coping with secondary traumatic stress by general duty ... · coping with secondary traumatic...

272 CanadianJournalofCounselling andPsychotherapy/Revuecanadiennedecounselingetdepsychothérapie

ISSN0826-3893 Vol.47No.2 ©2013 Pages272–298

CopingwithSecondaryTraumaticStressbyGeneralDutyPoliceOfficers:PracticalImplicationsLagestiondustresspost-traumatiquesecondaireparlesagentsdeservicesdepolicegénéraux :Enjeuxpratiques

StephanieM.ConnLeeD.ButterfieldAdler School of Professional Psychology

abstractThis study used the Critical IncidentTechnique to examine the factors that helped,hindered,ormighthavehelped10generaldutypoliceofficerstocopewithsecondarytraumaticstress.Thedatawerebestrepresentedby14categories:self-care,family/signifi-cantothersupport,talkingwithco-workers,emotionalengagement,workenvironment,mentalhealthresources,personality,abilitytohelpthevictim,relatabilitytothevictim,scenereminders,continuousexposure/dwelling,exposuretohumannature,vulnerabilityofthevictim,andpresenceofadditionalstressors.Thefindingsarepresentedandrec-ommendationsareofferedforcounsellorsworkingwiththispopulationandforpoliceagencyadministrators.

résuméPourmenercetteétude,leschercheursonteurecoursàlatechniquedesincidentscri-tiquespourexaminerlesfacteursquiontaidé,quiontnui,ouquiauraientpuaiderà10agentsdeservicesdepolicegénérauxdans leurgestiondustresspost-traumatiquesecondaire. On a mis les données dans 14 catégories qui les représentent le mieux :auto-soins,soutienfamilialetsoutiendelapersonnelaplusproche,conversationavecdescollèguesdetravail,engagementémotionnel,milieudetravail,ressourcesensantémentale,personnalité,aptitudeàaiderlavictime,capacitéd’établirunrapportaveclavictime,élémentsderappeldelascène,expositioncontinueoutendanceàrevenirsanscessesurl’incident,expositionàlanaturehumaine,vulnérabilitédelavictime,etprésenced’élémentsstressantssupplémentaires.Onprésentelesrésultatsetlesrecommandationsàl’intentiondeconseillersquitravaillentauprèsdecettepopulation,ainsiqu’àl’intentiond’administrateursdecorpspoliciers.

Theliteratureaboundswithdocumentationofthepsychological,physiologi-cal,behavioural,andspiritualeffectsofstressonpoliceofficers.Researchhasalsobeenconductedonthesourcesofpolicestressandhaslargelybeendividedinto(a)operationalstressors,suchastraumaticincidents;and(b)organizationalstres-sors,suchaspersonnelshortagesandshiftwork.Inthisstudy,weusetheCriticalIncidentTechniquetoexaminefactorsthathelporhinderpoliceofficersincopingwithsecondarytraumaticstress.Asummaryofexistingresearchisofferedfirst.

CopingwithSecondaryTraumaticStressbyGeneralDutyPoliceOfficers 273

impactofstressonpolice

Multiplestudieshavefoundevidencethatthestressofpoliceworkincreasesmentalhealthissuessuchasdepression,posttraumaticstress,andanxiety(Carlier,Lambert,&Gersons,1997;Collins&Long,2003).Onestudyfoundthattheproportionofpoliceofficerswithmeasurablementalillnessdoubledfrom1993to2003(Collins&Gibbs,2003).Thestressfrompoliceworkhasalsobeenfoundtohaveanegativeimpactonpoliceofficers’physicalhealth(Gershon,Barocas,Canton,Li,&Vlahov,2009;Gilmartin,2002;VanderKolk,1996;Violantietal.,2007).Behaviouraleffectssuchasabsenteeism,domesticviolence,excessiveuseofforce,andsubstanceabusehavealsobeenfoundinstudiesofpolicestress(Cross&Ashley,2004;Gershon,2000;Paton,Violanti,Burke,&Gehrke,2009).Theimpactoftraumaexperiencedinpolicingisnotconfinedtothetimespentonthe jobandmayevenaffect thefamilyof thepoliceofficer(Dwyer,2005;Gilmartin,2002;Violantietal.,2007).Researchalsoindicatesthattheimpactofcriticalincidentstressfrompoliceworkmaybelong-term.InastudyconductedbyKarlssonandChristianson(2003),officersreportedhavingvividvisual,tactile,andolfactorymemoriesoftraumaticeventsmorethan20yearsafterthoseevents.

sourcesofstress

Operationalstressorsofpoliceworkcanbedividedintoprimaryandsecond-arytraumas.Aprimarytraumainvolvesathreattothepoliceofficer’slife,asinthecaseofanofficer-involvedshooting.Thestressfromthistypeofeventhasbeendocumentedextensivelyintheresearchonpolicestress(Everly&Mitchell,1995;Gilmartin,2002;Kirschman,2000;Patonetal.,2009).Anothersourceofstressforpoliceofficersisrepeatedexposuretothesufferingofothers.Exposuretosecondarytraumamayresultinsecondarytraumaticstress(STS).“Secondarytraumaticstress(STS)referstoasetofpsychologicalsymptomsthatmimicpost-traumaticstressdisorder,butisacquiredthroughexposuretopersonssufferingfromtheeffectsoftrauma”(Baird&Kracen,2006,p.181).ResearchonSTShasonlyrecentlybegunandhastendedtofocusmoreontherapists,counsellors,andsocialworkersthanemergencyservicespersonnelsuchaspoliceofficers.Studieshaveindicatedthatpoliceofficerswhorepeatedlyrespondtotraumavictimsareat riskofdevelopingSTS, if notposttraumatic stress disorder (Hafeez, 2003;Marshall,2003;Salston&Figley,2003).

Inadditiontotheirexposuretooperationalstressors,policeofficersalsosuf-ferfromexposuretotheorganizationalaspectsofpolicework(Brough,2004;Hart,Wearing,&Headey,1995;Libermanetal.,2002).Documentedexamplesoforganizationalaspectsofpolicingthatcancauseoccupationalstress includeshiftwork,personnel issues, andpaperwork.Exposure to routineoccupationalstresshasbeenfoundtobeastrongerpredictorofpsychologicaldistress,includ-ingposttraumatic stress symptoms, than is thecumulativeexposure tocriticalincidentsordanger(Libermanetal.,2002).

274 StephanieM.Conn&LeeD.Butterfield

Areviewoftheliteratureonstressandcopingproducednumerousquantita-tivestudiesontheimpactsandsourcesofstressinpolicework.Whatseemstobemissingiswhatis workingforpoliceofficersandwhatwould helpmitigatetheimpactofSTSinpoliceofficerssothatitdoesnothaveacumulativeeffect.Thisstudywasundertakeninhopesof illuminatingthefactors thatofficersbelievehaveanimpactontheirabilitytocopewiththeirexposuretoSTSbyaskingthequestion:Whathelps,hinders,ormighthelpgeneraldutypoliceofficerstocopewithsecondarytraumaticstress?

The Enhanced Critical IncidentTechnique (ECIT) (Butterfield, Borgen,Maglio,&Amundson,2009;Flanagan,1954)wasusedtodevelopapictureofthecopingstrategiesemployedbygeneraldutypoliceofficersthatcouldnotbecapturedbyresponsestoquantitativesurveys.Priortobeginningtheresearch,approvalfortherecruitmentstrategy,protocolsused,planstoprotectparticipantconfidentiality,methodology,andcounsellingresourcesforparticipants,ifneeded,wasreceivedfromaninstitutionalResearchEthicsBoard.Noparticipantsrequiredthecounsellingresourcelist.

methodology

TheCriticalIncidentTechnique(CIT)isaqualitativeresearchmethodthatarose from industrial and organizational (I/O) psychology duringWorldWarII(Flanagan,1954).FlanagandevelopedtheCITtodeterminewhatdecisionsandbehavioursflightcrewsengagedinthatallowedthemtoreturnsafelyfrombombingmissions(Flanagan,1954).Hethenusedtheinformationtoselectandclassifyflightcrews.TheCITisexploratorybynatureand“isappropriatetousewhentheresearcherisinterestedinlearningmoreaboutlittle-understoodevents,incidents,factors,orpsychologicalconstructs”(Butterfieldetal.,2009,p.268).Itisdesignedtoelicit“criticalincidents,orfactors,thathelppromoteordetractfromtheeffectiveperformanceofsomeactivityortheexperienceofaspecificsituationorevent”(Butterfieldetal.,2009,p.266).

TheCIThasevolvedsinceFlanagan’s(1954)originaldescriptionanduseofit.First,Woolsey(1986)highlighteditsapplicabilitytocounsellingpsychologyissuesandmovedthemethodfromexpertobservationstoretrospectiveself-report.Second,itisnowknownastheEnhancedCriticalIncidentTechniquebecauseoftheadditionofcontextualcomponentsatthestartoftheinterview,the“wishlistitems”thatgiveparticipantstheopportunitytohighlightwhatthingsorfactorswouldhavebeenhelpfultothem,andtheadditionofninecredibilitychecksthatare intendedto increasethecredibilityoftheresults(Butterfieldetal.,2009).ReadersinterestedinlearningmoreaboutthegenesisoftheCITanditsevolutionwithincounsellingpsychologyaredirectedtoFlanagan(1954),Woolsey(1986),Butterfield,Borgen,Amundson,andMaglio(2005),andButterfieldetal.(2009).Forinformationaboutthemethod’sreliabilityandvalidity,readersaredirectedtoAnderssonandNilsson(1964)andRonanandLatham(1974).ThecurrentstudyfollowedtheECITproceduresdescribedbyFlanagan(1954)andButterfieldetal.(2009),whicharedescribedbelow.


The Five Steps in a Critical Incident Technique Study

Flanagan(1954)outlinedfivestepstofollowinaCITstudy:(a)ascertain-ingthegeneralaimsoftheactivitybeingstudied;(b)makingplansandsettingspecifications;(c)collectingthedata;(d)analyzingthedata,whichhasthreeparts(determiningtheframeofreference,formulatingthecategories,anddetermin-ingthelevelofgeneralityorspecificitytobeusedinreportingthedata);and(e)interpretingthedataandreportingtheresults.

Forthecurrentstudy,theactivitybeingstudiedinStep1wasidentifiedasthenaturallyoccurringcopingstrategiesemployedbygeneraldutypoliceofficerstodealwithSTS.Itincludedstrategiesthatwerehelpful,hindering,ormighthavebeenhelpfulifavailable(“wishlist”items).Thesecondstep(i.e.,makingplansandsettingspecifications)includedthedeterminationandcreationofaprescreeningquestionnaire,theECITinterviewprotocol(whichincludedbothacontextualcomponentandECITquestionsregardinghelping,hindering,andwishlistitems),andthesecondinterviewprotocol.Italsoincludedselectingpersonstoperformthecredibilitychecks.

Thethirdstep,datacollection, wasaccomplishedthroughin-personsemistruc-turedinterviewsusingtheinterviewguidedescribedabove.Thefourthstep,ana-lyzingthedata,wasconductedinaccordancewiththestepssetforthbyFlanagan(1954)andButterfieldetal.(2009).Determiningtheframeofreferencewasthefirstpartofanalyzingthedata.Theliteraturereviewconductedpriortoundertak-ingthecurrentstudyinformedthiswork.Baseduponthisframeofreference,theresearcherscollecteddataprimarilyinhopesofinformingpoliceagencypolicyinsupportofthewell-beingofofficers,andsecondarilytoinformcounsellinginter-ventionsthatassistofficersinmanagingworkplaceSTS.Thesecondpartofdataanalysiswastocreatecategoriesbasedupongroupingofsimilarincidents.Thiscon-sistedoforganizingrawdata,identifyingcriticalincidentandwishlistitems,andcreatingthecategories.Thethirdpartofdataanalysisconsistedofdeterminingthelevelofdetailthatwouldbeneededtoreportthedata(Butterfieldetal.,2009).Theresearcherschosetoreportthedataintermsofthenumberofhelping,hindering,andwishlistitemsandparticipationratesforeachcategory,andprovidedsupportforeachofthecategoriesbyofferingrepresentativequotes,whichisconsistentwiththemannerinwhichpreviousECITstudieshavereportedtheirfindings.

Thefifth andfinal step involved conducting credibility checks andwritingthefinalreporttodetailthestorythedatatold.Dataextractswereincludedinthefinalreporttoelucidatethestorytoldbyparticipants.Thecredibilitychecksconductedduring thisfifth step include (a)audio-recordingof interviews, (b)interviewfidelity,(c)independentextractionofcriticalincidents,(d)exhaustive-ness,(e)participationrates,(f )placingincidentsintocategoriesbyanindependentjudge,(g)cross-checkingbyparticipants,(h)expertopinions,and(i)theoreticalagreement.ThesecredibilitychecksaredescribedinmoredetailinAppendixA.

ThedatainanECITstudyarethefactorsorcriticalincidentsthathelpedorfacilitatedinthesituationbeingstudied(helpingincidents),thefactorsorinci-


dentsthatdetractedfromormadeitmoredifficulttodealwiththesituationbeingstudied(hinderingincidents),anditemsthatparticipantsbelievedwouldhavehelpedduringthesituationbutwerenotactuallyavailable(wishlistitems).TheN ofanECITstudyisthenumberofcriticalincidentscollected,notthenumberofparticipants(Flanagan,1954).

Theinterviewsbeganwiththecollectionofcontextualdatatoprovideabetterunderstandingoftheparticipants’generalworkexperiencesandperceivedcurrentstateofcoping.Thesequestionsaskedparticipantsabouttheiroverallexperienceaspoliceofficers, thenumberof exposures to secondary trauma thathad im-pactedthem,andhowwelltheyfelttheyhadbeencopingwiththoseexposures.Thedefinitionof“impact”oftraumawaslefttothepoliceofficertodecide.Anexampleofaneventthatmightbeconsideredtraumatic,anextofkinnotifica-tion,wasofferedanddelineatedfromanorganizationalstressor,suchasfeelingpressuretoleaveacallduetoothercallswaiting.Intheinterviewpreamble,STSwasdefinedtoparticipantsas“exposuretothosewhohavebeentraumatizedorwhoaresufferingindifferentways.”

TheCITquestionscomprisedthenextportionoftheinterviewandconsistedofinquiringaboutcriticalincidentsorfactorsthathelped,hindered,orwouldhavehelpedthemhandleatimewhentheywereexposedtoanotherperson’strauma.Probeswereaskedtoensureclarityandunderstanding,tofindouttheimportanceofthefactortotheirabilitytodealwiththeexposuretosomeoneelse’strauma,andtoobtainanexample.GatheringtheseadditionaldetailsisconsistentwiththeECITmethodandprovidesthecriteriafordeterminingwhetheranincidentiscountedandincludedinthefinaldataanalysis(Butterfieldetal.,2009;Flanagan,1954).Theinterviewconcludedwiththecollectionofdemographicdatainordertodescribethesample.

InterviewswereconductedatsixpoliceagenciesintheLowerMainlandofBrit-ishColumbiaandlastedfrom52to78minutes,averaging64minutes.Interviewsweretranscribedtofacilitateanalysisofthedataforthemesandcategories.Tenta-tivecategorieswerecreatedasdescribedbyFlanagan(1954)andButterfieldetal.(2009).FurtherdetailsabouthowthecategoriesarecreatedinanECITstudyareofferedbyButterfieldetal.(2009).Categories,data,andassumptionswerethensubjectedtotherigoursoftheECITcredibilitychecks(Butterfieldetal.,2009;Flanagan,1954).Theestablishedstandardsforallthecredibilitychecksweremet.

Participants

Apurposiveandsnowball samplewasobtainedthroughdisseminationofaresearchintroductoryletterasanattachmentinane-maildirectedtotheinter-viewingresearcher’sprofessionalcontactsinpoliceagencies.Professionalcontactsdirectedtheresearchintroductorylettertotheircontactswithintheirrespectivepoliceagencies. Interestedpersonswere instructed tocontact the interviewingresearcheriftheyhadquestionsorwantedtoparticipate.Thephonenumberande-mailaddressoftheinterviewingresearcherwereprovidedtofacilitatecontact.Theinterviewingresearcherdidnotpersonallyknowanyoftherespondingin-


terestedpersons,preventinganyproblemswithdualrelationships.Respondingpersonswerescreenedusingaprescreenquestionnairethatensuredparticipantsmettheinclusioncriteria.Inclusioncriteriaincluded(a)aminimumofoneyearofexperienceasapoliceofficer;(b)currentlyassignedtogeneraldutyassignment(patrol),orhavingbeenassignedtogeneraldutyassignmentwithinthe last6months;(c)beingoftherankofconstable;and(d)abletoread,write,andspeakEnglishfluently.Participantswerenotofferedremuneration,andwerepresumablymotivatedtoparticipatebasedupontheirownpersonalinterestsintheresearchtopic.Toprotecttheconfidentialityofparticipants,theiridentifyinginformationwasremovedandreplacedwithaparticipantnumberpriortoreportingtheresults.

Thesampleconsistedof7maleand3femalegeneraldutypoliceofficers.Par-ticipants’agesrangedfrom22to36yearsold(M=28).Yearsofexperiencerangedfrom20to60months(M=36months).Allparticipantshadbeenassignedtogeneraldutyfortheentiretyoftheirpolicecareers.Fourparticipantsidentifiedasmarried,3assingle,1ascommon-law,and2asengaged.Eightparticipantsidentifiedashavingbachelor’sdegreesand2hadmaster’sdegrees.

results

Inthissectionwefirstreportonthecontextualdata,thenontheCITdata.WithintheCITdata,thenumberofcriticalincidentscollectedisbrokendownintohelpingandhinderingcriticalincidentsandwishlistitems.Thenthecat-egoriesderivedfromthecriticalincidentsandwishlistitemsaredescribed,andparticipationratesandfrequenciesreported,aswellasthecategory’soperationaldefinitionandrepresentativequotationstoillustratethecategory.

Contextual Data

Togetageneralideaoftheirexperienceaspoliceofficers,participantswereaskedwhatitwaslikebeingapoliceofficer.Contextualdatareflectedanoverallpositivetone.Eightparticipantsexplicitlystatedthatbeingapoliceofficerwasapositiveexperience.Participantsreportedbetween1and10exposurestotraumaticsituationsashavinghadanimpactonthem(M=3.45).Participantsdeterminedwhathavinganimpactonthemmeantandcitedvarioustypesofevents,includingnextofkindeathnotificationsandmotorvehicleaccidents.Sevenparticipantsidentifiedasdoing“prettywell”while3identifiedasdoing“verywell”withrespecttocopingwiththoseexposures.

CIT Data

Thefirstinterviewyieldedatotalof155criticalincidentsandwishlistitems.Therewere74helpfulcriticalincidents,62hinderingcriticalincidents,and19wishlistitems.Thesecondinterviewdidnotyieldanyadditionalcriticalincidentsbutdidyieldoneadditionalwishlistitem.FollowingFlanagan(1954),theECITresultsarereportedintheformofcategorieswithself-descriptivetitlesandopera-tionaldefinitions.Operationaldefinitionswereassignedtoeachcategorybased


uponparticipantresponsesandarereportednext,accompaniedbytheparticipa-tionratesandfrequenciesassuggestedbyButterfieldetal.(2009).Participationrateswerecalculatedbydividingthenumberofparticipantscitingincidentsinacategorybythetotalnumberofparticipants.Table1depictsthe14categoriesintowhichthe156criticalincidentsandwishlistitemswereplaced.Therewerenoincidentsthatdidnotfitintoacategory.

self-care

Self-careplayedanimportanthelpingroleincopingfor8ofthe10participantsinterviewed(80%participationrate,17incidents).Therewerenohinderingorwishlistitemscitedbyparticipantsthatfitintothiscategory.Purposefulactivitytopromotephysicalandemotionalhealthconstitutedself-careforthepurposeofthisstudy.Thiscategorycontainedactivitiessuchasexercise,prayer,medita-tion,sleep,andtakingtime-outs.Someoftheself-carestrategieswerereportedtoenhancetheparticipants’focusonthemselveswhileotherswerereportedtobemorelikeaformofdistraction.Oneparticipantstated:

Ithinkalotofthingsthatpreventstresshappenbeforehandasopposedtoafter,sothingslikefitness,thingslikerelationships,lifestyle,[and]personality…Ithinkitgivesmeoutlets.Itgivesmewaystoeitherphysicallyburnoffstressoremotions.(Participant#4)

family/significantothersupport

Supportfromfamily,friends,andsignificantotherswasalsocitedby8ofthe10participantsasahelpfulfactor(80%participationrate,13incidents).Thelackofsupportwasdeemedashinderingby6participants(60%participationrate,6incidents).Therewasonewishlistitemfrom1participant(10%participationrate,1incident).Family or significant other support wasdefinedinthisstudyastheparticipant’sabilitytorelyonfamilymembers,suchasparentsandsiblings,andsignificantotherstohelpmeethisorheremotional,psychological,andspiritualneeds.Forthisstudy,lackofsupportmeanttheabsenceorunavailabilityoffamilymembersandsignificantothersoralackofunderstandingfromfamilymembersandsignificantothers.Significantothersincludedlovepartnersandfriends.Forsomeparticipants,friendsreferredtonon-policefriendships,andforothersitin-cludedpolicefriendshipsoutsideofwork.Formsofsupportandmeansofmeetingtheofficers’emotional,psychological,andspiritualneedsvaried.Oneparticipantwhoidentifiedfamilysupportashelpfultocopingreported:

Ithinkthey’re[familyis]veryimportantinthefactthathavingthosehealthyrelationshipsitdefinitelydoeshelptocope—havingpeopletotalktoand,youknow,havingpeoplearoundyouthatdoloveandcareaboutyou.Youknow,it’ssomethingworthgoinghometoattheendoftheday.(Participant#4)

Anotherparticipantspokeofthehinderingeffectofthelackoffamilial/significantothersupport,stating,“IfIwastogohome,say,andtellmygirlfriendortellmy


Tabl

e1

Crit

ical I

ncid

ent C

ateg

ories

Hel

ping

Inci

dent

s(n

=7

4)H

inde

ring

Inci

dent

s(n

=6

2)W

ishL

istIt

ems

(n=

20)

Cat

egor

ies

Part

icip

ants

N =

10

%#

ofin

cide

nts

Part

icip

ants

N=

10

%#

ofin

cide

nts

Part

icip

ants

N=

10

%#

ofin

cide

nts

Self-

care

880

170

00

00

0

Fam

ily/s

igni

fican

toth

ersu

ppor

t8

8013

660

61

101

Talk

ing

with

co-

wor

kers

880

130

00

00

0

Emot

iona

leng

agem

ent

660

103

305

110

1

Wor

ken

viro

nmen

t5

507

660

158

8014

Men

talh

ealth

reso

urce

s4

404

00

03

303

Pers

onal

ity3

304

00

00

00

Abili

tyto

hel

p th

evi

ctim

330

33

305

110

1

Rela

tabi

lity

toth

evi

ctim

220

24

405

00

0

Scen

ere

min

ders

110

13

303

00

0

Con

tinuo

us e

xpos

ure/

dwel

ling

00

05

5010

00

0

Expo

sure

toh

uman

nat

ure

00

05

505

00

0

Vuln

erab

ility

oft

hev

ictim

00

04

404

00

0

Pres

ence

ofa

dditi

onal

stre

ssor

s0

00

330

40

00


parents,itwouldbeahorriblethingforthem.Sotheydon’treallyseemtogetthatpart”(Participant#2).

talkingwithco-workers

Talking with co-workers was tied with family/significant other support asthesecondmostprevalentfactorthathelpedparticipantscopewithSTS(80%participationrate,13incidents).Forthisstudy,talking with co-workers included informalconversationswithoneormorefellowofficersafteranincident.Timingofconversationsincludedbothimmediatelyfollowingtheconclusionoftheinci-dentandthosethatoccurredlaterinthesameshiftordaysorevenweeksaftertheincident.Theywerenotinthecourseofastructuredoperationalorpsychologicaldebriefing.Oneparticipantstated:

Ifindthere’salittlebitofdifferencewith…thismightsoundalittlebad,buttalkingtosomeonewhoeithergetsitordoesn’t…therearesomepeople,sayfromwork,thatI’lltalktowheretheyhavebeeninthesamesituationssotheydounderstand,andIknowtherearetimeswhenthey’reinsituationslikethat.(Participant#6)

Anotherparticipantcommented,“Ithinkjusthavinganotherpersonwhocansay‘Yeah,youknowwhat,thatbotheredmetoo,’soyoujustfeellikeyou’renottheonlyone”(Participant#9).Beingabletospeakwithco-workersofferedtheseparticipantsasenseofbeingunderstoodandseemedtonormalizetheirreactions.

emotionalengagement

SixparticipantsidentifiednotbeingemotionallyengagedashelpfulincopingwithSTS(60%participationrate,10incidents).Beingemotionallyengagedinacallwascitedashinderingfor3participants(30%participationrate,5incidents).Nowishlistitemswerecitedthatfitintothiscategory.Forthisstudy,emotional engagementmeantlearningorpayingattentiontopersonaldetailsaboutthevictimthatmightcreateapersonalconnectionorfeelingsofempathyorsympathy.Alackofemotionalengagementcanbebestunderstoodasdirectingone’sfocustothetasksofthejobtotheexclusionoflearningorpayingattentiontopersonaldetailsaboutthevictim.Knowledgeofthesedetailsmightcreateapersonalcon-nectionorfeelingsofempathyorsympathy.Personaldetailsincludedlearningadditionalinformationaboutadeceasedpersonthatwasnotnecessaryforthecompletionofone’staskswhileonthecall.Italsoincludedtheuseofhumourtolightentheseriousnessoftheincident.Indiscussingwhathinderedtheircoping,someparticipantsexpressedatendencytoabstainfromgettingtoknowvictims.Foroneparticipant,havingthevisualimageofaccidentvictimsseemedtomakethemmorehuman,addingtothedifficultyincopingwithSTS.Thatofficerstated,“theNOK[nextofkinnotification]whereIdidseethebodies,wasmuchharderthantheNOKwhereIdon’t.LikeIdon’tknowhowtoexplainitotherthanit’smorethanjustaname”(Participant#6).


workenvironment

Beyond the factorof talkingwithco-workers,participantscited theirworkenvironmentasimpactingtheirabilitytocopewithSTS.Fiveparticipantsiden-tifiedasupportiveworkenvironmentaspromotingtheirabilitytocope(50%participationrate,7incidents).Sixparticipantsidentifiedfactorsoftheworken-vironmentasahindrancefortheircoping(60%participationrate,15incidents).Eightparticipantsidentifiedwishlistitemsthatfitintotheworkenvironment category(80%participationrate,14incidents).Forthisstudy,work environmentwasdefinedascharacteristicsoftheworksettingthatimpactedthepsychologicalwell-beingofthepoliceofficer.Itincludedtheworkatmosphereandtheprovisionofservicesthatimpactedtheparticipant’spsychologicalwell-beingsuchasformaldebriefings,membersoftheCriticalIncidentStressManagementTeam(CISM),specialized trainingonmentalhealth, and educationalmaterialspertaining tothetopic.Italsoincludedtheeaseofaccesstoemployeeassistanceprogramsandinformation.

Participantsdrewdistinctionsbetweensupportiveco-workersandabroaderor-ganizationalenvironment.Descriptionsofcamaraderieoccurredinthecontextofanorganizationwhosepoliciesandpracticesmayormaynothavebeenconducivetoemployeementalhealth.Oneparticipantspokeoftheworkenvironmentintermsofsupervisorysupport(Participant#4).WorkenvironmentwaslessabouttheproximalinterpersonalinteractionscapturedintheTalkingwithCo-workerscategoryandmoreabouttheoveralltone,policies,andprovisionofservicesthatpromoted employeementalhealth.Oneparticipant’s comment illustrates thispoint:“IfeltlikeIwasinanenvironmentwhereIcouldsitupandsayI’mnotcoping….Itwouldbelistenedtoandtakenseriously”(Participant#8).

Threeparticipantsidentifiedhavingaformaldebriefingasbeinghelpfulfortheircoping.Aformal debriefingforthepurposesofthisstudywasastructuredinterventionperformedbymembersoftheCriticalIncidentStressManagementTeam and/or designated mental health professionals that offered a forum fordiscussingone’semotionalreactiontoacritical incident.Acritical incidentinthiscontextreferstoatraumaticeventoneencountersatwork.Itshouldbedis-tinguishedfromacriticalincidentintheECITresearchcontextthatconstitutes“factorsthatpromoteordetractfromtheeffectiveperformanceofsomeactivityortheexperienceofaspecificsituationorevent”(Butterfieldetal.,2009,p.266).Oneparticipantreported,“Ispoketomembersonourcriticalincidentteamandtheywereveryhelpful,andtheyjustsaid,‘Youknowyou’regoingtothinkaboutitforacoupleofweeksandthat’sfine,that’snatural,andcontinuetoprocessthat’”(Participant#4).

Theworkenvironmentwasalsocitedasahindering factor, foravarietyofreasons.Thestigmaofseekinghelpwasanimpedimentforsomepoliceofficers.Participantsrelatedthatinformationwasnotreadilyavailabletothemwithoutgo-ingthroughasupervisor.Oneparticipantexpressedconcernaboutspeakingwiththedesignatedmentalhealthcontactpersonsatthedepartment,stating“Atthe


endofthedayIdonottrustthem,becauseforeverysinglepersonthatitis,they’realwayssupervisors”(Participant#3).InadequatetrainingforstressmanagementwasalsocitedashinderingtheirabilitytocopewithSTS.Someofthetrainingwasoptional,conveyingthemessagetooneparticipantthattheinformationwasnotregardedasimportant.

mentalhealthresources

FourparticipantsidentifiedthatmentalhealthresourceshelpedthemtocopewithSTS(40%participationrate,4incidents).Threeparticipantscitedhavingmentalhealthresourceswouldhavehelpedwithcopingifithadbeenavailable(30%participationrate,3incidents).Therewerenohinderingcriticalincidentscitedthatfitintothiscategory.Mental health resources fortheparticipantsinthisstudymeanttheprovisionandutilizationofpsychologicalservicesandmaterialsthatpromotepsychologicalwell-being.Itincludedaccessingprofessionalpsycho-therapeuticservicesormaterialspertainingtopsychologicalwell-being.Itincludedtheknowledgeand/orutilizationoftheseservicesandsourcesofinformation.Oneparticipantrelayedhowaccessingmentalhealthresourceswasahelpingfactor,saying“Iwenttoseeacounsellorandthatmadeahugedifference,justnormal-izingandjustsittingtheretalkingtosomebodyactuallythat’stotallynotinvolvedinyourlife”(Participant#8).

personality

Threeparticipants reported theirpersonalitynaturallyhelpedthemtocopewithSTS(30%participationrate,4incidents).Therewerenohinderingcriticalincidentsorwishlistitemscitedthatfitintothiscategory.Forthisstudy,person-alitywasoperationalizedascharacteristicsorqualitiesofmindandbehaviour.Arepresentativequoteillustratesoneparticipant’sstanceonhowpersonalityhelpedthatparticipanttocope:

Ithinkitbecomesamatterofpersonality…[to]nottakemyselftooseriously.BeingabletobetoldthatI’mwrongorIdidsomethingwrong.Beingabletoacceptcriticismandnotgetallriledupordefensive;Ithinkitisnotbeingafraidtomakemistakesthataremadeingoodfaith.(Participant#4)

abilitytohelpthevictim

ThreeparticipantsindicatedthattheabilitytohelpthevictimpromotedtheirabilitytocopewiththeSTSofthatcall(30%participationrate,3incidents).Theinabilitytohelpvictimshinderedcopingforthreeparticipants(30%participationrate,5incidents).Onewishlistitemrelatedtotheabilitytohelpthevictimwasalsocited(10%participationrate,1incident).Inthisstudy,ability to help the victim referredtothebeliefthatonecanmakeadifferenceorchangethecircum-stancesofthevictimorvictims.Theinabilitytohelpvictimswasoperationalizedasfacingasituationwhereonefeelshelplesstomakeadifferenceorchangethecircumstancesofthevictimorvictims.Participantsrelatedthatthisfeelingmay


havebeenbecausethevictimwasdeceasedwhenthepoliceofficersarrived,oritmayhavebeenthatthesituationrequiredalong-termsolution(Participants#2and10).Someparticipantsreportedfeelingtheywereunabletohelpthevictim,even referring to it as “helplessness” (Participants#2,5, and10).Oneofficerreportedthatshiftinghowoneinterpretedtheabilitytohelpthevictimhelpsoneselftocopebetter,stating:

Aslongasthereisasociety,there’sgoingtobecrime,ifthere’sgoingtobecrime,guesswhat?Somebodyhastocontrolthat,butIsupposenottolookatthelightattheendofthetunnelas,youknow,asanend,butperhapsyounowlookmoreatthelightattheendofthetunnelforthatparticularfile.Youknow,what’stheend?Welltheendiseithermakinganarrest,puttingareportinforaconviction,anynumberofthosethings,because…forthelongesttimeIwaslookingatlongterm…howcanwefeellikewe’reactuallybetteringsociety?Itdoesn’tseemthatway,butyouknowwhat?Justtryingtomakeadifferenceinoneperson’slifehoweveryoucan.(Participant#10)

relatabilitytothevictim

Two participants identified their ability to relate to the victim as helpful(20% participation rate, 2 incidents) while 4 participants cited this factor ashinderingtheircopingwithSTS(40%participationrate,5incidents).Nowishlistitemswerecitedthatfitintothiscategory.Relatability to the victimwastheparticipant’s identificationofsharedtraitsorcircumstanceswiththevictimorvictim’sfamilythatpromotedempathicfeelings.Oneparticipant’sabilitytore-latetothevictimfamily’ssituationpromotedthisofficer’scoping,asevidencedbythisquote:

IthinkitactuallyhelpsmycopingbecauseIknowthatIcan’tfixwhatI’vejustcomeinandtoldpeopleorwhatI’vejusthadtodealwithit.Iknowthatitdoesn’tmatterhowbrilliantIwasatdeliveringwhatevernewsitwasordealingwiththem,it’snotgoingtochange.(Participant#8)

scenereminders

Oneparticipantidentifiednotbeingatthesceneasahelpingfactor(10%par-ticipationrate,1incident).Threeofthe10participantsidentifiedsceneremindersashinderingtheirabilitytocopewithSTS(30%participationrate,3incidents).Therewerenowishlistitemscitedthatfitintothiscategory.Scene reminderswereoperationalizedinthestudytoincludevisual,tactile,olfactory,andauditorycuesthatinitiatedthememoryofatraumaticincident.Oneparticipantspokeofhowsceneremindershinderedthisofficer’scoping,stating:

[Thereisa]stenchasyoudrivethereandthenitwaskindofmixedwithlikesmokeandlikeprobablyburningpeople,sothere’sthissmellthatandwhenIdriveit,ifI’dsmellthesmellagain,thenitwouldlikeremindofitagain.(Participant#9)


continuousexposure/dwelling

For5participants,beingcontinuouslyexposedtoastressfulincidenthinderedtheirabilitytocopewithSTS(50%participationrate,10incidents).Therewerenohelpingincidentsorwishlistitemscitedthatfitintothiscategory.Forthepurposeofthisstudy,continuous exposure/dwelling wasdefinedastheinabilitytoescapeorremoveoneselfphysicallyoremotionallyfromanincident.Italsoin-cludedcontinuouslythinkingaboutanincident.Oneparticipantsharedastoryofhavingtoremainonadeathsceneforseveralhoursandbelievedthiscontinuousexposurehinderedtheabilitytocope,asitlefttheofficerlittlerespitephysicallyormentally.Thisparticipantstated:

I think it’sprobably just the fact that itwas suchanabnormal situationofhavingto,likeIsay,getthatlittlementalsnapshotsomanytimes,isprobablywhyitwasdifficulttocopewith.Justbecauseit’slikeyou’reouthere,you’rebyyourself,you’retired,andtimeisjustdraggingby.Youcan’tdoanything,youcan’tleave…it’sgoingtobealongnight.(Participant#2)

exposuretohumannature

Exposuretohumannaturewasidentifiedbyhalfoftheparticipantsasahinder-ingfactor(50%participationrate,5incidents).Therewerenohelpingfactorsorwishlistitemscitedthatfitintothiscategory.Thiscategorycanbedescribedasseeingthemannerinwhichpeopletreatthemselvesand/orothers.Whenaskedaboutwhathinderedtheability tocope,oneparticipantspokeofan incidentwhereaninfanthadbeensexuallyabused,stating:

Imeanyouoftenhearthatline,youknow,“I’veseenitall.”Ididn’tseethatonecoming.It’sjust,wow,Ican’tbelievetherearepeoplewhoactuallydothat,soit…it’shardtoprocesssomethingthatyoudon’tunderstand.(Participant#1)

vulnerabilityofthevictim

FourparticipantscitedthevulnerabilityofthevictimashinderingtheirabilitytocopewithSTS(40%participationrate,4incidents).Therewerenohelpfulincidentsorwishlistitemsforthiscategory.Victim vulnerabilitywasdefinedasthosecharacteristicsofthepersonthatmadethemmoreinnocentand/orreliantonothersforprotection.Oneparticipantrelayedastoryofanimpaireddriverhittinga“good”family,stating:

It’skindofbacktotheinnocencething,Iguess.Liketheywerejust…theyweregoodpeople.Liketheydidn’t…theydidn’thavecriminalrecords,liketheydidn’thaveanyprimehistory,liketheywerecompletelyoffthemapbecausetheywerejustthislikequietfamily…whenyouhadthetwoextremes.Peoplewith,like,lengthyrecordsandthenthepeoplethatarejusthardworking,goodpeople,it’ssenseless.(Participant#9)


presenceofadditionalstressors

Threeparticipantsidentifiedthepresenceofadditionalstressors ashinderingtheirabilitytocopewithSTS(30%participationrate,4incidents).Therewerenohelping factorsorwish list items thatfit into thiscategory.For this study,presence of additional stressors signifiedthepresenceofstressfulsituationsoutsideofworkthatcompoundedtheamountofstressexperienced.Itincludedpersonalproblemssuchasfinancialdistress,relationshipproblems,andscrutinyfromthedepartment,thepublic,andthemedia.Oneparticipantidentifiedmultiplesourcesofscrutinyasahindrancetocoping,andstated:

Ithinkanotherthingthatcanbeannoyingorcanmakeitdifficultislikearm-chairquarterbacking,iswhenyoustarthearingotherpeopleinothersectionsorotherunitssaying,“OhwellthisishowIwouldhavedoneit”or“Thisishowwediditbackintheday”or…thatwholeideaofpeoplewhoweren’ttherekindofofferingtheirtwocents.I’mjustlike,youknowwhat,whoareyou?Likeeveninthemediatoo,likethepublic…thatcanallbedifficult.(Participant#3)

discussion

The study illuminated several factors that helped, hindered, ormight havehelpedpoliceofficersincopingwithSTS.Overall,thefindingswereconsistentwithexistingliteraturepertainingtocopingstrategiesforSTS.Oneofthemostcommonlycitedhelpingcategories,Self-Care,hasbeendocumentedasaprotec-tive factor throughout the stress and coping literature (e.g., Gilmartin, 2002;Kirschman,2000;Palm,Polusny,&Follette,2004).Themostcommonlycitedhindering category,WorkEnvironment, has also beenwell-documented (e.g.,Burke&Paton,2006;Libermanetal.,2002;Patonetal.,2009).

Twosurprisingresultsarosefromthecurrentstudy.First, theprevalenceoftheexpresseddesireforaccesstomentalhealthresourcessuchascounsellingandeducation (80% participation rate) was a surprise based upon a documentedreluctancetoseekmentalhealthservicesamongpoliceofficers(e.g.,Graf,1986;Miller,1995).Second,noneoftheparticipantsrelayedusinganyofthemala-daptive behavioural coping mechanisms such as consuming alcohol or usingexcessiveforce.Thiswasunexpected,giventheextensivedocumentationofthesemaladaptivecopingmechanismsinthepolicestressliterature(Cross&Ashley,2004;Gershon,2000).Theresearcherscannotdeterminewhattheseunexpectedresultsmean,asthiswasnottheprimarypurposeofthestudy.Thisisthereforeanareathatwarrantsfurtherstudy.

Manyof theparticipants spokeof theirexpectationsregardingwhowasan“innocentvictim”andwhowasnot.Thereappeared tobea setofunwritten,unspokenrulesofjusticethat,whenbroken,hinderedtheparticipants’abilitytocope.SomeparticipantsseemedtoholdbeliefsconsistentwithLerner’s(1970)justworldtheory,which statesthatweliveinaworldwherepeoplegetwhatthey


deserve.Itlendsordertoeventsthatmightotherwisebedifficulttocomprehend.Itcanleadtovictim-blamingtocreateasenseofpersonalsafety.Itfostersthebeliefthatonewillnotfallvictimtotragiceventsunlessheorshedoessomethingthatcontributestothisfate.Whentherewasaviolationofthisorder,itseemedtohinderparticipants’coping.ThiswasparticularlyevidentintheVulnerabilityoftheVictim,RelatabilitytotheVictim,andExposuretoHumanNature cat-egories.Oneparticipantspokeofalogicalorderwhereitismoretraumaticwhensomevictimsdonotdeservetheirfatewhileothersdo.Anotherparticipantalsoreportedthattheabilitytorelatetothevictimhinderedthatparticipant’sabilitytocope,statingthatitchangesthings“when[thevictimis]someoneyouknoworIalsothinkifit’ssomeoneyoucanidentifywithor…youseesomesimilarities”(Participant#6).Anotherparticipantcitedrelatabilitytothevictimasahindrancetocoping,stating:

I’dsay,asfarascoping,Iwouldsayitwouldmakeitworsemaybe,becauseyousortofrelatetoitbeinglike…thiscouldbeme,andthensometimesyourmindwandersandyou’relike“OhGod,whatifthathappenstomyfamily?”(Participant#9)

Thepoliceofficers’ inabilitytohelpthevictimmaycreateanexistentialdi-lemma referred to as confrontingunfixable suffering,whichhasbeenused torefertoloneliness,angst,thrownness,andambiguity(Plomp,1997).Itcanbeastateofbeingoranaffectivereactiontocircumstancesonefaces.Participantsexpressedexperiencesconsistentwiththreeofthefourconcepts:loneliness,angst,andambiguity.Twoparticipantsreportedfeelingsofisolation.Angstreferstothefeelingsofhelplessness,andsomeparticipantsinthecurrentstudyrelatedfeelingsofhelplessnesstochangethecircumstancesforthevictim.Feelingsofambigu-itywerealsoexpressedbysomeparticipants,astheyexperiencedstresswithrolechangesanduncertainty.Aspreviouslymentioned,oneparticipant(#10)sharedanexperienceofshiftingperspectivetoredefinetheconceptualizationofhelpingpeople fromlong-term(changingsociety) to short-term(connectingwithonesmallchild,orhelpingthevictimbygettingaconviction).Thisnewperspectiveontheofficer’sabilitytohelpvictimspromotedcoping,changingtheinabilitytohelpthevictimfromahinderingincidenttoahelpingincident.

TheresultsofthisstudyarealsoconsistentwiththefindingsofMaddiandKobasa(1991),whocontendthatwhenpeoplehaveacontroldisposition,theyfeelasthoughtheycanhaveinfluenceoverthevariedcontingenciesinlife;con-sequentlytheydonotfeelhelpless.Thepersonperceivesasenseofcontrolinhisorhercircumstances.Itdoesnotimplythatonebelievesthatheorshehastheability tohave complete controloveroutcomes and eventsbut ratherhas thesensethatonehastheabilitytoinfluenceoutcomesbyexercisingskills,choices,andknowledge.Oneparticipant(#2)relayedthattheinabilitytouseskillsandknowledge to change circumstanceswas a sourceofdistress andhindered theabilitytocope.Theabilitytointerpretsituationsaschallengesinsteadofthreatsrequiresacertainlevelofflexibility(Maddi&Kobasa,1991).Thispersonalat-


tributewasidentifiedbyoneparticipant(#4)asafactorthathelpedtheofficertocope.Commitment indicates involvement,activeness, andapproaching theproblemratherthanavoidingit.Thisappearstoberelatedtothetask-orientationthatseveralparticipantsspokeof(Participants#1,2,3,4,6,and10).Participantsmentioned task-orientation during the critical incident to avoid experiencingemotionalengagement,buttheyalsouseddistractionactivitiesoutsideofworktoavoidexperiencingtheresidualsecondarystressfromwork.

TheExposuretoHumanNaturecategoryseemedtoreflectpsychologicaladjust-mentstothewaypeopleinterprettheirworld.ThisadjustmenthasbeendiscussedinthecopingliteratureusingavarietyofnamesincludingParkandFolkman’s(1997)conceptoforderandglobalmeaning,Lerner’s(1970,1980)just-worldtheory,andJanoff-Bulman’s(1989)assumptiveworldtheory.Thereisaninitialtendencytobelievethatthisisajust,fairworldthatispredictable,understand-able,andcontrollable.Thecumulativeexposuretothedarksideofhumannaturemayerodethesebeliefs.ParticipantsspokeoftheinnocenceofsomevictimsandtheculpabilityofothersasfactorsthatimpactedtheirabilitytocopewiththeirexposuretoSTS(Participants#1,4,5,6,and9).Itispossiblethatbeingexposedtothesufferingof“innocent”victimschallengedtheparticipants’beliefsinajustworld,makingthemmorevulnerabletosuffering.

Oneofthefrequentlycitedhelpingfactorsinthisstudywastheuseofself-care.Self-carehasbeen suggested for those inotherhelpingprofessions, suchas therapists, socialworkers, andnurses (Figley,1995;Pearlman&Saakvitne,1995).Palmetal.(2004)suggestspendingtimeinactivitiesthatgiveasenseofpurpose.Theyalsosuggestmaintainingbalancebyattendingtorolesoutsideofwork.SalstonandFigley(2003)echothissentimentandaddthatpeoplewhoworkwithtraumatizedpersonsshouldalsomaintainbalanceamongtheirphysicalself,emotionalself,andspiritualself.ThisrecommendationisconsistentwiththeidentityaccumulationtheoryproposedbyThoits(1983).

Itwasnotsurprisingthat60%oftheparticipantsidentifiedthelackofsup-portfromfamily/significantothersasahinderingfactorfortheircoping,giventhat80%identifiedthesupportoffamily/significantothersasahelpfulfactorfortheircoping.Forsomeoftheparticipants(#2,3,9,and10),theirfamily/significantotherswerenotable toprovideadequate supportbecause theydidnotfullyunderstandthejob.Thismaybeduetothestressor-supportspecificityprinciple, based upon Cohen andWillis’ (1985) buffering hypothesis, whichstatesthatthesourceofoptimalsupportmaybematchedtothesourceofthestress.For instance,workplace stressmaybestbe counteredby social supportfrom those in the workplace while familial support may be better suited forstressors outsideof theworkplace.Anotherparticipant (#10)didnotwish totalk to family/significantothers about traumatic experiences andexpose themtothetrauma.Thisshieldingmaybewarranted,asresearch indicates that thetransmission of traumatic stress from the police officer to the partner and/orfamily members interferes with their ability to provide support to the officer(Dwyer,2005).


Regardlesswhetherornotthepoliceofficersharesthetraumaticexperiencewiththefamily,thetraumatizationofthepoliceofficerhasbeenfoundtobeafamilystressoraffectingothermembersofthefamily(Dwyer,2005;Ruzek,2006).Dwyer(2005)foundthat28.2%ofpolicewivesmetthecriteriaforSTS.Higherlevelsofdistressexperiencedbypoliceofficerhusbandsrelatedtohigherdistresslevelsintheirspouses.TheliteratureonpreventionofSTSalsorecommendstheextensionof training initiatives to the familyofpoliceofficers (Anshel,2000;Gilmartin,2002;Kirschman,2000;Sewell,1993).Implicationsforcounsellingarediscussednext.

Counselling Implications

Therearenumerousimplicationsforcounsellingstemmingfromthisstudy. Implicationsarepresentedcategoricallyascognitive,behavioural,andemotionalinterventionsfollowedbyrecommendationsfordeliveryofcounsellingservices.

cognitiveinterventions

Participantsidentifiedfeelingsof“helplessness”whentheywereunabletohelpsomevictims(Participants#2,5,and10).Toaddressthissenseofhelplessness,itmaybehelpfulforcounsellorstoexplorewiththeofficerhowheorshequalifies“helping” thevictim.Unrealistic expectations that reflect cognitivedistortionsand/orperfectionisticstandardswouldneedtobetemperedwithmorerealisticappraisals.Thiscouldbeachievedbyexaminingtheevidenceforandagainstthecognitivedistortion.Psychoeducationabouthindsightbiasandperfectionismmayalsobehelpful.Adiscussionofahealthysenseofresponsibilityandanawarenessoffactorsoutsideoftheofficer’scontrolmayoffsethisorherinabilitytochangethevictim’scircumstances.MaddiandKobasa(1991)discussedtheconceptofhardinessascomprisingcommitment,control,andchallenge.Therapeuticinter-ventionsaimedatenhancinghardinessbyfosteringcommitment,temperingone’ssenseofcontrol,andinterpretingeventsaschallengesinsteadofthreatsmayalsobehelpfulforofficershinderedbytheirinabilitytohelpvictims.

Counsellingmaybehelpfulinaddressingthecumulativeimpactofexposuretothedarksideofhumannatureandthevulnerabilityofvictims.Agoodstart-ingpointmightbeinquiringaboutmaladaptive,negativeschemasabouttheself,others,andtheworld.Iftheofficer’sperspectivehasbeenskewedtowardnegativeappraisalsbaseduponhisorhercumulativeexposuretothedarksideofhumannature,collectingevidenceforadaptive,alternativeschemasmayassistthepoliceofficerinhavingamorebalancedviewofhumannature.Askingtheofficertolookforevidenceoutsideofhisorhercurrentnegativeschemawilllikelychangethewayheorsheperceivestheenvironment.

Techniquestooffsettheimpactofcontinuousexposuremayalsobetaughtby the therapist.Task-orientation (Endler&Parker,1994) and/or some formofrelaxationtechniquemightprovehelpfulforanofficerforcedtoremainatadistressingcall.Researchhas indicatedthat individualswhobecomedistressedbecomeself-preoccupied,whichimpairstheirperformanceandheightenstheir


alreadyhighlevelofanxiety(Meichenbaum,2007;Sarason,1975).Stressman-agementtrainingthatincludedinstructioninadaptivecognitiveresponsesandprogressiverelaxationhasdemonstratedareductioninanxietylevelsandimprovedperformance(Sarason,Johnson,Berberich,&Siegel,1979).

Itmightalsobehelpfultohelpofficersstrikeahealthybalancebetweende-tachmentandengagementtomitigatetheimpactofSTS,consistentwithFigley’s(1995) approach to avoiding compassion fatigue.Relatability to the victim, aconceptpossibly related to emotional engagement,might alsoneed tobe ad-dressed.Theliteratureoncountertransferenceamongtherapistsdiscussesover-identificationanddistancingfromthetraumavictim(Dutton&Rubinstein,1995;Pearlman&Saakvitne,1995).Theredonotappeartobestrategiesdesignedtoaddressthissamedilemmawithpoliceofficers.Itispossiblethatthetreatmentfortherapists’countertransferenceissuescouldbeadaptedtosuittheneedsofpoliceofficerswhomaybetroubledbytendenciestoover-identifywithordistancefromvictims.Counsellingimplicationscanbedrawnfromtherecommendationsaris-ingoutofthecountertransferenceliterature,whichincludesfosteringself-insight,differentiationofselffromothers,self-integration,conceptualability,empathy,andanxietymanagement(Hayes,2004).

behaviouralinterventions

Self-carewas a stronghelping factor forparticipants in this study,with an80%participationrate.Counsellingtreatmentplansencouragingself-caremightmitigatetheimpactofSTSforofficers.AccordingtoThoits’(1983)identityac-cumulationtheory,counsellinginterventionspromotingalifeoutsideofwork,participation in hobbies, and extracurricular activities might also counter theaccumulationofposttraumaticstress.ThesestrategieswouldbeconsistentwiththeadvicedirectedatofficersbyGilmartin(2002),whocontendsthatofficersarewell-advisedtobeactiveoutsideofworktocombatthe“biologicalrollercoaster”thatoccurswhenofficersleaveworkandreturnhome.

emotionalinterventions

Addressingtheemotionalwearandtearfromthejobwouldcomplementcogni-tivetherapeuticinterventions.Thismightbeaccomplishedbycultivatingpositiveemotionstopromoteresiliency(Frederickson,2001).Positiveemotionsmaybegeneratedbypositivereappraisal,problem-focusedcoping,andassigningpositivemeaningstoordinaryevents(Folkman&Moskowitz,2000).

counsellingservicedelivery

Related to the counselling interventions are theways inwhich counsellingservicesaredelivered.Severalimplicationsarisefromthisstudy,whicharedis-cussednext.

A systemic approach. Resultsofthisstudyhighlightedtheimportanceofsupportfromfamilyandsignificantothers.Itispossiblethatfamilyandsignificantothersareprotectivefactorsthatcouldbeincorporatedinthetherapeuticplan.Asystems


approachtocounsellingmayassisttheofficertomanagehisorherexposuretoSTSwiththesupportofhisorherlovedones.Atreatmentapproachthatincludesaffectedmembersofthefamilyseemswarranted.

Accessibility. Accordingtoparticipantresponses,mentalhealthresources,suchasaccesstocounsellingandeducationalmaterial,shouldbeaconsiderationforcounsellorsinpractice.Accessibilitytocounsellingmightincludefactorssuchasbeingavailableafternormalbusinesshoursandadvertisingafter-hourservices.Inanefforttopromoteaccessibilityofservices,onemayprovideoutreachcareattheplaceswherepoliceofficerscongregate(Ruzek,2006).Thisstrategy,coupledwiththeuseofmotivationalinterviewing(Miller&Rollnick,2013),mayincreasethelikelihoodthatofficerswilltakeadvantageofavailablementalhealthservices(Ruzek,2006).Motivationalinterviewingisrecommendedbecauseitisamethodofcommunicationthatisconsciouslydirective,yetstillfocusesonenhancingoffic-ers’intrinsicmotivationforchangebyexploringandresolvingtheirambivalence(Miller&Rollnick,2013).Itisnotexternallyappliedpressure,whichwouldlikelyberejectedbyanofficerwhowasalreadyhesitantaboutseekinghelp.

Tomeettheparticipants’statedneedforcounsellingresources,itmayalsobehelpfultoplacelinkstoinformativearticlesorfactsheetsonthecounsellor’sweb-siteregardingsymptomsofSTSandstrategiesformanagingthem.TheInternethasbeenusedasasourceofinformationforthosetroubledbytraumaticstressandhasbeendemonstratedtobeaneffectivemeansoftreatment(Lange,vandenVen,Schrieken,&Emmelkamp,2001).

Proactive interventions. Twoparticipants(#6and7)citedspecificpsychoedu-cationalmaterialonstress,policework,andcopingashelpful.Researchsupportstheparticipants’identificationofpsychoeducationalmaterialasbeinghelpfulincounteringtheeffectsofbeingexposedtosecondarytrauma.Bell,Kulkarni,andDalton(2003)state,“Trauma-specificeducationalsodiminishesthepotentialofvicarioustrauma.Informationcanhelpindividualstonametheirexperienceandprovideaframeworkforunderstandingandrespondingtoit”(p.467).

Anotherpossibleintervention—stressinoculationtraining(SIT)—canbeof-feredbycounsellors.SITprovideseducationonreactionstotraumaticeventstonormalizeofficers’experienceandpromoteaccurateexpectations(Meichenbaum,1977).AnimportantgoalofSITthatwouldlikelybehelpfulinacounsellingset-tingisdelineatingbetweenproblem-focusedandemotionalfocusedcopingefforts.

Familiarity with policing. Counsellorsmightwanttobecomeversedinbooksthatprepareofficersandtheirfamiliesforpolice-specificexpectations,aswellasbecomeeducatedonthecultureofpolicinganditsinfluenceonhelp-seekingbe-haviourandcommitmenttotherapy.Sewell(1993)suggestsmentalhealthprac-titionersshouldnotonlyunderstandtheworkofpoliceofficers,theyshouldalsobefamiliarwiththedepartmentandbefamiliarwithinthedepartmenttoavoidbeingregardedas“outsiders”or“uninvitedguests.”Additionally,Sewellsuggestsmental health practitioners should be sufficiently trained and experienced inboththephilosophyandtechnicalproceduresoftraumadebriefing.Criticalinci-dentstressdebriefings(CISD)havebeencriticized,purportingthattheyactually


doharm(Bisson&Deahl,1994).EverlyandMitchell(1995)haverespondedtothecriticism,notingthatthecriticismofCISDhaslargelysurroundeditsap-plication inan indiscriminatemannerorasastand-alone intervention.EverlyandMitchell contend thatCISD isnot a stand-alone interventionbut ratherisacomponentofthecriticalincidentstressmanagementcontextofcontinuedsupportservices.

Makingrecommendationsregardinghelpfulbooks,supportgroups,seminars,andotherresourcestoofficerscouldeducateandempowerthemtomanagestresslevels andenhance copingmechanisms.Theparticipantswhohad readbooksaboutwhattoexpectinpoliceworkreportedthatitnotonlyhelpedthemwiththeirexpectations,butitalsohelpedtheirfamilymemberstosupportthem.Thistiesintothefamily/significantothersupportcategory,enhancingthebenefitofsharingmaterialswithofficersand theirfamilies.Bibliotherapyhasbeenfoundtocontributetolearnedresourcefulnessintheclient(Whisman,1993).Accord-ingtoRosenbaumandJaffe(1983),learnedresourcefulnessallowstheclienttofeelthatheorshehasmorecontrolandleadstoperceptionoftheenvironmentaslessdemanding.

Anothermethodofalleviatingtensionisthroughtheuseofhumour.Partici-pantsinthecurrentstudyreportedusingdarkhumourtocopewithexposuretoSTS.Extendingthisnaturalcopingmechanismtothecounsellingsettingmaybehelpfulforworkingwithofficers.Miller(1995)suggeststhattheuseofhumourincounsellingcanbringasenseofbalancetohorrificcircumstances.Millercon-tendsthatincorporatinghumourintherapeuticworkalsoallowsofficerstoventtheiranger, frustration,andresentment. Incorporatinghumour in therapeuticworkcouldbeachievedbymakinglightofdarksituationswithjokes.Ofcourse,thetherapistshouldexercisecautionwiththistechnique,refrainingfromusingituntilrapporthasbeenestablishedandheorshehasnotedthattheclientusesdarkhumourasacopingmechanism.

Anotherrecommendationintheliteratureregardingtherapywithofficersistoprovidethemactive,concrete,problem-solvingapproachestoaddresspresentingissues(Miller,1995;Wester&Lyubelsky,2005).Asolution-focusedapproachthatexploresofficers’priorsuccessesinmanagingproblemsmaybefittingduetotheirself-identificationasproblemsolvers.Recognizingandenhancingexistingstrengthsmaybecomplementedbyfortifyingtheofficer’s skill repertoirewithadditionalconcreteproblem-solvingstrategies.

Police Agency Implications

Therearenumerouspoliceagencypolicyimplicationsarisingfromthisstudy.Akeyfindingwasthedesireforaccesstosupportservicesandstressmanagementtraining.Policeagenciesmaywishtoconsiderprovidingeducationalinitiativesduringbothinitialacademytrainingandongoingtraining.Extendingtraininginitiativesandsupportservicestopolicefamiliesisalsosuggested.PoliceagenciesmayalsobenefitfromexaminingtheirCriticalIncidentStressManagementpro-gramstoensuretheyreflectthespiritofcontinuouscare.Lastly,waystoensure


easeofaccesstoinformationaboutmentalhealthresourcesforallofficersshouldbeimplementedtofacilitatetheiraccessandabilitytoseekhelp.

Limitations of the Study

Theresultsofthisstudyshouldbeconsideredinlightofsomeofitslimita-tions.Onelimitationisthatparticipantswererecruitedinasmallgeographicarea.ResultsmayonlyreflectcharacteristicsoftheofficersinterviewedintheGreaterVancouverareaandmaynotapplytoofficersinotherareas.Participants’yearsofservicerangedfrom1to5years;therefore,theirresponsesmaydifferfromthoseofofficerswithseveralmoreyearsofservice.Itisunclearifnewerpoliceofficersaremoreopentoparticipatinginaresearchstudyanddiscussingtheirexperi-ences,iftheirparticipationisaproductoftheinclusioncriteriarequiringthattheybeoftheconstablerank,orsomeotherunidentifiedfactors.Noneoftheparticipantshadchildrenandsomeoftheparticipantsstatedthattheybelievedhavingchildrenwouldlikelychangetheirresponses,particularlywithrespecttothehinderingaspectofthevulnerabilityofsomeofthevictims.Finally,thiswasaqualitativeresearchstudysoitsresultscannotbegeneralized.However,thisstudywasdesignedtobeexploratoryandtoofferinitialsuggestionsforwaystosupportthispopulationandforareasneedingfutureresearch.

Thestudyalsopossessesseveralstrengths.ByusingtheECIT(Butterfieldetal.,2009;Flanagan,1954),theresearchersexploredin-depththeexperienceofcopingfromthepatrolofficer’sperspective.ECIThelpedilluminate,inawaythatasurveycouldnot,themannerinwhichofficerssuccessfullymanagedtheirSTS.Equallyasimportant,itallowedthemtotelltheirstory,intheirownwords,ofwhathadhinderedthemfromcoping.Italsoallowedparticipantsamomenttoreflectandsharewhatelsemighthelpthemifitwereavailable.Theinformationgatheredinthisstudycouldformthebaseforfurtherresearchandpolicyimplica-tions.Finally,theECITisawell-developedqualitativeresearchmethodwithanestablishedtrackrecordandsufficientlyarticulatedproceduresthatthestudycanbereplicated.TheECITprocedureswerefollowed,theninecredibilitycheckswereconductedasoutlinedbyButterfieldetal.(2009),andtheestablishedstandardsforthecredibilitychecksweremetorexceeded,allofwhichindicatedtheresultsarecredibleforthissampleofpatrolofficers.

Implications for Future Research

Thesurprisefindingofthedesireforaccesstomentalhealthresources,suchascounsellingandeducation,meritsfurtherinquiry.Theavailabilityofinforma-tiontoaccesscounsellingandeducationalresourcesshouldalsobeexaminedtodetermineif,infact,itresultsinincreasedusageofmentalhealthresourcessuchascounselling.Numerousquestionsarisefromthestudy:Howmightapoliceagencyprovideamoresupportiveworkenvironment?Howmightsupportfromfamilyandsignificantothersbepromotedbythepoliceagency?Howmightsupportbepromotedbytheindividualpoliceofficer?Howcanpoliceagenciesfacilitateaccesstoinformationaboutmentalhealthresources?Thecorrelationbetweenrelatability


to thevictim,emotionalengagement,andsceneremindersalsomerits furtherinvestigation.Theunexpectedfindingthatnoneoftheparticipantsreportedusingdrugsoralcoholasacopingmechanismshouldalsobeexploredinfutureresearch.

Conclusions

ThecumulativeexposuretoSTScanhavegraveconsequencesforthepsycho-logical,physiological,behavioural,andspiritualwell-beingofpoliceofficersandtheir families.Theparticipantsofthecurrentstudyindicatedtheyweredoingeither“prettywell”or“verywell”withtheirexposuretoSTS.TheyprovidedarobustlistofprotectivestrategiestheyemployedtocounterthecumulativeimpactofSTS.Thisisencouraging,asitindicatesthatpoliceofficersarenotdoomedtoafateofchronicstressproblems,butrather,theymayexercisesomecontrolovertheircircumstancestopromotetheirwell-being.Someoftheparticipantsevenstatedthatparticipatinginthecurrentstudyprovidedinsightintowhatwasworkingforthem.

Hopefully,theresultsofthisstudywillprovebeneficialbothtocounsellorsworkingwithpoliceofficersandtopoliceagencies,tobetterservetheneedsofpoliceofficers.Theresultsofthecurrentstudy,particularlythewishlistitems,contributetotheexistingbodyofliteraturethatprescribeswaystomitigatetheseconsequences.Theseprescriptionswillnotlikelysecurechangesovernight,butwillrequirevigilance,patience,anddedication.

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AppendixACredibility Checks for the Enhanced Critical Incident Technique

ThedescriptionsbelowofthecredibilitychecksfortheCIT/ECITresearchmethodarebasedonmaterial the readercanfind inButterfieldetal. (2005);Butterfieldetal.(2009);Flanagan(1954);andWoolsey(1986).Theyarelistedintheorderthecheckswouldtypicallybeconducted.1. Audio-recordinginterviews.Thishastodowiththedescriptivevalidity

of thedata,andspecificallywiththeaccuracyof theaccountofwhatparticipantshavesaid.Iftheaccountisnotaccurate,thenitispositedthatthedataanalysisandsubsequentresultsarenotaccurate.TheaccuracyoftheaccountisestablishedinaCITstudybyaudio-orvideo-recordingtheinterviews,havingthemtranscribedverbatim,andworkingoffthetranscriptsforthedataanalysis.

2. Interviewfidelity.Thiscredibilitycheck is related tohowwell the re-searcher adheres to the interview guide and to the principles of CITinterviewing.ThisisestablishedbyhavinganexpertintheCITresearchmethodlistentothefirstinterviewandapreviouslyagreed-uponsampleofsubsequenttapedinterviewstoensuretheinterviewerisconsistentlyfollowing the interview guide, asking probing questions for clarifica-tionwithoutprompting,andelicitingappropriatesupportinformation


(importanceandexamples)forthecriticalincidentsandwishlistitemsmentionedbyparticipants.ThisstepisintendedtoincreaseconsistencyinaCITstudywherenewresearchersormultipleresearchassistantsmaybeconductingtheinterviews.

3. Independentextractionofcriticalincidents.Thiscredibilitycheckinvolvessomeoneotherthantheresearcherexamining25%ofthetranscriptsandindependentlyidentifyingthecriticalincidentsandwishlistitems.Thesearethencomparedtothecriticalincidentsandwishlistitemsextractedbytheresearcher.Thehigherthematchrate,thegreaterthecredibilityisoftheclaimthattheincidentwasimportanttotheaimoftheactivitybeingstudied.

4. Exhaustiveness.Flanagan(1954)definedexhaustiveness(orredundancy)asthepointatwhichnonewcategoriesneedtobecreatedtofitthecriticalincidentsandwishlistitems.Itisconsideredasignthatthedomainoftheactivitybeingstudiedhasbeenadequatelycovered.

5. Participation rates.Participation ratesarecalculated foreachcategoryonceallcriticalincidentsandwishlistitemshavebeenplacedintoit.Theestablishedstandardforacategorytobedeemedviable isa25%participationrateorgreater.Participationratesarecalculatedbydivid-ingthenumberofparticipantswhociteitemsinacategorybythetotalnumberofparticipantsinthestudy,thenmultiplyingthatnumberby100toreportitasapercentage.

6. Placingincidentsintocategoriesbyanindependentjudge.Thischeckisintendedtotesttherobustnessofthecategoryschemeandtheoperationaldefinitions.Itentailsgivingapersonotherthantheresearcher25%ofthehelping,25%ofthehindering,and25%ofthewishlistitemsalongwiththecategoriesandtheiroperationaldefinitions.Thisindependentjudgeplacestheincidentsandwishlistitemsintothecategories.Theplacementiscomparedwiththeresearcher’splacement.Thehighertheconcordancerate,thegreatertheviabilityofthecategoryschemeisthoughttobe.Amatchrateof80%orgreaterhasbeenestablishedasthestandardtomeet.

7. Cross-checkingbyparticipants.Thisoccursafterthedatafromthefirstinterview have been analyzed and the critical incidents and wish listitemsplacedintothecategories.Thepurposeofthisistoensurepartici-pants’ experienceshavebeen represented accuratelyby the researcher,andconsistsofseveralsteps.First,theparticipantisaskedtoreviewthecritical incidents and wish list items extracted from the interview bytheresearchertoensuretheyarecorrect.Next,theparticipantisaskedtoreviewthecategories intowhichthecritical incidentsandwish listitemshavebeenplacedtodeterminewhetherthecategoriesmakesense.Finally,theparticipantisaskedtocommentonthecategorytitlesanddefinitionstoensurethecategoriesaccuratelyrepresenttheirexperiences.Ifaparticipantisunsureaboutwhetheranitemisacriticalincidentorwishlistitem,additionalcontextfromtheinterviewmaybeofferedto


the individual tohelp themmake adetermination. If theparticipantultimatelydecidesthatanitemlistedisnotacriticalincidentorwishlistitem,itisnotincludedinthefinaldataanalysisreport.Lastly,thisdiscussionwithparticipantsallowstheresearchertofollowuponanyitemsfromtheoriginalinterviewthatappeartobecriticalincidentsorwishlistitemsforwhichsupportinginformationwasnotobtained.

8. Expertopinions.Twoexpertsareaskedtoreviewthecategoriesthathavebeencreatedtocommentonwhethertheythinktheyareuseful,whethertheyaresurprisedbyanyofthecategories,andwhetherthereisanythingmissingbasedon their experience.The rationale for this is that theiragreementwiththecategoriesenhancesthecredibilityoftheresults.

9. Theoreticalagreement.Thiscredibilitycheckhastwoparts.Thefirstismakingexplicittheassumptionsunderlyingthestudy,whicharestatedduringtheplanningandproposalstageoftheresearchproject.Theseas-sumptionsarethenscrutinizedinlightoftheavailablescholarlyresearchtoseeiftheyaresupported.Thesecondpartoftheoreticalagreementiscomparingthecategoriesthathavebeencreatedfromthedataagainstthescholarlyliteraturetoseeiftheyaresupported.Supportforthecategoriesincreasesthetrustworthinessofthefindings.However,itisimportanttonotethatifacategoryfoundinaCITstudyisnotsupportedbythelit-erature,itdoesnotnecessarilymeanthecategoryisnotsound.GiventheexploratorynatureoftheCIT,itcouldmeantheresearcherhasuncoveredsomethingnewrelativetothedomainbeingstudiedanditthereforemaywarrantfutureresearch.Insuchsituations,theroleoftheresearcheristoexaminethecategoriesandmakereasoneddecisionsaboutwhatthetheoreticalagreement(orlackofit)means.

About the AuthorsStephanieM.ConnisagraduateoftheAdlerSchoolofProfessionalPsychology,VancouverCam-pus,andaregisteredclinicalcounsellorinprivatepracticeinVancouver,BC.Asaformerpoliceofficer,hermaininterestsincludementalhealthissuesaffectingpoliceofficersandpolicefamilies.

LeeD.Butterfield,theProgramDirectoroftheM.A.ofCounsellingPsychologyattheAdlerSchoolofProfessionalPsychology,VancouverCampus,isaregisteredpsychologistandcounselloreducatorinBritishColumbiawhosemainresearchinterestsareintheareasofcareerdevelopment,workerwellness,andtheimpactofchangeonworkers.

AddresscorrespondencetoStephanieM.ConnatConnCounsellingandConsulting,223-1628W.1stAvenue,Vancouver,BC,CanadaV6J1G1;e-mail<[email protected]>

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