바로가기메뉴

본문 바로가기 주메뉴 바로가기

The Korean Journal of Woman Psychology

Cognitive Behavioral Therapy for Reducing Secondary Traumatic Stress and Psychological Adaptation of Sexual Trauma Counselors

Abstract

The purpose of this study is to verify the effectiveness of a CBT developed for reducing secondary traumatic stress and psychological adaptation of sexual trauma counselors. Tested by STSS-K and IES-R-K, 23 sexual trauma counselors were selected and randomly assigned 8 people to experimental group (CBT), 7 people to comparison group (Art Therapy), 8 people to control group. The main findings are the following: First, the posttest results, the experimental group showed a significant difference from the comparison and control groups in both factors related to trauma and psychological adaptation. Second, in the follow-up test three months after the end of the inter-group program, the experimental group showed a significant difference from the comparison group in both trauma-related factors and psychological adjustment-related factors. Third, after program execution, the experimental group's cognitive errors which are categorized in the belief related to secondary traumatic experiences were able to be transformed into a more adaptive cognition.

keywords
성폭력 상담자, 이차적 외상 스트레스, 심리적 적응, 인지행동치료, sexual trauma counselors, secondary traumatic stress, psychological adaptation, cognitive behavioral therapy

Reference

1.

강경숙, 박태수, 최선남 (2010). 아동기 성학대피해 여성들의 개인미술치료에서 길 그림검사 활용 사례연구. 미술치료연구, 17(2), 277-295.

2.

강민아, 김혜정 (2010). 성폭력 피해아동 부모를 위한 인지행동치료 프로그램 개발. 피해자학연구, 18(2), 313-332.

3.

강방글, 한인영, 이현정, 박정림 (2013). 성폭력상담사의 대리외상에 대한 주관성 인식유형 연구. 정신보건과 사회사업, 41(3), 118-147.

4.

권해수 (2011). 성폭력상담자의 대리외상 관련변인 연구: 상담유형, 외상경험, 사회적지지를 중심으로. 상담학연구, 12(1), 415-430.

5.

권해수, 김소라 (2006). 성폭력 상담자의 대리외상 경험에 대한 질적 연구. 한국심리학회지: 상담 및 심리치료, 18(3), 495-518.

6.

김보경 (2012). 성폭력, 성매매 상담자의 이차적외상 스트레스와 대리 외상의 관계에서 외상 신념의 매개 효과. 이화여자대학교 석사학위논문.

7.

김아영, 차정은 (1996). 자기효능감과 측정. 산업 및 조직심리학회 동계학술대회 논문집, 51-64.

8.

김희진 (2010). 성폭력피해 여성의 우울 및 외상후 스트레스 감소를 위한 문양만다라 중심의 미술치료사례 연구. 영남대학교 석사학위논문.

9.

박지영 (2011). 한국형 이차적 외상스트레스척도(Secondary Traumatic Stress Scale)의 구성타당화 연구. 한국사회복지학, 63(4), 33-57.

10.

박지원 (1985). 사회적 지지척도 개발을 위한 일연구. 연세대학교 박사학위논문.

11.

백주현 (2015). 특수교사의 공감피로와 공감만족간의 관계. 부산대학교 석사학위논문.

12.

서호준, 채정호 (2006). 외상 후 스트레스 장애에 대한 인지행동치료의 최근 동향. 인지행동치료, 6(2), 177-129.

13.

석혜원 (2011). 미술치료가 외상 후 스트레스 청소녀의 우울감 감소 및 자아존중감 향상에미치는 효과: 성폭력 피해 지적장애 청소년단일 사례연구. 한양대학교 석사학위논문.

14.

손지연 (2012). 미술치료사의 대리외상 경험과대처에 관한 연구 -포커스 그룹 인터뷰를중심으로-. 영남대학교 석사학위논문.

15.

신혜섭 (2010). 가정폭력상담원의 스트레스, 대처전략과 직무요인이 대리외상에 미치는영향. 한국가족복지학, 15(1), 45-61.

16.

은헌정, 권태완, 이선미, 김태형, 최말례, 조수진 (2005). 한국판 사건충격척도 수정판의신뢰도 및 타당도 연구. 대한신경정신의학회지, 44(3), 303-310.

17.

이미옥 (2008). 빗속의 사람 그림 그리기. 제75회 미술치료연수회 자료집, 4(7), 36-39.

18.

이승희, 현은령 (2013). 성폭력 외상 후 스트레스에 관한 미술치료 연구의 메타 문헌분석. 디지털디자인학연구, 13(3), 80-90.

19.

이윤수 (2001). 놀이치료자의 자기효능감과 역전이 관리 능력에 관한 연구. 숙명여자대학교 석사학위논문.

20.

이진숙, 한영숙 (2006). 인지행동치료 프로그램이 외상 후 스트레스장애(PTSD) 아동에미치는 효과-학교폭력 피해아동을 중심으로. 한국가정과학회지, 9(2), 21-31.

21.

임수진, 김해숙 (2011). 자기 효능감, 지각된지지, 내재적 동기가 성폭력 상담소 종사자의 심리적 소진에 미치는 영향. 한국심리학회지: 여성, 16(4), 461-475.

22.

정미선, 최선남 (2014). 미술치료사의 스트레스대처, 사회적 지지, 자기효능감에 대한 대리외상 연구. 예술심리치료연구, 10(3), 19-38.

23.

차영주 (2013). 대리외상이 이차적 외상스트레스와 외상신념 및 행동에 미치는 영향 연구:ONE-STOP 지원센터 근무 여성경찰관 중심으로. 경기대학교 석사학위논문.

24.

채규만 (2004). 성폭력 피해자를 위한 인지-행동적 접근. 인지행동치료, 4(1), 13-31.

25.

최지영, 신의진, 오경자 (2009). 성폭력 피해아동에 대한 외상초점 인지행동 치료의효과 검증: 탐색적 연구. 인지행동치료, 9(1), 57-73.

26.

Alkema, K., Linton, J. M., & Davies, R. (2008). A study of the relationship between self–care, compassion satisfaction, compassion fatigue, and burnout among hospice professionals. Journal of Social Work in End-of-Life &Palliative Care, 4(2), 101-119.

27.

Bemak, F., & Hanna, F. J. (1998). The twenty-first century counsellor: An emerging role in changing times. International Journal for the Advancement of Counselling, 20(3), 209-218.

28.

Benatar, M. (2000). A qualitative study of the effects of a history of childhood sexual abuse on therapists who treat survivors of sexual abuse. Journal of Trauma & Dissociation, 1(3), 9-28.

29.

Brady, J. L., Guy, J. D., Poelstra, P. L., & Brokaw, B. F. (1999). Vicarious traumatization, spirituality, and the treatment of sexual abuse survivors: A national survey of women psychotherapists. Professional Psychology:Research and Practice, 30(4), 386-393.

30.

Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103(4), 670-686.

31.

Bride, B. E., Radey, M., & Figley, C. R. (2007). Measuring compassion fatigue. Clinical Social Work Journal, 35(3), 155-163.

32.

Chrestman, K. R. (1999). Secondary exposure to trauma and self reported distress among therapists. In B. H. Stamm (Ed.), Secondary trauma stress: Self-care issues for clinicians, researchers, and educators (2nd ed., pp. 37-47). Lutherville, MD: Sidran Press.

33.

Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. A. (2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child & Adolescent Psychiatry, 43(4), 393-402.

34.

Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents. New York: Guilford Press.

35.

Cohen, K., & Collens, P. (2013). The Impact of Trauma Work on Trauma Workers: A Metasynthesis on Vicarious Trauma and Vicarious Posttraumatic Growth. Psychological Trauma: Theory, Research, Practice, and Policy, 5(6), 570-580.

36.

Coles, J., Astbury, J., Dartnall, E., & Limjerwala, S. (2014). A qualitative exploration of researcher trauma and researchers’ responses to investigating sexual violence. Violence Against Women, 20(1), 95-117.

37.

Conrad, D., & Keller-Guenther, Y. (2006). Compassion fatigue, burnout, and compassion satisfaction among Colorado child protection workers. Child Abuse & Neglect, 30(10), 1071-1080.

38.

Devilly, G. J., & Spence, S. H. (1999). The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorder. Journal of Anxiety Disorders, 13(1), 131-157.

39.

Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319-345.

40.

Feather, J. S., & Ronan, K. R. (2009). Trauma-focused CBT with maltreated children:A clinic-based evaluation of a new treatment manual. Australian Psychologist, 44(3), 174-194.

41.

Figley, C. R. (1995). Compassion fatigue: Toward a new understanding of the costs of caring. In B. H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators (pp. 3-28). Lutherville, MD: Sidran Press.

42.

Foa, E. B., Dancu, C. V., Hembree, E. A., Jaycox, L. H., Meadows, E. A., & Street, G. P. (1999). A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. Journal of Consulting and Clinical Psychology, 67(2), 194-200.

43.

Foa, E. B., Ehlers, A., Clark, D. M., Tolin, D. F., & Orsillo, S. M. (1999). The posttraumatic cognitions inventory (PTCI): Development and validation. Psychological Assessment, 11(3), 303-314.

44.

Foa, E. B., Hembree, E. A., Cahill, S. P., Rauch, S. A., Riggs, D. S., Feeny, N. C., & Yadin, E. (2005). Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: Outcome at academic and community clinics. Journal of Consulting and Clinical Psychology, 73(5), 953-964.

45.

Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of event scale: A measure of subjective stress. Psychosomatic Medicine, 41(3), 209-218.

46.

Jenkins, S. R., & Baird, S. (2002). Secondary traumatic stress and vicarious trauma: A validational study. Journal of Traumatic Stress, 15(5), 423-432.

47.

Jex, S. M., Bliese, P. D., Buzzell, S., & Primeau, J. (2001). The impact of self-efficacy on stressor-strain relations: Coping style as an explanatory mechanism. Journal of Applied Psychology, 86(3), 401-409.

48.

Kassam-Adams, N. (1995). The risks of treating sexual abuse: Stress and secondary trauma in psychotherapists. In B. H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators (pp. 37-50). Lutherville, MD: Sidran Press.

49.

King, N. J., Tonge, B. J., Mullen, P., Myerson, N., Heyne, D., Rollings, S., Mertin, R., & Ollendick, T. H. (2000). Treating sexually abused children with posttraumatic stress symptoms: A randomized clinical trial. Journal of the American Academy of Child & Adolescent Psychiatry, 39(11), 1347-1355.

50.

Lack, H. S. (1996). The person-in-the rain projective drawing as a measure of children's coping capacity:A concurrent validity study using rorschach, psychiatric, and life history variables. Unpublished Doctoral Dissertation. California School of Professional Psychology, Alameda. CA.

51.

Larson, L. M., Suzuki, L. A., Gillespie, K. N., Potenza, M. T., Bechtel, M. A., & Toulouse, A. L. (1992). Development and validation of the counseling self-estimate inventory. Journal of Counseling Psychology, 39(1), 105-120.

52.

Malchiodi, C. A. (2006). 학대받은 아동을 위한미술치료 [Art therapy with children from violent homes]. (이재연, 홍은주, 이지현 역). 서울: 학지사. (원전은 1997에 출판).

53.

McCann, I. L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3(1), 131-149.

54.

McNally, R. J., Bryant, R. A., & Ehlers, A. (2003). Does early psychological intervention promote recovery from posttraumatic stress? Psychological Science in the Public Interest, 4(2), 45-79.

55.

Paunovic, N., & Öst, L. G. (2001). Cognitive-behavior therapy vs exposure therapy in the treatment of PTSD in refugees. Behaviour Research and Therapy, 39(10), 1183-1197.

56.

Pearlman, L. A. (2003). Trauma and attachment belief scale. Los Angeles, CA: Western Psychological Services.

57.

Perron, B. E., & Hiltz, B. S. (2006). Burnout and secondary trauma among forensic interviewers of abused children. Child and Adolescent Social Work Journal, 23(2), 216-234.

58.

Rankin, A. B., & Taucher, L. C. (2003). A task-oriented approach to art therapy in trauma treatment. Art Therapy, 20(3), 138-147.

59.

Rich, K. D. (1997). Vicarious traumatization: A preliminary study. In S. B. Edmunds (Ed.), Impact: Working with sexual abusers (pp. 75-88). Brandon, VT: Safer Society Press.

60.

Smucker, M. R. (1997). Post-traumatic stress disorder. In R. L. Leahy (Ed.), Practicing cognitive therapy: A guide to interventions (pp. 193-220). Northvale, NJ: Jason Aronson.

61.

Spiegel, D., Malchiodi, C., Backos, A., & Collie, K. (2006). Art therapy for combat-related PTSD: Recommendations for research and practice. Art Therapy, 23(4), 157-164.

62.

Stamm, B. H. (2009). Professional quality of life scale: Compassion satisfaction, burnout and compassion fatigue version 5. Baltimore, MD:Sidran Press.

63.

Stauffer, L. B., & Deblinger, E. (1996). Cognitive behavioral groups for nonoffending mothers and their young sexually abused children: A preliminary treatment outcome study. Child Maltreatment, 1(1), 65-76.

64.

Steed, L., & Bicknell, J. (2001). Trauma and the therapist: The experience of therapists working with the perpetrators of sexual abuse. The Australasian Journal of Disaster and Trauma Studies, 1(5). http://www.massey.ac.nz/~trauma/issues/2001-1/steed.htm에서 2016, 3, 31 자료 얻음.

65.

Steed, L. G., & Downing, R. (1998). A phenomenological study of vicarious traumatisation amongst psychologist and professional counsellor working in the field of sexual abuse/assault. The Australian Journal of Disaster and Trauma Studies, 2. http://www.massey.ac.nz/~trauma/issues/1998-2/steed.htm에서 2016, 3, 31 자료 얻음.

66.

Stetz, T. A., Stetz, M. C., & Bliese, P. D. (2006). The importance of self-efficacy in the moderating effects of social support on stressor-strain relationships. Work &Stress, 20(1), 49-59.

67.

Way, I., VanDeusen, K. M., Martin, G., Applegate, B., & Jandle, D. (2004). Vicarious trauma a comparison of clinicians who treat survivors of sexual abuse and sexual offenders. Journal of Interpersonal Violence, 19(1), 49-71.

68.

Wright, J. H., Basco, M. R., & Thase, M. E. (2009). 인지행동치료 [Learning cognitivebehavior therapy]. (김정민 역). 서울: 학지사. (원전은 2006에 출판).

The Korean Journal of Woman Psychology