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If we wanted to identify the group of people with the most traumatic histories globally, we would probably all think of refugees first. Refugees are a group that has been exposed to many traumatic events such as war, torture, sexual violence and had to leave their country to escape from them. They always live with the threat of discrimination and violence in the countries they also take refuge in. Refugees need much support (e.g., psychological, legal, medical) to adapt to the country they go to and continue their lives there. 

With the number of refugees (about 80 million at present) increasing in the world recently, the need for refugee service providers (e.g., doctors, psychotherapists, lawyers, interpreters) to support this group and the workload of refugee service providers have also increased. Adverse effects of working with traumatized individuals on mental health are known. The most prominent effects are Secondary Traumatic Stress (STS) and Vicarious Traumatic Stress (VTS). STS and VTS refer to trauma-like symptoms and changes in cognitive content that develop from witnessing others’ traumatic stories. In addition to STS and VTS, anxiety, depression, sleep difficulties, and burnout associated with workplace stressors are also prevalent problems among refugee service providers. 

Workplace-related stressors also have an adverse effect on mental health. Working in externally funded projects is the primary concern for refugee service providers since it creates employment insecurity. Besides this, lack of supervision and feeling undervalued are other problems that result in burnout. 

Although there are many studies on these issues in the literature, there are no intervention/prevention programs developed, standardized, and tested for effectiveness to provide psychological support to refugee service providers. Efforts for providing psychological support to this group are limited to non-governmental organization (NGO) guidelines. 

The absence of intervention and prevention studies aiming at refugee service providers leads to adverse mental health outcomes, workforce loss, and decreased professional competence. Providing mental health care to this group and improving their working conditions is crucial to prevent the aforementioned adverse consequences and provide appropriate assistance to refugees. 

In conclusion, this article aims to draw attention to the serious mental health problems and workplace difficulties that refugee service providers face and the lack of standardized intervention and prevention programs in the literature aiming at this specific group. Also, it includes possible negative consequences of this absence and recommendations to colleagues for future intervention and prevention studies. 

Target Article

Ebren, G., Çırakoğlu, O. C., & Demircioğlu, M. (2021). A neglected aspect of refugee relief works: Secondary and vicarious traumatic stress. Journal of Traumatic Stress. http://doi.org/10.1002/jts.22796https://onlinelibrary.wiley.com/doi/10.1002/jts.22796

Discussion Questions

  • What needs to be done to provide planned and effective psychological support to refugee service providers?
  • What are the cultural factors that should be taken into consideration while preparing STS and VTS intervention programs for refugee service providers? 
  • What are the limitations while generating intervention/prevention programs that specifically aim to reduce the adverse effects of STS and VTS for refugee service providers?

About the Authors

Gökhan Ebren., is a master’s student in clinical psychology at Başkent University, Turkey. He is also working as a psychologist at Başkent University Stress Management Application and Research Center. His research interests are trauma, stress, and secondary trauma. He is conducting psychotherapy sessions under supervision, and his main interest in that area is interpersonal neurobiology, mind-body interaction, and stress. Mr. Ebren can be contacted at gokhanebren97@gmail.com

Melis Demircioglu, PhD., is a Clinical Psychologist and Psychotherapist in Istanbul, Turkey. Her expertise is mainly on individual traumas and social traumas. She has been actively participating in social projects to address traumas arising from immigration, terrorism, and natural disasters in Turkey. She also focuses on preventing Secondary Traumatic Stress among healthcare workers in adult mental health, helping them with psychological self-care, and providing support in their workplace. Dr. Melis Demircioglu is working as a Clinical Supervisor in a Clinical Psychology Master’s Program and continues her profession at Metta Psychotherapy & Academy in Istanbul, which she co-founded in 2021. You can contact Dr. Demircioglu at melis@mettapsikoterapi.com.tr

Okan Cem Çırakoğlu, PhD., is a professor of psychology and the chair of Başkent University Psychology Department, Turkey. His interests are trauma, stress, refugee studies, depression, and addiction. He regularly gives seminars on secondary trauma, self-care, refugee relief works, stress management, and mediation. He is also the head of Başkent University Stress Management Application and Research Center. Dr. Çırakoğlu can be contacted at okancemc@baskent.edu.tr