When Helping Hurts: Sustaining Trauma Workers

When Helping Hurts: Sustaining Trauma Workers with Dr. Charles Figley was produced for trauma workers, relief workers and those exposed to trauma due to their professions or work as volunteers. This program outlines the symptoms of Secondary Traumatization and Compassion Fatigue. Six noted therapists discuss ways of recognizing these conditions in yourself and others, and the means of treatment and prevention.

All participants in this DVD donated their time.

The following areas are covered in the DVD:

DEFINITIONS AND EFFECTS

Compassion Fatigue  Compassion Stress  Secondary Traumatization Burn-Out  Countertransference  Work-Related Stressors

SYMPTOMS

Professional  Physical  Emotional  Psychological  Interpersonal  Behavioral  Spiritual

VULNERABILITY

Who’s vulnerable and why?

EXAMPLES OF COMPASSIONAL FATIGUE

RECOVERY, PREVENTION AND COPING TECHNIQUES

Organizational Prevention Techniques  Self Care  Peer Support

© 1998

The US Army uses this program as part of their Sexual Assault Prevention and Response Program.

50 minute version: $50.00 DVD

17 minute workshop version useful for individuals
and for training and classroom: $30.00 DVD copyright 2006)

Order DVD.View Video Clips When Helping Hurts: Sustaining Trauma Workers:
Video Clip 1: What is Compassion Fatigue
Video Clip 2: Direct & Secondary Exposure
Reviews

Reviews:
DVD Review

4. When Helping Hurts: Sustaining Trauma Workers

Dear reader,

Thank you so very much for your time and encouragement during our phone
conversation this afternoon. As I told you, those of us “in the
trenches” really appreciate all you are doing to support us as we try to
assist those in crisis and trauma.


As a Chaplain for the Police, Fire, and Emergency Services in my
community (all on a volunteer basis), I earn my living as a hospice
Chaplain and trainer. The people I serve are often unaware of the
effects trauma can have on ANY human being and feel so very alone. Your
videos, website, and materials help them to see that what they are going
through, however painful, is normal. That knowledge alone, supports and
encourages them to keep working through their pain.


I am grateful that you and everyone else at Gift From Within give
so generously of yourselves. Know that you and your work are in my prayers.

Blessings and peace,
Judith Joseph, Chaplain
Bereavement and Trauma

DVD Review

4. When Helping Hurts: Sustaining Trauma Workers

Dear Gift From Within:

I use all of your videos for our police officers. I am the clinical director and administrator for the Metropolitan Police Employee Assistance Program….a position I have held for nearly fifteen years. There are approximately 3800 officers on the Department. They are exposed on a daily basis to every possible trauma that you can imagine that takes place in a large urban city. They have “seen it all.”

However, nothing could have prepared them for the attacks of September eleventh. The officers of our crime scene examination section were dispatched to the Pentagon to assist Arlington County in the aftermath immediately following the crash. The horrific nature of this attack on the bastion of our military strength was unspeakable.

When they returned from the site, we conducted debriefings and showed the video, “When Helping Hurts: Sustaining Trauma Workers.” The response was incredible. The video actually gave them permission to feel emotion, to acknowledge the pain and still “be” the police.

I also provide training and debriefings to several other law enforcement agencies and have used the videos with the same result. Law enforcement officers are very isolated by virtue of the traumatic exposure that they experience. Our officers are very receptive to all the videos. They are especially impressed with Frank Ochberg’s sincerity. It’s pretty hard to fool a cop. Thanks for making these tapes available.

Dr. Beverly Anderson
Clinical Director & Administrator, Metropolitan Police Employee Assistance Program, Washington, DC

DVD Review

4. When Helping Hurts: Sustaining Trauma Workers

review by Norm Rooker, Paramedic firefighter

As rescuers, it is almost a cliche about how we are great at helping the public and terrible in helping ourselves an each other. Over the course of my 28 years as an EMT and paramedic, I’ve lost six coworkers to suicide and witnessed countless others go through rough times, Vicki and myself included. I’m a firm believer in the Critical Incident Stress Debriefing system when (key phrase here) it is properly administered.

I’m happy to share with you a relatively new video entitled When Helping Hurts: Sustaining Trauma Workers. This 50-minute video is a sensitive yet no-nonsense look at burnout or compassion fatigue, recognizing the symptoms in ourselves and others and strangers for what to do about it on both the personal and organizational levels–that’s quite a lot.

It is accomplished through a variety of first-person interviews with both therapists and trauma workers. A trauma worker is defined as anyone dealing directly or indirectly with the effects of traumatic events. This moves past the standard definition of front-line EMS, SAR, law enforcement, firefighters, doctors and nurses to a lot of support personnel, such as administration, clerks and therapists. The way, When Helping Hurts presents this, well, it just makes sense.

The video defines compassion fatigue and how the symptoms manifest. It goes on to recognizing the symptoms, successful strategies in dealing with them and even how to address the problem in individuals who aren’t aware or admitting they may be exhibiting compassion fatigue.

All of this is done through a variety of emergency responses, ranging from a fatal fire in my city that resulted in the death of one member and the permanent disabling of another to the Oklahoma City bombing events in Bosnia and Rwanda and more day-to-day stressors like working in a pediatric intensive care unit.

This is a great resource on a tough topic. I strongly recommend When Helping Hurts for every organization’s resource library. It is about as “must see” as a video can get for both front-line troops and support personnel and administrators. It is also great for family members with the caveat that there are some graphic images presented.

Norm Rooker is paramedic firefighter for the San Francisco Fire Dept. and has been active in EMS since 1973. He is a heavy rescue instructor for the California State Fire Marshal’s Office, An EMT-T, and is a member of his department’s surf and cliff rescue teams and technical rescue committee.

Jan. 2002 issue of EMS Magazine & Advanced Rescue Technology Magazine.

DVD Review

4. When Helping Hurts: Sustaining Trauma Workers

I did review the material you sent me and I found it very helpful and poignant. During my workshop presentations around the country, the topic of caring for the caregivers always comes up and your video adds just the right message to help viewers understand that while this work is exceedingly gratifying to those of us involved, it is not easy work! It does require that participants take good care of themselves so that they can take good care of those in crisis. I would have no difficulty recommending this resource to anyone doing crisis response work. Thanks so much for sharing this with us.

Dr. Ted Feinberg
Assistant Executive Director
National Association of School Psychologists

DVD Review

4. When Helping Hurts: Sustaining Trauma Workers

I would like to recommend this film as a useful teaching tool, both to students in training for various types of health care positions and for presentations to staff and community groups. I have been trained as a registered nurse, a marriage and family counselor and a clinical psychologist. Working in private practice and academic settings for the past twenty years. Your work is important in deepening awareness in the much needed areas of secondary trauma and fatigue in trauma work.

Patricia Moore, .M.F.C. PsyD…….

DVD Review

4. When Helping Hurts: Sustaining Trauma Workers

“I am the Director of Health Services for Jefferson County Schools. In that position I co-coordinate Crisis response and thus was on the scene on 4/20/99 at Columbine HS and coordinated a massive crisis response to the school staff, student and parents. As you can imagine–we had hundred victims and numerous helpers. I hooked up with Frank several months later and he told us about the video and sent us a copy. We then ordered several more. It provided excellent information during the emotional recovery time after the violent shooting at our school. Our crisis responders worked long hours at such an intense level and we found the video a helpful tool in validating our feelings and giving us support. We continue to use it, two years later.”

Betty Fitzpatrick, R.N. M.S., Director, Health Services, Jefferson County Schools

DVD Review

4. When Helping Hurts: Sustaining Trauma Workers

“When Helping Hurts clearly demonstrates the essence of compassion fatigue: there is a cost to caring. Members of the helping professions—from firefighters to aid workers to mental health professionals–risk their psyches and their somas when they confront the suffering of others. This brief video, made by a compassionate filmmaker, takes us to the frontline of working with people traumatized by natural and man made disasters. One minute we are in Oklahoma City, the next in Bosnia, the next in the local ER. There is no sentimentality or voyeurism here. We experience almost firsthand how direct contact with people, rendered powerless by overwhelming force, experience the same damaging consequences as the victims themselves. But lest the viewer be rendered helpless, When Helping Hurts, points the way to prevention and treatment of compassion fatigue. I wish I had copies of this video to use during my work in Bosnia and Africa. It is now an essential part of my first aid kit.”

Geoffry D. White, Ph.D. Recipient of the California Psychological Association 1998 Humanitarian Award 1995 and 1996 Recipient of the EMDR Humanitarian Services Award for Disaster Relief in Croatia and Sarajevo

DVD Review

4. When Helping Hurts: Sustaining Trauma Workers

“The video, When Helping Hurts, clearly struck a responsive chord with those in attendance. It made clear that the feelings experienced by many of them while on disaster assignments are normal and understandable. And, it offered valuable advice about recognizing the symptoms of secondary trauma and responding appropriately. I think that the video or other orientation on this subject should be part of Red Cross training for all DSHR volunteers. Thank you for helping us improve our understanding of this important subject. “

Jon P. Bachelder, Executive Director, American Red Cross of West Central Michigan.

DVD Review

4. When Helping Hurts: Sustaining Trauma Workers

“I’ve been working as a firefighter and paramedic for over thirty years. At the Academy, I’ve been teaching police officers and sheriffs. It gives me great satisfaction.

When disaster and tragedy strikes we need to ask the question, who takes care of professional emergency workers? We are vulnerable because of the compassion we give to those we care for.

Gift From Within’s video, When Helping Hurts: Sustaining Trauma Workers is the best tape on the market to help us all deal with our hidden pain.

We need to set the highest standards of prevention, self care, and peer support during these disastrous deplorable events in our lives, and this quality tape will improve our understanding and quality of all Emergency care workers.

My highest admiration for the producers of this marvelous video tape.”

FrankMcMahan, Instructor,CCSF
City College, San Francisco

DVD Review

4.When Helping Hurts: Sustaining Trauma Workers

B. Hudnall Stamm, Ph.D., C.T.S. VA National Center for PTSD & Psychiatry, Dartmouth Medical School https://home.dartmouth.edu/

Joseph M. Rudolph, M.A. Department of Psychology, North Carolina State University

Edward M. Varra, M.A. Albany Veterans Affairs Medical Center, Albany, NY

This 50 minute tape, a product of the organization “A Gift From Within” features Frank Ochberg, M.D., Charles Figley, Ph.D., John Wilson, Ph.D., Mary Beth Williams, LCSW, Ph.D., Angie Panow, Ph.D., CEAP, and Atle Dyregrov, Ph.D. The tape was designed as a way to help educate professionals and volunteers working with trauma about the potential effects of Secondary Traumatic Stress. The tape begins with a discussion of the breadth of professionals and volunteers involved in dealing with the direct and indirect effects of high magnitude, highly stressful events. Examples of potentially affected persons include health care personnel as well as journalists, teachers, and clergy. The discussion highlights the complexity of working with trauma and how subtly and dramatically it can affect us in our personal and professional lives.

The second segment of the tape highlights symptoms that can be associated with Secondary Traumatic Stress including loss of humor, isolation, fatigue/exhaustion, nightmares, intrusive recollections, and demoralization. The speakers use personal stories to illustrate their points and to serve as a poignant reminder that the work we do, while rewarding, can be very challenging and is best conducted from within personal and professional support systems.

Following symptoms, the tape discusses the development of Compassion Stress/Secondary Traumatic Stress. Through personal accounts and clinical observation, prominent factors such as the size of the incident, type of injuries sustained, as well as who (adults or children) and how many people were injured or killed. Other features of the events are also mentioned including social, organizational and personal responsibilities associated with our roles as a helpers; professional expectations in times of crisis; and emotional coping strategies that can develop to deal with overwhelming events. In the final section, the speakers remind us that balancing what we do for others with what we do for ourselves can help us keep our internal/emotional resources charged. Most of the discussion focused on caring for ourselves as much as we care for our patients and communities. The issues addressed include setting professional boundaries, exercising regularly, getting enough sleep, eating well, having a social life separate from work, and being able to take time off. It was interesting that the panel did not assume these things would be easy and extolled the value of having ongoing support from a peer community as opposed to relying solely on periodic debriefings.

One of the difficult aspects of training in trauma is the possibility of causing distress in the trainees with the teaching material (McCammon, 1995). It is important to strike a balance between exposure to the grotesque in an attempt to convey the seriousness of trauma work and appropriately avoiding adding to the stressor load by triggering previous exposure with cues from training materials. While clearly showing explicit footage, the editing of this film seemed sensitive to this balance. Some well known footage from disasters was used, as well as tape from emergency room settings, but the pace of the cuts was brisk, reflecting nicely the urgency of a crisis while not lingering on the hideousness of the situations. Additionally, the footage that was chosen focused on the affect of the involved persons rather than on the details of various injuries; clearly appropriate for a video about our reactions to working in highly stressful events. It is important to note, however, that the tape is stimulating and could serve as a powerful trigger for some people.

This tape should be a good vehicle for discussion among helpers. Many helpers, either for personal reasons or because of the expectations of their institutions, or even of the larger society, struggle with distress or even shame at “not being strong enough to take it.” One of the clear messages of this tape is that it is normal to be affected by our work in trauma. This permission, spoken with authority by the panelist, should make it easier for people to self-identify difficulties and seek help from colleagues. While it is appropriate and necessary to speak with authority, as these panelists do, it would have been useful to have more differentiation between what we know about Secondary Traumatic Stress through clinical observation and what we know through research. Perhaps the panelists also felt this way. At the end of the tape, Figley comments that he believes that research is the future of this emergent area of concern.

McCammon, S. L. (1995). Painful Pedagogy: Teaching About Trauma in Academic and Training Settings. In Stamm, B.H. (Ed.). Secondary Traumatic Stress: Self-Care Issues for Clinicians, Researchers, and Educators, p. 105-120.

DVD Review

4. When Helping Hurts: Sustaining Trauma Workers

Compassion Stress and Self-Insight: The Trauma Therapist’s Turn on the Couch by Erwin Randolph Parson, Ph.D. and Jane Marie Parson, M.S.W.

“When Helping Hurts: Sustaining Trauma Workers” is the only video of its kind that addresses the very critical subject of trauma-induced distress in therapists, highlight the need for self-care, and introduces systematic guidelines for resolution. Some people are very aware that working day in and day out with trauma victims is risky business at times proving hazardous to the practitioner’s mental and physical health. This video was produced for trauma workers in America and around the world-for psychologists, social workers, psychiatrists, nurses, chaplains, priests, journalists, firefighters, emergency on-site accident personnel, international disaster and relief workers, and others in direct human contact with the overwhelmed in mind.

Featuring six key trauma experts, the video heralds a new era of genuine openness among a group of individuals known for their fundamental reluctance to make disclosures about their personal lives. These experts tell their own stories about the professional hazards of caring and how their work has continually exposed them to the dangers of powerful internalizations of violence and tragedy. Honest self-inventory about the effects of stress on their thinking, general emotional well-being, interpersonal functioning, and intimate relating, was modeled admirably by the therapists. They speak from where it counts, from the heart, from the deep reservoirs of traumatic anguish within their own humanity, communicating openness, and humility. The video makes this point crystal-clear: Compassionate caring carries a price.

Therapists’ vulnerability to trauma-based internalizations is a very real occupational hazard. For when therapists expose themselves to “frontline encounters” with victim/patients who are traumatically stressed, stretched to their psychological limits, and bursting at the seams of the self with traumatic disintegrative anxiety, they may suffer significant professional- and life-disrupting symptoms that require recognition and management. Some therapists may be even more vulnerable to compassion fatigue due to previous traumatization and identifications.

In order to organize the principles of detection, prevention, and intervention in the area of therapy-induced PTSD, stress, depressive affects, panic reactions, and traumatic dreaming, speakers in the video use Dr. Figley’s new concept, “Compassion Fatigue” and related concepts like compassion stress, secondary traumatization, burn-out, countertransference, and work-related stress.

The featured experts in the video include such trauma field giants with over two decades of experience as Charles R. Figley, Ph.D., Frank Ochberg, MD and John Wilson, Ph.D, and Angie Panos, Ph.D, Mary Beth Williams, Ph.D, and Atle Dyregrov, Ph.D. Collectively, they identify a set of symptoms they and other helpers experience (in working with children, veterans, women, fire victims, and victims of war and political violence), and offer a framework for traumatherapist self-care and growth.

The occupation-induced stress responses that therapists encounter in their work has been of interest to me beginning with my volunteer consultations at the New York area Vietnam Veterans Counseling and Outreach Centers (“Vet Centers”) 21 years ago. At that time I became aware of the risk factors associated with intense self-engagements in human services with severely traumatized veterans. Seventeen years ago, as the newly appointed Regional Manager for the Vet Centers in northeastern U.S.A. I wrote a paper and presented it at my inaugural meeting with Vet Center managers and supervisors, who I was now supervising. After alerting the group to the insidious dangers lurking within their readjustment practice and the need for vigilance, I instructed them as leaders of their respective teams to engage in judicious monitoring, prevention effort, and develop programs for ameliorate induced-trauma responses in their counselors and therapists. In the paper (“Burn-Out Phenomena: Implications for Its Recognition, Prevention, and Management in Vietnam Veterans Outreach Teams” (Unpublished paper presented at the Northeast Regional Team Leader’s Conference at the New Haven Vet Center, New Haven CT on February l7, 1982).

I expressed my concern and support for their work: I am personally aware of the inordinate sacrifices many of you have made “in the name of the Program.” … and of the mental and physical exhaustion and fatigue that some…suffered due to tenacious…efforts and unselfish spirit…in the delivery of readjustment counseling care to veteran clients.” I defined this therapy-induced dysfunction in helpers “as a biopsychic state of chronic fatigue and exhaustion, anxieties, and personal depletion…an end-product of high energy-overachieving (and lost) original vitality, idealism, exuberance, and hopefulness.”

As shown clearly in “When Helping Hurts”, I found that therapists usually develop a set of compensatory trauma defenses to help them cope, and that therapists’ responses range from the normal and expectable to the unusual and pathological. I had observed these phenomena in Vet Center teams in the 70s and 80s, as well as in therapists I encountered in private sector supervisory and consultative contexts over the years. In many situations, the helpers’ intervention-induced responses were sufficiently serious and pathological to warrant extreme supervisory intervention and organizational remedial measures to halt traumatic decline and destructiveness, protect patients, examine and restore ethical standards of care, and promote health and growth in the helpers. I have applied the term, narcissistic defense of everyday life to capture the day after day chronic pattern of schizoid isolation, a turning inward to the self not for insight, inspiration, or reflection, but a “hiding out” motivated by a terror- based need to preserve the organization of the self. This narcissistic, self-protective avoidance is associated persistent mental, physical, affective, social, and interpersonal avoidance, denial, projection, chronic anger, irritability, mental confusion, sense of dejection, and persistent vacillation between interpersonal avoidance and enmeshment in therapists-victim relating.

I found that these troubled helpers had shown an early zeal, idealism, and overidentification with victims, but the lights finally went out, and, having very little insight into his or her behavior, the helper continues to “care” for their patients. They blindly speed down the road of psychological distress and behavioral anomalies. As admirably as commitment to one’s patients might be, the narcissistic trauma defense is always self-serving, it’s intense, anxious, and excessively defensive. Because of the high degree of intrapsychic disruption, derailment of empathic alignment between therapists and trauma victim is inevitable, and is a significant problem in this occupational pathology.

For less severe forms of stress responses I use the term universal intervention stress-induced responses, which the video presents as common traumatic mental/physical responses: mental confusion, loss of the sense of humor, denial, self-doubting, doubting God, losing sense of spirit, resentment, anger, demoralization, disrupted sleep and traumatic dreaming, diminished sexual functioning and desire, and skin rashes and ulcers, and other psychosomatic stress responses. In contradistinction to the normal and pathological forms of induced stress responses is what author Gerald Alper of New York City calls the therapeutic personality. These therapists remain in control of their mental and physical health over time, and are generally characterized by ;hardiness, psychological-mindedness, openness, nondefensiveness, make realistic judgments about self and others, monitor their responses to their trauma patients, maintain a balanced lifestyle, and understand and accept their capacities and limitations.

In a masterful tour de force, The Gift From Within corporation has masterfully conceived and orchestrated a tremendous resource, in clear language for professional and lay audiences. The experts speak in an authentic style that will delight the expert and the novice in the field of psychotherapy, and lay audiences, and will prove of great value to domestic and international trauma/emergency workers.

DVD Review

4. Review of Tape When Helping Hurts:

Ellen F. Kirschman, Ph.D.

“I have used both tapes in training critical incident response teams. The 50 minute tape is a little long and general for public safety viewers, although there is a particularly poignant short interview with Charles Figley from this tape that I have shown by itself to illustrate how even the most experienced trauma workers are at risk for having their own traumatic experiences triggered by their work.

I do think the longer tape, in its entirety, is very useful for training therapists. The 15 minute tape gives a bref overview of major teaching points and works well for teaching self care skills to public safety trauma team members or peer supporters .

Thanks to Gift from Within for the work they are doing on behalf of trauma survivors and victim of PTSD.”

Dr. Kirschman is author of “I Love a Cop: What Police Families Need to Know”

DVD Review

4. Review of Tape When Helping Hurts:

I am developing a Compassion Fatigue workshop which will be offered numerous times in order to provide training for all the Child Protective/Child Welfare Workers throughout the state of Oklahoma. After searching for a videotape on the topic, I took Dr. Figley’s suggestion and visited The Gift Within’s website. I find the video, When Helping Hurts: Sustaining the Trauma Workers,” to be an excellent introduction to the topic and plan to use it at the beginning of each training.

Cynthia M. Brady, M.A., Oklahoma City
Licensed Marital and Family Therapist
Licensed Professional Counselor

DVD Review

4. Review of Tape When Helping Hurts:

Both tapes, When Helping Hurts: Sustaining Trauma Workers and Recovering From Traumatic Events: The Healing Process were very well done and will be very helpful. They fill a huge void in the video world – I have found nothing else like this that presents in a positive and hopeful manner. Thanks.

Mike McEvoy, PhD
EMS Coordinator
Saratoga County, N.Y.

DVD Review

4. Review of Tape When Helping Hurts:

“This program addresses an issue that is too often ignored by first responders to crisis. These dedicated individuals usually recognize their own ‘fatigue’, and understand all too well the meaning of ‘compassion’. Unfortunately, vigilant first responders including health care professionals are often blind to the combination of the two, and the impairment that accompanies ‘compassion fatigue’. This video gives testimony to the syndrome, and the critical need to recognize and intervene with the syndrome. The solutions that the video provide gives hope for all responders who are subject to the strain and ultimate impairment of unrecognized compassion fatigue.”

Gregory Saathoff M.D.
Executive Director
Critical Incident Analysis Group

DVD Review

4. Review of Tape When Helping Hurts:

Review by Daniel W. Clark, Ph.D.
Critical Concepts Consulting
drdan@criticalconcepts.org

When Helping Hurts: Sustaining Trauma Workers focuses on helping those who help others. Especially in the wake of recent national events such as Hurricanes Katrina and Rita, this is a relevant and valuable video.

Drs. Charles Figley and Mary Beth Williams describe compassion fatigue as the stress trauma workers experience when they are trying to help others – and cannot let go. Whereas burnout generally involves doing something you do not like, compassion fatigue may be defined as wanting to continue helping but becoming ineffective because you are too affected.

Trauma workers include more than emergency responders; trauma workers may also include mental health professionals, the clergy, hospital workers, Red Cross volunteers, administrators and support staff, and the media who are covering the event. Many of these trauma workers respond with idealistic expectations, feeling responsible for making the victims feel whole once again. Trauma workers may experience both direct and secondary exposure to trauma

Exposure to traumatic events may trigger reactions ranging from feeling so overwhelmed that you distance yourself and emotionally shut down to over-identification with the victim. Either extreme, avoiding or getting too close, can interfere with the trauma workers ability to continue helping. An additional potential complication occurs when the event stirs up events from the helper’s own past.

One of the earliest signs of compassion fatigue is losing your sense of humor. Other indicators may include feeling angry, resentful, and overwhelmed; decreased patience and tolerance; increased alcohol or substance abuse; sleep difficulties; and physical complications such as headaches, skin rashes, and GI tract disturbances.

Experts in the video point out that trauma workers typically deny the toll the event is having on them personally. Many feel it is easier to deny their reactions than to risk cracking open Pandora?s Box. Many trauma workers distance themselves from events as part of their usual job, potentially complicating their reaction to these traumatic events.

How can we mitigate the impact of these horrific events on trauma workers? One way is to practice what we preach: getting good sleep, exercising, talking to others because talking helps, staying connected with family and friends, setting reasonable limits and boundaries, and trying to keep a balance in life.

Dr. Figley also recommends positive self-talk such as “I’m doing the best I can for them” and “They have their lives and I have mine” to counter personal invulnerability and the thought that “I have to fix this.” Another recommendation is working in a buddy system, promising to observe and support each other, even confronting the other when necessary. Dr. Angie Panos offers recommendations for team leaders or managers for dealing with the diverse population of trauma responders.

A remarkable aspect of this video is the candor with which the experts self-disclose. The panel of six experts openly discusses their own reactions and responses to trauma, as well as how they have learned to cope, intensifying the impact of their message.

In closing, the video recommends useful books and websites, as well as organizations such as the International Society for Traumatic Stress Studies, the Association for Traumatic Stress Specialists, the American Red Cross, the National Center for PTSD, the National Organization for Victim Assistance, and the National Victim Center.

This is an effective, professional quality video worthy of adding to your audio-visual library.