Predictors and Moderators of Difficulties and Coping for Trauma Therapists Open Access
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This study is designed to determine to what extent therapist work experience with complex trauma and trauma training moderates anxious and avoidant attachment styles and self-differentiation in effecting therapist difficulties and therapist coping with complex trauma patients. A random sample of trauma therapists was surveyed from a large, international trauma association. Approximately 126 trauma therapists participated in the study where the majority identified as female (62%), white (93%), with a doctoral-level degree (64%), and where a majority described themselves as experienced, expert-level trauma therapists with complex trauma patients. Self-differentiation and attachment avoidance were found to predict difficulties. Self differentiation was a predictor of avoidant coping where the lower the level of self differentiation, the more avoidant coping employed. Experience with repeated trauma patients/clients was found to moderate the relationship between attachment anxiety and difficulties experienced with complex trauma patients. More difficulties were reported by trauma therapists with higher attachment anxiety and less experience with repeated trauma patients. Experience with patients with single-incident trauma moderated the relationship between attachment anxiety and avoidant coping. More avoidant coping was reported by trauma therapists with higher attachment anxiety and more experience with single-incident trauma patients. Experience with patients with single-incident trauma also moderated the relationship between attachment avoidance and avoidant coping. More avoidant coping was reported by trauma therapists with higher attachment avoidance and more experience with single-incident trauma patients. The findings of this study suggest that experienced, expert-level trauma therapists experience few difficulties when working with complex trauma patients, and employ little avoidant coping strategies. These findings are contrary to some previous research findings. Further investigation is needed to determine potentially unique ways in which experienced, expert-level trauma therapists experience difficulties and cope differently than other non-trauma or less experienced therapists. Future studies may also focus on other potential moderators of trauma therapist attachment anxiety, attachment avoidance, and self-differentiation in addition to work experience and training.