair actually exist as a paradox because despair “receives its definition through the presence or absence of hope” (Jenmorri, 2006, p. 44). Indeed, Jenmorri (2006) argued that the interrelated relationship between hope and despair conveys something profound about human existence despite the way they come across as contradictory to each other. Recent studies have started to expand research on VPTG among several helping professions working with groups of individuals who have experienced extreme traumatic experiences, including large-scale natural disaster survivors (Nishi et al., 2016), torture survivors (Hernandez et al., 2015), survivors in warzones (Lev-Wiesel et al., 2009), and survivors of child abuse (Rhee et al., 2013). The nature of the work that professionals working with refugees do can also lead to sensitivity to traumatic subject material (e.g., Barrington & Shakespeare-Finch, 2013; Chan et al., 2016; Puvimanasinghe et al., 2015). Although the level of vulnerability for these professionals seems to be no less than the vulnerability of the other previously studied groups, the amount of research interest in their work has been relatively scant. Indeed, as Chan et al. (2016) recently suggested, given the extent to which helping professionals delivering services to refugees experience VT through their work, studies on VPTG are “even more limited” (p. 295). Jenmorri (2006) has shed light on how silences and gaps in stories can restrict our sense of identity and room for growth and argued that potentials for living are compromised if narratives are missing. She also prodded helping practitioners towards filling in these silences and gaps with new narratives. Many of the narratives echoed by both frontline helping professionals and scholars regarding trauma work have largely described VT as an inevitable hazard of the work (McCann & Pearlman, 1990, p. 144). When it comes to studying the lived WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 6 experience of settlement workers, evaluating their experience through the lens of VPTG can expand the idea that their endeavours to address the needs of trauma survivors are hazardous and unsustainable. My hope is that, through this project, we can raise an awareness for settlement workers to shift their understandings in ways that nurture, rejuvenate and sustain them. The aim of my project is to contribute to the search for missing stories among a group of helping practitioners who have received little attention and whose roles are important in today’s world (Barrington & Shakespeare-Finch, 2013). The following questions anchor my exploration: 1. In what ways do settlement workers personally flourish as they work with refugees who have lived through trauma? 2. In what ways do settlement workers resist or reinterpret vicarious trauma narratives? WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 7 CHAPTER 2: LITERATURE REVIEW Despite the large volume of research on the effects of trauma, the factors relating to the trajectory of possible recovery for those who experience trauma vary and remain uncertain. While certain individuals suffer significant chronic negative psychological ramifications, others go through transient distress and restore their functioning within time. Likewise, we have yet to reach a consensus on why certain helping professionals working with trauma survivors are left to experience negative consequences, whereas others can survive or, in some instances, thrive in similar environments. This chapter maps out existing literature relating to vicarious impacts of trauma work on practitioners supporting trauma survivors. The first half highlights several ways in which negative effects of trauma work are conceptualized, including constructivist self-development theory (CSDT), methodological and conceptual challenges, and evidence for vicarious traumatization (VT). The second half illustrates the shifted emphasis within the literature away from the negative and towards the positive effects of trauma work (i.e., vicarious posttraumatic growth; VPTG). CSDT Model of Vicarious Traumatization Between the 1990s and early 2000s, incremental steps were made to help understand how clinicians working with individuals who suffered trauma become affected by their work. During this period of time, a large number of researchers paid attention to the negative impacts of trauma work, an experience referenced within the literature in several different ways. Among the first wave of researchers, McCann and Pearlman (1990) are recognized for introducing the construct of VT. In their work with survivors of sexual abuse and incest, the authors defined VT as “enduring psychological consequences for therapists of exposure to the traumatic experiences WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 8 of victim clients” (p. 133). Not long afterwards, Pearlman and Saakvitne (1995) further defined VT as a transformation in helping professionals’ internal experience following empathetic attunement to the client’s trauma. The description of VT by McCann and Pearlman is founded upon the CSDT. According to this theoretical model, individuals actively interpret their experiences and environment through the construction of cognitive structures, or schemas. Further elaborated by JanoffBulman who coined the terminology of “shattered assumptions” (1992), CSDT posited that one’s original schemas—their beliefs, assumptions, and expectations about oneself, others, and the world—are subject to being challenged when new information does not fit with the existing schemas and thus cannot be assimilated (McCann & Pearlman, 1990). Through empathic engagement with traumatized clients, the helping professionals bear witness to the existences of people’s deliberate brutality to each other, leaving them vulnerable to VT (Pearlman & Saakvitne, 1995, p. 151). When exposed to VT, their schemas suffer from enduring disruptions (i.e., shattered assumptions), which will have a negative influence on their relationships, emotional well-being, and general functioning (McCann & Pearlman, 1990). Because of the way in which victims’ trauma material overwhelms helps’ sense of self, they begin to reveal characteristics similar to those of their clients (Figley, 1995). McCann and Pearlman (1990) listed several aspects of long-term alterations that helpers will ultimately go through in their own schemas: a sense of trust/dependency, the ability to manage one’s own sense of power, the ability to maintain a sense of safety, and the ability to maintain self-esteem as well as intimacy. Moreover, helpers may experience harrowing imagery related to clients’ traumatic incidents, reexperiencing clients’ traumatic materials, and disruptions in their own imagery system of WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 9 memory (McCann & Pearlman). Concise theoretical contexts for understanding this complex phenomenon are included in Figure 1. Figure 1 Processes of Vicarious Traumatization There have been disagreements and even confusion within the literature regarding the manner in which the negative effects of working with trauma survivors are conceptualized. In fact, VT is only one construct of several that theorists have proposed to elaborate on the negative impacts of trauma work. Other constructs include STS, burnout, and CF. Methodological & Conceptual Challenges Naming conventions have not been formalized into an overarching theoretical framework since researchers have utilized varied nomenclature to represent the adverse impacts of working WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 10 with trauma survivors on helping professionals. Stamm (2009), an author of ProQOL, which purports to measure VT concepts, claimed that clarifying the vocabulary remains to be a taxonomical challenge. Throughout the literature, some authors have interchangeably used the terms STS, CF, and VT even though precise definitions of theoretical constructs for making sense of helpers’ negative experiences of their trauma work are somewhat different (SabinFarrell & Turpin, 2003). For example, given the diverse manners in which VT was operationalized, Baird and Kracen (2006) redesigned the format of their meta-analysis into a narrative review and synthesis of the existing literature. Although Baird and Jenkins (2003) have started to evaluate components that discriminate between VT, STS, and burnout, more research in this regard will certainly be appreciated. In the beginning stages of this work, researchers adapted standardized instruments originally developed to assess PTSD symptoms in order to measure VT/STS, including the Impact of Event Scale (IES; Horowitz et al., 1979) and the Trauma Symptom Checklist-40 (TSC-40; Elliot & Briere, 1992). More recently, authors have invented specific instruments tailored to more comprehensively capture the specific theoretical frameworks pertaining to VT: The Traumatic Stress Institute Belief Scale (TSI) by Pearlman (1996), The Compassion Fatigue Self-Test for Practitioners (CFST) by Figley (1996), the Professional Quality of Life Scale (ProQOL) by Stamm (2009), and the Secondary Traumatic Stress Scale (STSS) by Bride et al. (2004). Because they have used various methods to measure the negative impact of providing trauma support on the helping professional, there have not been conceptually shared frameworks to help distinguish between constructs derived from different instruments. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 11 Existing Methodological Challenges Despite the emergence of several standardized instruments designed to quantify VT, a number of criticisms have been generated in the literature, particularly regarding the methodological issues related to measuring VT (Sabin-Farrell & Turpin, 2003). Perhaps the most noteworthy critiques were raised by Sabin-Farrell and Turpin (2003) who conducted a systematic review on the empirical research on VT. Primarily, the authors pinpointed that the majority of the standardized instruments used to date had only assessed some aspects of VT rather than the concept of VT as a whole. Furthermore, they pointed out that the use of primary trauma assessment scales as means to indirectly quantify VT was questionable. In other words, it is unclear if such scales were measuring helpers’ responses to the exposure to client’s traumatic stories or whether they were measuring helpers’ own personal experiences of primary trauma. Moreover, this field merits the benefits from fine-tuning the boundaries of the concept of VT with respect to relevant terms (i.e., STS, CF, burnout) as there seem to be subtle but noticeable differences between them (Stamm, 2009). Additional criticisms of the previous VT research include lack of clear differentiation on the overlap amongst the commonly used scales, the use of survey methodology with low response rates, and heavy reliance on cross-sectional designs, which restricts many insights on causal inferences and development over time (SabinFarrell & Turpin, 2003). As a means to address the concern regarding over-reliance on the crosssectional designs, Baird and Kracen (2006) suggested that future researchers consider longitudinal methods. In summary, the conceptual and methodological clarity of exploring VT and its associated concepts is subject to further debate and development (Sabin-Farrell & Turpin, 2003). WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 12 Evidence for Vicarious Traumatization Researchers have developed diverse insights on the aspects of VT through both quantitative and qualitative inquiries (Cohen & Collens, 2013; Sabin-Farrell & Turpin, 2003). The main areas highlighted in the literature so far include corroborating both the existence and the prevalence of VT, establishing a point after which indirect exposure to traumatic material leaves helpers most vulnerable to VT (i.e., patterns of cumulative impact), pinpointing individual and organizational factors that may protect individuals from VT, and identifying personal variables that might be involved in vulnerability to being triggered into VT. Sabin-Farrell and Turpin (2003) conducted a systematic review of both quantitative and qualitative evidence for VT/STS during the 1990s. Some studies (Arvay & Uhlemann 1996; Cunningham, 2003; Pearlman & Mac Ian, 1995) highlighted that being newer to trauma work (i.e., less than 10 years of experience) is associated with likelihood of VT, and other studies (Kassam-Adams, 1995; Schauben & Frazier, 1995) found that a high percentage of trauma survivors in one’s caseload predicts VT. Another study (Brady et al., 1999) suggested that higher levels of VT symptoms are related to cumulative exposure to trauma. Despite somewhat scattered evidence for VT, Sabin-Farrell and Turpin (2003) acknowledged that emerging studies that utilized qualitative methods to investigate VT have offered valuable evidence about VT in addition to their questionnaire-based counterparts. Therefore, the literature regarding VT deserves to be reviewed in a manner that includes both quantitative and qualitative research. Vicarious Traumatization: Quantitative Inquiry An early study that investigated VT as it relates to helping professionals was conducted by Follette et al. (1994). The authors assessed for "secondary traumatization" (p. 276) among mental health practitioners (n = 225) and law enforcement officers (n = 46), both of whom WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 13 provided services to childhood sexual abuse survivors. Using the Therapist Reaction Questionnaire, these researchers assessed the way mental health practitioners and law enforcement officers experienced the negative clinical responses to child sexual abuse cases and negative coping strategies. Follette et al. also employed the Trauma Symptoms Checklist-40 to assess for participants’ PTSD symptoms. Overall, the authors found that while police investigators reported significantly more distress on all measures, mental health practitioners reported relatively lower levels of VT. Interestingly, the authors also found that levels of VT were not associated with the personal trauma history of mental health practitioners. Following Follette et al.’s inquiry (1994), two studies that have been quoted frequently in the literature as primary sources of evidence for VT are those of Schauben and Frazier (1995) and Pearlman and Mac Ian (1995). Schauben and Fraser (1995) found results substantiating the hypothesis that trauma work disorients the cognitive schemas of helping practitioners. Female rape crisis counsellors (n = 30) and female psychologists (n = 118) supporting survivors of sexual violence were recruited and tested using a variety of well-established measurements such as the TSI Beliefs Scale and the Brief Symptom Inventory. The researchers also incorporated qualitative analysis by adding two open-ended written-response questions regarding the participants’ work that they found enjoyable and challenging. It is worth noting that the results showed significant positive correlations between the number of sexual violence survivors in counsellors’ caseloads, PTSD symptoms, counsellors’ schema disruptions, and self-reported VT. When it comes to the qualitative data, the helpers’ responses attesting to the challenges of working with trauma survivors—schema descriptions and emotional distress—matched their responses from the quantitative data. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 14 Pearlman and Mac Ian (1995) conducted their study to investigate the nature of VT. Both professional and student therapists (N = 188) filled out the IES, TSI Belief Scale, and Symptom Checklist-90-Revised (SCL-90-R). The participants also completed a questionnaire developed by the authors intended to acquire information about one’s personal trauma history, amount of exposure to client’s trauma narratives, and use of supervision. The results suggested that trauma therapists without personal trauma history showed fewer negative effects from the work than those with personal trauma history. Pearlman and Mac Ian also found that beginning therapists who had less experience working with trauma clients had more symptoms of VT and cognitive schema disruptions, and vice versa. Another study conducted by Arvay and Uhlemann (1996) found similar theme of the negative correlation where VT is more likely to be experienced by therapists with less than 10 years of clinical experience pertaining to trauma work. Cunningham (2003) compared the level of VT between social work clinicians (n = 151) working with survivors of human-induced trauma, such as sexual abuse, and social work clinicians (n = 153) serving survivors of naturally caused traumas, such as cancer, by using the Traumatic Stress Institute Belief Scale (TSIBS). The result of the quantitative study supported one of their main hypotheses: clinicians working with survivors of human-induced trauma experience more symptoms of VT—particularly more disruptions in the schemas of other-esteem and other-trust—than clinicians working with survivors of naturally caused traumas. Furthermore, the authors also found that those new to trauma work, as well as clinicians with a personal history of sexual abuse, are more likely to experience VT. Likewise, empirical studies have produced salient, yet somewhat divergent findings when it comes to the likelihood of VT among helping practitioners (Sabin-Farrell & Turpin, 2003). WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 15 Exposure to Trauma CSDT postulates that there may be a positive association between one's exposure to a client’s trauma and one’s likelihood of experiencing VT. In other words, the more helping practitioners are exposed to the traumatic material of clients, the higher likelihood that they will report the symptoms of VT. However, the findings in the literature have not been unequivocal in this regard. Some scholars supported CSDT through their findings, reporting that the amount of exposure (i.e., percentage on caseload, cumulative exposure, and hours spent with trauma clients) to the traumatic material of clients increases the likelihood of VT. For example, Shauben and Frazier (1995) reported that therapists who took on higher percentages of survivors on their caseloads experienced more severe schema disruptions about the trustworthiness of others and displayed more PTSD symptoms. Similarly, Brady et al.’s (1999) questionnaire-based study found that practitioners with a greater cumulative exposure to sexual abuse clients or with a higher rate of sexual abuse clients on their caseloads had a significantly increased rate of VT. Brady et al.’s (1999) findings paralleled those of other quantitative studies (Arvay and Uhlemann, 1996; Kassam-Adams, 1995). However, other scholars disputed CSDT, finding that the amount of exposure to the traumatic material of clients does not necessarily promote the likelihood of VT. Pearlman and Mac Ian (1995) found that therapists who had a higher rate of human-induced trauma survivors on their caseloads had less cognitive schema disruptions. Follette et al.’s (1994) findings also supported this trend, as they reported that the likelihood of VT was not predicted by having a higher percentage of sexual abuse survivors on a caseload. Their findings suggested that the opposite might be the case: a higher rate of trauma survivors (thus, a higher degree of exposure WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 16 to traumatic material) on one’s caseloads can be associated with fewer disruptions in one’s cognitive schema. Contrary to quantitative studies whose findings were somewhat contradictory up until the early 2000s, more recent qualitative studies seemed to produce more consistent findings regarding the relationship between exposure to traumatic material and the occurrence of VT (Sabin-Farrell & Turpin, 2003). Vicarious Traumatization: Qualitative Inquiry Several scholars (Barrington & Shakespeare-Finch, 2013; Benatar, 2000; Illiffe & Steed, 2000; Puvimanasinghe et al., 2015; Steed & Downing, 1998) have investigated VT through qualitative methods such as phenomenological analysis and thematic analysis. Using semistructured interviews, Steed and Downing (1998) studied the lived experiences of mental health practitioners (N = 12) who supported sexual violence survivors. The authors extracted thematic content from the interview data that suggested all participants went through various severe negative effects from working with clients, including anger, frustration, sadness, and shock. It was also evident that the participants often became mistrustful of not only their spouses but also of males in general and experienced distressing dreams, flashbacks, and thoughts about the traumatic material of clients. They also became wary of their competency with clients, lost hope in humanity, and withdrew from their family and friends. Benatar’s (2000) study identified five themes about VT through their open-ended interviews with experienced trauma mental health workers (N = 12). These included a decreased sense of safety, a change in worldview, an altered relationship to self, and an altered relationship to work and others. Illiffe and Steed (2000) also discovered similar threads of evidence for VT in their qualitative inquiry when they interviewed Australian counsellors (N = 18), all of whom WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 17 reported that at least 50% of their clients had survived human-made trauma. In particular, disruptions in cognitive schemas (i.e., reduced sense of trust of others, reduced sense of safety, altered worldview about power and control dynamics in relationships) as well as psychological agony (i.e., horror, helplessness, anger) were prominent complaints from the interviewees. Evidence of Vicarious Traumatization for Settlement Workers Despite increased attention to VT among professionals working with trauma survivors, the influence of working with refugee-related trauma survivors on settlement workers has been relatively unexplored (Barrington & Shakespeare-Finch, 2013). Barrington and ShakespeareFinch pioneered research on this unsung group, exploring the lived experiences of Australian service providers—frontline clinical practitioners (N = 13) and administrative or managerial staff (N = 4)—who worked primarily with refugees and asylum seekers. Similar to the previously examined qualitative studies, data from the semi-structured interviews was then analyzed for thematic content. All participants reported symptoms indicative of VT because of their work with traumatized clients, including intrusive images, adverse emotional responses, and shattering of previous belief systems. To the authors’ surprise, their responses also revealed a glimmer of positive effects (i.e., VPTG), which will be reviewed later. Another qualitative study that assessed for VT among those who work with refugee populations was that of Puvimanasinghe et al. (2015). A diverse group of Australian service providers (N = 26)—mental health, physical healthcare, and settlement workers—were interviewed. Via inductive thematic analysis, the authors found that the themes from their interview involved VT, VR, work satisfaction, and cultural flexibility. In particular, service providers revealed facets of VT such as becoming frustrated in the government’s resettlement system, identifying with clients’ despair against harsh realities of resettlement, and witnessing WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 18 the manner in which clients’ past trauma had a negative influence on their capacity to attune to various work tasks (Puvimanasinghe et al., 2015). Overall, the two studies affirmed the existence of VT as well as VPTG/VR in service providers who work with refugee populations. Risk Factors and Protective Factors Amongst the individual characteristics that have been identified as predictor variables for VT, many researchers prioritized investigating clinicians’ personal trauma history (Sabin-Farrell & Turpin, 2003). Unlike early speculations of McCann and Pearlman (1990) that unresolved childhood traumas of mental health clinicians may increase the likelihood of emerging symptoms of VT, empirical findings up until the late 2000s regarding clinicians’ personal trauma history have been inconsistent (Dunkley & Whelan, 2006). On one hand, Pearlman and Mac Ian (1995), Arvay and Uhlemann (1996), Cunningham (2003), and Way et al. (2007) documented significant association between VT and helpers’ personal trauma history. On the other hand, other theorists (Benatar, 2000; Bober & Regeher, 2006; Follette et al., 1994; Schauben & Frazier, 1995) reported that there was no clear evidence that one’s personal trauma history predicts higher levels of VT. Besides one’s personal trauma history, other characteristics are identified as potential sources of vulnerability for developing VT. They include age (Baird & Jenkins, 2003; Way et al., 2007), gender (Illiffe & Steed, 2000; Peled-Avram, 2017; Way et al., 2007), unhelpful or irrational beliefs (McLean & Wade, 2003), maladaptive defense styles (Adam & Riggs, 2008), and insecure attachment (Bober & Rogeher, 2005; Merhav et al., 2018). Past research has also found that negative coping strategies such as substance use and interpersonal withdrawal predicted higher levels of VT (Follette et al., 1994). Since the initial stage of studying VT and its related constructs, researchers have also examined a variety of coping strategies deemed valuable in dealing with the perilous side of WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 19 working with trauma survivors. These protective factors include, but are not limited to, balancing clinical work with other work (i.e., teaching, research, etc.), adhering to the predetermined percentage of trauma survivors on a caseload, receiving individual therapy, having selfcompassion as well as realistic standards for oneself, developing a sense of humour, and seeking self-care activities not related to work (McCann & Pearlman, 1990; Pearlman & Saakvitne, 1995; Schauben & Frazier, 1995). Furthermore, actively seeking supervision, engaging in peer consultation, countering isolation, developing mindful self-awareness, having active optimism, maintaining clear boundaries, creating meaning, and participating in continuous professional development and training are recommended by some scholars (Harrison & Westwood, 2009; Iliffe & Steed, 2000; Pearlman & Saakvitne, 1995). Bober and Regehr’s (2005) study helped equip the frontline helping professionals with more profound insights about the nature of coping strategies. The study examined the extent to which various coping strategies in the literature engendered lower levels of VT. Surprisingly, they found that despite the fact that helping professionals generally had faith in the usefulness of the coping strategies, the correlation between the faith and actual time allotted to practice them was low. Another pivotal finding was that the time devoted to coping activities and levels of VT were not associated, suggesting that the coping activities do not act as a buffer against VT. Based on these results, the authors concluded that, just like the survivors of trauma are not to be blamed for their victimization and resulting trauma symptoms, helping professionals going through symptoms pertaining to VT should not be held responsible for ensuing traumatic response as if they were not managing work-life balance well and not adequately practicing leisure, self-care, or supervision. In other words, the implication of their study was that the solution to the issue of WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 20 VT needs to come from the system rather than the individual and be one that does not stigmatize the clinicians for not doing their due diligence. Movement towards Flourishing Based on the literature reviewed so far, it is apparent that scholars in the field of traumatology have prioritized exploring VT and its related constructs. Indeed, despite somewhat inconclusive empirical evidence to ascertain the nature of VT and its related methodological challenges, many have assessed and written about VT with faith and certainty (Sabin-Farrell & Turpin, 2003). Several scholars have offered rationales for focusing on the risks of VT as well as coping strategies to avert or diminish its negative impact at the policy and practice level to abate the emotional and psychological sequelae of trauma work, improve the service quality, and maintain workers’ wellbeing (Puvimanasinghe et al., 2015). On the other hand, in their attempt to understand the full range of effects of trauma work, McCann and Pearlman (1990) emphasized that the field of traumatology has to go beyond the construct of VT and endeavor to recognize the various meaningful experiences in our work as well as the affirmative effects this has had on our lives. After discovering the themes pertaining to both positive and negative changes in the aftermath of working with trauma survivors, Steed and Downing (1998) noted that further exploration of the positive influence of trauma work on helping professionals would facilitate understanding the phenomenon in a more holistic manner. Alternative Narratives of Trauma Work In the field of traumatology, a distinctive pattern of research in the impact of trauma on survivors has emerged. The focus was initially on pinpointing the effects of trauma (e.g., PTSD) and documenting coping strategies for ameliorating and preventing those effects. Scholars then shifted to identifying internal resilience and meaning making, particularly emphasizing a group WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 21 of protective factors in the face of negative influences of trauma (e.g., Linley et al., 2005; Luthar, 2015). Eventually, Tedeschi and Calhoun (1996) established a research program on posttraumatic growth (PTG). The core process of their research acknowledged that there are also positive outcomes after one survives and experiences growth in the wake of traumatic experiences. The Posttraumatic Growth Inventory (PTG-I) developed by Tedeschi and Calhoun (1996) has become a standardized survey questionnaire for measuring this phenomenon. Transition towards Growth and Resilience Since the 1980s, the traumatology literature has been following a somewhat parallel pathway in the context of helping professionals. Similar to the way our understanding of the effects of trauma on survivors was followed by growing recognition of post-traumatic growth, assessment for VT and related constructs has been followed by research focused on a pathway to amelioration, prevention, and the promotion of coping strategies, in addition to meaning-making and growth in the face of VT. Since the mid-2000s, a small group of researchers has attended to the presence of positive outcomes in the experiences of practitioners who work with trauma survivors, a phenomenon variously labelled vicarious post-traumatic growth (VPTG; Arnold et al., 2005), vicarious resilience (VR; Hernendez et al., 2007; Engstrom et al., 2008), adversarial growth (AG; Linley & Joseph, 2007), or shared resilience in a traumatic reality (NuttmanShwartz, 2015). This movement—an emerging interest regarding the positive effects of trauma work—starkly contrasts with the previous research programs that focused on investigating VT. In other words, the research regarding the positive impact of trauma work shifted from merely anecdotal or tangential data (i.e., the by-products of studying VT) to become a primary target of study (Arnold et al., 2005; Linley & Joseph, 2007). WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 22 Due to the nascent stage in the literature, theorists have begun to explore the nature of the relationship between VT and VPTG. Some conjecture that there is a symbiotic connection between vicarious trauma and vicarious posttraumatic growth (Arnold et al., 2005; ManningJones, et al., 2016, p. 27). This conceptualization is analogous to its counterpart, PTG, which requires traumatic experience to act as its catalyst. Linley and Joseph (2005) subsequently expanded the previous model, suggesting the possibility for growth as one is suffering emotionally and psychologically. Examining the experiences of trauma workers using their metasynthesis, Cohen and Collens (2012) noted in a similar manner: “the possibility of experiencing growth whilst still feeling some distressing feelings may be seen through the two broader approaches to well-being … and positions VPTG within the eudaimonic tradition of selfactualization rather than positive emotions” (p. 17). Vicarious Posttraumatic Growth: Initial Studies A growing number of inquiries have been undertaken to assess for VPTG across a diverse group of helping practitioners in a few settings. Though the research in this regard is still in early phases, both quantitative and qualitative studies, particularly those conducted since the mid2000s, are strengthening these programs of research. A seminal article written by Arnold et al. (2005) paved the way for VPTG research and coined the theoretical construct as they explored potential positive effects for psychotherapists who struggled to cope with VT. Drawing on their previously established survey (PTG-I; Tedeschi & Calhoun, 1996) and using naturalistic interviews, the investigators assessed for both VT and VPTG in psychotherapists (N = 21). Their reports suggested various signs of VT, such as intrusive thoughts, images associated with clients’ trauma, distressful emotions, and self-doubt about one’s own competence as a therapist. All participants also reported experiencing at least WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 23 one of the following positive outcomes: awareness of one’s own personal growth as a result of witnessing and advocating for their client’s posttraumatic growth, enduring and noticeable development of personality traits (e.g., sensitivity, empathy, tolerance, insight), and a deepened sense of spirituality in relation to their relationship with trauma survivors. Arnold et al. (2005) noted that the descriptions of positive impact of the work are strikingly analogous to reports of growth in the wake of directly experienced trauma and asserted that, contrary to the existing literature’s rather minimal attention to VPTG, the implications for the benefit of VPTG may be a lot more consequential and extensive. Several qualitative studies that utilized methodology similar to that of Arnold et al. (2005) supported the strength of their findings. For instance, using the term VR, Hernandez et al. (2007) also verified the presence of VPTG among psychotherapists (N = 12) who were exposed to VT amidst working with victims of political violence and torture in Colombia. Furthermore, both Hyatt-Burkhart (2014) and Possick et al. (2015) found similar evidence pertaining to VT and VPTG after interviewing mental health workers (N = 12) and social workers (N = 14) respectively. Hyatt-Burkhart, in particular, found it deeply concerning that the theme of VPTG emerged at the end of the discussions, and only did so after rounds of discussions fraught with VT, because the workers become acquainted to the detrimental effects from the work. A growing number of scholars believe that such preoccupation in the literature is detrimental to both mental health professionals as well as traumatized clients (Hyatt-Burkhart, 2014; Rogers et al., 2016). Vicarious impacts of trauma work have been documented in the literature, albeit to a limited extent, with respect to those providing services to refugees. As mentioned earlier, in their study with Australian frontline clinical practitioners (N = 13) and administrative or managerial staff (N = 4) who mostly work with refugee and asylum seekers, Barrington & Shakespeare- WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 24 Finch (2013) were surprised to find not only symptoms of VT but also signs of VPTG. Their study delved into the manner in which effortful meaning-making positively predicted the development of VPTG. Similar reports were found in Puvimanasinghe et al.’s (2015) study, featuring another group of Australian service providers (i.e., mental health, physical healthcare, and settlement workers). Puvimanasinghe et al. found that, in addition to VT, VR, work satisfaction, and cultural flexibility were reported in their inductive thematic analysis, verifying the positive impacts for practitioners working with this challenging population. Lastly, Splevins et al. (2010) found evidence of VPTG among language interpreters working with refugees and asylum seekers: the interpreters shared experiences relating to feelings of inspiration, admiration, joy, and hope as a result of their contribution to supporting their refugee clients. Splevins et al. demonstrated that, with empathic and intimate rapport with people who have gone through events of traumatic nature, practitioners can be subject to both positive and negative effects even in the absence of clinical interactions. Vicarious Posttraumatic Growth: Further Evidence Since the emergence of VPTG as a theoretical construct (Arnold et al., 2005), several researchers have investigated VPTG using quantitative measures. They examined various populations including mental health workers/therapists (Linley & Joseph, 2007; Brockhouse et al., 2011; Manning-Jones et al., 2016), child protective workers (Rhee et al., 2013), telephone counsellors (O’Sullivan & Whelan, 2011), and medical professionals (Mairean & Turliuc, 2013; Măirean, 2016). These investigators frequently drew relationships between VPTG and measures of VT/STS (i.e., previously documented standardized instruments), and they often relied on Tedeschi and Calhoun’s (1996) PTG-I as a measure of VPTG (Reynolds, 2020). However, it is worth noting that the PTG-I was originally developed for direct survivors of traumatic incidents, WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 25 rather than the helping professionals indirectly exposed to them, which could suggest that some qualities distinctive to VPTG could become unacknowledged (Reynolds, 2020). Some researchers (Brockhouse et al., 2011; Linley and Joseph, 2007) attempted to reinforce the construct validity of their study by utilizing other secondary instruments as an additional method of measurement (e.g. Crisis Support Scale, Jefferson Scale of Physician Empathy, Perceived Organizational Support Scale, Working Alliance Inventory, Professional Quality of Life Scales, Sense of Coherence Scale, etc.). It is apparent, however, that the way VPTG has been operationalized is scattered and far from complete. Moreover, similar to VT literature, there is no consensus regarding naming conventions (i.e., VPTG, VR, AG, shared resilience in a traumatic reality) due to the fact that investigators continue to adhere to varied nomenclature to refer to the positive impacts of working with trauma survivors. Divergent conceptualizations and research methods make related themes harder to identify and comprehend. Inspired by their previous qualitative research (viz., Hernandez et al., 2007; Engstrom et al., 2008; Hernandez et al., 2015) on the constructs of VR, Killian et al. (2017) developed and pilot-tested the Vicarious Resilience Scale (VRS). A total of 190 participants with varying degrees of experience in trauma work were recruited and subsequently asked to complete a preliminary version of a VRS questionnaire. Using exploratory factor analysis, Killian et al. (2017) identified seven factors: increased capacity for remaining present while listening to trauma narratives, increased recognition of clients’ spirituality as a therapeutic resource, increased consciousness about power relative to social location, increased capacity for resourcefulness, increased self-awareness and self-care practices, client-inspired hope, and changes in life goals and perspectives. Reliability of subscales identified by the factors were WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 26 deemed to be acceptable (Cronbach's alpha were .65, .79, .84, .86, 83, .80, .88, respectively) and VRS results moderately and positively correlated with the participants’ scores. Purpose of Current Study One purpose of the study lies in exploring the distinctive and converging experiences of settlement workers who specialize in serving refugee populations. The vicarious impacts of trauma have been explored among various populations of frontline helping practitioners (firefighters, therapists, psychologists, social workers, nurses, etc.). However, the literature specifically addressing VPTG among service providers doing refugee work, especially settlement workers with diverse backgrounds, is extremely limited (Chan et al., 2016). Therefore, it is worthwhile to compare the results of this proposed project with the existing VPTG literature. I will keep in mind the extent to which settlement workers are likely to experience VT through their work with refugee populations, many of whom are exposed to the effects of preflight trauma in their home country and postflight stressors in the new country. Despite growing interest in VPTG, the way that frontline helping practitioners perceive the effects of their work is still fraught with negativity. As Hyatt-Burkhart (2014) recently remarked, the mental health professions are largely pathologically engaged, and well-being and growth are seldom the focal point of intervention. When they are revealed, they are generally referred to as evidence of progress or improvement. In an era where the DSM has become the foundation for helping practitioners to assess clients based on pathological symptoms, mental health is perceived as the absence of negative symptoms (Seligman et al., 2006). Therefore, my purposeful investigation into the narratives of settlement workers in relation to VT and the possibility of the VPTG will seek to contribute to raising awareness about positive impacts of trauma work. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 27 As a counsellor-in-training, continuous reassessment of the vicarious trauma narrative is closely related to formulating a third important research purpose. My research questions originated from my own visceral response to the ongoing literature about working with trauma survivors. While working with refugee populations and newcomers, many of whom experienced events of a traumatic nature, I have had mixed feelings about the narrative that describes the work as hazardous and the danger as inevitable (McCann & Pearlman, 1990). On the one hand, the narrative has inspired me to value the suffering derived from taking in some of the emotional pain that clients have left with us as a secondary witness (Nelson, n.d., para. 2). The professional narrative has also motivated me to pay attention to strategies for coping with the intensity of the work, including practicing self-care, giving myself permission to accept that it will impact all of us and recognizing that it is not anomalous to be profoundly shaped by the nature of the work (Nelson, n.d.). On the other hand, internalizing the narrative that has framed VT as an occupational hazard (Jenmorri, 2006) ultimately made me feel disempowered as a helper. The framework (albeit unintentionally) insinuates that VT is a ticking time bomb, and coping strategies are devices that merely extend the countdown without deactivating the bomb. I encountered several authors’ discussions warning that the engrossment in negative effects can be partly responsible for high turnover rates, never mind negative professional and psychological ramifications for trauma workers (e.g., Depanfilis & Zlotnik, 2008). Others noted that these warnings can also stigmatize trauma survivors who are portrayed as unsafe or challenging to work with (Rogers et al., 2016), adding a layer of shame to their posttraumatic stress. While reflecting on my own competency in being able to pursue trauma work in the context of the existing VT narrative, I became passionate about examining, not only for myself but also with my participants (i.e., WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 28 settlement workers), the extent to which some VT narratives have actually framed the experience of our work as unsustainable and dangerous. I also wanted to investigate whether there are any alternative narratives for us to thrive through our work in a sustainable fashion. Hence, I chose to adopt the following questions: 1. In what ways do settlement workers personally flourish as they work with refugees who have lived through trauma? 2. In what ways do settlement workers resist or reinterpret vicarious trauma narratives? WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 29 CHAPTER 3: METHODOLOGY As the previous two chapters have highlighted, the purpose of this study is to better understand the psychological impacts of working with refugee populations, particularly the experience of flourishing through work with refugees who have lived through trauma. Because of the meaningful nature of thriving in the face of experiencing vicarious traumatization (VT) while working with one’s traumatized clients who are forced to leave their country, I determined it was essential to explore the ways in which settlement workers resist or reinterpret VT narratives, vicarious posttraumatic growth (VPTG), through a methodology that listens to their storytelling. I offer my rationale for my choices in selecting the design of this study, including both the research paradigm and the research question. I also discuss selected characteristics of my research participants and of recruitment strategies as they unfolded in practice. Following that, I summarize data collection and analysis procedures used in this study. Lastly, I engage trustworthiness features, including the position of the researcher and ethical considerations. For the purpose of this project, I am going to use the terms growth, flourishing, doing well, and thriving synonymously as they are closely tied to VPTG. Research Design Research Paradigm Assumptions The design of this qualitative study assumes that reality is socially constructed and is aligned with participants’ perception (Creswell & Miller, 2000). Furthermore, reality is constructed in the mind of a person, shaped by the situational contexts, specifically their experience, perceptions, the sociocultural, and even historical positions (Ponterotto. 2005). Constructivism is predicated on such ontological conviction that people create meaning from their experiences, which constitutes their perspective regarding what reality is. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 30 Epistemologically, our own perspectives are inevitably constructed by our understanding of the world. Hence, integrating these experiences, we took part in interpreting participants’ narratives and consequently became more familiar with their understanding of reality. To that end, research findings produced from this study have manifested themselves as participants’ construction of reality that has been formulated through the lens of the researcher (Bailey, 2007). Using my own lens as a principal investigator of this study, I aimed to understand the meaning that participants attribute to their experiences from an emic perspective. Somers and Gibson (1994)’s stated that “it is through narrativity that we come to know, understand, and make sense of the social world, and it is through narratives that we constitute our social identities” (p. 58- 59). In other words, through this research design, I have strived to understand the world from the experiences of participants and I who live in it (Schwandt, 2000) and who share those experiences with one another through storytelling (Chase, 2002). Honouring this process increased the trustworthiness of research (Loh, 2013). This view is in line with the constructivist epistemological and ontological values inherent in the narrative inquiry (Chase, 2002). The ontological and epistemological values within the constructivist framework revealed multiple realities through the active interaction between the participants and me, as we interpreted together the meaning of their experiences. This essentially supports a hermeneutical approach, believing that meaning is concealed, only to be revealed via deep reflection and social interaction (Schwandt, 2000). While addressing the paradigm assumption of this research, I note the caveat that unearthing settlement workers’ narratives of trauma work can be properly understood as showing that trauma is real, and the diverse meanings that the settlement workers share are equally legitimate. When it comes to understanding trauma alone, I lean more towards the realist WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 31 ontology (Maxwell, 2012). This is because I acknowledge that the manifestations of trauma (i.e., PTSD) are real events and are knowable within a specified level of probability, supported by the field of traumatology. However, I align more strongly with the epistemology and ontology of constructivist framework since the focal point of the research question aims to explore the implicit and explicit meanings and knowledge embedded in participants’ narratives in relation to their experiences of vicarious trauma. I also resonate strongly with systemic thinking that embraces the complex, interactive, and reciprocal nature of levels of systems. In this project, the way in which settlement workers are connected strongly with their agency environment can be described with insight (See Bronfenbrenner & Morris, 2006; See Glossary). As a constructivist researcher, Lincoln’s (2009) recommendation on the ethical practices of qualitative research, or its axiological assumption, have resonated with me. In addition to treating participants with dignity, respect, and the avoidance of harm, I have striven to offer a balanced representation of views in order to raise participant awareness (2009). Throughout the study, I have examined ways in which this research both serves and does not serve participants, who devoted their time, effort, experiences, and wisdom to shape my study. I also hope that the practical implications of the findings serve the broader community, including refugees, asylum seekers, other immigrants, and residents in the community. Because the quality of relationship is an essential component to knowing, reflexivity, rapport, and reciprocity have been promoted as additional criteria of ethical practice during this research. Nevertheless, differences in power or privilege do exist in the relationship between researchers and participants. Therefore, throughout the research process, I strived to reduce the hierarchy by intentionally inviting and honouring their stories, particularly of VT and of resisting or reinterpreting it. In addition, I have identified WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 32 political, organizational, and cultural implications of the results of the study, thereby informing and educating others about the results of this study. Rationale for the Narrative Approach as Methodology Narrative inquiry is about understanding various texts that share a storied form (Riessman, 2008). The underlying theoretical assumption of the narrative approach posits that human beings are prone to engaging in the act of storytelling as a means to construct the self, make sense of experience, and create and communicate meaning; they share perspective, emotion, a sense of belonging, and their resources through dialogue (White & Epston, 1990; Riessman, 2008; Creswell & Poth, 2016). Furthermore, since the person shares their story with the audience, personal narratives are social and interactional in character (Chase, 2002). For instance, White (1980) stated that “so natural is the impulse to narrate, so inevitable is the form of narrative for any report of the ways things really happen, that narrativity could appear problematic only in a culture in which it was absent” (p. 5). Furthermore, Ewick and Silbey (2003) also observed that people prefer reporting, accounting for, and reliving their activities through narratives to offering categorical principles, rules, or reasoned arguments. In this way, one’s accounts of stories are regarded as unique processes of active meaning-making as they engage in storytelling in such a way as to have both a temporal and moral ordering (White & Epston, 1990). This idiographic stance is best facilitated in narrative inquiry, which is by design intended to honour individual agency and intention (Polkinghorne, 1988). Additional distinctive characteristics of narrative study identified by Riessman (2008) include shifting one’s attention to the details (i.e., how and why one develops a particular event in a certain manner), privileging particularities and context to the fore, and allowing many voices and subjectivities to surface by inviting human agency and the storytellers’ imagination. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 33 My rationale for selecting a narrative approach for this study was developed out of a recognition that the current “reality” constructed by clinical psychological and traumatological studies of individuals who are exposed to VT is largely pathologizing. By focusing largely on risk factors, personal variables, and negative symptoms regarding VT, existing literature on VT paints a picture in which caring for people who have suffered trauma is hazardous and one’s vulnerability to VT is inevitable. From a constructivist perspective, however, the existing literature can be seen as one way of unraveling the experiences of individuals who have been exposed to VT narratives. This suggests that other interpretations, like the recent studies of VPTG, are not only possible but also likely. While reflecting on this insight, I came across Riessman’s work on narrative approach (2008). I appreciated how the narrative approach, embedded in the constructivist paradigm, made room for the introduction of new stories and realities from the voices of settlement workers who sought to resist or reinterpret VT. Indeed, it allows me to seize the nuance and texture of participants' stories and frameworks of meaningmaking. In my eyes, narrative inquiry is a methodological framework that is best suited to place participants’ experience at the centre of analysis, allowing them to describe their experiences as they mattered to them. Furthermore, I believe that the limited amount of literature investigating the multiple meanings of VPTG in the midst of VT, especially within the field of settlement work, has made the use of narrative approach more significant. Since the approach is relatively open to creativity, researchers devote their sole attention during their data gathering to the process of coconstructions between narrators and themselves (Squire et al., 2014). As Riessman (2011) identified, the field of narrative research is primarily non-linear, elusive, and interdisciplinary. In fact, researchers who are not familiar with this methodology might find it difficult to find a WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 34 coherent explanation about how to “do” narrative research (Andrews et al., 2013, p. 1; Riessman, 2008) as there are no strict protocols for conducting and analyzing research (Squire et al., 2014). Nevertheless, the flexibility and malleability characterized by narrative approach became an asset for this study. These characteristics helped me honour the missing stories among a group of helpers who have not received much attention yet whose roles are important in today’s world. Another rationale for selecting narrative inquiry was that it complements the major areas of exploration for this qualitative research that draw on events, actions, chronology, and sequence (Riessman, 2008). Through reviewing the emerging yet limited literature, I learned that clinicians’ experiences of growth (i.e., VPTG) often follow their experiences of VT (Arnold et al., 2005). Thus, as participants reflect and elaborate on the events leading up to VT and VPTG, the context of their sharing inherently encompasses narrative inquiry, which embraces a chronological, sequential structure and exhibits events and actions for the participants who have experienced them. Lastly, it is often deemed plausible that individuals gain a sense of self-efficacy, empowerment, and hope through re-storying, an additional strength of narrative inquiry (Gutterman & Martin, 2016; White, 2007). In other words, through re-storying with a researcher, the narrator would liberate themselves from problem-saturated stories such as VT—which are often embedded in social, political and cultural contexts—to discover and explore their preferred stories such as VPTG (White & Epston, 1990). Indeed, Williams (1984) referred to this idea as “narrative reconstruction”: the act of facilitating someone else to link up and interpret different aspects of her biography, thereby reconfiguring past and present as well as self and society. The research question of this study invites the participants to co-construct with me the meaning of the extent to which the problem-saturated VT narrative, as the dominant discourse, has actually WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 35 determined their work to be unsustainable and dangerous. The process of examining how participants share their preferred stories through engaging in re-storying and narrative reconstruction with me in the face of VT narratives naturally encapsulates narrative inquiry. Based on these indicators, I am convinced that use of narrative inquiry is valid and most fitting for this research. Its attention to subjectivity, identity, and human agency facilitates social construction of realities, manifesting through participants’ stories (Riessman, 2011). Conceptual Thinking for Thematic Analysis Working as a toolkit for narrative inquiry, thematic analysis is considered a versatile and practical supplement because it is not exclusively tied to any established theoretical modalities, and consequently it can be utilized within diverse theoretical frameworks (Braun & Clarke, 2006). Furthermore, thematic analysis is known for its ability to accommodate a constructivist paradigm when investigating realities, meanings, and experiences within the community; it allows the researcher to posit the structural contexts as well as sociocultural backgrounds that give way to the individual narratives that are afforded (Braun & Clarke, 2006). Indeed, Braun and Clarke (2006) noted that the flexible characteristics of thematic analysis make it a “useful research tool, which can potentially provide a rich and detailed, yet complex, account of data” (Braun and Clarke, 2006, p. 78). By virtue of this versatility, I utilized both Braun and Clarke’s (2006; 2019; 2021) reflexive thematic analysis and Riessman’s (2008) thematic narrative analysis to develop a method of analysis to understand the way in which settlement workers think and speak about narratives in relation to vicarious trauma and the possibility for vicarious posttraumatic growth. In general, narrative inquiries focus on the meaning of a story being told. However, while other methods within the broader spectrum of narrative analysis (e.g., performance, structural, WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 36 and visual) pay more attention to “how,” “to whom,” and “for what purposes” (Riessman, 2008, p. 54) one’s experiences are structured and mutually generated, thematic narrative analysis is more interested in the content of the participants’ reports of events and experiences. In other words, thematic analysis prioritizes exploring “what” is told, written, or visually revealed in a transcript (Mishler, 1986). Riessman (2008) noted that thematic narrative analysis has gained popularity within narrative work due to the general perception that it is the most straightforward and practically appealing in applied settings. However, akin to other forms of qualitative analysis (i.e., grounded theory, interpretive phenomenology, and hermeneutics) that involve inductive and iterative steps, indicators of strong thematic analysis include characterization as meticulous, disciplined, and thorough (Braun & Clarke, 2006; Riessman, 2008). In order to achieve this objective, thematic narrative analysts extract themes from the entire data while still keeping the “full stories” of research participants. Moreover, they often preserve extended accounts and explore them analytically as a whole rather than break the biographical story apart into thematic categories (Riessman, 2008). Put another way, committing to conserving narrative features is the primary methodological strategy that distinguishes thematic narrative analysis from other forms of qualitative analysis. Under reflexive thematic analysis, researcher subjectivity is acknowledged as a resource and primary tool for research because knowledge generation is quintessentially individual and situated (Braun & Clarke, 2021). Researchers must strive to own their perspectives as highquality analysis is derived from their clarification of and insight into their role in research (Braun & Clarke, 2021). Furthermore, it is often predicated by previous theoretical models. Consequently, the resulting data is often theory-saturated from the outset. This is a particularly salient point for my research question since it explores participants’ experience of thriving, WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 37 which some scholars in the field have already established a relevant theoretical framework for: vicarious posttraumatic growth. For instance, in order to produce thematic categories, I was tagging back and forth between motivations for the study, the previous and emerging theoretical framework, past research, and the data. It is nevertheless important to search for and develop new theoretical arguments through narratives (Riessman, 2008). Connecting my research interests, epistemological and ontological positions, and conceptual underpinnings behind narrative inquiry, I appreciated the insights of both narrative thematic analysis and reflexive thematic analysis for this project. With this method, I hope to develop a more robust and nuanced knowledge of the way in which the research participants make meaning of the positive impacts of their work while serving refugees as well as resist or reinterpret the preexisting vicarious trauma narrative. Participants and Recruitment The participants selected for this study were six settlement workers (see Table 1) who met the following criteria: (a) had a minimum of three years of professional experience working with refugees and asylum seekers and (b) self-identified as having managed well in this work. All six participants were asked to respond to a background questionnaire (see Appendix B), as well as the Pro-QOL (Stamm, 2003; see Appendix C). The Pro-QOL scale is one of the most frequently used measures of compassion satisfaction and vicarious traumatization (Geoffrion, 2019). Since the scale (as well as the questionnaire) was designed to be less of a diagnostic assessment but more of a screening and planning instrument in this project, it was used exclusively as a means to negotiate participation (Stamm, 2003). Since all six participants generally received lower than average on the Compassion Fatigue subscales (i.e., less VT and WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 38 burnout than the average helper), I proceeded to negotiate consent with all six participants who were considered fitting for this project. Table 1 Participants’ Backgrounds AS Gender Female BM Male JSB Female LMB Female MM Female RA Female Culture Middle East; BIPOC European Descent; White Work experience 1 year 3 months Work title Case Specialist 7 years South American; BIPOC South American; BIPOC European Descent; White Middle East; BIPOC 12 years Care coordinator/support worker Outreach case worker 12 years 1 year 2 months Clinical Social Worker Settlement worker 5 years Refugee and Specialized Experience Program Coordinator In addition to Pro-QOL, the background questionnaire allowed the participants to self- define their background information, including their fluency in communication, occupational title, and duration of work experiences in settlement. However, overall participant selection processes were not made based on their gender, ethnicity, socioeconomic status, and cultural background. All participants were recruited through several non-profit agencies and relevant institutions including the DIVERSEcity Community Resources Society, BC Refugee Hub, UBC School of Social Work program, the Vancouver Association for Survivors of Torture (VAST), and the immigration service department at Options Community Services (OCS), as well as other professional networks. BC Refugee Hub is a province-funded association that serves as an online resource hub to empower and assist both individuals and organizations in the refugee settlement WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 39 process. VAST represents BC’s largest centre for refugee mental health, working with refugees from around the globe. Lastly, DIVERSEcity and OCS are non-profit organizations providing social services; the immigration service departments within these agencies offer tailored support to immigrants and the newcomer population in BC. Particularly, its “Moving Ahead Program” (MAP) supports vulnerable immigrant and refugee clients with multiple barriers to settlement. I made detailed arrangements with these agencies and distributed my recruitment poster. Since pre-existing relationships were seen as a risk factor for participation, I implemented the following strategies to those who were interested in this research while negotiating their participation. From the initial stage of recruitment, I disclosed my role as a researcher/interviewer and then explained my responsibility to ensure the participants’ identity and confidentiality. I additionally ensured participants felt no obligation to participate in the project. I implemented this by not directly soliciting their participation and verbally reiterating the policy specified in the consent form that they could withdraw at any time. As previously stated, research worth conducting shall induce change that empowers those participating. To that end, the informed consent form (see Appendix F) additionally stated that the benefit of this study for participants was to lead to the development of important understanding in the field of VPTG and VT. It further highlighted that the participants might also gain further insight into their personal perspectives on how experiences of VT and burnout affect them. Sampling and Data Collection I employed criterion-based, purposeful sampling strategies in order to acquire information-rich cases (Morrow, 2005). Taking into context the situations surrounding the COVID-19 pandemic, all interviews—the primary method of data collection—were conducted and recorded over Zoom in order to ensure safety of the participants and were 60 to 120 minutes WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 40 in length. I began the interview by welcoming the participant and reviewing the informed consent form (see Appendix F). Riessman (2008) encouraged narrative researchers to have repeated conversations so I developed two interview protocols: one for the first interview (see Appendix D) and one for the second interview (see Appendix E). In the first interview, I encouraged participants to share their experience of thriving as a result of their work with trauma survivors. Though the participants had access to interview questions attached to the protocol ahead of each interview, I also assured them that the protocol was simply there for ensuring our conversation stayed thematically on track and that they were free to share their stories in whichever ways and sequences made most sense to them. Intentionally keeping the flow of the conversation semi-directive enabled participants to freely share the topics and themes and to choose which details to include. In turn, this elicited their authentic narratives pertaining to VT and reinterpretation of VT. In the second interview, the participant and I engaged in a follow-up discussion, centred on their experiences of reading the selected written highlights of the first interview, which I referred to as the narrative summary (NS). At this stage, I asked a few individualized follow-up questions that emerged from reflecting on the NS. Upon finishing the two interviews, participants were debriefed (see Appendix G) and thanked for their time. Since the participants had already completed the Pro-QOL scale and the background questionnaire prior to conducting repeated conversations with me, my primary objective for semi-structured interviews was focused on constructing rich, in-depth narratives rather than short or generalized answers. Therefore, even though protocols for the interviews were preconceived (see Appendices B and C), I characterized the general interview process as an open-ended conversation, inviting stories of growth from participants in the face of VT. The questions WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 41 included in the protocols also represented the ways in which I learned about VT and VPTG as theoretical constructs and made sense of my work experiences confronting the symptoms of VT. In other words, while the interview protocols were shaped by my own story and experiences, the actual interviews were aimed to encapsulate the stories and experiences of the participants. Lincoln and Guba (1985) reminded me that the point at which qualitative researchers gain “enough” data is when no new information is expected from new data (i.e., the point of redundancy, saturation, or exhaustion). Their reminder also fits well with Morrow’s (2005) recommendation: the validity, insights, and meaningfulness pertaining to qualitative studies have less to do with sample size and more to do with the depth of information of the cases chosen and the analytical proficiencies of the investigator. Taking into consideration these recommendations, the core method of data collection involving two interviews each, and the extent to which the participants' voices were heard through the data, I determined that the study indeed reached the point of saturation after interviewing the sixth participant. At that point, I stopped recruiting further participants; therefore, the total number of participants recruited was six. Even though the size of the sample was relatively small, the rich detail accompanying the narrative inquiry enabled in-depth description of participant experiences. Research relationships created during a qualitative study are intricately intertwined with the data collection process (Maxwell, 2012). On that note, I reflected that a research interview is for the most part “a social process, and what emerges from that process is a richly expressive inter-view that neither person could have produced alone” (Lindlof & Taylor, 2019, p. 220). My active participation in the data collection process became clearer once I tailored my research activities to engage the full idiographic richness of all participants (Maxwell, 2012; Riessman, 2008). At the core of such research interviews lay the collaborative relationship between the WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 42 interviewer (me) and the interviewee (participants) as we co-constructed the narrative and engaged in the meaning-making process (Mishler, 1986). In retrospect, I can say that both of us paid attention to the context of our communication as co-creators of meaning rather than an external investigator imposing their own viewpoint on a passive research participant (Riessman, 2008). In alignment with confidentiality, I utilized a double-security system, where all interview data (i.e., audio recordings, transcripts) were backed up from the secure mobile application into an encrypted flash drive, which was stored in a locked file in my home. Only the principal investigator, direct supervisor, and key informants accessed the information that participants provided. To preserve anonymity, any identifying information about the participants was protected in a number of ways including changing names and other identifying details. In fulfillment of the requirements of the Trinity Western University Ethics Board, I will destroy all paper and electronic files once the project has been completed. Data Analytical Strategy The thematic elements of one’s narrative provide a lens for understanding the multiple meanings of vicarious post traumatic growth in the midst of vicarious traumatization in the field of settlement work. More often than not, however, not all choices and decisions that qualitative researchers make at the analytic stage are made explicit in the discussion. Being cognizant of the constructivist paradigm, which lends itself to value-bound activity and subjectivity, I strived for transparency in all stages of research. Transcription as Interpretation Rather than implementing the research design in a strictly linear fashion, qualitative researchers often alternate between the literature and various stages of their research design as WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 43 their project blossoms (Tracy, 2012). In a similar vein, many scholars (DiCicco- Bloom & Crabtree, 2006; Riessman, 2008) noted that data analysis (i.e., interpretation), in principle, takes place in parallel with data collection (i.e., interviewing and transcription). Therefore, I regarded transcription and interpretation as simultaneously occurring activities rather than separate phases of this project. Furthermore, engaging in data collection was an inherently interpretive practice because transcribing sets of dynamic speech into linear written language mirrored my painstaking decision-making process regarding the inclusion criteria. For example, it was important to purposefully decide the extent to which nonlexical expressions were included in the transcription. Lastly, I analyzed the transcribed data in a manner that purported to honour the multiple contexts and perspectives that constructed the participants’ realities. Synthesizing Riessman’s (2008) thematic narrative analysis and Braun and Clarke’s (2006; 2019; 2021) reflexive thematic analysis, the following section reflects four steps of the data analysis procedures for this study. Applying the Thematic Analysis The first stage involves examining transcribed interviews. An initial transcription was created by Zoom’s audio transcription software. After receiving the initially transcribed file of each interview, I perused the preliminary transcript and excluded a number of nonverbal and paraverbal elements, repeated phrases, additional filler of conversation, as well as most vocal fillers (e.g., stuttering, hesitation, pursing lips, frowning; minimal utterances such as “uh-huh,” “yeah,” “mhmm”) to improve the clarity of the conversation and focus on the elements that contributed to meaning. The semantics of one’s intention, however, is sometimes shaped by a select subset of paraverbal expressions. Therefore, I intentionally preserved certain partial expressions, misspoken words, and pauses only when I determined they would serve as pivotal WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 44 clues to understanding the meaning of the participant's narrative. Though the messy spoken language is transformed to make it easily readable, ambiguity of meaning still remained to a certain extent, presenting an inevitable limitation of thematic narrative analysis within the data analysis stage. Nevertheless, exploring the ambiguity of meaning was not my foremost priority because I presumed that a reader would fill in and grasp the main point (Riessman, 2008, p. 58). Furthermore, I altered the names of characters and places disclosed in the course of the interview and took out other information that could potentially identify the participants. I kept my questions, comments, and statements to highlight that the co-construction of self is produced dialogically (Riessman, 2008). In other words, the autobiographical self is best constituted with the act of storytelling in dialogue, not monologue (Riessman, 2008). The second stage involves reading and re-reading (Braun & Clarke, 2006) the participant’s stories. I immersed myself in the data to the extent that I became familiar with the depth and breadth of the content. Whilst re-reading the transcriptions, I jotted down initial ideas and impressions regarding study intent, particularly participants’ experience of flourishing as settlement workers in the context of working with traumatized clients and the extent to which they resist or reinterpret vicarious trauma narrative. I identified narratives of vicarious posttraumatic growth by means of paying additional attention to the seven signs of growth and resilience (Killian et al., 2017). Overall, my objective for this stage was examining the contents of participants’ stories and spotting common thematic elements in each account. The third stage relates to producing initial codes across the entire data set, followed by collecting them into possible overarching categories of themes and subthemes, while conserving narrative features (i.e., setting, character, plot, meaning). It further involves analyzing the connection between codes, themes, and different levels of themes (Braun & Clarke, 2006). Braun WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 45 and Clarke (2019) conceptualized themes as “stories about particular patterns of shared meaning across the dataset” and cautioned against confusing themes with domain summaries, which merely relate to the summary of shared topics (p. 8). Moreover, themes are to be produced from the convergence of the data, theoretical and conceptual understanding, the researcher’s subjectivity, and training (Braun & Clarke, 2021). Keeping this guidance in mind, in order to formulate overarching themes, I noted whether the formulated themes found in one participant’s narrative were shared with other participants (i.e., shared themes) or were capable of standing on their own (i.e., idiographic themes). The fourth stage is about refining and formulating overarching themes and subthemes, which I did in partnership with the participants, existing theories, and concepts. To aid in this process, I utilized NS, a written highlight of our first interview transcript in summary form. After producing the NS, roughly four to five pages in length, I emailed it to the corresponding participant along with an invitation to have a second interview with me. I invited the participant to edit, affirm, and/or add to the summary. As several participants read through the narrative summaries, we were able to have a richer and more thought-provoking dialogue during the second interview. Perhaps, having uncovered implicit meanings of some of their responses to the questions, which took shape during the interview level, transcription level, and NS level, was a key accomplishment of this fourth stage in the context of talking about VT and VPTG. Contrary to the explicit aspects of their stories whose meanings were directly observable on the surface of the data and in detail (i.e., manifest meanings), a few areas of participant’s stories contained implicit features. While significant in themselves, they were far more subtle in meaning (i.e., latent meanings), underneath the data surface and hidden in the context (Braun & Clarke, 2021, WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 46 p. 3). For this research, both the manifest meanings and latent meanings are regarded as equally significant and legitimate in honouring participants’ experience as it mattered to them. Therefore, it was essential to use the follow-up interview to ask for further details, examples, and background information in order to grasp both the manifest and latent meanings. Equally crucial for this process was attuning to social, cultural, and organizational influences that inspired their diverse meanings of growth. Following the end of the second interview, I formulated themes, searching for coherent patterns and sequences, by reviewing the paragraphs of the original transcript and the NS. I also considered the validity of the themes in aiming to accurately represent the meanings across the whole data set (Braun & Clarke, 2019). At the end of this stage, I clearly articulated my themes and subthemes and became ready to produce the report. Rigour and Quality Morrow (2005) stated that a researcher should assess the quality of qualitative research that fits with the research paradigm of the study. This study was located within the constructivist paradigm and, as such, is distanced from the positivist and post positivist paradigms in assessing rigour. As the principal investigator, I examined the data in a way that explored the meaning of participants’ personal narratives while attuning to the attached sociocultural contexts and organizational influences that inspired their meaning-making process. Rather than meeting the criteria for validity, reliability, and generalizability, the emphasis is on examining trustworthiness in the participants’ stories (Morrow, 2005; Loh, 2013). Loh (2013) suggested that narrative researchers adhere to the trustworthiness criteria presented in the broader qualitative field. For this study, I used the lens of the researcher, the study participants, and the people external to the study while I delineate below the criteria and techniques broadly selected to assess the trustworthiness of this project (Creswell & Miller, 2000). The techniques I used WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 47 include reflexivity, disconfirming evidence, collaboration, and peer-debriefing (Creswell & Miller, 2000). Reflexivity The primary form of practicing trustworthiness under the constructivist paradigm that reflects the lens of the researcher is reflexivity. Reflexivity, as a form of situating oneself in the study, refers to positioning the self as the principal investigator in a qualitative research, a key to increasing the trustworthiness of research (Braun & Clarke, 2021; Creswell & Miller, 2000). In elucidating the role of reflexivity in writing a qualitative study, Wolcott (2010) said the following: “Our readers have a right to know about us … They want to know what prompts our interest in the topics we investigate … and what we personally stand to gain from our study” (p. 36). Therefore, throughout the research process, I have assessed the manner in which my worldview, beliefs, biases, and values productively shape the realities of research participants. In turn, I have learned from my own thoughts and feelings in response to what participants were saying in their narratives. As a constructivist researcher, this attention to myself heightens my capacity to distinguish my own ideas and feelings and how they do or do not line up with settlement workers’ words, thus avoiding imposing my own story over them. Interrogating Assumptions. Braun and Clarke (2021) encouraged researchers to first interrogate their assumptions and previous practice as they align with the practice of reflexivity. In light of their suggestion, I reflected on my initial assumption that my past work experiences serving refugees, as well as my own history of immigration into Canada as an ethnic minority, might be a double-edged sword. On the one hand, it allowed me to seamlessly immerse myself into, and intuitively understand as an insider, the context of settlement work. One part of me regarded having the insider stance prior to data collection and analysis as an asset to WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 48 effectiveness and authenticity towards the interview process. On the other hand, another part of me was aware that leaning heavily on the insider stance could be dangerous as it could distract the aim of the methodology: encapsulating the narratives that emerge within the interviews with settlement workers. Rehearsing the ethos of the constructivist paradigm was helpful to address this emerging concern: multiple realities are socially constructed through the interaction between researcher and participant, and it is the researcher's ethical commitment to represent views equally in order to raise participants’ awareness (Mertens, 2020). After all, researcher subjectivity within reflexive thematic analysis is not a bias that should be avoided and certainly not a liability that should be managed (Braun & Clarke, 2021). Rather, for this research, it is to be taken as virtuous as it is the basis for the story that I can tell, equipping me with the perspectives and insights that shape all that I do as a researcher (Maxwell, 2012). Therefore, while bringing myself knowingly into the process of listening, I strived to strike a fine balance between the outsider role as a researcher exploring alternatives to the problem-saturatednarrative within communities of settlement workers and the personal, insider stance of settlement industry. Research Journal. As a means to sensitize myself to the necessity for extended and conscious engagement with the data to yield telling and valuable analysis, I put together a working research journal, (i.e., researcher identity memo; Maxwell, 2012), in which my involvement throughout the project was recorded in detail (Braun & Clarke, 2021). From proposal drafting to data analysis to reporting the results, the diary contained a history of the research process, my thoughts and questions in relation to the research process, the various influences of my past work experiences in the settlement field, and plans of action based on my reflections. In other words, keeping a research journal allowed me to situate myself in the study, WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 49 transparently revealing the role of my relationship to the topic and relevant personal and professional experiences. Moreover, I included in the journal aspects of my reflection on social, cultural, and political forces that I thought would influence my interpretation. For instance, I reflected that the race and social class variations, especially between executive management and frontline service provider-refuge client dyads, have had a meaningful contextual relevance for this study. To be precise, many service providers personally resonate with refugee clients’ vulnerability, either with the identity of migrants to Canada or with the survivors of various oppressions while living as ethnic/cultural minorities. Consequently, they naturally connected with their clients’ sense of well-being in a more relational way than anyone else. Such reflection was further reviewed with not only participants but also with the research team including the key informants, eventually leading to the key conceptualization, the Core Processes of Relational Shaping of Growth Model (see the Discussion Chapter for more). My Relationship with the Topic of Research. Continuing to situate myself in the research process, I describe below my own identity and perspective with the research topic. Both my personal lived experiences as well as my professional experiences have deeply inspired me to study VT and VPTG as they relate to settlement in Canada. As a hyphenated immigrant of colour who has been settling into Western Canada for more than a decade, I have been interested in working with the immigrant and refugee population. I completed an undergraduate degree in social work and began practicing in the field of immigrant services in 2015, helping newcomers with multiple barriers meet their settlement needs. During my program of study in social work, I worked as an intern caring for Syrian refugees at the local immigrant service agency, the Immigrant Services Society of BC. Because of the Syrian civil war, many Syrians had been displaced from their home country, triggering a worldwide humanitarian crisis. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 50 Observing the immense challenges that the refugees were undergoing, I utilized support networks for newcomer refugee youths. This involved connecting Canadian-born volunteers with refugees to act as a one-on-one mentorship. I also organized regular outreach events to provide necessary information based on the needs of each client. For instance, one of the young newcomer youths received tailored information regarding educational enrollment requirements and how Canadian institutions work, whereas an adult newcomer made connections in the community, learned about Canadian culture and local sites, activities and resources, and practiced communicating with native Canadians. As a result of learning about the terms vicarious trauma, compassion fatigue, and burnout from my school of social work, my concern for myself in this regard also started to develop as I delved into listening to refugee clients’ stories. While working with the refugees, I realized that my perception of my own competency and of the world gradually changed. The stages of the settlement process did not seem to fit into the linear process (e.g., honeymoon, challenge and crisis, reconstruction and recovery, adjustment) my agency had explained to the refugee clients. Due to the sheer magnitude of preflight trauma from their home country and postflight stressors upon arriving in Canada, many seemed to experience cyclic processes of the challenge and crisis stage and the reconstruction and recovery stage without complete adjustment. Even though I could not fully understand the influence of their history of trauma due to the language barrier, I observed the difficulties many clients faced when resettling. They often included securing housing, the insensitivity of the healthcare system, language acquisition, and cultural differences. In my eyes, Canada’s humanitarian program failed to meet the political rhetoric of multiculturalism. Because the resources allotted to supporting each family were very limited, and there was not much I could WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 51 do about this, my initial optimism about making a positive difference in newcomers’ lives had been replaced with a feeling of frustration and helplessness. After graduating from schooling in social work, I continued to work with refugees at another non-profit agency. Unfortunately, my sense of frustration, and even despair toward the difficulties clients encountered upon resettling in Canada, as well as the disappointment at what I had considered a considerate immigration system still remained. My colleagues — seasoned veterans in settlement work — shared with me similar sentiments about the challenges: mainstream healthcare services did not sufficiently address the clients’ unique requirements such as interpreting, understanding their family situations, and their expression of illness. Furthermore, they confided in me that, as an occupational category, the field of settlement work was “fuzzy” and unregulated, contributing to a lack of job security (which is often a yearly contract-based) and fairly low average income. Moreover, though many possess cultural skills, speaking the same language and sharing similar cultural backgrounds as their clients, a majority of them do not possess clinical or counselling skills. Because of the scarcity of bilingual and culturally diverse clinicians, the effective delivery of psychological interventions to refugees has depended largely on interpreters, settlement workers, and volunteers. In addition to providing vital services to their clients (similar to the work of a social worker), such an ironic reality has placed an extra burden on my colleagues who were overwhelmed with having to juggle multiple roles, insufficient resources, and unstable job tenure. Listening to their narratives whilst managing my own caseload, I, too, wondered if I could constantly experience growth and hope by virtue of working in this field. After two years, I decided to put a pause on working with refugees and immigrants on the frontline and instead study counselling psychology in a graduate program in order to acquire WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 52 more clinical skills. Despite my aspiration to seek growth and meaning as a professional, in the past two years I had had very few conversations about thriving in this line of work. Indeed, Puvimanasinghe et al. (2015) pointed out that feelings of frustration and disappointment are not equal to VT, but the accumulation of those negative emotions seemed to result in VT among settlement workers. Therefore, this thesis was developed out of my own struggle to personally and professionally connect to the refugee and immigrant population. Contrary to the narrative of vicarious trauma that is “problem-focused,” the emerging “growth-focused” narratives (i.e., vicarious posttraumatic growth, vicarious resilience, and adversarial growth) could offer a more balanced understanding of trauma work. Overall, I firmly believe that the outcome of this research would help settlement workers become aware of the alternative narratives of their work in a more sustainable and replenishable direction. Disconfirming Evidence While situating myself as a researcher from the previous section, I appreciate the way in which my past experience of caring for refugees during their settlement enabled me to solidify the lens of the researcher, engaging in the research process as a whole and interacting with the participants more effectively and with deeper insight. Another form of practicing trustworthiness that relies on the lens of the researcher is looking for disconfirming evidence. For instance, after establishing the preliminary themes, I was intentional in searching through the data for both confirming and disconfirming evidence (Creswell & Miller, 2000). In general, since reality is multiple and complex, searching for disconfirming evidence enhances the credibility of the account (Creswell & Miller, 2000). The act of finding unexpected evidence that defies anticipated patterns of results — going against the researcher’s proclivity to exclusively look for confirming evidence — achieves depth and richness in this qualitative research. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 53 Collaboration with Research Participants In order to actively involve the lens of the participants in assessing the extent to which the interpretations accurately represent them, a constructivist researcher holds the collaborative relationship between researcher and participant precious (Creswell & Miller, 2000). Maxwell (2012) stated that the relationships between researcher and participants in the qualitative research are real phenomena, which color the context of the research including its analysis and results. In light of working collaboratively with research participants, I encouraged the participants to actively assist with the data analysis process and invited them to shape the process of writing the narrative account. Furthermore, two practical benefits arose from including a second interview with participants to discuss preliminary findings from the first interview. Obtaining their view on the credibility of the findings and interpretation in the second interview process allowed me to conduct “member-checking” by having the participants confirm and correct the information and preliminary narrative account. This same process also helped enrich disclosure and trustworthiness in the data quality through close collaboration. Collaboration with Research Team Another facet that a researcher who endorses the constructivist paradigm draws on to establish trustworthiness is that of people who have some relevant background knowledge related to the research. It includes providing support, challenging my assumptions, and asking hard questions about my methods and interpretations, as well as doing parts of analysis together. This way, my own expertise and experience in this field became finely tuned through collaborating with people who are familiar with the research method, context, and theoretical frameworks informing my research question. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 54 For instance, in addition to seeking an official review from an external reader, a requirement of this thesis, I worked in a research lab with colleagues in my program as well as with a supervisor and a second reader. Furthermore, I consulted with key informants who are currently working in the sector at a managerial level, directly supervising settlement workers who work with refugees with multiple barriers. They provided additional resources to get access to participants, offered feedback on the data, and discussed with me policy implications for sustainable practices of settlement workers. The consultation with key informants turned out to be crucial and formative to the overall data analysis, contributing to formulation of overarching themes and sub-themes. Ethical Considerations I appreciate Josselson’s (2007) description of narrative research as intrinsically a interactive exertion in which every aspect of the work is affected by the ethics of the research relationship. Since the narrative inquiry of this study involves interacting with people, and in the process understanding their lived experience, it is bound by relevant ethical practice and codes. To that end, this research was approved by Trinity Western University’s Human Research Ethics Board. Before the study, I served an informed consent form to the participants, which outlined the study’s purpose, benefits, risks and discomforts, confidentiality, incentives, and contact information. To preserve confidentiality, I changed their names and other identifying details throughout the research process. The potential benefits for participating in the study included an opportunity to gain further insight into vicarious posttraumatic growth and apply the insight to their ongoing career in settlement work. Furthermore, the participants could become more motivated to reinterpret trauma work and disseminate awareness on the topic. Potential risks for participation included WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 55 emotional and psychological distress as a result of sharing their stories regarding vicarious trauma, burnout, and need for healing for themselves. The clinical training from the program in interviewing/assessment skills equipped me with the capacity to assess the impact of the distress and, if needed, to interrupt the interview and support the participant in connecting with their resources for addressing the distress. Furthermore, I made accessible for participants a resource sheet of free or low-cost supports (see Appendix H). Throughout the interviews, however, no one experienced a level of distress severe enough to warrant the use of the resource sheet. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 56 CHAPTER 4: RESULTS The purpose of this study was to explore the narratives present within settlement workers’ experiences of working with refugees who have lived through trauma. Two research questions have anchored this study: “In what ways do settlement workers personally flourish as they work with refugees who have lived through trauma?” and “In what ways do settlement workers resist or reinterpret vicarious trauma narratives?” I conducted semi-structured interviews with six participants—AS, BM, JSB, LMB, MM, and RA—who identified as frontline settlement service providers (often known to the public as settlement workers) serving refugees and asylum seekers who have lived through trauma. The specific vocational titles of these participants range from outreach caseworkers and program coordinators to social workers. Listening to their career journeys allowed our team to discover both the positive (i.e., “thriving”) and negative (i.e., “suffering”) aspects of working with their refugee clients. Drawing on the narrative summaries and thematic analysis principles, I was actively engaged in the data analysis (i.e., active researcher involvement). Moreover, I tuned into participants’ stories that highlighted vicarious traumatization and its alternative, positive counterpart, vicarious posttraumatic growth. Our results revealed that, notwithstanding the challenges faced when providing refugee practical settlement support (e.g., basic crisis counselling, housing, community connection support, and other necessary resources in the community), there was a sense of dedication and enthusiasm towards this work among settlement workers. Participants spoke of how much of their work in the Canadian resettlement system had been influenced and shaped by therapeutic relationships they have with their refugee clients. We specifically examined how the participants experienced signs of vicarious traumatization and burnout as well as growth and healing. As settlement workers discussed their WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 57 work experiences with me, two overarching/unifying themes emerged (Vicarious Traumatization and Vicarious Posttraumatic Growth), as well as a number of subordinate themes, forming an effective framework for capturing the vicarious impacts of trauma work on helping practitioners supporting refugee trauma survivors. Our research team then organized the results chapter into semantically meaningful themes and their corresponding descriptions, followed by key direct quotations of participants’ stories. While most themes represent interwoven narratives from multiple different professionals (i.e., shared themes), a few themes reflect unique and personally meaningful narratives of individual professionals (i.e., idiographic themes). They all embody participants’ voices evident during our co-construction of their narratives. At the end of the chapter, I present an integrative summary of the results, including a thematic map and consultations with key informants. Vicarious Traumatization (VT) Frustration with the System One overarching theme reflects frustration with the barriers in the Canadian immigration system that frequently get in the way of participants facilitating their clients’ settlement in Canada to the best of their ability. Immigration, Refugees and Citizenship Canada (IRCC; n.d.) funds resettlement through Resettlement Assistance Program (RAP) and settlement through settlement programs (see Appendix A: Glossary). Under the two overarching programs, the majority of settlement workers have been hired to help newcomers, including refugees, settle and adapt to life in Canada. The list of their regular scope of work highlighted by IRCC includes, but is not limited to, liaising refugees with childcare, use of public transportation, translation and interpretation services, literacy assessment and classes, as well as making a referral to shortterm/crisis counselling if needed. However, the narratives of several participants suggested that WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 58 the availability of these service provisions, while seemingly adequate in theory, differs significantly from the actual circumstances of working on the frontline. Several threads of their narratives imply that, in reality, the lack of sufficient coordination and collaboration between the federal (IRCC) and the provincial governments often gets in the way of refugees receiving holistic continuum of services from them. For instance, they discussed issues such as inconsiderate policies of housing refugee families (e.g., not considering family size, geographic location, length of contract), insufficient translation and interpretation services for refugees with certain ethnic backgrounds, and insensitivity to the LGBTQ status of refugees during the immigration-related interviews. Several participants reiterated that the delivery of both RAP and settlement services program often fell short, in terms of the funding amount and service duration. For instance, AS, BM, and MM reported episodes of their clients’ cases where they could not meet these crucial needs and struggled with the sense of having failed their clients in the process. AS: The way they handle housing often brings up intimidation for a lot of families because the welcome centre wants to house them. That is their criteria, but they don’t look at the needs of the family whether this is a good landlord or not ... whether this is a house fit for living. A lot of the people [I support] complained about: “I don’t want to be here. I don’t want this house, [but they tell you that] if you don’t take this house, then you will live on the streets” ... Between [the welcome centre staff housing the refugees] and us getting their file, there is a gap [in the system] … I’ve had families say that “I’ve been feeding my kids plain rice for the past two weeks.” This is what they shopped for her when she first arrived… that’s all that’s left. Another family said, “we’ve been in a house with no working oven and no curtains, no blinds”. Can you imagine? WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 59 Imagine you’ve been moved to a new place, a new language and then you’ve been sitting in this strange place for a month, and you’ve been given meeting after meeting after presentation after presentation … They don’t retain any of this information because they have health concerns and other needs ... On paper, there is a checklist [of service provisions]. It looks like holistic support, but on the ground, it doesn’t make sense when you just throw it at them. (During the follow-up interview with AS) We are bridging a gap between crisis counsellors and us. So, we are given training on trauma informed practice and how to spot violence in the family and address many other issues. However, I still think this is not fair because it is not my educational background … Given a five-hour session or tenhour session is still not enough because that does not equip me to give this one client enough time to address these issues as I have other clients to watch … so even though they are trying to equip us, I still think we are just filling a gap and it is not fair for anyone, not for us and not for the clients. BM: For refugees with LGBTQ backgrounds, [they are] not necessarily feeling safe [even after immigrating to Canada]. During the refugee application process and related interviews with the government agents, they are often forced to use the gender, legal name, and gender markers given by their home country against their wishes. [Such protocol] is a constant reminder of something that they do not feel comfortable … you are being made aware of [your] LGBTQ status to the public. [You only get to rely on] just immigrant and refugee serving organizations if you're being outed. [While] the needs of LGBTQ refugees were [more] specific and somewhat different than straight WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 60 refugees ... all contributed to burnout because our organization was doing too much with too little staff. MM: [One of my clients was] a really difficult person to work with, he had some mental health issues besides living with a refugee status but then, because of some discrimination and systemic failures, he has also been treated really poorly in Canada and has had a hard time … it is a complicated mess … it was draining [me]. Identification with Helplessness and Hopelessness Furthermore, many shared that they experienced intense negative emotional reactions such as helplessness, hopelessness, deep sadness, and fear, all of which resembled their clients’ experiences. Several participants, RA, AS, and LMB, conveyed that the cumulative experiences of listening to the traumatic stories of their clients seemed to lead to severe distress evident in such negative feelings. These aspects of VT came about more prominently for participants who worked with asylum seekers, whose mental traumas, along with the uncertainty and insecurity about their temporary status, often continued to plague them during their stays in Canada. RA: Their frustrations and other negative emotions related to their own dissatisfaction with their lives were often contagious, cumulatively affecting my mood in a similar manner. You get impacted by the details. Listening to the mom cry about her lost son and her sons who are still away from her and how hard it is to get them to get here, losing their business and losing their house… Mental health issues weren't something I was so informed about ... Something is happening [inside], I feel down somehow why? After going back to home after work in the initial years of working with refugees, I was getting triggered easily. I feel like something about me was sad at some point, especially when you try to help someone, and you get stuck … Some families just give up and whatever WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 61 you do it’s not working. They keep on complaining and they are frustrated, and the frustration is contagious. It comes back to you. I asked myself: why am I not as happy as I used to be? Something is gloomy in the air. My close friends at work and I, even when we were not working, often chat about the cases that we found challenging and triggering us. It was like a small black cloud that was following you. AS: The exact disclosure of their trauma history doesn’t happen at the start, but it came up later [during the year of our working relationship]. These talks usually happen when I am on a very long accompaniment, for example, to a hospital ... It’s horrifying. I’ve had a woman tell me “I’ve seen my husband being killed in front of my eyes ... I’ve seen my brother dragged and killed and I’m not allowed” ... A bit of me, I don’t know [if] I’ve internalized too much trauma but I’m starting to worry, “What if Canada went into war? If someone broke through my door and attacked my children?” It’s starting to be an issue you know? When I sleep, I’m like “Did I hear something? What is my plan if someone attacks my house?” It’s starting to be a part of my thought process and I don’t think that’s healthy. LMB: I really struggled professionally when I learned of one of my clients was being investigated for consuming child pornography… Some topics like that personally trigger me … are against my value system to such an extent that I struggle with supporting the client beyond the [minimum] mandated level. Some participants’ descriptions of their emotions matched the most severe symptoms of VT because of their work with refugee claimants, most of whom lived in constant fear of being deported even after fleeing to Canada from their home countries (mentioned above). One of the participants who support asylum seekers mentioned that the most challenging times for him had WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 62 been when he feared his clients’ claims for asylum being rejected and them being deported from Canada. BM: I definitely felt anxious sometimes after talking with clients because I was worried about them… that they wouldn't get refugee status ... Knowing the experiences they had in their country of origin, I often got worried that they would be deported back to their country of origin. I definitely took that home with me sometimes, just those feelings. I've had situations where clients are describing an assault they've experienced ... At [some] points I've found those sharing of the clients triggering my lived experience. Vicarious Posttraumatic Growth Despite personal and systemic difficulties and the threats of VT, the participants also reported several facets of VPTG. In their accounts of providing successful service provision, the participants alluded to the unique strategies for translating narratives of vulnerability to those of thriving. While some strategies took place at an individual level, some occurred at an organizational level. Several settlement workers encountered and made sense of growth as they met the immediate needs of clients within the boundaries of their work, differentiated their own identity from that of clients, and accepted themselves unconditionally. Lastly, a few narrated hindering factors to VPTG. Organizational Support Almost all participants capitalized on various forms of organizational resources to develop and later maintain competence and well-being. Half of the participants had been motivated to care for refugees because they shared the clients’ personal experiences of coming to Canada as immigrants or refugees themselves. It is quite frequent in the settlement sector where settlement worker-client dyads naturally build close bonding due to their sharing the mother WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 63 tongue, cultural background, and history of immigration to Canada. On top of enjoying these commonalities, the settlement workers still appreciated diverse forms of agency support through which to hone and reinforce their skills. These included utilizing professional training opportunities, debriefing with colleagues, and receiving regular supervisions: LMB: After going through a difficult case, when I have such a significant visceral and emotional reaction, I check in with myself “why am I triggered, why is it that this is such a hard case for me?” That’s the part where I feel very lucky because I can debrief with my team…and a colleague of mine who is a clinical counsellor… I realized that even my fellow colleagues who had been in this role for a number of years process vicarious trauma in unhealthy ways… but now shifting years later I realize an evenness in the struggles I go through with those of my colleagues… That’s a part I feel I have matured. MM: Whenever I really feel stuck in my case, I bring my boss into it as well. We would just like to debrief after I'd have a couple of hours of meeting with this guy. I would call my boss and we would just talk through it and he would just let me express, talk it out. Another participant, AS, reported appreciation of various supports their agency has provided to ensure their well-being. In our follow-up conversation, she also shared that, despite frequent training opportunities, the “haphazard” nature of professional development trainings got in the way of her processing them fully: I took advantage of all the professional development courses, which I found very helpful for developing skills for my job. I am grateful that my agency cares about my wellbeing… they want me to be able to avoid burnout… upon being triggered during my work, my manager lets me safely debrief so that I don’t carry the burden all alone. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 64 (During a follow up interview) I have a little excel sheet. I have so many PRO-Ds by the end of the year, but how much [do I] get from them? Not much, maybe 20%, 30% of it… because they are very haphazard, there is no rhyme or reason for them… some of them are at 10 some of them at one, some of them are at three. It doesn’t give you a mental state to focus on… It’s not fair for the clients who are expecting me to be there to help them. Personal counselling was another strategy that one of the participants utilized as a way of making meaning and continuing to do her work sustainably. JSB, a refugee case specialist, narrated benefiting from personal counselling support, covered through agency-sponsored health insurance: I see [asking for help] totally normal like if I go see a counsellor [through the] Blue Cross if I'm feeling down, for example ... It is an 1-800 number that we can call ... because we have an extended health benefit. I know that I am not crazy. I'm actually doing something good for myself. Self-Care Strategies Individually oriented self-care strategies emerged as collective responses from a few settlement workers. Despite the support from the organizational training, supervisors, and colleagues, they still expressed the need to take care of themselves individually in the face of vicarious traumatization. For instance, developing novel strategies of self-care was a particularly salient issue for AS as she recognized that the “conventional” self-care became inaccessible due to the Covid 19 crisis. She stated: Before the COVID-19, I used to do the traditional means of self-care such as going to the gym and drinking coffee with friends. But now [with] Covid 19, there is no drinking WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 65 coffee with anyone, there is no going out anywhere … so it's becoming more difficult to [do these traditional forms of self-care anymore]. After working with difficult cases which often take a lot of toll on me, I [now] have to replenish energy by practicing selfreflection and meditation [instead]. (During the follow-up conversation) This past couple of months, I’ve got more new clients and they’ve had horrifying stories [to share with me]. I’m trying to appreciate what I have, like being more mindful [of what I have with me]. I hug my kids more often. I try to count my blessings. The other participant, JSB, also revealed her strategies, which involve “taking a walk, participating in the wellness support group, listening to music, and journaling.” Lastly, another participant, RA, narrated her self-care strategies in the following way: RA: Doing well in the context of working with refugees is about protecting myself with several forms of self-care activities so that I can provide consistent, quality support to my clients. For example, after listening to their traumatic narratives, especially ones that trigger me like violence in the family or somebody who just lost their child, I do deep breathing, practice some positive self-talk, and look up ways to refer the clients to the right people like therapists and doctors. After becoming familiar with her work, MM, a case manager who works primarily with asylum seekers, reported a deepened sense of spirituality in relation to their relationship with trauma survivors. As a Christian, the emerging sense of humility, which was derived from admitting her finite capacity as a helping professional, has shaped the way she experienced selfhealing and self-care significantly. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 66 MM: The most significant way that I like to engage in self-healing is through my faith… coming from a Christian background and still believing in Jesus, the tenets of responsibility and spirituality related to Christianity [have] informed the way that I selfheal really significantly. Detecting and Meeting Clients’ Needs within Our Capacity A few participants pointed out that it is very important to articulate their service provision, helping clients understand their duties and the range of services offered within the agency. Since most participants were not trained in clinical counselling (except for one participant who held a master’s degree in social work), they focused more on resourcing the clients rather than providing clinical counselling beyond a basic level. For instance, after assessing where refugees are at and meeting their basic needs (e.g., assisting with housing, income assistance, community connections, English/French language programs), the settlement workers often make referrals to other mental health professionals. RA: As a refuge caseworker, it’s important for me to ask the right questions that would not overly trigger my clients’ past traumas. I found asking calculated questions a significant part of this process because by doing so clients would say things that they feel comfortable sharing and not end up saying things that they do not want to say in the first place. BM: There are moments [where] what a client says seems heavy or potentially not beneficial for our relationship. For example, when some clients share with me really detailed stories about their trauma experiences when my work is providing them with specific healthcare services. In that case, while respecting their intention, I gently reiterate my service provisions boundaries, remind them what I can do for them, and open WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 67 up space for making a referral to a trauma counsellor. In this way, I believe I give my clients the best services they can get. I know that the boundaries between trauma therapy and care coordination are not so clear-cut and fuzzy. However, in my last role, I did steer people away from sharing a lot of details about trauma because it was not usually necessary for the relationship that we were building for the support they were seeking. Differentiation of Self from Clients Several participants also expressed a strong desire to differentiate their sense of self from their clients. The differentiation of self as a theme appeared in statements that verbalized the degree of separation the participants felt towards their clients at multiple systems in which both are embedded (e.g., individual, familial, ethnic, religious, and sociocultural levels). For example, some participants highlighted the value of paying more attention to their families and intentionally disconnecting themselves from thinking about work during off-work hours. Others recognized the value of distinguishing themselves as unique human beings from their clients and colleagues as well as some family members, the social norms, and cultural narratives. They found such mental compartmentalization helpful to maintaining their practice in a more sustainable and replenishable direction. RA: When I go home and think “Okay, why am I sad? Why am I not listening and being attentive with my kids? I am hearing them speak to me but I’m not listening. Okay. Why am I not as connected as I used to be?” So, I started to disconnect. I tried my best to disconnect myself from work and start to be more attentive at home. I … sit down with myself [and ask]: “Is there something that’s going on in my life? Or is it that client’s story that’s impacting me?” And I started to separate it so … I would try to let whatever happens at work go and deal with it the next day when I am at work. And I started to be WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 68 less hard on myself … Even though you provide those resources, they don’t want to [utilize them], then it is beyond my control. JSB: Another important factor to doing well in my work is to wear “the working hat,” switching it off after work, and wearing “the life hat” It is about differentiating who I am as a case specialist and who I am in my personal life. BM: I've had situations where clients are describing an assault they've experienced. At points, I've found clients’ trauma narratives triggering my lived experience, but I think less so because of being more in it with a client, not necessarily in that time, my own experience. I tried to focus more on the other person. I guess in that way, compartmentalizing seemed helpful. AS: My journey for growth and self-healing is related to successfully differentiating who I am with the restraints, social norms, and expectations from other family members, some clients, colleagues, community, and society. Main thing is trying to not take things personally. When the client is upset, bringing all his anger in my direction, I should not take it personally because it’s not about me. It’s about him trying to get his things done. I am the only channel for him to get there, so I am trying [to understand it that way] even though it’s difficult sometimes …[I] know they don’t have work ... they don’t have friends, they don’t have family here. I am their only means of connection to the world to a certain extent... I do not want to lose a part of me in this healing process … I want to be able to help people, connect with people, but still be able to put the emotional boundary [so] that … their negative emotions do not affect me negatively. That’s where I feel I succeeded in healing. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 69 Factors Hindering VPTG Three participants narrated several factors that interfere with thriving in their role (VPTG). Therefore, they are also tied to the narratives of VT. One participant recognized the way in which systemic barriers and oppression obstructs the self-healing process for both the settlement workers and refugee clients. As a White Canadian, he said that the culture of White supremacy negatively affects healing because it makes people feel inferior and forces them to do things in a certain way. BM: A culture of White supremacy, capitalism, hegemony we live in teaches us or makes us feel like we are not enough for that and have to do things in a certain way. I have internalized that a lot … I think especially for White people, there is a kind of this sense that you’re the normal or the average, but my journey growing as a person is recognizing that Whiteness … is actually a culture, [not a norm]. Western culture … have defensiveness as a big piece of their cultural norm. I think that impacts people's healing because it means you're not as in tune with your feelings, because you're constantly ... being defensive about stuff. Another participant discussed her perception that some bureaucratic policies are insensitive and inflexible, adding additional burdens to both the refugee clients and settlement workers. In turn, these challenges seem to hinder the refugees from PTG and the settlement workers from VPTG. AS: More and more [the systemic environment] is becoming a checklist ... The person himself has become a commodity of some sort … I’ve done one two three four for him, whether it actually translated into him settling properly or not is a different story … Although we do have crisis counseling, we have [only] one Arabic speaking crisis WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 70 counseling. And the waitlist is ridiculous … crisis counseling means they wanted right now. They are in crisis. They don’t want to wait six months, they don’t want to wait a year … Now we have a counsellor who checks in one on one on their mental health, but he doesn’t speak the language … As an unofficial interpreter, I don’t know the [exact words]. I would do a semi-literal translation … but for a counsellor their words that you’ve used that [have to] makes sense in your language to have an effect … Also, as a [client, it is possible that] I might want to tell something to my counsellor that I don’t want my settlement worker to know about. I don’t necessarily want to tell my settlement worker about my deep anxieties. The other participant recognized how the prejudices against refugees had got in the way of her competence as a refugee caseworker, especially during her initial tenure. She explained that the negative view of refugees became prominent in the wake of the 2016 Syrian refugee crisis amongst Canadian citizens and service providers working with the refugees in the frontline. RA: I [initially] found myself to be judgmental towards refugees ... We had those misconceptions that some of [the refugees] took advantage of the trauma and symptoms, to manipulate the system … this [narrative] was a trend at the time amongst some settlement workers that they are exaggerating, why are they so demanding, why are they so pushy … From these narratives, you cannot help but get affected. Unconditional Self-Acceptance Being both inspired and challenged by working with refugee clients, several participants brought up moments of transformation. They gradually talked about accepting themselves for who they are, as settlement practitioners and as people. They also talked about appreciating what WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 71 they already have, including their families and friends. For instance, LMB, a social worker working at a refugee clinic, stated: I realize that I am a perfectly imperfect person and a professional. I unapologetically express who I am with my foibles and realize that self-healing has much to do with selfacceptance and self-love … Even though there are parts of me that need to do selfhealing, I recognize that some parts of me have not been quite there yet to process the meaning of healing. And that’s ok. Perhaps, journeying with refugees who have put up with adversities in settling in a new country acted as an impetus for creating a positive meaning of working in the field. AS and RA, refugee case specialists, explained how practicing unconditional self-acceptance led to their experience of healing in the face of VT. AS: As an Arabic woman, I experienced lots of restrictions on what women should and should not do, the way they wear clothes, do makeup, make career decisions, and so on. I used to be internally torn between the part of me that wants to conform to those dominant cultural narratives and the other part of me that desires resisting those narratives. Likewise, my personal backgrounds like ethnic, educational, cultural, and socioeconomic status did affect the way I understand myself in the process of growth. Nowadays, while working with clients, I am content with creating my own narratives surrounding my own values, identities, and preferences, without feeling bitter or guilty … The part of me containing the helping nature … I like that part who wants to go above and beyond for my clients … I like that soft, vulnerable piece of my soul, rather than doing the work strictly by the book and not doing anything else. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 72 RA: I allow myself to be sad, it’s not wrong. I allow myself to get introduced to my emotions and listen to myself … I let myself cry and release that energy … Being aware that the work I do could be the reason behind that rather than thinking that it is something that I did. It is not because I failed … trying to educate myself and listen to more stories and having those friends around me, appreciating my life and my kids. That’s how I heal myself. Postecstatic Growth Several novel threads of narratives suggested that not all forms of growth might be directly associated with vicarious traumatization. In fact, several participants brought up anecdotal experiences showing how witnessing relatively neutral and positive life experiences in refugees have also been mutually inspirational. Considering the participant narratives of beneficial psychological changes resulting after positive life events in their clients, our research team formulated a provisional term: “vicarious postecstatic growth” (cf. e.g., Roepke, 2013). This formulation was strengthened by the key informant consultation. Empowering and Being Empowered Some participants expressed a sense of joy, hope, and inspiration as they cared for their clients, joining the stories of recovery from pre-migration trauma and growth in the face of postmigration stressors. Alleviating the burdens of vulnerable clients and walking alongside as they reach milestones in their settlement bestowed them with a sense of reward and satisfaction, despite acknowledging the emotionally exhausting nature of their endeavour. Such positive experiences inspired via successful empowering interventions were acknowledged as a possible catalyst for their testimony of thriving experience. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 73 LMB: Eventually, I recognize my clients’ successes … such as acquiring citizenship or purchasing a nice gift to her daughter, showing mother to her, [which] gives me a sense of purpose and fulfillment. I thrive in those moments while celebrating the growth of the clients with them. The process of witnessing the client’s success is often exhausting, yet there are some joyful parts of it. Furthermore, some participants found their clients’ sense of resilience, personal strength, and perseverance reinvigorating and were proud to be a part of such promising stories of settlement. In that sense, they described the highlights of their work as neither only about themselves nor only about the clients. Rather, healthy working relationships became embodied in their notion of growing together in collaboration with the clients. For instance, RA passionately illustrated how working with one of the families under her caseload was inspirational. The entire family were displaced from their country by the Syrian war and had to start their life over from scratch in Canada. Despite the chronic health conditions in two children, RA said that the family was “so passionate about succeeding in the country.” After listening to this case, I shared with RA that it also made me feel empowered and inspired. RA: Those two sons, regardless of their sickness … Some days they can’t move from the bed … I’ve never seen them not smiling. They are a very optimistic family …When my son got a little bit of fever, I used to panic and go to places and doctors … but [this family’s] resilience was so eye opening for me. They had so many dreams; they wanted to have their own business and they actually have their tailoring business now here. A very successful story and I mentioned this story everywhere. They are in magazines now. They exemplified an unrelenting spirit of resilience, despite their challenging resettlement experiences including their life-threatening health problems, so many WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 74 traumatic experiences, and losing so many things. So that encouraged me to do so many things [like] start studying, start working harder, start being more optimistic and trying to be more resilient when facing challenges, it’s not the end of the world [anymore]. I have to come up with a way to get over it and find [solutions] … It was rewarding for me that me supporting this family had this impact on them, but then looking at them and their resilience also empowered me. Facilitating Self-Sustainability Adjacent to the nature of Empowering and Being Empowered, another closely affiliated theme shared amongst a few participants was cultivating self-sustainability in clients through scaffolding. The participants underlined the value of cultivating self-sustainability and confidence in their clients after helping them overcome initial resettlement difficulties. They include language barriers, cultural differences, and difficulty of transferring professional credentials/education acquired in their home country. Ultimately, they encouraged their clients to navigate through and settle in the Canadian system by themselves. Several participants shared stories where they initially co-navigated diverse basic community resources around the clients’ residence while “holding the clients’ hands”. For instance, AS shared an episode where she and her client used public transportation (i.e., Skytrain and bus) multiple times together so that the client could eventually do it by herself. Even during our interview, AS had to excuse herself shortly to be in touch with her client who arrived at the local ICBC and taught her over the phone how to ask for an interpreter. AS: I see being resourceful for my clients [when] I can help them so that they can help themselves eventually, be sustainable by themselves. To get the client to have an “Aha” moment is like “oh, I can do it by myself, oh, I have learned how to use the bus. It’s not WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 75 hard.” Those moments make me feel good, a step towards independence, so they are moving beyond their challenges ... I often accomplish this by juggling through the daily tasks well ... meeting my clients where they are at, walking alongside their learning curve … from the very first step to the final step. JSB: Another way to do my job well is to help my clients cultivate accountability for their own actions through our relationship, rather than letting them victimize themselves every time. This is something that I always tell my clients “Don't expect me to do magic and come in and try to do everything [for you all the time] ... I am holding your hand and we'll do it together because this is for you, and I want you to learn how to do it [on your own] because there will be one day that you won't have a worker to come out here and [you will be independent on your own].” Intersectional Allyship and Sense of Privileges Another salient thread of conversation lay in the growing identification with the full profiles of intersectional allyship. While identifying themselves as persons of privilege compared to their clients, they strive to work in solidarity with their marginalized clients, unlearning and re-evaluating where they are in the spectrum between privilege and oppression. Some also revealed their own experiences of oppression directly, paralleling the experiences of their clients. Moreover, the participants experienced a heightened sense of awareness of their privileges as their relationships with their clients deepened. Following passages reflect some of the highlights of their narratives. JSB: I came to Canada as a government-assisted refugee. As a refugee receiving services from a settlement agency, I became familiar with the role of a refugee case specialist as a client. Growing up, I knew I have a lot of empathy for refugee populations and having WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 76 first-hand experiences as a refugee helped me to be knowledgeable about doing my job well. BM: Working with refugees has taught me to not take what I already have here for granted. Despite intersectional identities and my experiences of oppression … as a queer, trans, and disabled person, it helped me become aware of the number of privileges I have … Working with refugees was like: “These people are experiencing oppression in almost all of the ways that a person can experience oppression.” Just to see the vast difference from that person’s life experience to mine … I think it made me grow as a person … Stories they told me … things they notice in Canada [are something I am] not taking that for granted. LMB: I think part of flourishing through one’s work-life or lived experiences is coming to terms with understanding your own oppression and other people's oppression [to see] how those interact. The issue may not completely be resolved, and it will always be a journey and knowing that that's not my journey. It is their journey. I just walk part of that journey with them. And that’s a privilege.” In addition to talking about intersectional allyship and problems in the system, one participant, BM., shared his particular desire to continue to resist injustice and inequality in the system. Particularly, he brought up an ongoing involvement in and aspiration to activism as a means to seek a collective level of healing—for both his clients and himself. BM: Working with refugees also helped me with the journey of moving into the world as somebody who is an activist in my own struggle and also an ally. Engaging in diverse forms of activism is also where I’ve found healing for myself as well. This includes both the work that I've been able to do with refugees and the work involved at an interpersonal WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 77 level over the years. Furthermore, I’ve voluntarily engaged in advocating for queer and trans issues as well as supporting those who are incarcerated. For me, the healing lies in … the process of being an activist, resisting unjust systems, and doing the work that resists burnout. I agree with scholars like Reynolds who talks about resisting burnout through being an activist, through supporting our clients. Changing the Narrative Through Research Participation Co-constructing and uncovering a positive narrative to work with trauma survivors was meaningful and empowering to some participants. In particular, through participation in this research, some participants felt empowered to redefine their understanding of vicarious traumatization and process vicarious posttraumatic growth, ultimately increasing quality of care for their refugee clients. AS: I found this conversation meaningful for my work because I realized that vicarious trauma and burnout narrative seems to work as a negative self-fulfilling prophecy. When the majority of people are talking about burnout and dissatisfaction, all these negative things, the frontline workers will start absorbing that if that is all we hear. I am expecting to have a burnout within the first year. Instead, by participating in this research, I am changing the narrative. If more people talk about this, [they] will have a different mentality going into this. I think your project is very important… and it will change the scene that we have of settlement work. RA: Throughout my participation in this research, I was really empowered in that I reviewed my entire career up to this point but also realized how much I grew up as a professional … Having this conversation can be triggering for some people. For me, I WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 78 find it rewarding … having to remember all those memories and the journey and the end results and the learnings … I am still learning [through this interview] for sure. When put together, these overarching themes and their corresponding sub themes have captured the experiences of the participants for this study. Integrative Summary of Results As I see subjectivity and value-bound activity as intrinsic to the integrity of research, it is my responsibility to organize in this section what emerged from formulating the results. This was a non-linear process, involving analysis of participant interviews and examining these data analysis processes with the research team. As a critical criterion for the trustworthiness, I reviewed the data with the key informants, seeking their insights into the findings and implications of this research. The research team refined overarching themes and subthemes by sharing preliminary themes with key informants and asking for feedback, which was conducive to formulating a thematic map (See Figure 2). Figure 2 Thematic Map: Vicarious Impact of Working with Refugees WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 79 In general, a thematic map represents the culmination of such effort as it offers the conceptual formulation of the overview of broader findings. As a commonly used visual rhetoric in tandem with thematic analysis, key concepts embedded in the thematic map highlight the main findings through revealing overarching themes and subthemes, and present them in a mind-map. The final step involves interpreting the derived themes further, setting them in context with the research question and comparing them to the relevant literature (implication of the latter will be revealed in the discussion chapter). These exercises allow a thematic analyst to interpret what is said in a text by pointing to the meaning of participants’ stories. Inside the preceding thematic map (See Figure 2), I juxtaposed overarching themes with the underlying subthemes and the thematic relationships with one another. Circles represent overarching themes, and squares represent main underlying subthemes. Solid lines indicate that the attached thematic contents were commonly found amongst multiple participants (i.e., shared WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 80 themes), whereas dotted lines suggest that the attached thematic contents were unique to individual participants (i.e., idiographic themes). When combined, they reflect the broader narrative of the vicarious impacts of working with refugees. Overall, the research team found three overarching themes—vicarious traumatization narrative, its counter-narrative of vicarious posttraumatic growth, and the provisionally labelled “vicarious postecstatic growth”—each of which branches out into several shared and idiographic subthemes. Utilizing the reflexive practice embedded in data analysis, collaboration with the research team, and consultation with key informants, I found several features of the results worth highlighting. First, as shown in our thematic map, the number of themes and subthemes surrounding VPTG is larger and more multifaceted than that of VT. Indeed, we traced nine underlying themes (counting both shared and idiographic themes) linked to the VPTG narrative compared to three themes connected to the VT narrative. Such a distinction suggests that, while recognizing the inherent stressors of working with refugees, most participants are relatively more drawn to the orientation towards growth. Furthermore, setting the two groups of contrasting themes side by side—one group of themes of suffering and another of healing and growth—illustrates the holistic nature of the vicarious experience of professionals working with refugees. In other words, settlement workers who support refugees are both positively and negatively affected by their work. In tandem with the holistic nature of working with refugees who have lived through trauma, a relational component has emerged in the result as a major underlying characteristic of growth. Affirmed through the discussion I had with the participants during our follow-up interviews, the sense of mutuality between the settlement workers and refugee clients, their close bonding, appears to have shaped the mutual, dyadic growth. Indeed, analyzing the thematic map WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 81 revealed that, for both positive (growth) or negative (traumatization) categories, most themes highlight the ways in which participants value the collectivist approach to work. In defining the concepts of thriving, being “fully human,” and becoming aware of one’s need to be “healed” owing to the exposure to client’s distress, they revealed that the needs and goals of the group as a whole take precedence over those of each individual. Such a collectivist cultural identity was vivid in the participants’ stories, in which relationships with fellow settlement workers, and refugee clients as well as the overall interconnectedness between them play a central role. For instance, several themes such as Intersectional Allyship, Organizational Support, and Frustration at Canadian Immigration System point to how participants regard affiliation with their colleagues and collective well-being of their clients and themselves as essential work values. Finally, we traced four sub-themes (under the overarching theme: vicarious postecstatic growth) that extend beyond the traditional theoretical construct of VPTG, which holds that only exposure to a client’s traumatic experience might result in helper’s personal growth. These themes—Empowering and Being Empowered; Facilitating Self-Sustainability in Clients; Intersectional Allyship; Engaging in Activism; and Participating in VPTG Research—suggested that one’s perception of euphoric experiences, either directly or vicariously, could also lead to lasting beneficial changes to themselves and their witnesses. While several themes relevant to the vicarious posttraumatic growth (VPTG) do allude to settlement workers’ experience of growth in consequence of their clients’ posttraumatic growth (i.e. suffering as its catalyst), refugee clients’ sense of personal accomplishments coloured by their positive life events (i.e., positive experiences as its catalyst) may also vicariously shape settlement workers’ growth experience. Inspired by this finding, I along with the research team and key informants formulated a provisional overarching theme, vicarious post ecstatic growth (VPEG). This allows us to WELL-BEING IN THE FACE OF VICARIOUS TRAUMA appreciate the exciting possibility that both life’s best and worst events could equally impact one’s growth experience, and the pathway to positive changes in the context of working with traumatized clients may be multi-faceted. 82 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 83 CHAPTER 5 DISCUSSION My purpose of this project was to learn about the alternative, positive narrative to the vicarious traumatization (VT) narrative so that we can help sustain service providers who support refugees and all immigrants with a longer, more fulfilling career trajectory. To attain this objective, I explored the ways in which people who work with refugees make sense of VT narratives and vicarious posttraumatic growth (VPTG). In this chapter I begin with a summary of the rationale for the study and research question. Contributions to the literature are summarized where I examine how the narratives found in our study relate to previous research. Then, I will discuss contributions to theory and introduce the Core Processes of Relational Shaping of Growth model. I will then share policy implications of the study. This chapter concludes with the study’s strengths, limitations, and future directions for research on supporting the supporters through exploring their sense of well-being in the face of vicarious trauma. Summary of Rationale and Research Question During the last two decades, there has been growing interest in the vicarious impacts of trauma work on helping practitioners who support trauma survivors. In addition to the ongoing research on the negative effects of trauma work, namely VT, both clinicians and theorists have recently studied the positive consequences and benefits of trauma work, namely VPTG. Those groups who have been studied frequently include therapists, firefighters, social work clinicians and ambulance workers (Arnold et al., 2005; Brown et al., 2002; Clohessy & Ehlers, 1999; Cunningham, 2003). Settlement workers have been broadly defined in this document as a group of helping professionals who work with immigrants and refugees. In particular, as evident in recent studies, those who care for refugees who have lived through trauma are also exposed to the vicarious impacts of trauma work (Barrington & Shakespear-Finch, 2013; Chan et al., 2016; WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 84 Puvimanasinghe et al., 2015). Although the level of vulnerability for this group of helpers is no less than the vulnerability of the other previously studied groups, the amount of research interest in their work has been relatively scant in 2016 and continues to be (Chan et al., 2016). Therefore, the aim of this project is to contribute to the search for missing stories among a specific group of settlement workers who have received little attention yet whose roles are important in today’s world. In addition, it is my hope that this research will raise awareness for the alternative, positive narrative to the VT narrative so that we can help sustain service providers who support the refugees/immigrants with a longer, more fulfilling career trajectory. This study was guided by the research questions: In what ways do settlement workers personally flourish as they work with refugees who have lived through trauma? In what ways do they resist or reinterpret vicarious trauma narratives? Contribution to Literature This study contributes to the literature as it provides the opportunity for us to engage with participants specializing in providing care for refugees by reflecting on their narratives regarding VT and VPTG. Through thematic narrative analysis, we identified three recurring patterns in the data, namely VT, VPTG, and VPEG, alongside related themes and subthemes (Figure 2). We outline below how our findings have been similar to as well as extended beyond the various streams of existing literature. Relevance to VT Literature As noted in the literature review (chapter 2), VT refers to the negative psychological influence of caring for trauma survivors and identifying with their stories of trauma (Pearlman & Saakvitne, 1995). According to the Constructivist Self-Development Theory (CSDT), people actively interpret their experiences and environment using their cognitive structures or WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 85 schemas—beliefs, assumptions, and expectations about oneself, others, and the world (McCann & Pearlman, 1990). However, when encountering new information, such as being exposed to traumatic materials either directly or vicariously, their schemas are subject to being disrupted and transformed (Janoff-Bulamn, 1992). Therefore, VT refers to the enduring psychological turmoil experienced by service providers as a consequence of their exposure to the traumatic experiences of their clients. Several of our study’s findings regarding settlement workers’ narratives of VT appear to be consistent with both the theoretical construct of VT and the way in which it was applicable to other groups of helping professionals (e.g., firefighters, social work clinicians and ambulance workers). Indeed, not all participants were aware of the term VT itself, yet many were familiar with the notion. As participants shared several episodes of stories where they were exposed to refugee clients’ accounts of trauma, such as fleeing from the war or being persecuted on the basis of their sexual orientation, they were concerned that this might have an impact on their view of the world as a safe and secure place. Further dialogue with me revealed that the participants were identifying with the clients in some form, through sharing with them either the history of resettling in Canada as refugees/asylum seekers themselves or a sense of intersectionality in the experience of oppression. Their belief in what is just and fair seemed to result in frustration and disappointment at the perceived inadequacy of Canada’s humanitarian program, hindering clients’ resettlement into Canadian society, heightening their current distress, and reactivating past traumas. Some were discontent or even baffled at the cultural insensitivity of immigration officers, who examine applications for immigration, citizenship and visas and interview people to determine their eligibility for residence in Canada. Others were concerned about the prejudices against some of the refugees which portray them as manipulative, overly demanding, and lazy. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 86 In support of previous literature examining experiences of working with refugees and asylum seekers in South Australia (Puvimanasinghe et al., 2015), our findings also suggest that perhaps people caring for asylum seekers tend to be under the most severe emotional distress. As one of the participants narrated, people working with asylum seekers often identify themselves with their clients’ fear of uncertainty that they may be deported. Though they strive to free themselves from the sense of sole ownership of their clients’ future, learning that their client’s right of asylum was denied by the immigration officers often took its toll on the participants. To that end, the finding of this study attests to Puvimanasinghe et al.’s (2015) claims that workers who are most at risk of VT are those “who are aware but feel helpless to do anything about their clients’ plight” (p. 759). Relevance to VPTG Literature Nevertheless, the data from this study showed that there were also several positive facets of working with refugee survivors. Our participants were appreciative of the many resources of the refugee clients with whom they worked, including coping strategies, family, community, and also their relationship with the settlement workers. In participants’ eyes, some refugee clients’ ability to rebuild relationships in the new community, seek job opportunities, and live each day with optimism demonstrated their resilience, grit, and resourcefulness. Perhaps the fact that the settlement workers were more eager to recount the benefits of their work—while acknowledging the inherent emotional turmoil associated with bearing witness to clients’ suffering—suggests that the existing VT theories fall short in accurately representing the total vicarious experience of those who care for refugee survivors. In fact, a substantial feature of our findings—the overarching themes “VPTG narrative” “VPEG narrative” and some of their underlying subthemes—closely align with the theoretical construct of VPTG (Tedeschi & Calhoun, 2004; WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 87 see also Arnold et al., 2005; Splevins et al., 2010). While acknowledging that distress is inevitable as trauma often shatters people’s fundamental worldviews, whether it is experienced directly or vicariously, VPTG theories posit that trauma also acts as a catalyst for meaningmaking processes followed by positive outcomes (Arnold et al., 2005; Barrington & Shakespeare-Finch, 2013). Though the process of meaning-making itself in the aftermath of VT was not the focal point of this study, several sub-themes in the thematic map bear noticeable similarity to the originally proposed constructs associated with VPTG (Arnold et al., 2005; Barrington & Shakespear-Finch, 2013). For instance, participants frequently referred to the way in which they were empowered to witness and advocate for their clients’ growth, relied on spirituality to seek positive meaning from their distress, gained insights, and became empathic and compassionate towards themselves (e.g., Empowering and Being Empowered; Spirituality; Intersectional Allyship; and Unconditional Self Acceptance). Relational Shaping of Growth. The results in our study also showed meaningful distinctions between settlement workers’ experience of growth and the form of growth according to the VPTG model. In contributing to further development of the theory, our research team conceptualized a provisional model (See Figure 3), which shows a form of growth embedded in the relational solidarity between settlement workers and refugees. We named this model the Core Processes of Relational Shaping of Growth. This formulation honours the patterns of growth based on a high degree of collectivism and mutuality shared between settlement workers and clients. Studying the meaning of relational shaping of growth and its cultural backdrop enriches our understanding of the ties among all themes in the thematic map (Figure 2) and all features of an extended model (Figure 3). WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 88 Figure 3 Core Processes of Relational Shaping of Growth Model Many refugees and settlement workers have come from more collectivistic societies and therefore share distinctive cultural contexts which appear to shape their mutual growth. In the semi-structured interview format, I guided the flow of the first half of the interview on doing well and thriving and that of the second half of the interview on self-healing from VT. The participants still had full latitude to share their stories in whichever sequence and structure they preferred. As we engaged in the second half of the interview, I realized that a few participants were eager to rehearse what they had said in the first half: benefits to the clients by virtue of their working relationship with their clients. Reflecting with the key informants on the pattern of responses from several participants, our research team identified patterns of results that emerged WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 89 from the analysis that they might be answering the question of self-healing from a relational perspective. In other words, for our participants, the meaning of self-healing from burnout or symptoms of VT might be similar to seeing thriving as at the heart of their caring relationships with their clients. Informed by relationally focused cultural contexts, we concluded that, for many settlement workers, the relational and collective understanding of well-being seems to constitute a key factor to experiencing thriving and vicarious (posttraumatic) growth. Considering these observations, we in the research team posit that, with similar linguistic, socioeconomic, and/or cultural backgrounds, the two think of themselves as members of a dyadic relationship rather than as distinct individuals. Indeed, many settlement workers share with their clients the identity of settlers as they were once refugees/asylum seekers themselves. Those who are native Canadians also felt closely connected to their clients through their experiences of oppression that paralleled the experiences of their clients. Hence, we produced two provisional pathways within the Core Processes of Relational Shaping of Growth Model (See Figure 3). Under path 1, we posited that trauma acts as an impetus for effortful meaning-making and subsequent positive outcomes for both refugees and settlement workers. Complementing the VPTG theories, our results highlighted that the collaborative relationships and contextually significant circumstances appear to drive the process of mutual growth in the face of trauma for both refugees (i.e., PTG) and settlement workers (i.e., VPTG). Because of a dearth of bilingual and culturally diverse clinicians, the effective delivery of case management, crisis intervention, and emotional comfort to refugees and asylum seekers depends largely on settlement workers to this day. Consequently, they often serve the role of the primary point of contact for refugees. They also fulfill the role of cultural, linguistic, and logistical brokers by bridging refugees to the local communities, crisis counselling, health care resources, and/or employment opportunities. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 90 For instance, the research team found that many participants said that one of the ways they understood thriving was to detect and meet clients’ needs within the boundaries of their service provisions (i.e., Subtheme: Meeting Their Needs Within the Boundaries). Another way was to differentiate themselves from their clients to maintain their practice in a more sustainable direction (i.e., Subtheme: Differentiation of Self From Clients). In other words, settlement workers have their contextually meaningful coping strategies to resist VT and to make sense of VPTG. Under path 2, we delineated how the settlement worker-refugee client dyads were catalyzed to co-experience growth after the clients processed positive events in their lives. Participants’ narratives showed that, similar to path 1, collaborative relationships and contextually significant circumstances directly impact the process of their mutual growth. However, in this pathway, the growth is facilitated not by trauma, but by the emotional peak experiences of the clients. Some researchers have argued that life events that enhance positive emotions (including awe and elevation) can also cultivate personal development and, later, have termed this phenomenon postecstatic growth (PEG; Roepke, 2013; see also Mangelsdorf & Eid, 2015). During data analysis, since the participants’ narratives of growth took shape vicariously following their refugee clients’ experience of postecestattic growth, our research team, including the key informants, labelled it vicarious postecstatic growth narrative (VPEG). As illustrated in the results chapter, several themes from participants’ stories verified the legitimacy of path 2. For example, some talked about the sense of purpose, joy, and thriving when they witnessed their clients enjoying euphoric moments in life such as acquiring citizenship or purchasing a nice gift for their daughter (i.e., Empowering and Being Empowered). Others cherished narrating episodes of helping their clients to become ultimately self-sustainable (i.e., Facilitating Self- WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 91 Sustainability). As the participants saw their clients gain confidence in their abilities to use public transportation alone or request ICBC’s interpretation services independently, the participants became elated over their clients’ huge triumphs in life. A few participants also shared at the end of the interview that participating in this study, during which they had a chance to review the thriving moments of their career with the principal investigator, helped them fully appreciate the meaning of growing/thriving (i.e., Participating in VPTG Research). Overall, our alliance with several streams of previous literatures on VT, VPTG, postecstatic growth (PEG; Roepke, 2013) and the formulation of vicarious postecstatic growth (VPEG) highlights that those caring for refugees in recovering from trauma are both positively and negatively affected by their work. That is, not all forms of positive psychological changes require suffering (Mangelsdorf & Eid, 2015; Mangelsdorf et al., 2018). It is worth noting that the two provisional pathways are to be regarded as complementary and mutually non-exclusive. We acknowledge that negative life events (including ones that remind people of their past traumas) and positive life events often show up in our lives in an unexpected, non-linear manner. Moreover, the resulting model of psychological growth processes requires a more comprehensive framework that takes into account processes of well-being (e.g., eudaimonic perspective, Ryan & Deci, 2001; psychological well-being, Ryff, 1989) and broader psychological changes (e.g., selfconcept, character, relationships, meaning in life; Roepke, 2013). Implications for the Study: Supporting the Supporters Consulting with the key informants allowed us to delve into the socio-political and institutional contexts of the Canadian settlement and integration sector, particularly the lack of sufficient support from the Canadian government to the workers and refugees. For instance, our consultation with key informants revealed that settlement workers at times experience distress WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 92 because of an unstable funding structure and a culturally insensitive service delivery model that fails to acknowledge the need for long-term trauma-oriented family counselling to refugee populations. According to the official government of Canada (IRCC) website, newcomers including refugees are eligible to “[access] short-term/crisis counselling if needed” via settlement programs funded by the government (Immigrant, Refugees, and Citizenship Canada, n.d.). The results of our study also pointed to the systemic barriers to doing well in the face of vicarious trauma. Ewick and Silbey (2003) said that stories “as a form of social action … reflect and sustain institutional and cultural arrangements, bridging the gap between daily social interaction and large-scale social structures” (p. 1341). Indeed, several themes emerging from the stories of participants, including “Frustration at Canadian Immigration System, Systematic Barriers and Oppression, and Biased Narratives Against Refugees,” highlighted how systematic factors are at play, hindering their pathways to flourishing. Similar findings from previous research demonstrated that, because of multiple barriers, immigrants and refugees did not have viable access to dominant mental health resources including counselling services (Grant et al., 2001). These findings alluded to work-related stressors besides hearing traumatic stories that appear to be closely associated with VT amongst settlement workers. As a means to help service providers enjoy a longer, more fulfilling career trajectory, the research team offers several practice recommendations for current Canadian refugee settlement agencies. Policy Recommendations The relevance of the following recommendations for policy change as an application of the results of the study reflect priorities and the insights offered by the participants in this project and key informants. Moreover, relevant studies not only affirm much of the accounts emerging in this study, but also elucidate the Canadian settlement sector in relation to the current WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 93 immigration context. In light of resisting and reinterpreting VT, we believe in taking into consideration structural and systemic issues rather than individualizing the problem. 1. Based on the consultation with key informants, we learned that the Canadian settlement workers should be equipped to better address the needs of the refugees who are underserved by current policies of IRCC. One key informant affirmed that the realistic nature of work expected of the staff is very similar to that of social work. However, credentials and certifications (or lack thereof), official acknowledgement from the government, and the hourly wage do not necessarily match the intensity of their work. Indeed, several scholars and experts in the sector highlighted a number of ways settlement workers – majority of whom share immigrant backgrounds – are not looked after properly (Bhatta, 2017; Türegün, 2013). For instance, Sarita Bhatta (2017), a community development professional, noted that settlement workers often work in precarious environments, enduring job insecurity, low pay, and lack of opportunities for professional and career development. The results from the current study (i.e., participants’ narratives) also point out that the current model of professional development in this sector tends to focus on short-term, intensive professional development and training for frontline professionals. Overall, to help settlement workers develop sustainable and replenishable practice for serving refugee populations, the professionalization of the sector is necessary. This will equip the practitioners with the capacity to assess and identify gaps in the system, so they can exercise more lobbying power and bargaining capacity for themselves and for their clients. For instance, they would recommend an increase in the maximum length of service provision, stable funding with adequate pay, a greater number of official, WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 94 government-funded interpreters, more refugee-centered housing policies. Furthermore, professionalization process will require settlement workers to receive and get access to long-term education and training regarding culture-infused, diversity-sensitive, traumainformed practice. Nurturing competencies in these areas is critical in addressing the needs of immigrant and refugee clients, many of whom have multiple barriers and trauma backgrounds. 2. In the context of referring immigrants and refugees to various social services, many frontline professionals working in the Canadian settlement and integration sector have often struggled with responding to the counselling needs of immigrant and refugee families. Similar to the multiple partnership model (MPM) by Grant et al. (2001), we recommend an all-encompassing service framework that serves to be a bridge between existing expertise and resources in the dominant culture and the solutions available in various language and cultural groups. To that end, it is pivotal to establish co-therapy partnerships between ethno-specific settlement counsellors (settlement workers) serving the role of bi-cultural consultants and on-site family therapists. For instance, in consultation with an on-site family counsellor through case review, the settlement worker could provide counselling and at times co-counselling. When the family counsellor serves the main role of clinical counselling, the settlement worker becomes involved in the process as a cultural consultant and co-facilitator. In this kind of scenario, in addition to serving the role of an interpreter alone, the settlement workers facilitate channeling the culturally appropriate verbal and non-verbal messages, the exchange of which are critical to effective counselling (Grant et al., 2001). This kind of approach facilitates and draws upon distributed expertise and collaboration rather than hyper-specialization in WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 95 professional development. If the refugee clients already possess a fluent command of English, they may opt to see the family counsellor alone. 3. The two most prevalent terms for job titles of those who work with refugees have been ‘settlement workers’ and ‘case specialists’. In honouring the all-encompassing nature of the work they do, which sometimes goes above and beyond their usual job descriptions, we recommend that we reframe their work using the terminology of ‘settlement counsellors’. Throughout the interviews, I observed that the work that participants were doing involved various forms and levels of counselling as well as assessment, in addition to offering resources relevant to settlement. Therefore, in providing immigrant and refugee families more streamlined, multi-disciplinary support, I advocate for the consistent and transparent allyship between family counsellors, social workers, and “settlement counsellors” (Grant et al., 2001). Dissemination of Findings During the Next Phases of COVID-19 Pandemic During the COVID 19 pandemic, social interactions have been disrupted in various ways. The government of Canada has advised “non-essential” businesses and services to be closed in an effort to contain the spread of the virus. The settlement work industry — any program that serves refugees with dire and multiple needs — belongs to the essential category of services. Indeed, many refugee clients depend on settlement workers for vital social contact because they are alienated from their family, the community, and society in the host country (Puvimanasinghe et al., 2015). Considering the circumstances surrounding the pandemic, supporting the settlement workers in charge of providing essential services in a sustainable manner has become more significant than ever. As an ally to refugees as well as settlement workers who serve them on the frontline, I see that one key implication of this research can be connecting me directly to the WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 96 knowledge translation process as a counsellor-in-training. Specifically, through doing online workshops about the outcome of the findings and available literature for interested settlement workers in Canada, this research, to a certain extent, helps to marry the VPTG/PEG narrative as a potential alternative and supplement to VT narratives with benefits for the well-being of participants and the broader communities of settlement workers. Strengths, Limitations, and Future Directions for Research Through employing the narrative inquiry methodology in combination with thematic analysis as a toolkit, the present study brought to light some missing stories among settlement workers. These stories reveal settlement workers who cherished ways in which they personally flourish while supporting refugees and resist VT narratives. Since the number of refugees coming to Canada keeps increasing and awareness of the impact of trauma work is rising, research on this topic has important implications for service quality, policymaking, service providers’ well-being, and refugee clients’ lives. Adding to the handful of previous studies (Barrington & Shakespeare-Finch, 2013; Puvimanasinghe et al., 2015; Splevins et al., 2010), this research explored VT and VPTG amongst service providers who work with refugees and found that their narratives represent both negative and positive impacts of their work. Thanks to our group of six participants, the detailed descriptions of their narratives engendered a rich and distinctive understanding of the pathways to growth orientation in the face of VT. In particular, this study underlined the relational shaping of growth as a primary conceptualization of well-being in service provider-refugee client dyads, a limited or absent feature in prior research. Thus, the results from the study reflect six distinctive experiences of VPTG and VPEG as they strengthen resistance to VT. Consulting with informants who have WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 97 been working in the settlement sector at the managerial level unveiled latent, industry-specific implications for frontline service providers. Our study is limited as we could not disregard the possibility that participants depicted themselves and their work in an optimistic light for a university research interview. However, we alleviated this concern for trustworthiness by avoiding direct questions regarding VT and VPTG during the interviews. In fact, the participants willingly accepted my invitation to informally elaborate their stories of “thriving” and “desire for self-healing” in ways that are most authentic to their lived experiences (see Appendix D: First Interview Protocol). Since the available means of communicating with participants was restricted to online (i.e., Covid-19 pandemic), we also acknowledge that their contextually relevant backgrounds (often more readily available in person-to-person engagement) might have been compromised at the data gathering stage. Moreover, having an English-only interview as the norm during the data gathering stage needs to be addressed by the larger program of research. This study was limited in that regard because the researcher was able to conduct interviews with only those who spoke fluent English. In the future, we ought to collectively establish multilingual interview resources. Furthermore, despite our identification of positive and negative sequelae of working with clients as VPTG and VT, we acknowledge that other researchers and professionals might emphasize overlapping concepts to refer to parallel findings (e.g., compassion fatigue; secondary traumatic stress; burnout; vicarious resilience; adversarial growth). Ongoing work in professional development and research will be needed to help sort out these various connections and overlaps. Another tentative feature of the results was the theme of post ecstatic growth (PEG) which emerged during the course of the data analysis. VPEG (cf. PEG; Roepke, 2013) as an emergent pattern within this study requires additional investigation clarification and WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 98 confirmation. The evident connections among VT, VPTG, VPEG, and the relational shaping of growth reflect thick descriptions of the experiences shared in this study, suggesting that additional study promises enduring contributions to the literature on service providers and their refugee clients. The journey to supporting the supporters does not end here. Complementing this retrospective study we recommend that future qualitative researchers conduct prospective studies in which they explore how service providers anticipate the unfolding of their work as they encounter trauma in the lives of their refugee clients. Moreover, more research is needed to explore the likely role of the relational shaping of growth in both the positive (VPEG) and traumatic (VPTG) experiences of settlement worker-refugee client dyads and to bridge these processes with theories of well-being and broader psychological changes. We also recommend that future research projects compare settlement workers with other helping professionals (e.g., counsellors, psychologists, doctors, nurses, etc.) on the same topic. Besides being exposed to traumatic stories of their clients, a few identified with work-related stressors (e.g., understaffing, unstable funding structure, culturally insensitive service delivery model). It is unclear at this stage of research as to how these contextual stressors might connect with the processes of VT, VPTG, VPEG. To that end, future researchers could investigate if such stressors have an impact on service providers’ level of traumatization or growth. Conclusion Research describing the experience of caring for those recuperating from trauma has emerged as a robust, relevant outlook. Following studies that explored VT narratives, the negative, debilitating aspects of trauma work, recent research has shed light on the positive, transformative outcomes, such as narratives relating to VPTG. In addition to the diverse array of WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 99 helping practitioners, settlement workers are professionally involved with the settlement process of those who are recovering from refugee-related trauma. Their significant role in assessing and delivering therapeutic services to refugees and asylum seekers calls for a more accurate understanding of the vicarious impact of their work on themselves. My hope for this study was to learn more about settlement workers who have been able to align with narratives of positive transformation vis-a-vis their relationship with refugee clients and in doing so have resisted or reinterpreted VT. By listening to their narratives, I became hopeful that settlement workers do experience VPTG and VPEG in the face of VT, even in a culture that portrays their work to be hazardous and even unsustainable. While wrestling with the discourses of VT, they have chosen to see their work more holistically. 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Asylum seekers must apply for protection in the country of destination, which implies that they must arrive at or cross a border in order to apply. Then, they must be able to prove to authorities there that they meet the criteria to be covered by refugee protections. Not every asylum seeker will be recognized as a refugee (see also Refugee). Immigrants: Someone who chooses to resettle to another country. Many, especially economic migrants, choose to move in order to improve the future prospects of themselves and their families, such as finding work, seeking better education, or reuniting with family. Unlike refugees who cannot safely return home, migrants can return home if they wish. This distinction is important for governments since countries handle migrants under their own immigration laws and processes. Refugee: A person who owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 116 the protection of that country. Refugees are unable to return home unless and until conditions in their native lands are safe for them again. Once these people are legally recognized and granted the definition of refugee status by official entities such as a government or the UN’s Refugee Agency (The Office of the United Nations High Commissioner for Refugees), they have a right to international protection (see also Asylum Seeker). Resettlement and Resettlement Assistance Program (RAP): Resettlement refers to the transportation/relocation of a group of people from the first country of asylum ("the host country") to a third country, especially when conditions in countries of origin remain unstable or there is a risk of persecution upon repatriation. Resettlement in a third country, such as the United States or Canada, is often the last resort and available to only a small fraction of the world's refugees. Under the Resettlement Assistance Program (RAP), the Government of Canada (i.e., the federal government; IRCC) helps government-assisted refugees and other eligible clients for a limited time when they first arrive in Canada by providing direct financial support and funding the provision of immediate and essential services such as housing and monthly income support for basic needs (e.g., food). More comprehensive contextual information is found in RAP Service Provider Handbook (See also Settlement and Settlement Services Program). Settlement and settlement services program: Settlement generally refers to the period following immigrants’ and refugee's arrival in the new country until they feel they become fully settled and independent in the new society. In the Canadian context, the settlement service program guides the overall process of one’s settlement. The primary goal of the program is to WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 117 support resettled immigrants and refugees to overcome barriers specific to newcomers’ experiences so that they can fully participate in social, cultural, civic, and economic life in Canada and acquire citizenship. The provincial, territorial, or municipal governments often work in allyship with not-for-profit organizations/community agencies to deliver services including, needs assessment and referrals, information and orientation, language training, employmentrelated services, support services, and building community connections. Systems Thinking: Any entity whose parts relate to one another in a pattern. Based on this definition, all biological organisms from bacteria to whales are systems. Human systems include everything from an individual (“micro system”), community (“meso system”), and a nation (“macro system”), and include belief systems (e.g., cultural traditions or a set of laws). In the context of Canadian resettlement/settlement, a key aspect of working with refugees considers the systemic contexts in which they live. These contexts exist in and are interwoven at multiple levels, including the individual (the refugee), the family, the community, frontline settlement workers, and not for profit agencies, as well as the relevant (provincial and federal) government policies. Systems thinking is fundamental to the well-being of settlement workers and their ability to support their refugee clients. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA APPENDIX B: Background Questionnaire 1. Are you legally an adult (i.e., 19 years old or older)? 2. Are you comfortable speaking English in this interview? 3. Do you believe that your state of mental health significantly hinders you from participating in a conversation that may emotionally and physiologically trigger you? 4. What is your job title and your educational background? 5a. How long have you lived in Canada? 5b. How long have you worked with refugees who are victims of trauma? 6. Do you have any questions about me before the interview? 118 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA APPENDIX C: Professional Quality of Life Scale (PROQOL) When you [help] people you have direct contact with their lives. As you may have found, your compassion for those you [help] can affect you in positive and negative ways. Below are some questions about your experiences, both positive and negative, as a [helper]. Consider each of the following questions about you and your current work situation. Select the number that honestly reflects how frequently you experienced these things in the last 30 days. 1=Never 2=Rarely 3=Sometimes 4=Often 5=Very Often 1. I am happy. 2. I am preoccupied with more than one person I [help]. 3. I get satisfaction from being able to [help] people. 4. I feel connected to others. 5. I jump or am startled by unexpected sounds. 6. I feel invigorated after working with those I [help]. 7. I find it difficult to separate my personal life from my life as a [helper]. 8. I am not as productive at work because I am losing sleep over traumatic experiences of a person I [help]. 9. I think that I might have been affected by the traumatic stress of those I [help]. 10. I feel trapped by my job as a [helper]. 11. Because of my [helping], I have felt "on edge" about various things. 12. I like my work as a [helper]. 13. I feel depressed because of the traumatic experiences of the people I [help]. 14. I feel as though I am experiencing the trauma of someone I have [helped]. 15. I have beliefs that sustain me. 16. I am pleased with how I am able to keep up with [helping] techniques and protocols. 17. I am the person I always wanted to be. 18. My work makes me feel satisfied. 19. I feel worn out because of my work as a [helper]. 20. I have happy thoughts and feelings about those I [help] and how I could help them. 21. I feel overwhelmed because my case [work] load seems endless. 22. I believe I can make a difference through my work. 23. I avoid certain activities or situations because they remind me of frightening experiences of the people I [help]. 24. I am proud of what I can do to [help]. 25. As a result of my [helping], I have intrusive, frightening thoughts. 26. I feel "bogged down" by the system. 27. I have thoughts that I am a "success" as a [helper]. 28. I can't recall important parts of my work with trauma victims. 29. I am a very caring person. 30. I am happy that I chose to do this work. From Stamm (2009). See https://proqol.org/uploads/ProQOLManual.pdf. Reprinted with permission (see p. 70). 119 WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 120 APPENDIX D: First Interview Protocol I. What led you to work for the immigrant service agency? II. What helped you grow your experience and skill set? III. Are there certain clients that you helped in the past that you found the most rewarding/satisfying to work with? Please briefly describe. 1. How has working with clients who have faced trauma helped you become more resourceful? Would you say that you have become more resourceful? If so, how? I. How would you describe thriving (doing well) in the context of working with refugees? (Some people also refer to this ‘flourishing’ or ‘being fully human’) II. How did your work with trauma victims strengthen your personal well-being? III. Have you had any ‘turning points’ in your experience as a helper where you noticed yourself willing to go above and beyond for your clients? 2. When did you become aware of your own need to be “healed” as a result of being exposed to the client’s distress? I. Within the context of a relationship with a client, could you illustrate a time when you realized you yearned for “healing” for yourself? II. Could you recall any specific client that invoked in you the feeling that you were less than “fully human” or “more resourceful”? What aspects of this client unsettled you? III. What did you do in response? IV. Has your personal background (i.e. ethnic, educational, cultural, SES etc.) affected the way you understand yourself in the process of self-healing? If so, how? WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 121 APPENDIX E: Second Interview Protocol The following questions are illustrative of the kinds of questions that may be asked during the interview. 1. What was it like for you to read over the selected portion of the transcript? What’s it like for you to put this together and what’s it like for me to watch this and witness with you together? a. What was your initial response to your narrative? b. In what ways did the text represent how you see yourself? c. In what ways did the text represent a shift in how you understand yourself? d. If at all, in what ways did you feel that the text misrepresents your experience? 2. What was it like to share about how your work has inspired you to realize that you have developed or “healed” as a person? a. At which point have you shared this with another person? b. Upon sharing this with another person, what was it like for you? c. In the past have you explained this development and/or healing experience in a different way? WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 122 APPENDIX F: Informed Consent Form Supporting the supporter: Exploring well-being in the face of vicarious trauma Principal Investigator: Victor Lee, MA in Progress Supervisor: Marvin McDonald, PhD Department of Counselling Psychology Department of Counselling Psychology Trinity Western University Trinity Western University Resilient.narrative@gmail.com mcdonald@twu.ca Purpose: The aim of this project is to contribute to the search for missing stories among a group of helping practitioners who have received little attention and whose roles are important in today’s world Procedures: You will partake in two semi-structured narrative interviews, each lasting about 90120 min. As part of the first interview, you will be asked several preliminary questions including: "What led you to work for the immigrant service agency? Then you will also respond to main questions including: "How have you become more fully human through caring for clients with trauma history? What is your definition of being fully human?” In the second interview, you and your interviewer (Victor) will engage in a follow-up questions discussion, centered on your experiences of reading selected portions of the first interview transcript. Your responses will be recorded, transcribed later analyzed in search for themes and sub-themes. It is important that you reflect on and respond to the questions as genuinely as you can. You will be debriefed at the end of your participation and are welcomed to ask questions or make comments at any time during the study. Potential Risks and Discomforts: It is possible that you may experience emotional and psychological distress as a result of sharing your vicarious traumatization stories. These issues will be addressed through providing participants a list of support resources, including counselling and a crisis line. The training of the researcher as an interviewer from the counselling psychology program equips the researcher with the capacity to assess the impact of the distress and as needed to interrupt the interview and support you in connecting with your resources for addressing the distress. Potential Benefits to Participants and to Society: Your participation in this study may lead to the development of important understanding in the field of vicarious posttraumatic growth. At personal level, you may gain further insight into your personal perspectives on how experiences of vicarious traumatization and burnout affect you. Through sharing your stories in a supportive environment, you could reframe your understanding about vicarious traumatization and become motivated to seek out vicarious posttraumatic growth, ultimately increasing their quality of care for your refugee clients. You will be notified once the study reaches its completion. You are welcome to contact the researcher to determine the results of the research project for your own knowledge and professional development. WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 123 Confidentiality: Identifying information (e.g., name, birthday) will be recorded in a master list and will remain confidential. Only the principal investigator, direct supervisor, and if necessary, research assistants, will have access to the information that you provide (e.g., computer files, video recordings, written records). The principal investigator will utilize a double-security system where all sensitive information will be backed up from the secure mobile application into an encrypted flash drive, and it will be stored in a locked file cabinet in his home office for a minimum of 1 year. Data may be stored anonymously for future use. After the end of the project, the data will be stored in a secure location in the Counselling Psychology department. Compensation: Each participant at the preliminary stage (i.e., upon filling out the questionnaire for the screening) would receive $25 worth of incentives; this could be a form of cash or a gift card. Contact for information about the study: If you have any questions, you may contact Victor Lee at Resilient.narrative@gmail.com. Contact for concerns about your rights as a research participant: If you have any concerns about your treatment or rights as a research participant, you may contact Elizabeth Kreiter in the Office of Research, Trinity Western University at (604) 513-2167 or researchethicsboard@twu.ca. Consent: Your participation in this study is entirely voluntary and you may refuse to participate or withdraw from the study at any time. If you choose to participate, you may skip any questions in the survey you do not wish to answer. Should you choose to withdraw from the study, your data will not be used in the study and will be destroyed in a confidential manner. This project has been reviewed and received ethics approval through the Research Ethics Boards of Trinity Western University (File # 20G12). Signatures -Your signature below indicates that you have had your questions about the study answered to your satisfaction and that a copy of the consent form will be provided for your own records (upon request). -Your signature indicates that you consent to participate in this study and that your responses may be put in anonymous form and kept for further use after the completion of this study. -Options for signing: You can either provide e-signature here, actual printed signature, or send me a note in the return email that you read and agree to the consent form. ______________________________ Research Participant Signature _______________________ Date _____________________________________________________________ Printed/Typed Name of the Research Participant signing above WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 124 APPENDIX G: Debriefing Form Supporting the supporter: Exploring well-being in the face of vicarious trauma Thank you for participating in our study! Your participation has helped us understand how your experiences in serving refugee populations who have lived through a trauma could affect the ways you think about yourself, others, and the world around you. We are also drawn to understanding how your general sense of well-being is impacted by vicarious traumatization narratives and its counter-narratives, vicarious posttraumatic growth. Scholars have contended that one’s original schemas — beliefs, assumptions, and expectations about oneself, others, and the world — are subject to being challenged when new information does not fit with the existing schemas, and thus cannot be assimilated. Therefore, when helpers are exposed to the traumatic experiences of their victim clients, their schemas suffer from enduring disruptions, which will have a negative influence on their relationships, emotional wellbeing, and general functioning – a phenomenon known as vicarious traumatization. Recent studies on this topic, however, have de-emphasized the negative effects of working with traumatized populations and highlighted a higher likelihood that many helpers could experience thriving as a direct consequence of their work with clients who have lived through trauma –a phenomenon known as vicarious posttraumatic growth. In this study, we want to examine the extent to which some narratives surrounding vicarious traumatization have actually framed the experience of your work as unsustainable and dangerous. We also want to investigate whether there are any “counter” narratives (like vicarious posttraumatic growth) for you to thrive through your work in a sustainable fashion. To do this, we are collecting your stories using two semi-structured interviews, focusing on understanding the meanings that you attribute to your experiences gained through working with your refugee clients. We aim to identify recurring themes across your entire narrative, coconstructed with us in relation to the topic of our conversation that both of us hold precious. We expect that helping professionals will identify stories pertaining to the commitment and work satisfaction, cultural awareness and adaptation, vicarious traumatization (e.g., frustration, identification with helplessness and hopelessness, and shattering of previous belief systems), and vicarious posttraumatic growth (e.g., learning from each other, bonding and reconnecting, empowering and being empowered). This research is important as it will contribute to the search for missing stories among helping practitioners who have received little attention and whose roles are important in today’s world. If you have any questions regarding this study and/or if you would like to know more about this topic, please contact Victor Lee. You are also invited to contact Victor to request a report of the research findings upon conclusion of the study. Victor Lee, MA in progress, RSW Trinity Western University, resilient.narrative@gmail.com WELL-BEING IN THE FACE OF VICARIOUS TRAUMA 125 APPENDIX H: Resource Sheet It is possible that participation in this study may bring up emotional or psychological distress for you. This handout lays out possible resources for you if you would like to speak to someone about your discomfort. Emergency Services – 911 In any situation where harm to yourself or another person seems likely in the immediate future, please call emergency services. Care for Caregivers Care for Caregivers is an online resource established in response to the 2020 COVID-19 pandemic to provide support for the dedicated healthcare workers who support others. Designed specifically for professional care providers and the leadership team who supports them, Care for Caregivers provides resources and targeted support for COVID –19 related mental health stressors. Crisis Center BC – 310-6789 or 1- 800- 784 – 2433 The crisis line is a free service, available 24/7. The helpers on the line are happy to speak with you about any kind of emotional distress. Fraser River Counselling – 1- 604 – 513 – 2113 This is a community counselling program in Langley designed to provide counselling services at a very low cost for those whom typical counselling is financially inaccessible.