Chapter 6 Mental Health Needs
Section 2, Stress Management
In the field of victim advocacy, conflicts can arise from the structure of organizations; the
adversarial nature inherent in the justice systems; communication distortions and barriers;
interpersonal or behavioral factors among individuals; and social conditions, such as conflicts
of interest, dependency upon others for performance of one's job, and degree of participation
in decision making within an organization or collaborative structure. This section discusses the
unique stressors experienced by victim service providers, including those related to working
with and providing advocacy for victims and dealing with the limitations, as well as adversarial
nature, of the justice system. Techniques for recognizing and managing stress, preventing
burnout, and conflict management are also presented.
Upon completion of this section, students will understand the following concepts:
- Unique sources of stress in working with crime victims.
- How to recognize signs of stress.
- How to recognize unhealthy coping skills.
- Techniques to relieve stress and to help prevent stress from becoming burnout.
- How to take charge of stress.
- Guidelines for managing conflict.
The cost of occupational stress to business and industry in monetary terms has become
increasingly well documented. Annually, U.S. industry loses approximately 550 million
working days due to absenteeism. It is estimated that 54% of these absences are in some way
stress-related (Elkin and Rosch 1990). Moreover, researchers at the American Institute for
Stress, a nonprofit organization based in New York, suggest that 75% to 90% of patients'
visits to physicians are for ailments that have some kind of link with stress and that controlling
stress could be instrumental in controlling rising health care costs (Nowroozi 1994, 82). Stress
can influence the immune system, weakening the body's defenses against many viral disorders.
Preliminary research conducted by Carnegie Mellon University in Pittsburgh, Pennsylvania,
found that of 400 people intentionally exposed to common-cold viruses, those who scored
highest on a test of stressful life events were more than twice as likely to develop colds after
this exposure than people who scored the lowest (Ibid.). Clearly, occupational trauma and
stress are critical problems faced by many professionals. Victim service providers, due to the
inherently stressful and traumatizing nature of their work, are particularly vulnerable.
Unique Sources of Stress in Working with Crime Victims
Professionals who serve crime victims face many unique sources of stress that go beyond the
typical stressors experienced by professionals and volunteers in other work environments.
Victim service providers are expected to provide comforting and compassionate support for
crime victims while, at the same time, be outspoken advocates to ensure that victims are
extended their rights within the justice system and receive necessary services. In addition,
many crime victim assistance professionals work within the very system they are trying to
change and improve; they know all too well its limitations. The responsibility of serving in
roles that sometimes conflict can be a major source of stress.
Another source of stress that often affects those in helping professions relates to the desire to
assist those in need. How do you know when "enough is really enough?" This question
plagues the victim service profession and often arises in training sessions conducted on stress
and burnout for victim service providers. With no clear standards for the field (varying
organizational policies on how far the role of the victim service provider extends) and no
"manual" on what it takes to provide reasonable and appropriate victim assistance, most victim
service providers find they must set their own limits. This, too, can cause stress.
Finally, the nature of the work causes many crime victim advocates to be in regular contact
with people who have suffered severe trauma and loss. The provision of effective victim
assistance requires tremendous emotional energy and resilience, which can be a near-constant
source of stress. The following are stressful situations that the victim-serving community may
- Working with victims and witnesses who have experienced or witnessed acts of
indescribable human cruelty.
- Working with children who have suffered repeated inhumane acts of sexual, physical, or
- Dealing with grieving family members of deceased victims, immediately after a homicide
when providing death notification or in the weeks or months that follow.
- Assisting scores of victims and survivors in the aftermath of mass murder or terrorism.
- Working with victims who, for a variety of reasons, continue to be at risk for further abuse.
These represent work-related stressors that are quite different from most job settings and may
affect an individual victim advocate in profound ways.
Vicarious Trauma: Overview of Research and Terminology
The field of victim services is paying increasing attention to the issue of vicarious trauma,
which is defined as "a stress reaction experienced by therapists and researchers who are
exposed to disclosures of traumatic images and materials by clients and research participants,
in which the therapists or researchers experience enduring changes in the manner in which they
view self, others, and the world" (McCann and Pearlman 1990).
Victim service providers become, in the line of duty, prime candidates for vicarious trauma.
Their acute and chronic exposure to the trauma, grief, and other reactions that are common to
many crime victims can have a cumulative, and often devastating, effect on their view of the
world and, sometimes, on their choice of careers.
Dr. Charles Figley, Professor and Director of the Florida State University Traumatology
Institute, developed a brief overview of the history of vicarious trauma, which is summarized
There are four "conceptual building blocks" that may occur prior to the emergence of
3. Posttraumatic stress disorder (PTSD).
4. Secondary victimization.
Countertransference can be used in several ways: as a reference to all the feelings a therapist
has toward a client, as the therapist's reactions to a client's transference, or as the therapist's
own transference toward a client. When the client's behavior evokes in the counselor
(provider) conflicts relating to unresolved situations in the counselor's life, causing the
counselor to respond to the client in nonobjective way, the counselor is experiencing a form of
The term "burnout" emerged from studying worker discontent, and is defined most recently as
"a state of physical, emotional, and mental exhaustion caused by a long-term involvement in
emotionally demanding situations" (Pines and Aronson 1988, 9).
POSTTRAUMATIC STRESS DISORDER
The term "posttraumatic stress disorder" emerged from the study of Vietnam veterans. PTSD
is an anxiety disorder caused by a traumatic event or series of events and is characterized by
symptoms of withdrawal to avoid the troubling memories that often intrude the lives of victims
and cause distress. (See Section 1 of this chapter for further information on PTSD.)
Secondary victimization and secondary trauma occur when family members are traumatized by
the symptoms of PTSD of a family member.
Secondary trauma stress. The concept of secondary trauma stress emerged from the study of
trauma therapists, child protection workers, pediatric critical care nurses, law enforcement
officers, fire fighters, emergency workers, and victim service providers. Secondary trauma
stress is the natural consequent behaviors and emotions resulting from knowing about a
traumatizing event experienced by a significant other, and the stress resulting from helping or
wanting to help a traumatized or suffering person. Figley has also coined the term
"compassion fatigue," which derives from secondary traumatic stress disorder (Figley 1999).
Understanding One's Ability to Tolerate Stress
An individual's ability to tolerate stress often depends on the frequency, severity, and types of
stressors confronted. It also depends on many intrinsic or personal characteristics:
- Past victimization. For many victim service providers, their past life experiences also
involve personal victimization. The concept of "victims helping victims" is an inherent
strength of America's victims' rights discipline. Many service providers have transformed
tragic events into heroic and life-giving achievements. Sometimes termed "wounded
healers," such individuals can possess a degree of fortitude, courage, and insight
unattainable by other means, and yet, the very source of this transformed strength can be
their deepest area of vulnerability to stress and secondary traumatization.
- Personal values and attitudes. All professionals and volunteers in the field of victim
advocacy have a core foundation of values and attitudes that affects their perception of
others, of their work environment, and of life in general. One's personal beliefs may
conflict with the expectations of the job and affect, in particular, a person's individual
interactions with others.
- Sense of control. While providing victims with resources to return control to their lives is a
core tenet of victim services, it is also necessary for advocates to feel in control of their
professional actions and decision making. With so many unknown and unpredictable factors
in cases of crime and victimization, a sense of true "control" can be difficult to achieve.
- Personality. The job description for a victim advocate requests the strength of an ox, the
patience of Job, and the resiliency of teflon. When one is expected to be a "pillar of
strength" for countless people in need of support, the challenges of victim services can
- Residual stress level. Unless victim advocates possess strong stress management skills, they
are likely to develop cumulative "layers" of stress that eventually lead to burnout.
- General state of health. Both physical and mental health play a significant role in a victim
advocate's ability to fulfill his or her job duties. Chronic illness or an acute ailment can
weaken a person's ability to cope with job responsibilities. In addition, harmful coping
skills such as smoking or substance abuse can affect one's overall health.
In addition, several external or organizational factors can contribute to stress:
- Work overload. There are few victim advocates whose jobs are limited to a forty-hour work
week. An inability to say "no" to tasks that are not essential or to establish work priorities
are common sources of both acute and chronic stress.
- Family conflicts. The difficulty of balancing the rigors of the job with a healthy family life
at home is a common challenge to many professionals. For victim service providers, this
problem is magnified because of the trauma and evils they can encounter on literally a daily
basis. The burden of keeping this kind of daily exposure from negatively affecting victim
service providers' relationships with family members can be tremendous.
- Threat of job loss. For victim service providers who work "grant-to-grant" or whose
positions are reliant on external (and often unstable) sources of funding, the issue of job
security is a major concern.
- Job conflict or job ambiguity. Without clearly defined boundaries and job descriptions that
guide the duties of a victim advocate, conflicts are likely to occur. When system-based
victim service providers find themselves advocating for victims whose cases have limited
legal rights under state or federal law, anger and frustration can ensue.
- Interpersonal conflicts. Ongoing disputes can easily arise between people who have
different personalities and outlooks. In addition, victim services is a field that requires a
tremendous amount of collaboration which, when not approached with openness and
honesty, can rapidly erode into competition. Indira Gandhi once described two kinds of
people: "those who do the work, and those who take the credit." She suggested it was
better to be in the first group, because there was much less competition!
- External agency conflicts. There are multiple sources of stress over which victim advocates
have little control: lack of victims' rights laws; lack of continuous funding; a media barrage
around a high-profile case; and the reliance on other individuals and agencies to complete
part of a larger task in order for the advocate to be able to do his or her job, to cite a few. If
victim service providers cannot control these, and similar, external forces, they must learn
to be able to at least know about them and accommodate the possible influence of such
forces on their work.
- Organizational culture. The atmosphere of one's work environment can either reduce or
add to personal stress. If superiors are supportive and colleagues are understanding, the
organization's culture can be a source of strength. On the other hand, many victim service
providers work in environments that are frenetic, disorganized, and lack respect for
individuals' needs and achievements. Moreover, victim advocates may work in
organizational cultures that simply do not (traditionally) understand or support victim
- Insufficient resources. There are few (if any) victim service agencies that have the
financial, human, and community support resources needed to accomplish their mission and
goals. While insufficient resources are often viewed as a significant barrier to success, they
can also force victim assistance organizations to prioritize, set realistic goals, and learn to
live within the limits of available resources. When this does not occur, organizational
burnout (and even demise) are possible outcomes.
- Inadequate job training. There are few institutions of higher education that adequately
prepare students for a career in victim advocacy. Furthermore, on-the-job training
opportunities are often limited because there is not enough time to "do the work, and do the
training." The professionalism of the victims' rights discipline and, indeed, the sanity of
professionals and volunteers within the field, require systematic attention to orientation and
continuing education. The National Victim Assistance Academy text is designed to provide
exactly this type of basic training for professionals in this field.
- Supervisor's attitudes. An understanding and supportive supervisor can be one of the
greatest stress reduction assets to a victim advocate. However, when a supervisor fails to
show respect and appreciation for and understanding of the work of a subordinate, the end
result is chronic work-related stress.
Manifestations of Stress: Recognizing the Signs
- Changes in organizational structure or vision. As the victims' rights discipline has grown
and matured, it has witnessed significant changes in the thousands of organizations that
comprise it. Broadened funding bases, passage of new laws that increase victims' rights,
the hiring of additional staff, and stronger links to the community are all positive outcomes
of this growth and maturity. Yet it can be difficult to adapt to such changes, particularly if
a victim advocate has become accustomed to "the old way" of doing business. Change can
(and should be viewed as) positive. As Pauline Kezer noted, "Continuity gives us roots.
Change gives us branches, letting us stretch and grow and reach new heights" (1992, 48).
Stress has an effect on all aspects of an individual's emotions, behavior, and physical health.
Researchers generally divide the manifestations of stress into three general categories:
psychological, cognitive, and physical.
The symptoms of psychological stress can include the following:
There are also cognitive symptoms associated with stress. These symptoms can affect an
individual's work performance, such as follows:
- Inability to make decisions.
- Blocked creativity or judgment.
- Difficulty concentrating.
Finally, the physical manifestations of stress are often ignored by the individual experiencing
long periods of stress until they reach the point of critical consequences. The following are
common signs of the physical impact of stress:
- Changes in sleeping patterns, such as insomnia.
- Gastrointestinal disturbances.
- Changes in eating patterns.
- Susceptibility to illness.
ADDITIONAL SIGNS OF STRESS
Other signs of being highly stressed include the following observations expressed by victim
service providers who have attended stress workshops held at victims' rights conferences:
- Inability to feel empathy with all or some crime victims.
- Inability to meet deadlines.
- A constant frustration with the lack of adequate monetary compensation.
- Uncharacteristic forgetfulness, such as leaving a wallet or purse behind, or failing to keep a
scheduled appointment with a victim or colleague.
- Fighting with friends and family over insignificant events; increased interpersonal conflicts.
- Feeling overwhelmed with the demands of the job and a sense that it is consuming one's
- A lack of being able to put current stressors into perspective.
- A feeling of inadequate reward, respect, and recognition for constant sacrifices from the
Harmful Coping Mechanisms
- Being overwhelmed with the desire to seek other employment but feeling there are few
options to do so.
There are many good ways to cope with and manage stress that are addressed later in this
chapter. Too often, however, victim service providers choose to use (and in some cases,
abuse) harmful coping mechanisms to reduce their stress when, in reality, they are more likely
reducing the length and quality of their lives:
- Smoking cigarettes equates to ingesting poisons--tar and nicotine--which stimulate one's
body to produce hormones (such as adrenaline) that increase one's energy and alertness.
Cigarette addiction requires greater amounts of nicotine to produce the desired feeling.
Instead of responding to stressful situations by seeking calm and respite, some victim
service providers smoke cigarettes that, in essence, keeps their level of anxiety higher.
- Alcohol is the most widely used--and abused--drug in the United States today. While some
victim service providers occasionally have a drink or two to unwind and relax, some
use/abuse alcohol as a daily or regular stress-coping technique instead of utilizing other
positive coping strategies:
When alcohol is abused, health problems, such as heart disease, raised blood pressure, brain
dysfunction, cancer and sleep problems may arise. Many problem drinkers become alcoholics, which
in turn can lead to malnutrition, blackouts, disrupted home life and job inefficiency. Alcohol is also
high in calories, but low in nutrition (Cornelius 1994).
- Like alcohol, prescription drugs can be abused and used as a negative coping mechanism.
Many Americans use tranquilizers to relax, calm down, and relieve the pressure and stress
of every day living. Valium and similar drugs designed to reduce stress can effectively
reduce anxiety and stress in the short term. If used chronically for long periods of time,
however, addiction may develop. When a "hooked" worker tries to stop, he/she may
experience anxiety, nervousness, taste and smell distortions, and difficulty sleeping
There are several approaches that victim service providers can take to address substance abuse
within the profession:
- Be proactive in discussing substance use/abuse as a harmful way to cope with the stress of
victim advocacy. By bringing the topic up on a regular basis, professionals and volunteers
are constantly reminded to "self-check" for their own personal health.
- Establish clear agency policies and procedures that discourage substance use/abuse as a
means of coping with stress.
- Avoid group situations that include overuse or abuse of alcohol or other drugs. Instead of
meeting after work for drinks, start a walking group to get exercise and discuss the events
of the day or week.
- Have a list of referrals available through employee assistance for staff or volunteers who
may be experiencing difficulties with substance abuse.
HARMFUL COPING MECHANISMS: CORE ISSUES
Regardless of the coping mechanism that victim service providers may use, the goal is
probably the same: reduction of stress and, in some cases, a distancing of the providers' own
sense of self from the traumas afflicting their clients. This can lead to more subtle versions of
harmful coping mechanisms that represent an emotional shutting down. As described by Dr.
Henry Tobey, Director of the Colorado-based Healthbridge Alliance, a trauma support and
psychotherapy center, victim service providers (or other caregivers) can, as a consequence of
long-term stressful service, " armor their hearts, to use Ram Dass' evocative phrase, and shift
to a stance of what could be called 'professional warmth' in which they appear to be
emotionally present with their client, but actually are not" (Tobey 1999). Although such
behavior may be completely unintentional, the result can be that providers "in very insidious,
hard-to-see, but ultimately injurious ways act to keep their clients from disclosing the real
depth of their trauma because the provider cannot handle it anymore, or cannot tolerate that
particular variety of it" (Ibid.). This is doubly tragic in that it prevents service providers from
establishing a genuine healing connection with victims, while at the same time, they personally
will lose the enriching aspect of that connection, which for many providers was a fundamental
motivation for entering the field of victim services.
Recognizing Stress in One's Working Environment
In addition to the inherent stress involved in responding to crime victims, victim service
providers also face many other circumstances that add to stress in their working environments.
While criminal- and juvenile justice-based victim service professionals may face different
stressors than professionals in community-based agencies, common stressors are experienced
by most victim service providers.
In March 1997, the National Institute of Justice (NIJ) released a comprehensive report entitled
Developing a Law Enforcement Stress Program for Officers and Their Families. NIJ's Report
provides a list of psychological stressors facing law enforcement officers. Developed by Dr.
Terry Eisenberg, the report has been used by the International Association of Chiefs of Police
in their law enforcement training programs. The following overview of stressors facing victim
services professionals has been adapted from Dr. Eisenberg's work as reported in the NIJ
- Isolation. Victim service providers often experience a sense of isolation if they feel they
work for the only victim-serving agency in the community, or if there is not an ongoing
network of support among victim assistance professionals to help them cope with chronic
stress. In addition, if victim advocates are working on an initiative that lacks support from
allied professionals in justice and public safety, feelings of isolation are likely to be
- Funding pressures. Most (if not all) victim service agencies face funding pressures and
must seek financial support for their agency from a variety of local, state, and federal
sources. This can give staff a sense of insecurity in not always knowing if their positions
will be funded for the following year, or if the provision of comprehensive, quality victim
services will continue.
- Irregular work schedules. Many victim services agencies offer twenty-four-hour, seven-days-a-week assistance to victims of crime; thus staff must rotate their schedules to provide
adequate coverage. Even in agencies that have "regular" business hours, staff often have to
work overtime to meet the needs of crime victims, for example helping to make funeral
arrangements, preparing victims for trials, providing crisis intervention and counseling, and
responding to unexpected high-profile crimes.
- Sense of helplessness or hopelessness. The inability to completely resolve victims'
problems and help them cope with the trauma of victimization confronts victim service
providers on a daily basis.
- Absence of "closure." Much of the work of victim service providers is fragmented:
making a referral, helping a victim complete a compensation claim, or providing short-term
crisis intervention. Very few victim service providers help and guide the victim through the
entire criminal or juvenile justice process. The crisis counselor on call when the victim first
contacts the agency may not be the same advocate as the one who provides court support.
Thus, advocates must rely on allied professionals to provide a continuum of quality support
and services. Consequently, opportunities for feedback on the ultimate outcome of a case
- Role conflict. It has long been said that an effective victim service provider must be able to
wear many hats: one moment being a kind, sensitive, supportive counselor, and the next
moment, being a strong, outspoken advocate on behalf of victims to ensure that their rights
are accorded. When advocates work in a justice system that cannot always meet the
expectations and needs of the victims they serve, it can be very frustrating.
- On-going human suffering and cruelty. On a daily basis, victim service providers are
exposed to the inequalities and brutalities of life. Over time, the exposure to human
suffering, and the daily outpouring of empathy by victim service providers to each victim
they serve, may take its toll.
- Lack of referral agencies. Often, the lack of other agencies to help victims, whether they
are other criminal or juvenile justice system-based or community-based agencies, can
frustrate victim services providers and may add to their already overburdened workload.
- Frustration with the criminal or juvenile justice system. Victim service providers, both
within and external to the criminal and juvenile justice systems, are often frustrated with
many aspects of justice processes, finding out the hard way that many victims' rights are
simply not implemented due to a lack of education and knowledge of justice professionals
about victims' rights, a lack of funding for victim assistance programs across the justice
continuum, and often, because basic victims' rights are not legislated in their states or
- Poor equipment. The lack of access to current technology that makes the demands of the
workplace easier (computers and software programs for entering client reports and reporting
data to funding agencies, Internet access for research and communications, or automated
victim notification systems) adds to the workload and frustration of victim service
- Lack of career opportunities. Opportunities for promotion are viewed by some victim
assistance professionals as being limited or unfair. This is a particular problem in victim
service agencies that have a limited number of staff and few opportunities for advancement
within the agency.
- Inadequate rewards. Recognition for a job well done is rare; however criticism for
mistakes seems to occur on a regular basis. Unless one examines, and is cognizant of, the
significant impact victim service providers have on the people they help, inadequate
recognition of small successes and significant accomplishments can be very frustrating.
Techniques to Help Prevent Stress from Becoming Burnout
- Extensive paperwork. The need for extensive or duplicate reporting on client case loads to
meet the reporting requirements of different federal and state grants that support agency
activities is viewed as burdensome.
Burnout is a severe reaction to stress that results in a state of physical and emotional depletion
caused by the conditions of one's occupation (Canadian Public Service Commission 1992).
Because of the intense nature of the work required in the field of victim assistance (dealing on
a daily basis with issues involving injury and violent death; frustrations faced with each new
case requiring renewed advocacy, compassion, and vigor; and often low pay and a lack of job
security), burnout can occur. In addition to reducing the number of stressors, the following
techniques are suggested for program directors to help prevent staff burnout; they also can
serve a useful purpose for program staff to assess whether their agency is taking necessary
steps to prevent staff burnout.
(The following information has been adapted from Developing a Law Enforcement Stress
Program for Officers and Their Families, National Institute of Justice, March 1997.)
To prevent burnout of victim services staff, program directors should:
- Warn new victim assistance staff about not over-identifying with the job. Let them know
about the possibility, nature, and symptoms of burnout, and encourage them to monitor
their own vulnerability. Keep a close eye on professionals and volunteers who appear to be
overwhelmed with their job responsibilities.
- Meet regularly with staff to discuss and resolve problems of work overload. Many staff
have difficulty saying "no" to added responsibilities. It is helpful to conduct reality checks
on a regular basis to assure that no one individual is overburdened with job duties.
- Arrange for scheduled staff meetings at which experienced and inexperienced victim service
providers discuss the impact of their work on their own emotions and lives.
- Help victim service providers set limits on how much time they will spend on the job and
give them an opportunity (without guilt) to refuse on occasion to accept certain assignments,
especially if the individual is responding too often to emergencies.
- Help victim service providers understand the limits of what they can expect to accomplish in
their work in terms of helping victims as well as in achieving organizational or system-wide
change. Provide opportunities for group brainstorming and working toward collaborative
solutions, when possible.
- Help victim service providers to tolerate common stressors by providing opportunities for
them to develop an awareness that they are doing important work that affects people's lives
in positive (and often monumental) ways. This obvious, but critical information, is often
forgotten or minimized by overworked staff.
- Encourage victim service providers to take vacation time, without their work files, laptop
computer, and pagers!
- Promote a work environment that encourages victim service providers to get regular
exercise before, during, and after work. Explore agency discounts for group health club
memberships. Organize a walking group at lunch. Coordinate a fifteen-minute stretching
or yoga session for staff a few times a week.
- Encourage your agency to provide training opportunities for staff to increase their
knowledge, skills, and confidence level in their daily work, and to foster opportunities to
promote career advancement and build networks with allied professionals.
TIPS FOR HELPING TO RELIEVE STRESS
Time management. It is important to have balance in your life: balance between work and
play; between adult social time and alone time; between family time, physical activity time and
spiritual expression. Assess your priorities; make time for each category. Look at how you
establish your priorities. Do you only do things you "have to" or do you include things you
"want to" do? Try to turn the "have-to's" into "want-to's."
Attitude. How you think can have a profound affect on your emotional and physical well-being. Each time you think a negative thought about yourself, your body reacts as if it were in
the throes of a tension-filled situation. If you see good things about yourself, you are more
likely to feel good; the reverse is also true. Eliminate words such as "always," "never,"
"should," and "must." These are telltale marks of self-defeating thoughts. Talk to yourself,
switch negative self statements to positive statements. For example, "I can do . . . (whatever
it is you are setting out to do)" or, "I made a mistake, but I can do . . . (whatever it is you are
setting out to do)," or "I made a mistake, but I do a lot of things right."
Relaxation, meditation, guided imagery. Physiologically relaxing your body brings down
heart rate and blood pressure and slows breathing. These are all manifestations of stress
release in your body. At least once per day (twenty to thirty minutes) center yourself with
meditation, relaxation exercises, or guided imagery tapes.
Exercise. Our bodies were designed to move. Built-up stress can often be relieved by
physical activity. Walk if you cannot do anything else. Aerobic activity, on a regular basis,
plays a significant role in boosting the immune system. Work up to incorporating some form
of physical exercise three times per week.
Fun and laughter. There is a measured effect of the relaxation response after a good laugh.
Laughing reduces stress! Do something playful at least once per week, if not once per day.
Have fun in your life!
RELAXATION EXERCISES FOR RELIEVING STRESS
Stress can be relieved in a number of ways. The same method may not work each time an
individual attempts to relieve stress; so try different things. One way to reduce stress is to
employ relaxation techniques. The following overview provides some exercises that victim
service providers can use to relax. Each exercise usually takes fifteen to twenty minutes, but
"mini" sessions can always be tried in situations where one is pressed for time and in desperate
need of some stress relief (Sharp 1996).
- Deep breathing. Take a deep, slow breath. Let the air come in through your nose and
move deep into your lower stomach. Then breathe out through your mouth. Repeat this for
several minutes. Imagine that the air coming in carries peace and calm, and the air you
exhale contains your tension.
- Body scan. Close your eyes and do some deep breathing exercises. Then, in your mind, do
a scan of your entire body, beginning with the top of your head and moving down to your
feet. With each breath, focus on a different part of your body. As you breathe in, notice
any muscle tension in the various parts of your body. As you breathe out, let go of that
- Progressive muscle relaxation (PMR). As you perform a body scan, tighten the muscles in
each area to increase the tension. Then slowly release the tension. Do this for each part of
your body, from head to toe. You will find that you feel much more relaxed after letting go
of the tension.
- Meditation. Find a comfortable place to sit or lie down and close your eyes. As you
breathe deeply, repeat a word or sound over and over again either to yourself or softly
aloud. Concentrating on your breathing or on the repeated word helps you to focus your
attention. Meditation can help you to slow down your breathing and heart rate, ease
muscular tension, and respond calmly to stressful situations. Once you are used to
meditating, you can use it to relieve stress while you stand, walk, or jog. Some people even
meditate while doing everyday things such as waiting for the bus, doing the dishes, etc.
- Guided imagery. Find a quiet, comfortable place to sit. Then close your eyes and take a
few slow, deep breaths. Now imagine you are in a place where you know you can relax,
such as on the beach or in your bed. Now visualize yourself at this one spot. Take in the
sounds, smells, and scenery around you. Savor them one by one. As you become more
experienced with imagery, you can use it anywhere. For example, if stress takes over your
mind while you are waiting for someone to show up for an appointment, take a couple of
minutes to use imagery to relax so you can focus.
- Yoga. This is one of the oldest relaxation techniques. There are many different kinds of
yoga, but all involve physical poses, meditation, and deep breathing. Everything you do as
you practice yoga helps to strengthen, stretch, and relax both your mind and body. There
are many classes, books, and videos available to help teach you how to practice this ancient
- Aerobic exercise. Finally, any kind of physical exercise, whether it is a team sport or a
simple walk at lunch time, can help reduce stress. Remember, if you can release pent-up
energy, your body will benefit in the long run.
ADDRESSING STRESS THROUGH MUTUAL SUPPORT
Many victim advocates find that the greatest tool for stress maintenance and reduction is
mutual support. Just as many victims find comfort and solace in speaking with others who
have endured similar experiences, so can victim service providers. The fortunate aspect of this
technique is that victim advocates possess many relevant skills: empathy, understanding,
listening, validation, brainstorming, and a strong dose of humor!
The "sixth sense" that many victim advocates have that helps them assess when a victim needs
immediate help or crisis support can be utilized for their peers as well. By keeping a vigilant
watch on colleagues who appear to be under a great amount of stress, service providers can
and should intervene, as appropriate, when support is needed.
Mutual support can be achieved through a variety of venues. Victim service providers can do
any of the following:
- Schedule and participate in informal meetings to share ideas, discuss current cases with a
focus on problem solving, and talk about mutual concerns. In some communities, victim
service providers meet for regularly scheduled brown-bag lunches, coffee, or potluck
dinners that provide great forums for support.
- Consider initiating or joining a discussion group or chat room on the Internet. This
approach crosses boundaries of geography and time, and "widens the net" of advocates who
need, or are eager to provide, mutual support. The Internet also provides excellent, cost-effective opportunities for rapid communications through e-mail, listservs, and user groups.
- Make exercise a scheduled group activity. At many training forums (including the National
Victim Assistance Academy), regular morning or evening walks give victim service
providers an opportunity to get fresh air and exercise and discuss current events and issues.
One victim service organization has a volunteer who is a masseuse and yoga instructor;
these skills, when applied to weary victim advocates, combine to make her "volunteer of the
Taking Charge of Stress
- Schedule retreats for staff and volunteer rejuvenation, seeking low-cost or donated sites and
resources to provide an atmosphere of relaxation, mutual support, and planning for the
future. For example, long-time victim advocates try to meet at least annually for their
national "Old Buffalo" reunion, whose major agenda items are mutual support and laughter,
as well as examining important trends and topics that contribute to the future of victims'
rights and services in the nation.
(The outline for this section is derived from Stress Management: How to Handle Life's
Challenges," published by Great Performance in 1995. It has been adapted to specifically
address stress and the victim advocate.)
In any stressful situation, one has four choices: accept, avoid, alter, or adapt.
Sometimes all one can do is learn to accept things as they are. Victim advocates should
- Learning from past experiences. Too often, victim advocates "fight the same fights" over
and over again, which leads to both cumulative stress and tremendous frustration. It is
helpful to consider similar situations from one's past: Did the actions taken resolve the
situation or stressor? Was there one approach that worked better to reduce stress? Was
there one significant barrier (human, monetary, or otherwise) that was insurmountable, and
required adaptation to cope?
- Talking with someone about the situation. The concept of "mutual support" that is critical
to victim assistance is also helpful for service providers. Sometimes, options and solutions
become more clear when they are discussed with somebody who has shared similar
experiences. For example, the National Center for Victims of Crime has established a
network of "mentors" and "protegees" for adult corrections-based victim advocates. If an
advocate has a problem or issue that is causing frustration or stress, he or she is a telephone
call or e-mail away from support and/or technical assistance. Many problems are solved
with the guidance of "someone who has been there."
- Using positive self-talk. When overwhelmed by stress, it can be difficult to remember there
is the "light at the end of the tunnel." It is helpful when work and home life are relatively
calm, to make a mental or written list of one's strengths, such as "I have good people
skills," "I am patient," "I can make people laugh," "I know how to stretch a tiny little
paycheck," etc. During times of stress, reliance on one's inveterate strengths and abilities
can contribute to a sense of control.
- Keeping a smile, even in difficult times. The power of a simple smile can be remarkable.
One victim advocate tells how she copes with her monotonous subway commute: She
smiles at everybody in the station and on the train and finds great delight in the fact that
many (not all . . .) smile back.
To avoid needless stress, victim advocates can try to plan ahead and rearrange their
surroundings, to the degree possible, by doing the following:
- Avoiding someone who constantly bothers you. When conflict management techniques are
unable to adequately address a personal conflict, it is a good idea to control the amount of
time one must spend with the person who is causing friction or stress. One victim advocate
speaks of physically removing herself from a room in which a person with whom she cannot
get along is, or physically distancing herself by moving to the other end of a room. While
attempts at total avoidance do not resolve a stressful situation, they can give a degree of
control to the situation.
- Leaving for work or home earlier to avoid traffic, maintaining a flexible lunch schedule, etc.
If flexibility is at all possible in a victim advocate's work schedule, it can also offer a degree
of control in avoiding minor stressors that contribute to cumulative, chronic stress and
eventual burnout. One group of victim service providers maintains a flexible lunch
schedule in order to take group walks when the weather permits.
- Avoiding taking on more work than one can handle. The capacity to say "no" to increasing
workloads is a crucial skill that many victim service providers lack. It is important to
remember that one's capabilities to provide quality assistance to victims and support to
allied justice professionals are seriously eroded by chronic work overloads.
- Avoiding discussion of a specific topic or subject. If there are certain topics that create
friction among co-workers or professional colleagues, there can be a general agreement to
"not go there." Avoiding controversial topics can help victim service providers avert what
is guaranteed to be a stressful situation.
It is always important to consider options that help elude stress. It is impossible, however, to
avoid all stressors in life.
Altering a stressful situation in some ways might be the best response. In the field of victim
advocacy, control is a major tenet of helping victims reconstruct their lives in the aftermath of
a crime. Similarly, seeking control over untenable situations can help victim service providers
avoid the cumulative effects of stress. Options include the following:
- Asking someone to change their behaviors and being willing to also change. When stress is
interpersonal, it is a good idea to identify specific behaviors that are irritating or contribute
to chronic friction. Often, it is fairly simple to pinpoint recurring behaviors that can be
easily remedied such as "When you always turn in your time sheet late, I can't complete my
monthly reports" or "Every time you make an inappropriate victim referral to my agency, it
can be traumatic for the victim, and a poor use of time for both you and me." Such
discussions can result in a "give-and-take" of new information that contributes to problem
solving; avoiding such discussions can contribute to chronic stress.
- Communicating feelings in an open way. Open communications require both bravery and
honesty on the part of all parties involved in a stressful situation. It helps to
"compartmentalize" stressors into manageable issues that can be addressed one at a time. It
is also a good idea to avoid discussions among colleagues in an attempt to shore up support
for "one's side." The concept of "staff infection" in dealing with conflict results in a "no-win" situation for all involved.
- Taking risks. ". . . if you don't risk anything, you risk even more." This observation by
Erica Jong contains valuable advice for victim service providers. When one avoids taking
chances, the end result is stagnation. When victim advocates are willing to take risks to
confront their sources of stress, the results can be positive and empowering.
- Managing time better. The longstanding technique of developing a "time-task" assessment
is helpful to determine how time can be better spent serving victims. Is time wasted
responding to nonemergency calls? Would it help to consolidate monthly report writing
into a standardized time frame every week? Can the agency develop information packages
for "the most frequently asked questions" that are easily replicated and disseminated by a
volunteer? While the process of "time-tasking" is time-consuming in itself, it is guaranteed
to save time and reduce stress in the long run.
- Collaborating on problem solving. One agency of victim advocates created a "problem-solving bulletin board" where staff can post specific information about cases (without, in
any way, identifying the victims involved), or barriers to successfully completing their work
assignments. Often, a colleague may have dealt with a similar situation that was resolved
with a certain strategy. This information should be shared!
- Being more assertive. Susan B. Anthony said: "Cautious, careful people, always casting
about to preserve their reputations, can never effect a reform." Victim advocates can gain
considerable control over stressful situations by clearly defining problems, offering options
for solutions, speaking out, and working hard (often collaboratively) to achieve success.
In seeking to alter a stressful situation, it is helpful to rehearse before it occurs and anticipate
what might happen. Usually, it is fairly simple to anticipate possible responses related to
people or situations that cause stress, which lead to options for positive responses that offer
Adapting to stressful situations and learning to cope with them can be a better response than
accepting, avoiding, or altering. By anticipating stressors and making plans to adapt, victim
advocates can go a long way toward stress reduction. Options include the following:
- Changing one's thinking. Seek as much information as possible that contributes to positive
decision making and, ultimately, stress reduction. Accumulating facts and other relevant
background information may contribute to a change in one's perception of a situation,
and/or provide information that can help change others' thinking as well.
- Looking at stress as an opportunity. Some individuals appear to thrive in stressful
situations. They view the act of overcoming stress as a source of strength. However, it is
important to avoid adopting a "martyr" complex when it comes to handling multiple
stressors at the same time.
- Thinking of the positive things in life. The comparison of assets to deficits in certain
situations can be a useful stress reduction technique. In many (if not most) situations,
building upon assets instead of mulling over deficits can have a positive influence on one's
life and ability to manage stress. Visualization of positive (and often simple) things that
bring joy to life, from a beautiful sunrise to a favorite vacation spot, can alleviate the effects
of acute stress.
- Considering how much this will matter in a year. Sometimes, a "global" perspective of a
bigger picture can make a stressful situation seem minor. By simply asking, "Will this
matter in the long run?" victim advocates can put a stressful situation in perspective.
- Considering whether it is worth getting upset over. If it is not ultimately worth the time and
energy to focus one's limited resources on a stressful situation, it is time to move on.
- Changing one's actions. By slowing down, talking to someone about feelings and concerns,
and seeking information and advice, victim advocates have the power to change stressful
situations by changing their own actions in positive ways. Many victim advocates find it
helpful to discover a new hobby: one victim service provider took up boxing, another
discovered a talent for painting, and yet another discovered a "green thumb" for gardening.
It is imperative to avoid making matters worse by using destructive coping techniques, such
as caffeine, smoking, alcohol and other drugs, and eating disorders (overeating or bulimia
or anorexia), as they may temporarily reduce stress, but cause long-range and potentially
severe physical and mental health problems.
"Conflict" describes a situation in which the concerns or interests of two or more parties
appear to be incompatible. This simple definition clearly characterizes a number of situations
that are common to victim advocacy. Conflicts can occur within individuals in an
organization, between two different agencies, and/or among the many entities that seek to
promote public safety and victim assistance.
Traditionally, "conflict resolution" has been a goal of individuals and entities that need to
work together in order to resolve the situation and achieve mutual success. There is a new
trend, however, toward "conflict management" and learning to work within conflict (which
recognizes that while not all conflicts can be resolved, most can be managed with positive
results and success for all involved parties).
The American Association of University Women (AAUW) identifies five ways that people deal
with conflict (1977):
1. Compromise. Each party gives a little and gets a little in seeking resolution.
2. Competition. One party gets all his or her needs met, while the other gets nothing.
3. Accommodation. One party gives in, and another gets everything.
4. Avoidance. Neither party confronts the conflict, and neither gets their needs met.
5. Collaboration. A problem-solving process where the problem/issue is redefined to find a
"win-win" situation where all parties involved get what they need.
The AAUW (1977) recommends a conflict management process that incorporates problem
clarification and problem solving into six steps:
Step 1: Define the problem in terms of needs (not competing solutions). This is a critical step.
The problem should be stated in a way that does not suggest blame or judgment, then
verbalized from the other person's point of view. This takes time and may require that the
problem be redefined as it is discussed. Mutual understanding and acceptance of the (possibly
new) problem definition, as well as a willingness for involved parties to work together to find a
solution that is acceptable to all, should be tested.
Step 2: Generate possible solutions. Creativity and exploration of alternatives are critical.
Parties should avoid being evaluative and critical of new suggestions and treat all ideas with
Step 3: Evaluate and test various solutions. There should be tremendous honesty at this stage.
Are there weaknesses in any of the solutions proposed? Will it be too difficult to implement?
Is it fair to both/all parties involved? In the process of evaluation, a new and even better
solution may be discovered and tested.
Step 4: Decide on a mutually acceptable solution. A mutual commitment to one solution
should be agreed upon. It is recommended that the solution be written down so that
misunderstandings do not develop later.
Step 5: Implement the solution. When arriving at a creative solution, it is important to
determine "who does what by when." It is crucial to trust that the other person will carry out
his/her part of the decision, and to offer suggestions to help him/her remember to do what is
expected, and what was agreed to.
Step 6: Evaluate the solution. If the solution does not work out, the original problem should
be re-examined, with other possible solutions generated. Solutions are always open for
revision, but neither party should unilaterally modify a decision.
Some of the best tools for effective problem-solving and conflict management include:
- Clear, honest communication.
- Respect for the needs of others.
- Being open to new data and information.
- Firmness in one's willingness to have the solution "fail."
- In 1998, The Office for Victims of Crime awarded a grant to the Healthbridge Alliance, a
Colorado-based trauma and psychotherapy center, to develop a model training program to
serve victim care providers experiencing secondary traumatic stress. This project will
address the impact of the huge emotional demands that can be experienced by victim service
providers who assist victims of crime. In addition to developing a training program for the
purpose of assisting individual victim service providers, the project will also identify
organizational practices that appear effective at supporting the well being of care providers.
Grant products will include a curriculum development manual and a trainer's manual.
Stress Management Self-Examination
1. Describe one intrinsic or personal characteristic that may contribute to stress among victim
2. Describe one external or organizational factor that may contribute to stress among victim
3. Describe one harmful mechanism that is used to cope with stress.
4. Describe three ways to reduce stress (either as described in this section or from personal
5. Name the six ways that people generally manage conflict.
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