Secondary distress in violence researchers: a randomised trial of the effectiveness of group debriefings

Abstract

BackgroundSecondary distress including emotional distress, vicarious trauma (VT) and secondary traumatic stress (STS) due to exposure to primary trauma victims have been described in helping professionals and in violence researchers. To our knowledge, there are few prevalence studies, and no tailored interventions have been tested to reduce secondary distress in violence researchers. The study aims to (1) describe the epidemiology of secondary distress experienced by violence researchers; to (2) assess the effectiveness of group debriefings in mitigating secondary distress; to (3) assess risk and protective factors.MethodsWe conducted an un-blinded, individually randomised trial with parallel assignment. Eligible participants were 59 Ugandan researchers employed by the Good Schools Study to interview children who experienced violence in a district of Uganda. Fifty-three researchers agreed to participate and were randomly allocated. The intervention group (n = 26) participated in three group debriefings and the control group (n = 27) in three leisure sessions (film viewings). The primary outcome was change in levels of emotional distress (SRQ-20); secondary outcomes were levels of VT and STS at end-line. A paired t-test assessed the difference in mean baseline and end-line emotional distress. Un-paired t-tests compared the change in mean emotional distress (baseline vs. end-line), and compared levels of VT and STS at end-line. Separate logistic regression models tested the association between end-line emotional distress and a-priori risk or protective factors.ResultsBaseline and end-line levels of emotional distress were similar in control (p = 0.47) and intervention (p = 0.59) groups. The superiority of group debriefing over leisure activities in lowering levels of emotional distress in the intervention group (n = 26; difference in SRQ-20 = 0.23 [SD = 2.18]) compared to the control group (n = 26; difference in SRQ-20 = 0.23 [SD = 1.63]) could not be detected (p = 1). In regression analysis (n = 48), baseline distress increased the odds of end-line distress (OR = 16.1, 95%CI 2.82 to 92.7, p = 0.002). Perceived organisational support (OR = 0.09, 95%CI 0.01 to 0.69, p = 0.02) and belief in God (OR = 0.21, 95%CI 0.03 to 1.26, p = 09) was protective against end-line distress.ConclusionWe found no evidence that violence researchers experienced elevated emotional distress after doing violence research. There was no difference between group debriefings and leisure activities in reducing distress in our sample. However, the hypotheses presented should not be ruled out in other violence research settings. Our findings suggest that organisational support is a significant protective factor and belief in God may be an important coping mechanism.Trial registrationClinical Trials NCT02390778. Retrospectively registered 19 March 2015. The Good Schools Trial was registered at (NCT01678846), on August 24, 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-017-1327-x) contains supplementary...

Psychological interventions for common mental disorders in women experiencing intimate partner violence in low-income and middle-income countries: a systematic review and meta-analysis

“…However, several were designed to be trauma-informed, by addressing cognitive processing of traumatic events, 21 habituating traumatic memories, 22 focusing on traumatic experiences, 29 or debriefing. 28 The remaining interventions had a more practical focus and were likely to benefit women disclosing intimate partner violence through problemsolving, 25,31 behavioural activation, 21,26,32,34 coping skills, 27,30 or a mixture of methods. 33 Given that anxiety is an important manifestation of trauma, more trauma-focused interventions might yield even greater gains than generic interventions in women experiencing intimate partner violence.…”

“…CMD=common mental disorder. 27,28,31 or Violence, War, Abduction and Exposure Scale. 22 Most studies asked a single question about intimate partner violence 32,33 or domestic violence 21,26,29,30,34 exposure, which might have included abuse by non-partners.…”

“…Included interventions were delivered by various staff: a public health professional and researcher, 28 psychology Masters-educated therapists, 29 community mental health workers, 21,30 general health workers, 31,33 other community workers, 27 and lay individuals. 22,25,26,32,34 Five studies [25][26][27]32,34 compared the control intervention (enhanced usual care [EUC]) with the intervention plus EUC, but the content of EUC, and other studies' control interventions, varied from face-to-face or telephone-delivered basic counselling 31,33 to diagnosis and the opportunity for WHO mental health gap action programme intervention guided treatment, 26,32,34 a home visit, 27 film screenings, 28 and waiting lists. 21,22,29,30 Numbers of sessions ranged from three 28 to 14, 33 delivered at clinics, 21,30 in community settings, 25,27,28 at home, 22,31,34 or a mixture of locations.…”

“…21,22,29,30 Numbers of sessions ranged from three 28 to 14, 33 delivered at clinics, 21,30 in community settings, 25,27,28 at home, 22,31,34 or a mixture of locations. 26,32,33 Most interventions were delivered individually, with two in groups 27,28 and one mixed. 26 All studies, except two, 28,33 reported significant improvements in at least one CMD in the intervention group compared with the control group.…”

“…26,32,33 Most interventions were delivered individually, with two in groups 27,28 and one mixed. 26 All studies, except two, 28,33 reported significant improvements in at least one CMD in the intervention group compared with the control group. Mean baseline CMD scores differed between women who did and did not report intimate partner violence in none of the five interventions reporting anxiety symptoms, in two (25%) of eight interventions reporting PTSD symptoms, in five (42%) of 12 interventions reporting depression symptoms, and in one (25%) of four interventions reporting psychological distress symptoms (appendix pp [8][9].…”