The realities of caring : a qualitative exploration of mental health professionals' experience of working with survivors of trauma in Sri Lanka

There is an increasing recognition of the transformative nature of trauma work and that\nindividuals are changed by the work they do with survivors of trauma. For mental health\nprofessionals these changes could be both positive and negative. The present study engages\nin a qualitative exploration of the impact of working with survivors of trauma. More\nspecifically it examines the professional and private experience of twelve mental health\npractitioners in their work with survivors of trauma in the on-going conflict situation and\npost-disaster setting of Sri Lanka. The aim is to provide some insight into our\nunderstanding of the psychological processes which determine and maintain effective\ncoping strategies when working with survivors of trauma. Very little qualitative research\nhas been carried out in this area, with most research investigating moderating factors in\nrelation to "secondary trauma" using survey questionnaires and psychometric scales. Semistructured\nin-depth interviews were carried out with twelve native mental health\nprofessionals who had worked long-term with survivors of trauma in Sri Lanka. The data\nanalysis followed the theoretical principles of Interpretative Phenomenological Analysis\n(IPA). The main analytic focus was to look at the meaningfulness of trauma work for the\nparticipants from different perspectives. A second analytic focus was to explore some\naspects of the social constructedness of the participants' 'talk' about trauma work. The four\nmaster themes that emerged collectively showed how working with survivors of trauma is\nconceptualised and experienced. The complexity of these factors is illustrated by various\ndialectical processes that seem to be in action in trauma work. Each of the four themes is\nalso examined with respect to the use of discourses and practices located within specific\nsocial, cultural, historical, political and ideological contexts. These findings highlight the\nimportance of raising awareness of the potentiality of both "secondary trauma" and the\nopportunities for "growth through adversity". The strategic role of reflective practice, selfcare\nand supervision are discussed with respect to their implication for Counselling\nPsychology. This study also considers the value of taking an authentic psycho-social\nframework with a focus on the wider realities of social and cultural dynamics.