Date of Award


Document Type


Degree Name

PHD - Doctor of Philosophy


Expressive Therapies


Existing studies indicate the widespread existence of secondary traumatic stress (STS) in aid personnel and suggest the need for preventive and response strategies. This study examined the effectiveness of an integrated approach to reducing STS among aid personnel through a model that used psychoeducation, psychodrama, and cognitive behavioral resolution techniques. Data were collected pre- and post-intervention with the Professional Quality of Life Scale (ProQOL) (Stamm, 2009) and at a two-month follow-up (TMFU) for the intervention and control groups. An analysis of variance test was used to evaluate whether the intervention group showed more change on ProQOL scores than did the control groups. The results were not significant, indicating a small decrease in STS and burnout symptoms and a slight increase in compassion satisfaction. However, results from the TMFU open questionnaire suggested that retention of learning was higher with the intervention group than with the active control group. This finding challenges the widely held assumption that training is an effective modality of support for aid personnel exposed to trauma and traumatized populations, and underscores the urgent need to conduct evidence-based study of the efficacy of training for STS mitigation. The pilot research the author conducted (Gertel Kraybill, 2013) as antecedent to this dissertation, using the expressive trauma integration (ETI) model in a format of six individual sessions incorporating expressive therapy and psychoeducation, offers a promising alternative to existing STS training. The reality of increasing natural disasters and conflicts means that the number of aid personnel exposed to traumatized populations is certain to grow, and aid agencies must, as a matter of priority, expand their understanding of what is effective in supporting trauma-exposed staff.

Number of Pages





The author owns the copyright to this work.