How do I protect against vicarious traumatisation when working from home?

The COVID pandemic led many of us to start offering PTSD therapy online from our homes. For many of us, this arrangement has continued at least some of the time, as it can be more convenient for both therapists and clients, and appears no less effective. Also, the demand for digital therapies is growing, meaning more and more of us may work from home in the future. But this also introduces potential new risks. When our living space is also our workplace, we lose the natural physical boundary between work and home. Working with PTSD can make this a particular challenge, because of the potential emotional ‘toxicity’ [ELS1] of the traumatic experiences we listen to. Without the physical and travel time buffer between work and home, it can become harder to “leave things at work” and we may find ourselves thinking more about them outside of working hours.

A good first step is to be aware of this risk and take active steps to reduce it. We can try to find alternative ways to create buffers between our home and work lives. For example, ideally, it is better to have a workspace that does not double as a living or sleeping space. If you don’t have a spare room to use as an office, try to demarcate an area for your workspace. Ensure you have fixed breaks and mark a clear end to the working day by closing down your computer and closing the door to, or clearing away, your workspace at a set time, without letting the working day blur into your free time. It often helps to create a ‘buffer’ task, like taking a walk or run at the end of the working day, to replicate the effect of commuting time and create some mental distance from work. If you can, shut down devices that you use for work or, if you use the same phone and/or laptop for everything, turn off email notifications so that you aren’t tempted to read work emails when they arrive.

During client session time, reduce the potential distractions in your workspace, by turning off phones and email and asking co-habitants not to disturb you (although child and pet-related interruptions are sometimes unavoidable!). Being in your own home might make it easier to make self-disclosures to your clients so think through what feels appropriate and comfortable for you. For example, take note of what is in your background when you make video calls – are you happy to have personal items visible or would you prefer to have your back to a plain wall or blur the background on your call?

Working from home can also be more isolating, so we need to plan to keep connected with our team to nurture our morale and team cohesion. Arrange with colleagues to speak regularly and have the option to arrange a call with a peer or supervisor if you need to talk through a difficult session. Consider setting up a text/email ‘group chat’ so you can replicate the casual ‘check-ins’ with each other throughout the day, and share ‘distraction files’ (e.g. pictures of cute animals or landscapes; Rees, 2017).

It is also important to recognise when we are beginning to show signs of vicarious traumatisation or compassion fatigue. Doing a “self check-in” and, ideally, making this a standard item for supervision helps us to notice when we are beginning to struggle. This will differ between each of us, so learn to spot your own personal triggers and “burnout signature”. Example warning signs could be noticing a sense of dread on a Sunday evening or before speaking to certain clients, thinking about work over the weekend or on holiday, feeling more detached or irritable, or even having nightmares or becoming jumpy in situations that didn’t previously bother you. These may be signs that some traumatic impact is leaking through into your home life, and you need to review how you are working and take steps to protect yourself. Again, this will be different for everyone but might include changes to your work patterns like taking a break from trauma work or reducing your contact hours, and/or prioritising your self-care. Speak to your manager or supervisor about how you are feeling – it is better to catch problems early and get support if possible. Many of us feel reluctant to speak up when we are struggling, but as well as protecting ourselves, it means we are better placed to support our clients and our colleagues.

Key practice points

· Increased home working can blur work-life boundaries and increase risk of vicarious traumatisation

· We can create boundaries by establishing a separate workspace in our homes, finishing work at a regular time, clearing away our work and turning off devices

· Reduce distractions in your workspace and be aware of disclosure boundaries

· Working from home can be more isolating so consider how you can stay in touch informally with colleagues

· Monitor your own warning signs of vicarious traumatisation and consider changes to your work pattern and self-care to prevent problems escalating.