Effect of Somatic Experiencing Resiliency-Based Trauma Treatment Training on Quality of Life and Psychological Health as Potential Markers of Resilience in Treating Professionals

Abstract

Background: Individuals who treat trauma are at significant risk of vicarious traumatization and burnout. Somatic Experiencing® (SE®) is a resiliency-focused trauma treatment modality designed to address autonomic nervous system (ANS) dysregulation and its impacted physical health and mental health symptoms e.g., anxiety, depression, post-traumatic stress disorder, migraines, fibromyalgia, and chronic fatigue, etc. The SE® training supports the development of clinical skills to reduce physical health/mental health symptoms as well as increase clinician resilience. Individuals who display resilience often have increased experiences of well-being (quality of life) and decreased levels of self-reported psychological symptoms. Greater resilience could mitigate the risks to providers and the clients they treat. Materials and Methods: This within-groups, longitudinal study assessed students (N = 18) over the course of a 3-year SE® practitioner training. This training focuses on increased ANS, physical, and emotional regulation skills. The convenience of a web-based survey allowed for: measures of a general quality of life (WHOQOL-BREF), psychological symptoms, somatic, anxiety, and depressive symptoms (PHQ-SADS), as well as a measure of early life exposure to adversity (CDC/Kaiser Permanente ACE Score Calculator Questionnaire). The clinician survey was conducted yearly for 3 years. Future studies would do well to also include laboratory-based objective measures of ANS functioning. Results: ANOVA with repeated measures showed that there were significant reductions in anxiety symptoms (GAD7, p < 0.001) and somatization symptoms (PHQ15, p < 0.001). Health-related quality of life (a measure of physical well-being) and social quality of life (a measure of interpersonal well-being) both increased significantly (Health QoL p = 0.028; Social QoL p = 0.046). Conclusions: Results suggest that professionals attending the 3-year SE® training course experience a significant improvement in self-reported measures associated with resiliency including: quality of life (well-being) and psychological symptoms (anxiety and somatization). Our results support the importance of future research in a larger sample and support the exploration, cross-sectionally and prospectively, of the relationship of clinician resiliency and changes in clinician resiliency with SE® training and clinical outcomes. These data have implications for other professions at risk of exposure to vicarious trauma (VT) including nurses, medical providers, and paramedics.

Keywords: ANS dysregulation; Somatic Experiencing®; burnout; compassion fatigue; quality of life; resiliency; traumatic stress; vicarious traumatization.

Figure 1

Study timeline. This figure displays the study timeline including informed consent and data collection points. Data was collected over the course of the 3-year training period.

Figure 2

WHOQOL-BREF health related quality of life. Results indicated significant improvement in health related quality of life (p = 0.028) on the WHOQOL-BREF. While the sample size is too small to clearly identify trends it is notable that there was a flattening of the trend line during the intermediate training year i.e., between the final beginning class (Beginning III) and final intermediate class (Intermediate III). Intermediate year training focuses on addressing specific types of traumas and focuses less on training of emotional regulation skills. It is possible that the exposure to learning about specific traumatic events may lead to a short-term level of distress that is reduced in the final two advanced year trainings.

Figure 3

WHOQOL-BREF social quality of life. Results indicated significant improvement in social quality of life (p = 0.046) on the WHOQOL-BREF. The trend in social quality of life was flat over the course of the three beginning modules. As above the sample size is too small to clearly identify trends. The beginning training year has several aspects that would address social quality of life. One of the core modules that could impact social quality of life is somatic boundaries and trauma. This module focuses on interpersonal safety and setting limits to support self-regulation. It could be that these skills require more significant practice before they can impact one's social connections or social quality of life. Alternatively, social quality of life may have a lag time from skill increase to change in behavior due to relationships being built over time.

Figure 4

PHQ-15 somatic symptoms. Results indicated significant reductions in somatic symptoms scale (PHQ-15) of the PHQ-SADS (p < 0.001). While the data set is too small for clear trends to emerge, these data indicate a possible step-wise reduction in symptoms over the course of the training. The main focus of the training in each module is increased somatic awareness, capacity to regulate stress states when engaging in clinical work and increased skills in recognizing one's own indication of stress states through interoception and description of the state. The regular time for reflection and skills practice could be a driver for the change at each point of measurement.

Figure 5

GAD-7 generalized anxiety scale. Results indicated significant reductions in anxiety scale (GAD-7) of the PHQ-SADS (p < 0.001). As stated above, the data set is too small for trends to be clearly identified but there appears to be a stable downward trend in symptoms of generalized anxiety. There is a slight flattening of the downward trend in the last two points of measure. It is likely that there are floor effects as the symptom level trends toward zero in the last two measures.