Two studies look at secondary posttraumatic stress (also referred to as compassion fatigue or vicarious PTSD) in Swedish ambulance workers and Israeli social workers in the ER, and make practical recommendations.. Researchers at Boras University College in Sweden looked at posttraumatic stress symptoms in ambulance workers, and found that post-traumatic stress symptoms, guilt, shame and self-reproach are commonplace after duty-related traumatic events, such as severe injuries, suicides, injuries in children and death. The research concludes that defusing, debriefing and counseling help mediate guilt and shame, and can reduce symptoms of PTSD.

Citation: Jonsson A, Segesten K. Guilt, shame and need for a container: a study of post-traumatic stress among ambulance personnel. Qualitative Health Research. 2004 Oct;14 (8): pages 1077-93. [email protected]

Researchers from The University of Haifa School of Social Work in Israel analyzed the emotional responses of 38 Israeli hospital social workers to working with civilian casualties from terrorist violence. Three themes emerged in this qualitative study that defined how these emergency room social workers found stepping stones toward resuming and maintaining their professional performance:
(a) Restoring the lost sense of personal security;
(b) Meeting the families'' pain and responding to it, and
(c) Disconnecting emotionally in the service of the professional self.

Citation: Somer E, Buchbinder E, Peled-Avram M, Ben-Yizhack Y.The stress and coping of Israeli emergency room social workers following terrorist attacks. Qualitative Health Research. 2004 Oct;14 (8): pages 1077-93.