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Resilience of Professional Counselors Following Hurricanes Katrina and Rita

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Title: Resilience of Professional Counselors Following Hurricanes Katrina and Rita
Language: English
Authors: Lambert, Simone F., Lawson, Gerard
Source: Journal of Counseling & Development. Jul 2013 91(3):261-268.
Availability: Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA
Peer Reviewed: Y
Page Count: 8
Publication Date: 2013
Document Type: Journal Articles
Reports - Research
Descriptors: Resilience (Psychology), Posttraumatic Stress Disorder, Trauma, Burnout, Fatigue (Biology), Stress Management, Counselors, Mental Health Workers, Satisfaction, Online Surveys, Measures (Individuals), Questionnaires, Likert Scales, Tables (Data), Weather, Natural Disasters
Geographic Terms: Louisiana, Mississippi, Texas
DOI: 10.1002/j.1556-6676.2013.00094.x
ISSN: 0748-9633
Abstract: Professional counselors who provided services to those affected by Hurricanes Katrina and Rita completed the K6+ (screen for severe mental illness), the Posttraumatic Growth Inventory, and the Professional Quality of Life Scale. Results indicated that participants who survived the hurricanes had higher levels of posttraumatic growth than participants who served as volunteers. Both volunteer and survivor-volunteer participants were susceptible to compassion fatigue. To further resiliency, self-care strategies were found to minimize burnout, compassion fatigue, and vicarious traumatization. (Contains 2 tables.)
Abstractor: As Provided
Number of References: 36
Entry Date: 2014
Accession Number: EJ1013135
Database: ERIC
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  Value: <anid>AN0088005492;[nrnp]01jul.13;2025Apr04.08:10;v2.2.500</anid> <title id="AN0088005492-1">Resilience of Professional Counselors Following Hurricanes Katrina and Rita. </title> <p>Professional counselors who provided services to those affected by Hurricanes Katrina and Rita completed the K6+ (screen for severe mental illness), the Posttraumatic Growth Inventory, and the Professional Quality of Life Scale. Results indicated that participants who survived the hurricanes had higher levels of posttraumatic growth than participants who served as volunteers. Both volunteer and survivor‐volunteer participants were susceptible to compassion fatigue. To further resiliency, self‐care strategies were found to minimize burnout, compassion fatigue, and vicarious traumatization.</p> <p>posttraumatic growth; compassion fatigue; burnout; vicarious traumatization; resilience</p> <p>On August 29, 2005, Hurricane Katrina made landfall in Louisiana as a Category 3 hurricane, the costliest and the third deadliest hurricane to strike the United States (Knabb, Rhome, & Brown, [<reflink idref="bib16" id="ref1">16</reflink>] ). Hurricane Katrina and the subsequent levy breach led to the flooding of 80% of the New Orleans metropolitan area (Kamps, [<reflink idref="bib11" id="ref2">11</reflink>] ) and obliterated coastal towns in Mississippi. “The scope of human suffering inflicted by Hurricane Katrina in the United States has been greater than that of any hurricane to strike this country in several generations” (Knabb, Rhome, & Brown, [<reflink idref="bib16" id="ref3">16</reflink>] , pp. 10–11). On the heels of Katrina, Hurricane Rita came ashore on September 24, 2005, and brought more devastation to already affected areas of western Louisiana and eastern Texas (Matthews, [<reflink idref="bib23" id="ref4">23</reflink>] ). Hurricane Rita prompted the largest evacuation in U.S. history, with nearly 2 million people evacuated in advance of the storm (Knabb, Brown, & Rhome, [<reflink idref="bib15" id="ref5">15</reflink>] ). It is estimated that these hurricanes caused approximately $85 billion in damages and claimed over 1,200 lives (Knabb, Brown, & Rhome, [<reflink idref="bib15" id="ref6">15</reflink>] ; Knabb, Rhome, & Brown, [<reflink idref="bib16" id="ref7">16</reflink>] ). Unlike other disasters, hurricane recovery is a slow process, and these storms caused physical, mental, and emotional strain well beyond monetary damages (Matthews, [<reflink idref="bib23" id="ref8">23</reflink>] ).</p> <p>Professional counselors responded to the needs of those affected by these disastrous hurricanes by serving clients either (a) as a continuation of their own employment/volunteer work as residents of the affected areas or (b) as external volunteers. External volunteer counselors either served briefly in a region that was directly hit by the hurricane or served hurricane evacuees who sought refuge in their own city. Many professional counselors came to hurricane‐affected areas from all over the country. The American Counseling Association (ACA) collaborated with the American Red Cross (ARC) to enlist counselors to work in the disaster areas. The ARC Disaster Mental Health (DMH) workers were called on when</p> <p>(a) children were involved, (b) a death or serious injury had occurred, (c) pets had been lost, (d) homes had been damaged, or (e) people seemed confused or depressed. Nearly everyone in the Gulf Coast region met at least one of those criteria. (Haskett, Scott, Nears, & Grimmett, [<reflink idref="bib8" id="ref9">8</reflink>] , p. 94)</p> <p>For 10 to 12 hours each day, DMH volunteers helped clients to process feeling overwhelmed and problem solve for pressing needs; then, they often spent additional time each day with ARC volunteers who needed to process their experience as a relief volunteer as well. Haskett et al. ([<reflink idref="bib8" id="ref10">8</reflink>] ) stated, “Physical and emotional fatigue were unavoidable” (p. 97). Those DMH workers who counseled in shelters for nearly 3 months in host states had prolonged exposure to secondary trauma, while often balancing their relief work with maintaining their full‐time employment (Marshall, [<reflink idref="bib21" id="ref11">21</reflink>] ). Marshall ([<reflink idref="bib21" id="ref12">21</reflink>] ) reported that counselors in the host cities were doubly taxed emotionally and physically by addressing the mental health needs of their own community and the influx of evacuees, many of whom had preexisting mental health concerns or were developing trauma‐related mental health issues.</p> <p>Professional counselors who were residents of the affected areas likely experienced personal trauma, in addition to vicarious trauma from serving those in their own community.</p> <p>For instance, mental health care providers who evacuated their homes experienced the same trauma of other evacuees, such as finding out their home was submerged underwater, having concerns about employment status, and being separated from family members and unsure of their well‐being (Kamps, [<reflink idref="bib11" id="ref13">11</reflink>] ). When providers were allowed to return to the New Orleans metropolitan area, they were disoriented; Osofsky ([<reflink idref="bib24" id="ref14">24</reflink>] ) stated that “everything in New Orleans was unlike anything we had experienced before” (p. 14). Kamps ([<reflink idref="bib11" id="ref15">11</reflink>] ) described her frequent return visits to New Orleans in the first few months after Katrina as an “attempt to retrieve any belongings from our house that were salvageable, dispose of any belongings that were destroyed, and gut our house to prevent additional mold growth” (p. 8). After reflecting on the intense smells and disease prevention strategies, Matthews ([<reflink idref="bib23" id="ref16">23</reflink>] ) reflected on her experience of being affected by both Hurricanes Katrina and Rita and stated that the storms changed her both professionally and personally, in part by helping her to reevaluate priorities. Both Osofsky and Matthews emphasized the importance of self‐care as part of the recovery process. These authors found that being a mental health provider who dealt with the aftermath of Hurricanes Katrina and Rita professionally and personally heightened the need for support, exercise, and nonwork activities.</p> <p>Systemic challenges also affected mental health care providers professionally and personally. The mental health care community as a whole suffered from the hurricanes. Haskett et al. ([<reflink idref="bib8" id="ref17">8</reflink>] ) described that the “systems of mental health care and social services in the Gulf Coast region had been obliterated” (p. 98). Given the disabled mental health care system, Kamps ([<reflink idref="bib11" id="ref18">11</reflink>] ) described two major professional challenges in New Orleans immediately following Hurricane Katrina: (a) having difficulty locating existing clients to resume counseling and (b) not having mental health resources in place necessary to address the vast need for new services. In the first few months following Katrina, mental health professionals were unsure if their agencies would remain open, compacting the personal stress experienced by providers who were wondering if they still had a job (Toriello et al., [<reflink idref="bib33" id="ref19">33</reflink>] ). Those agencies that did remain open struggled to stay connected to employees who were scattered throughout the state and nation (Osofsky, [<reflink idref="bib24" id="ref20">24</reflink>] ). Additionally, Louisiana mental health providers who were licensed had to somehow make their way to the state capital to complete paperwork before being allowed to volunteer in shelters (Matthews, [<reflink idref="bib23" id="ref21">23</reflink>] ). The hurdles to reestablish mental health services were numerous and brought their own set of stressors for mental health providers. Although many mental health providers struggled with the short‐term personal or vicarious trauma related to the hurricanes, the long‐term trauma exposure lasted for months or years for the providers who continued to work in this region (Leitch, Vanslyke, & Allen, [<reflink idref="bib20" id="ref22">20</reflink>] ).</p> <hd id="AN0088005492-2">Posttraumatic Responses of Professional Counselors</hd> <p>When counselors provide services for treatment of clients' trauma, counselors are at risk of experiencing vicarious trauma. Vicarious trauma is sometimes referred to as secondary traumatic stress. Vicarious trauma/secondary traumatic stress symptoms are similar to those of posttraumatic stress disorder, even though those with secondary traumatic stress have not directly experienced the trauma and are not in harm's way (Figley, [<reflink idref="bib6" id="ref23">6</reflink>] ). In addition, vicarious trauma can occur when counselors recall their own previous trauma after being exposed to the trauma of their clients (Pearlman & Saakvitne, [<reflink idref="bib25" id="ref24">25</reflink>] ). Finally, there is the potential for those who have experienced trauma to also encounter posttraumatic growth. Posttraumatic growth is considered positive psychological change that is a result of the struggle with highly challenging life circumstances (Tedeschi & Calhoun, [<reflink idref="bib31" id="ref25">31</reflink>] ). This struggle can bring about changes in perceptions of self, sense of relationships with others, and one's philosophy of life. The following is a description of both maladaptive responses (burnout and compassion fatigue) and adaptive responses (compassion satisfaction, posttraumatic growth, and resilience) of professional counselors who have experienced a vicarious trauma.</p> <hd id="AN0088005492-3">Burnout</hd> <p>Burnout includes three components experienced by counselors: emotional and physical exhaustion, cynicism, and decreased perceived efficacy (Maslach, [<reflink idref="bib22" id="ref26">22</reflink>] ). Burnout can result from inadequate resources and excessive demands over a long duration, leading counselors to no longer be able to provide effective services (Lawson & Myers, [<reflink idref="bib18" id="ref27">18</reflink>] ). Burnout prevention strategies include identifying and increasing healthy coping and self‐care approaches, such as participating in supervision, balancing work and nonwork life, and incorporating relaxation and stress management methods (Stevanovic & Rupert, [<reflink idref="bib29" id="ref28">29</reflink>] ). Alleviating burnout may require a change in employment position or career (Figley, [<reflink idref="bib6" id="ref29">6</reflink>] ), particularly when counselors experience an incongruence in their job duties with who they are as a person (Lawson & Myers, [<reflink idref="bib18" id="ref30">18</reflink>] ).</p> <hd id="AN0088005492-4">Compassion Fatigue</hd> <p>Compassion fatigue limits one's ability or desire to be empathic and bear others' suffering (Figley, [<reflink idref="bib6" id="ref31">6</reflink>] ). Often, mental health providers who experience compassion fatigue feel a sense of isolation, helplessness, and confusion (Figley, [<reflink idref="bib6" id="ref32">6</reflink>] ). Counselors are at risk for developing compassion fatigue when they neglect their own self‐care, avoid resolving their own trauma, have elevated work stressors, and do not experience satisfaction from their own work (Figley, [<reflink idref="bib5" id="ref33">5</reflink>] ). Unlike burnout, compassion fatigue may result in secondary symptoms of posttraumatic stress disorder (Craig & Sprang, [<reflink idref="bib3" id="ref34">3</reflink>] ). Once it is recognized and addressed, compassion fatigue can dissipate with treatment, which may include desensitization and increasing social support (Figley, [<reflink idref="bib6" id="ref35">6</reflink>] ).</p> <hd id="AN0088005492-5">Compassion Satisfaction</hd> <p>Compassion satisfaction has been defined as “the pleasure you derive from being able to do your job well” (Stamm, [<reflink idref="bib28" id="ref36">28</reflink>] , p. 5). Compassion satisfaction may counteract compassion fatigue when counselors are aware of the joy derived from assisting clients (Lawson & Myers, [<reflink idref="bib18" id="ref37">18</reflink>] ). Limited studies examining compassion satisfaction are available (e.g., Jacobson, [<reflink idref="bib10" id="ref38">10</reflink>] ; Sprang, Clark, & Whitt‐Woosley, [<reflink idref="bib26" id="ref39">26</reflink>] ); therefore, further exploration is needed regarding this potential protective factor for counselors.</p> <hd id="AN0088005492-6">Posttraumatic Growth</hd> <p>Posttraumatic growth is a positive psychological change that results from struggling through a highly challenging life circumstance (Tedeschi & Calhoun, [<reflink idref="bib31" id="ref40">31</reflink>] ). Posttraumatic growth is both a cognitive and an emotional process that leads to increased psychological functioning and life awareness, as well as the outcomes of growth and adaptation stemming from a traumatic experience (Tedeschi, Park, & Calhoun, [<reflink idref="bib32" id="ref41">32</reflink>] ). According to Tedeschi et al. ([<reflink idref="bib32" id="ref42">32</reflink>] ), there are three aspects of posttraumatic growth: (a) perception of self (survivor vs. victim, self‐reliance, and vulnerability), (b) interpersonal relationships (self‐disclosure, emotional expressiveness, compassion, and giving to others), and (c) philosophy of life (priorities and appreciation of life, existential themes and sense of meaning, and spiritual development). Counselors can experience personal growth through vicarious trauma by hearing and assisting clients who have been through traumatic events (Calhoun & Tedeschi, [<reflink idref="bib1" id="ref43">1</reflink>] ). Counselors' negative reactions from exposure to vicarious trauma can be mediated through participation in self‐care activities, relying on social supports, and having a strong philosophical and spiritual grounding (Calhoun & Tedeschi, [<reflink idref="bib1" id="ref44">1</reflink>] ).</p> <p>Thus, counselors can avoid compassion fatigue and experience posttraumatic growth by engaging in personal and professional activities, which counteract the negative impact of vicarious trauma. The following is a relevant example of posttraumatic growth:</p> <p>All of the members of our team know that we have experienced a life‐transforming event. We have all grown and continue to grow as educators, clinicians, and individuals. Many of our colleagues have found strength in that they could not have anticipated before Hurricane Katrina. (Osofsky, [<reflink idref="bib24" id="ref45">24</reflink>] , p. 17)</p> <p>These comments encapsulate the domains of posttraumatic growth: increased appreciation of life, closer personal and professional relationships, increased awareness of new possibilities, improved personal strength, and spiritual change (Tedeschi & Calhoun, [<reflink idref="bib31" id="ref46">31</reflink>] ).</p> <hd id="AN0088005492-7">Resilience</hd> <p>Resilience is “the ability to cope in the face of adversity” (Ward, [<reflink idref="bib36" id="ref47">36</reflink>] , p. 17). Thus, individuals can overcome challenges through the development of coping mechanisms (Walsh, [<reflink idref="bib35" id="ref48">35</reflink>] ). In addition to viewing change/stress as a challenge and having the ability to adapt to change, Connor ([<reflink idref="bib2" id="ref49">2</reflink>] ) also included understanding the strengthening effect of stress, using past successes to overcome current challenges, and having a sense of meaningfulness and faith as additional components to resilience. Fink‐Samnick ([<reflink idref="bib7" id="ref50">7</reflink>] ) defined professional resilience for mental health providers as a “commitment to achieve balance between occupational stressors and life challenges, while fostering professional values and career sustainability” (p. 331). Professional resilience develops over time by turning challenges into growth opportunities that become part of the professional's identity and core values (Hodges, Keeley, & Grier, [<reflink idref="bib9" id="ref51">9</reflink>] ).</p> <hd id="AN0088005492-8">Statement of the Problem</hd> <p>The goal of the study was to examine the posttraumatic growth and professional resilience to secondary trauma of professional counselors who assisted clients affected by Hurricanes Katrina and Rita. Results were compared with other national studies using Lawson's ([<reflink idref="bib17" id="ref52">17</reflink>] ) Counselor Wellness and Impairment Survey. By comparing the posttraumatic growth and resilience of professional counselors who have been affected by Hurricanes Katrina and Rita to a normative national sample, we were able to gain knowledge about the long‐term effect of natural disasters on personal posttraumatic growth and professional resilience of professional counselors.</p> <p>We anticipated finding higher levels of posttraumatic growth and professional resilience among counselors who were not affected by the storms than among professional counselors who were directly or indirectly affected, as indicated by scores on the Professional Quality of Life Scale Revision III (ProQOL‐R‐III; Stamm, [<reflink idref="bib28" id="ref53">28</reflink>] ), the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, [<reflink idref="bib30" id="ref54">30</reflink>] ), the K6+ (screen for severe mental illness; Kessler et al., [<reflink idref="bib13" id="ref55">13</reflink>] ), and a brief self‐care assessment. We also anticipated a positive correlation between greater use of self‐care behaviors and overall wellness among counselors affected by the storms.</p> <hd id="AN0088005492-9">Hypotheses of the Study</hd> <p>Counselors are among the first to volunteer in times of crisis, and DMH service is an emerging specialty area within the professional counseling field. The literature is replete with examples of the toll that counseling in general, and DMH counseling in particular, can take on the individual. There is also the potential for resilience. This study examined the following hypotheses:</p> <p>Hypothesis 1: Mood disorders (as measured by the K6+) and burnout and compassion fatigue/vicarious trauma (as measured by the ProQOL‐R‐III) will be higher among those who responded to the hurricanes than among normed samples.</p> <p>Hypothesis 2: Posttraumatic growth, as measured by the PTGI, will also be higher among those who responded than among normed samples.</p> <p>Hypothesis 3: There will be a positive relationship between the practice of self‐care activities while deployed and posttraumatic growth and a negative relationship with burnout and compassion fatigue/vicarious trauma.</p> <hd id="AN0088005492-10">Method</hd> <hd id="AN0088005492-11">Participants and Procedure</hd> <p>We identified ACA members who participated as DMH volunteers following Hurricanes Katrina and Rita by posting a general announcement on ACA's website, professional newsletter, and e‐newsletter. ACA also sent the announcement to members who responded to Hurricanes Katrina, Rita, Ike, and Gustov. In addition, those members who served on the ACA trauma interest network or resided in Texas, Louisiana, and Mississippi were sent a direct e‐mail soliciting participation. The wide canvassing of ACA members allowed the potential to solicit: (a) counselors who served as ARC DMH volunteers in affected areas, (b) counselors who work regularly and volunteered in affected areas, and (c) counselors who volunteered in out‐of‐region shelters and support. Although it is unclear how may ACA members responded to the call to assist after Hurricanes Katrina and Rita, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that over 1,000 professional counselors assisted in recovery efforts, more than any other mental health profession (D. Kaplan [ACA Chief Professional Officer], personal communication, March 2, 2011).</p> <p>ACA members who participated in the study completed an online survey that included a cover letter explaining the purpose of the research and participants' rights. A small number of participants requested a paper‐and‐pencil survey, and they were sent the survey in the mail with a stamped return envelope. Once participants consented and verified that they had indeed provided services to those affected by Hurricanes Katrina and Rita, they were asked to complete the approximately 20‐minute survey.</p> <hd id="AN0088005492-12">Measures</hd> <p>The overall survey was a compilation of three standardized measures, a self‐care assessment, and a demographics questionnaire. The standardized measures were the ProQOL‐R‐III (Stamm, [<reflink idref="bib28" id="ref56">28</reflink>] ), the PTGI (Tedeschi & Calhoun, [<reflink idref="bib30" id="ref57">30</reflink>] ), and the K6+ (Kessler et al., [<reflink idref="bib13" id="ref58">13</reflink>] ).</p> <p>ProQOL‐R‐III. The ProQOL‐R‐III is composed of 30 items designed to measure three dimensions of professional quality of life: compassion satisfaction, burnout, and compassion fatigue/vicarious traumatization. Participants report the frequency of specific work‐related experiences on a scale ranging from 0 (never) to 5 (very often). Alpha reliabilities on each of the scales for the instrument's normed sample were the following: Compassion Satisfaction (.87), Burnout (.72), and Compassion Fatigue/Secondary Trauma (.80; Stamm, [<reflink idref="bib28" id="ref59">28</reflink>] ). The current study yielded the following internal consistency coefficients: Compassion Satisfaction (.89), Burnout (.81), and Compassion Fatigue/Secondary Trauma (.86). The construct validity of the Pro‐QOL‐R‐III has been well established and suggests that the scales measure three distinct constructs (Stamm, [<reflink idref="bib27" id="ref60">27</reflink>] , [<reflink idref="bib28" id="ref61">28</reflink>] ).</p> <p>PTGI. The PTGI, developed by Tedeschi and Calhoun ([<reflink idref="bib30" id="ref62">30</reflink>] ), is a self‐report measure that examines the potential positive outcomes of a traumatic event. The instrument has 21 items, and respondents complete questions using a 6‐point Likert‐type scale that ranges from 0 (I did not experience this change as a result of my crisis) to 5 (I experienced this change to a very great degree as a result of my crisis; Tedeschi & Calhoun, [<reflink idref="bib30" id="ref63">30</reflink>] ). Item responses corresponding to each factor are summed to form the scale scores. The factors include New Possibilities, Relating to Others, Personal Strength, Spiritual Change, and Appreciation of Life. The internal consistency of the PTGI is.90, with the following scale alpha reliability scores: New Possibilities (.84), Relating to Others (.85), Personal Strength (.72), Spiritual Change (.85), and Appreciation of Life (.67; Tedeschi & Calhoun, [<reflink idref="bib30" id="ref64">30</reflink>] ). Internal consistencies of the scales for the current sample were as follows: New Possibilities (.89), Relating to Others (.89), Personal Strength (.90), Spiritual Change (.86), and Appreciation of Life (.86).</p> <p>The K6+. The K6+ scale of nonspecific psychological distress screens for mood disorders and allows an assessment of individuals in a broad population into three categories: at risk for serious mental illness, at risk for mild–moderate mental illness, or nonsymptomatic (Kessler et al., [<reflink idref="bib13" id="ref65">13</reflink>] ). The K6+ is composed of six items that ask respondents to report how frequently they experienced symptoms of psychological distress (e.g., “feeling so sad that nothing can cheer you up”) during the past 30 days, along a 5‐point scale from 1 (all of the time) to 5 (none of the time; Kessler et al., [<reflink idref="bib13" id="ref66">13</reflink>] ). The internal consistency of the K6+ has been established between.89 and.92 (Kessler et al., [<reflink idref="bib12" id="ref67">12</reflink>] , [<reflink idref="bib13" id="ref68">13</reflink>] ). The internal consistency for the current sample was.87.</p> <hd id="AN0088005492-13">Analyses</hd> <p>Demographics. Given that it is unclear how many ACA members responded to the call to assist after Hurricanes Katrina and Rita, we were unable to calculate an accurate response rate. What we do know is that the SAMHSA reported that over 1,000 professional counselors assisted in recovery efforts (D. Kaplan, personal communication, March 2, 2011), and our usable sample was 125. The sample consisted of 72.8% female counselors, 23.2% male counselors, and 4% who chose not to report their gender. The average respondent was 49 years old (SD = 11.8), respondents ranged from 26 to 71 years of age, and they had been working as a professional counselor for an average of 14 years (SD = 10.0, range = 1–43 years). Individuals in our study's sample described their race/ethnicity as Caucasian or White (86.8%), African American or Black (9.1%), Hispanic (3.3%), and American Indian or Alaskan Native (0.8%). Most of the respondents (30.9%) worked in private practice, followed by a community agency setting (23.6%), a college or university setting (22.7%), a K–12 school setting (11.8%), or a hospital or residential setting (10.0%), with a small number of respondents (0.9%) in a variety of other settings (e.g., correctional settings, employee assistance, church). The vast majority of our respondents (85.2%) were licensed as a professional counselor.</p> <p>Posttraumatic response. To explore resilience, we first wanted to assess the extent to which this group was affected by their experiences, both personally and professionally. The most striking feature is that 31.2% of the counselors who responded (n = 39) lived in the affected area and were personally affected by the hurricanes (e.g., evacuated or displaced from home or residence, personal injury, destruction of property, death of a family member or friend). That became a point of comparison, and we used the terms survivor volunteer and responder volunteer to differentiate between the two groups. We measured overall mental health using the K6+ screen (Kessler et al., [<reflink idref="bib13" id="ref69">13</reflink>] ), which indicates that scores above 13 on the 24‐point scale suggest the presence of serious mental illness, whereas scores of 8 to 12 suggest moderate mental illness within the nonspecific mental concerns (most likely a mood disorder such as anxiety or depression). Among our sample, only one respondent (0.9%) scored above the cutoff point on the K6+ for serious mental illness, whereas 10.4% of respondents met the criteria for moderate mental illness. It is interesting that, when we examined just those counselors who were survivor volunteers, there were no statistically significant differences as compared with the larger responder group. Of the survivor‐volunteer group, there were no counselors who met the criteria for serious mental illness, and 11.1% of this subgroup met the criteria for moderate mental illness. Even with the passage of 3+ years, these percentages compare favorably to percentages for samples of survivors of Hurricane Katrina generally. In March 2006, the serious mental illness prevalence was 10.9% and the moderate mental illness prevalence was 19.8% for such Hurricane Katrina survivor samples (Kessler et al., [<reflink idref="bib14" id="ref70">14</reflink>] ).</p> <p>Professional resilience. We used the ProQOL‐R‐III to measure professional resilience. The ProQOL‐R‐III assesses the following dimensions: compassion satisfaction, burnout, and compassion fatigue/vicarious traumatization. Cutoff points are established by the instrument's author for each of the scales. On the Compassion Satisfaction scale, 9.2% of the sample scored below the cutoff point, suggesting that those participants are either no longer deriving satisfaction from their work or that they find satisfaction elsewhere. On the Burnout scale, 9.9% of our sample scored above the cutoff point, suggesting that they are at higher risk for burnout and may be experiencing difficulty with their work, particularly with feeling hopeless or ineffectual as counselors. Finally, on the Compassion Fatigue/Secondary Trauma scale, 22% of our sample scored above the cutoff point, which may result in a diminished ability to develop empathy for their clients or manifesting trauma‐related symptoms themselves.</p> <p>The rates of Compassion Satisfaction and Burnout are similar to what Lawson and Myers ([<reflink idref="bib18" id="ref71">18</reflink>] ) found in a sample of ACA members generally. More specifically, Lawson and Myers found a rate of 8.9% for Compassion Satisfaction and 6.1% for Burnout, which are moderately better than the rates in the present study. On the Compassion Fatigue/Secondary Trauma scale, however, our rate was more than double the rate found by Lawson and Myers (10.3%). A t test revealed that the mean for the Compassion Fatigue/Secondary Trauma scale (M = 12.59, SD = 6.65) was significantly higher than that found by Lawson and Myers ([<reflink idref="bib18" id="ref72">18</reflink>] ) among ACA members (M = 10.32, SD = 5.98), t(<reflink idref="bib623" id="ref73">623</reflink>) = 3.66, p <.001, η<sups>2</sups> =.03. There is a very modest effect size associated with this finding, with approximately 3% of the difference detected attributable to being a hurricane responder. There were no differences in terms of professional quality of life between responder volunteers and survivor volunteers.</p> <p>The posttraumatic response is encouraging, particularly because resilience involves more than simply the absence of distress. Posttraumatic growth is one way to measure personal resilience following a traumatic incident. The PTGI (Tedeschi & Calhoun, [<reflink idref="bib30" id="ref74">30</reflink>] ) provided scores among hurricane responders on each scale: Relating to Others (M = 21.66, SD = 7.99), New Possibilities (M = 14.29, SD = 6.88), Personal Strength (M = 13.83, SD = 5.52), Spiritual Change (M = 5.85, SD = 3.20), and Appreciation of Life (M = 10.65, SD = 3.89). There are some within‐group differences that are interesting. Most notable, the total PTGI scores for the survivor volunteers (M = 76.97, SD = 23.38) were significantly higher than those for the responder volunteers (M = 62.43, SD = 23.57), F(<reflink idref="bib1" id="ref75">1</reflink>, 102) = 8.88, p <.004, η<sups>2</sups> =.08. The effect size for this difference is somewhat modest, with approximately 8% of the difference between the groups explained by group membership (as opposed to other influences). This trend also continued across most of the subscales, with all except the Spiritual Change factor showing significant differences at the.05 level (see Table [NaN] ).</p> <p>Differences in Mean PTGI Subscale Scores Between Survivor and Responder Volunteers</p> <p> <ephtml> <table><tr><th /><th align="center">Survivor Volunteers (n = 35)</th><th align="center">Responder Volunteers (n = 69)</th><th /><th /></tr><tr><th>Factor</th><th>M</th><th>SD</th><th>M</th><th>SD</th><th>F</th><th>η<sup>2</sup></th></tr><tr><td>Relating to Others</td><td>25.49</td><td>7.82</td><td>20.62</td><td>7.58</td><td>9.35**</td><td>.08</td></tr><tr><td>New Possibilities</td><td>16.97</td><td>6.34</td><td>13.33</td><td>6.89</td><td>6.81*</td><td>.06</td></tr><tr><td>Personal Strength</td><td>16.00</td><td>4.70</td><td>12.89</td><td>5.42</td><td>8.27**</td><td>.08</td></tr><tr><td>Spiritual Change</td><td>6.60</td><td>3.07</td><td>5.49</td><td>3.03</td><td>3.06</td><td>.03</td></tr><tr><td>Appreciation of Life</td><td>11.91</td><td>4.15</td><td>10.08</td><td>3.70</td><td>5.22*</td><td>.05</td></tr></table> </ephtml> </p> <p>1 Note. N = 104. PTGI = Posttraumatic Growth Inventory.</p> <p>2 *p <.05, two‐tailed. **p <.01, two‐tailed.</p> <p>Self‐care. The final component we examined was counselors' self‐care practices during their deployment and during the past 30 days, and the significant findings are reported in Table [NaN] . We found a very modest positive relationship between self‐care practices and compassion satisfaction, suggesting higher levels of compassion satisfaction among counselors who engaged in more self‐care practices during the response. Relatedly, there was a very modest negative relationship between self‐care and burnout, with lower levels of burnout noted among counselors who endorsed more self‐care activities. Similarly, there was a modest negative correlation between self‐care strategies in the past 30 days, and scores on the K6+, suggesting that counselors who practiced fewer self‐care strategies in the past 30 days were more likely to score higher on the measure of nonspecific mental illness. The effect size for each of the relationships was modest. At the low end, the relationship between compassion satisfaction and self‐care during the deployment accounted for 4% of the shared variance in those scores. On the upper end of effect size, the relationship between compassion satisfaction and self‐care during the past 30 days accounted for nearly 9% of the shared variance in those scores. There was no significant relationship between the self‐care practices and posttraumatic growth (see Table [NaN] ).</p> <p>Relationship Between Self‐Care and Resilience</p> <p> <ephtml> <table><tr><th /><th align="center">Compassion Satisfaction</th><th align="center">Burnout</th><th align="center">K6<sub>+</sub></th></tr><tr><th>Self‐Care Practice</th><th>r</th><th>Sig.</th><th>r<sup>2</sup></th><th>r</th><th>Sig.</th><th>r<sup>2</sup></th><th>r</th><th>Sig.</th><th>r<sup>2</sup></th></tr><tr><td>During the response</td><td>.20*</td><td>.035</td><td>.04</td><td>−.29**</td><td>.002</td><td>.08</td><td>ns</td><td /><td /></tr><tr><td>Past 30 days</td><td>.30**</td><td>.002</td><td>.09</td><td>−.22*</td><td>.022</td><td>.05</td><td>.27**</td><td>.006</td><td>.07</td></tr></table> </ephtml> </p> <ulist> <item>3 Note. N = 113. Sig. = significance; K6+ = screen for severe mental illness.</item> <item>4 *p <.05, two‐tailed. **p <.01, two‐tailed.</item> </ulist> <hd id="AN0088005492-14">Discussion</hd> <p>There are a number of findings from this study that provide insight into how professional counselors fare after providing services to clients affected by major hurricanes and may have larger implications for DMH counselors. First, we found that professional counselors who responded to Hurricanes Katrina and Rita had fewer instances of mood disorders than the general population samples of Katrina survivors. Second, burnout and compassion satisfaction were comparable for the sample in our study and a general national sample of ACA members (Lawson & Myers, [<reflink idref="bib18" id="ref76">18</reflink>] ); however, individuals in our sample who responded to Hurricanes Katrina and Rita demonstrated more than double the rate of compassion fatigue and vicarious traumatization than did the general sample of ACA members. Third, there were no differences in terms of professional quality of life between responder volunteers and survivor volunteers. Our findings suggest that all professional counselors engaging in DMH counseling are at risk for compassion fatigue, whether or not they are affected personally by the disaster. Professional counselors should have prevention strategies in place to decrease the likelihood of developing compassion fatigue given that all are susceptible to a natural disaster, small or large.</p> <p>In examining resilience and posttraumatic growth, we did indeed find that those counselors who not only volunteered but also were personally affected by Hurricanes Katrina and Rita had significantly higher levels of posttraumatic growth than those counselors who only volunteered and were not personally affected by the storms. Those who had lived through the disaster achieved higher levels of posttraumatic growth than their counterparts. Finally, our findings indicated a modest positive relationship between the practice of self‐care activities while deployed and posttraumatic growth and a modest negative relationship with burnout and compassion fatigue and vicarious traumatization.</p> <hd id="AN0088005492-15">Implications for Professional Counselors</hd> <p>To be effective with clients, counselors must be aware of their own reactions and work to maintain an optimal wellness level (Lawson, Venart, Hazler, & Kottler, [<reflink idref="bib19" id="ref77">19</reflink>] ). Venart, Vassos, and Pitcher‐Heft ([<reflink idref="bib34" id="ref78">34</reflink>] ) suggested wellness strategies for counselors, including maintaining physical health (e.g., fitness, nutrition, mindfulness), emotional health (e.g., self‐reflection, self‐awareness, expressing emotions), cognitive wellness (e.g., working collaboratively with clients, celebrating personal and professional achievements, continuing education) and interpersonal relationships (e.g., friends/family, personal counseling, consultation, supervision). To increase resilience and posttraumatic growth, counselors need to self‐examine whether these wellness components are present, including “physical, emotional, social, spiritual, and intellectual” aspects (Cummins, Massey, & Jones, [<reflink idref="bib4" id="ref79">4</reflink>] , p. 41).</p> <hd id="AN0088005492-16">Limitations</hd> <p>Participants completed the survey approximately 4 years after Hurricanes Katrina and Rita. In terms of measuring long‐lasting posttraumatic growth, the time span may have been reasonable. Yet other results may have been skewed given the duration from the actual event, particularly for those who were not still providing services to victims of Hurricanes Katrina and Rita. The solicitation of participation included those ACA members who also served after Hurricanes Gustov and Ike; however, there were not enough participants who served only after those storms to make a 2‐ and 4‐year comparison of data. In fact, many of the participants who served clients affected by Hurricanes Gustov and Ike also served clients affected by Hurricanes Katrina and Rita. Finally, we used an open recruitment approach to solicit participants, which limited our ability to further describe our sample or provide any type of randomization in selecting participants.</p> <hd id="AN0088005492-17">Conclusion</hd> <p>Counselors who work with clients who have been traumatized from a hurricane or other natural disaster may themselves be at risk for vicarious traumatization and may develop posttraumatic growth and professional resilience from having helped these survivors. The level of self‐care following exposure to vicarious trauma affects whether counselors will have positive or negative outcomes in their personal and professional lives. Counselors who take care of their emotional, social, physical, and spiritual needs are better equipped to provide quality mental health services to their clients (Lawson, [<reflink idref="bib17" id="ref80">17</reflink>] ). Professional organizations, such as ACA, can use this information to better prepare counselors before they are disseminated and debrief after serving as DMH counselors. These efforts would help to protect clients affected by the natural disaster, clients in the counselors' regular caseload upon resuming normal duties, and professional counselors who hope to remain effective and engaged in their work with clients.</p> <ref id="AN0088005492-18"> <title>References</title> <blist> <bibl id="bib1" idref="ref43" type="bt">1</bibl> <bibtext>Calhoun, L. G., & Tedeschi, R. G. ( 1999 ). Facilitating post‐traumatic growth: A clinician's guide. Mahwah, NJ : Erlbaum. </bibtext> </blist> <blist> <bibl id="bib2" idref="ref49" type="bt">2</bibl> <bibtext>Connor, K. M. ( 2006 ). Assessment of resilience in the aftermath of trauma. Journal of Clinical Psychiatry, 67 ( Suppl. 2 ), 46 – 49. </bibtext> </blist> <blist> <bibl id="bib3" idref="ref34" type="bt">3</bibl> <bibtext>Craig, C. D., & Sprang, G. 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  Data: Resilience of Professional Counselors Following Hurricanes Katrina and Rita
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  Data: <searchLink fieldCode="AR" term="%22Lambert%2C+Simone+F%2E%22">Lambert, Simone F.</searchLink><br /><searchLink fieldCode="AR" term="%22Lawson%2C+Gerard%22">Lawson, Gerard</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Counseling+%26+Development%22"><i>Journal of Counseling & Development</i></searchLink>. Jul 2013 91(3):261-268.
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  Data: Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA
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  Data: <searchLink fieldCode="DE" term="%22Resilience+%28Psychology%29%22">Resilience (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Posttraumatic+Stress+Disorder%22">Posttraumatic Stress Disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Trauma%22">Trauma</searchLink><br /><searchLink fieldCode="DE" term="%22Burnout%22">Burnout</searchLink><br /><searchLink fieldCode="DE" term="%22Fatigue+%28Biology%29%22">Fatigue (Biology)</searchLink><br /><searchLink fieldCode="DE" term="%22Stress+Management%22">Stress Management</searchLink><br /><searchLink fieldCode="DE" term="%22Counselors%22">Counselors</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Health+Workers%22">Mental Health Workers</searchLink><br /><searchLink fieldCode="DE" term="%22Satisfaction%22">Satisfaction</searchLink><br /><searchLink fieldCode="DE" term="%22Online+Surveys%22">Online Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22Measures+%28Individuals%29%22">Measures (Individuals)</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Likert+Scales%22">Likert Scales</searchLink><br /><searchLink fieldCode="DE" term="%22Tables+%28Data%29%22">Tables (Data)</searchLink><br /><searchLink fieldCode="DE" term="%22Weather%22">Weather</searchLink><br /><searchLink fieldCode="DE" term="%22Natural+Disasters%22">Natural Disasters</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Louisiana%22">Louisiana</searchLink><br /><searchLink fieldCode="DE" term="%22Mississippi%22">Mississippi</searchLink><br /><searchLink fieldCode="DE" term="%22Texas%22">Texas</searchLink>
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  Data: 10.1002/j.1556-6676.2013.00094.x
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  Data: 0748-9633
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  Data: Professional counselors who provided services to those affected by Hurricanes Katrina and Rita completed the K6+ (screen for severe mental illness), the Posttraumatic Growth Inventory, and the Professional Quality of Life Scale. Results indicated that participants who survived the hurricanes had higher levels of posttraumatic growth than participants who served as volunteers. Both volunteer and survivor-volunteer participants were susceptible to compassion fatigue. To further resiliency, self-care strategies were found to minimize burnout, compassion fatigue, and vicarious traumatization. (Contains 2 tables.)
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        PageCount: 8
        StartPage: 261
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      – SubjectFull: Resilience (Psychology)
        Type: general
      – SubjectFull: Posttraumatic Stress Disorder
        Type: general
      – SubjectFull: Trauma
        Type: general
      – SubjectFull: Burnout
        Type: general
      – SubjectFull: Fatigue (Biology)
        Type: general
      – SubjectFull: Stress Management
        Type: general
      – SubjectFull: Counselors
        Type: general
      – SubjectFull: Mental Health Workers
        Type: general
      – SubjectFull: Satisfaction
        Type: general
      – SubjectFull: Online Surveys
        Type: general
      – SubjectFull: Measures (Individuals)
        Type: general
      – SubjectFull: Questionnaires
        Type: general
      – SubjectFull: Likert Scales
        Type: general
      – SubjectFull: Tables (Data)
        Type: general
      – SubjectFull: Weather
        Type: general
      – SubjectFull: Natural Disasters
        Type: general
      – SubjectFull: Louisiana
        Type: general
      – SubjectFull: Mississippi
        Type: general
      – SubjectFull: Texas
        Type: general
    Titles:
      – TitleFull: Resilience of Professional Counselors Following Hurricanes Katrina and Rita
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Lambert, Simone F.
      – PersonEntity:
          Name:
            NameFull: Lawson, Gerard
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 07
              Type: published
              Y: 2013
          Identifiers:
            – Type: issn-print
              Value: 0748-9633
          Numbering:
            – Type: volume
              Value: 91
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: Journal of Counseling & Development
              Type: main
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