Resumo Las peregrinaciones de Teresa é um livro de contos escrito por María Teresa León e publicado em 1950. Neste artigo são analisados dois dos contos a partir da perspectiva do uso que, na introdução, a autora faz do neologismo transmemoria. O objetivo é explorar o potencial crítico deste termo como significado essencial dos contos analisados. Isto leva a refutar o uso que Hirsch, Young e Bedingfield fazem dos conceitos de pós-memória e transmemória desde o início do século XXI para realçar o valor da produção de discursos “vicariantes” sobre o passado pela segunda geração de exilados e imigrantes a partir da sua própria reinterpretação do trauma sofrido pelos seus pais. Com base na análise das duas narrativas e no uso que León faz do termo transmemória, este artigo reivindica um modelo alternativo de memória em que as narrativas resultantes têm um papel emancipatório e em que a utopia prevalece sobre o trauma e a experiência sobre a herança.

Resumen Las peregrinaciones de Teresa es un libro de cuentos escrito por María Teresa León y publicado en 1950. En este artículo, se analizan dos de los cuentos desde la perspectiva del uso que, en la introducción, la autora hace del neologismo transmemoria. El objetivo es explorar el potencial crítico de este término como significado esencial de esos relatos. Ello lleva a cuestionar la utilización que, desde principios del siglo XXI, han hecho Hirsch, Young y Bedingfield de los conceptos de postmemoria y transmemoria para destacar el valor de la producción de discursos “vicarios” sobre el pasado por parte de la segunda generación de exiliados e inmigrantes según su propia reinterpretación del trauma sufrido por sus padres. A partir del análisis de los dos relatos y del uso que León hace del término transmemoria, este trabajo reivindica un modelo alternativo de memoria en el que los relatos resultantes poseen un papel emancipador y en el que la utopía prevalece sobre el trauma y la experiencia sobre la herencia.

Abstract María Teresa León’s Las peregrinaciones de Teresa is a short story collection published in 1950. This article examines two of its stories from the perspective of the neologism transmemoria, which the author presents in her introduction, with the aim of exploring its critical potential for analyzing the essential meaning of the stories. This allows us to question the use that Hirsch, Young and Bedingfield have made of the concepts of postmemory and transmemory since the early 21st century to highlight the value of the production of “vicarious” discourses about the past by the second generation of exiles and immigrants based on their own reinterpretation of the trauma suffered by their parents. From the analysis of the two narratives and León's use of the term transmemoria, this article argues for an alternative model of memory in which the resulting narratives have an emancipatory role and in which utopia prevails over trauma and experience over inheritance.

In this article we report on a study in which we explored life orientation (LO) teachers' experiences in providing psychosocial support to high school learners in the Johannesburg West district. High school learners are in the adolescent developmental stage, which is marked by major shifts in physiology, cognition, and social interactions, rendering them vulnerable to psychosocial problems. To cope with these challenges, they need sufficient age-related guidance and support. However, there is a shortage of social workers, registered counsellors and psychologists who are trained to provide psychosocial support for these issues in South African educational settings. As a result, LO teachers are frequently left with the responsibility of providing these services. Semi-structured telephonic interviews were conducted with 15 LO teachers from 11 schools (Quintiles 1 to 4) in the Johannesburg West district. The data were analysed using thematic analysis. The findings show that LO teachers play a critical role in providing psychosocial support to learners. They are, however, exposed to stressful experiences, which make them vulnerable to vicarious trauma, implying that they require support. It is thus recommended that they be provided with opportunities for debriefing and counselling.

BACKGROUND: Qualitative data on the experiences of treating post-traumatic stress disorder (PTSD) in a psychiatric setting in a low-resource context is sparse AIM: The authors aimed to explore the lived experiences of clinical psychologists who treat patients who are either trauma survivors or perpetrators in a psychiatric hospital SETTING: A public psychiatric hospital in the Eastern Cape, South Africa METHOD: A total of six individual semi-structured interviews were conducted with three clinical psychologists. Data were analysed using interpretive phenomenological analysis (IPA RESULTS: The analysis for each participant identified several significant themes, namely (1) support as a male person, (2) being appreciative, (3) difficult trauma narratives, (4) a mother and a psychologist and (5) fear and hopelessness CONCLUSION: Treating traumatic stress amongst clinical psychologists working in a public psychiatric hospital can lead to experiences of vicarious trauma and traumatic stress. In addition, the participants experienced an added danger in treating high-risk state patients, exposing psychologists to traumatic stress. Furthermore, psychologists recognised the influence of gender and race and its impact on their roles in their personal and professional lives as practitioners treating traumatic stress

Abstract Vicarious trauma, secondary stress, and compassion fatigue are standardized concepts to describe the alterations suffered by caregivers when empathy is at stake in their daily work. This phenomenon is a specific form of burnout, which emerges from the dynamics that regulate the field of care and the patient-caregiver relationship. At all times, and, especially, in times of social and health crises, the professional should be aware of the importance of personal responsibility for self-care so that he can intervene in this relationship, by identifying the lack or presence of psychological resources, which favor compassion fatigue or compassion satisfaction, respectively.

Resumen Trauma vicario, estrés secundario y fatiga por compasión, son conceptos homologados para describir las alteraciones que padecen los cuidadores cuando está en juego la empatía en su trabajo cotidiano. Este fenómeno es una forma específica de burnout que emerge de las dinámicas que regulan el campo del cuidado y la relación paciente cuidador. En todo momento y principalmente en tiempos de crisis sociales y de salud, el profesional debe advertir la importancia de la responsabilidad personal del autocuidado, de modo que pueda intervenir esta relación, identificando la carencia o presencia de recursos psicológicos que favorecen la fatiga por compasión o la satisfacción por compasión respectivamente.

Resumo Objetivo Sintetizar a prevalência de resultados psicológicos e de saúde mental dos profissionais de saúde que tratam doentes com COVID-19. Métodos Revisão sistemática da literatura. A busca dos estudos foi realizada nas plataformas PubMed, CINAHL e Scopus. Foram incluídos estudos em língua inglesa, portuguesa e espanhola, com data de publicação de 1 de dezembro de 2019 até 31 de julho de 2020. A revisão sistemática foi realizada com meta-análises binárias de efeito fixo de prevalência utilizando-se o STATA®15.0 e método do inverso da variância com transformação Freeman-Tukey double arcsine. Resultados A estratégia de pesquisa identificou 38.657 registos, dos quais apenas cinco estudos foram selecionados e integraram o corpus final da revisão. A meta-análise de prevalências para a depressão foi de 27,5% (IC95%=25,9-29,3; p<0,001), ansiedade 26,8% (IC95%=25,1-28,5; p<0,001), insônia 35,8% (IC95%=33,8-37,9; p=0,03) e estresse 51,9% (IC95%=49,6-54,3; p<0,001). Em três dos estudos incluídos os profissionais de saúde relataram níveis de trauma vicário adicionalmente importante, estresse pós-traumático, somatização e sintomas obsessivo-compulsivos. Conclusão A pandemia da COVID-19 apresenta um impacto psicológico muito significativo nos profissionais de saúde, assumindo importantes prevalências de depressão, ansiedade, insônia e estresse. Os profissionais de saúde da “linha de frente” são uma população particularmente vulnerável e merecem especial atenção/ intervenção.

Abstract Objective To synthesize the prevalence of psychological and mental health outcomes among healthcare professionals who are responsible for treating patients with COVID-19. Methods Systematic literature review. The literature search was carried out in the PubMed, CINAHL and Scopus databases. Studies written in English, Portuguese and Spanish and that were published between December 1st 2019 and July 31st 2020 were included. The systematic review was performed using fixed-effect meta-analysis of binary data with STATA®15.0 and inverse-variance method using Freeman-Tukey double arcsine transformation. Results The search strategy identified 38,657 records. Only five of those studies were selected and were included in the final review corpus. The meta-analysis conducted showed that the prevalence of depression reached 27.5% (95%CI=25.9-29.3; p<0.001), the prevalence of anxiety was 26.8% (95%CI=25.1-28.5; p<0.001), that of insomnia 35.8% (95%CI=33.8-37.9; p=0.03) and the prevalence of stress amounted to 51.9% (95%CI=49.6-54.3; p<0.001). Three of the studies included in the review show that healthcare professionals have also reported significant levels of vicarious traumatization, posttraumatic stress, somatization, and obsessive-compulsive symptoms. Conclusion The COVID-19 pandemic is found to have a very significant psychological impact on healthcare workers and is quite likely to lead to an important prevalence of depression, anxiety, insomnia, and stress. Frontline healthcare professionals are a particularly vulnerable group and deserve special attention/ intervention.

Resumen Objetivo Sintetizar la prevalencia de resultados psicológicos y de salud mental de los profesionales de la salud que tratan enfermos de COVID-19. Métodos Revisión sistemática de la literatura. La búsqueda de los estudios fue realizada en las plataformas PubMed, CINAHL y Scopus. Se incluyeron estudios en idioma inglés, portugués y español, con fecha de publicación entre 1 de diciembre de 2019 y 31 de julio de 2020. La revisión sistemática fue realizada con metaanálisis binarios de efecto fijo de prevalencia mediante la utilización del STATA®15.0 y el método del inverso de la varianza con transformación Freeman-Tukey double arcsine. Resultados A través de la estrategia de investigación se identificaron 38.657 registros, de los cuales solo cinco estudios fueron seleccionados e integraron el corpus final de la revisión. El metaanálisis de prevalencias de la depresión fue del 27,5 % (IC95 %=25,9-29,3; p<0,001), ansiedad 26,8 % (IC95 %=25,1-28,5; p<0,001), insomnio 35,8 % (IC95 %=33,8-37,9; p=0,03) y estrés 51,9 % (IC9 5 %=49,6-54,3; p<0,001). En tres de los estudios incluidos, los profesionales de la salud relataron niveles importantes de trauma vicario, estrés postraumático, somatización y síntomas obsesivo-compulsivos. Conclusión La pandemia de COVID-19 presenta un impacto psicológico muy significativo en los profesionales de la salud, con importantes prevalencias de depresión, ansiedad, insomnio y estrés. Los profesionales de la salud de la “línea de frente” son una población particularmente vulnerable y merecen especial atención/intervención.

RESUMEN La resiliencia vicaria se ha definido como el impacto positivo sobre los terapeutas y su consecuente crecimiento personal como resultado de su contacto con la resiliencia de sus clientes. Este artículo ofrece un resumen comprensivo de las investigaciones cualitativas y cuantitativas del tema realizadas durante los últimos diez años y ofrece sugerencias para investigaciones futuras.

ABSTRACT Vicarious resilience has been defined as the positive impact on and personal growth of therapists resulting from exposure to their clients’ resilience. This review provides a comprehensive summary of the qualitative and quantitative research conducted in the past 10 years, and offers suggestions for future research.

RESUMO A resiliência vicária tem sido definida como o impacto positivo sobre os terapeutas e seu consequente crescimento pessoal como resultado de seu contato com a resiliência de seus pacientes. Esta revisão oferece um resumo compreensivo das pesquisas qualitativas e quantitativas do tema realizadas durante os últimos dez anos, além de sugestões para pesquisas futuras.

Resumo Objetivo Este artigo se refere à tradução, adaptação transcultural e validação aparente da Trauma and Attachment Belief Scale (TABS), instrumento utilizado para avaliar os efeitos psicológicos das experiências de vida traumáticas e do trauma vicário. Métodos Este estudo envolveu uma revisão de literatura e avaliação da equivalência conceitual e dos itens, empregando grupos de discussão de especialistas, focando na existência e pertinência dos conceitos teóricos subjacentes e na correspondência dos itens dentro de um contexto brasileiro. Duas traduções e respectivas retrotraduções foram realizadas durante a avaliação da equivalência semântica, bem como foi feita uma avaliação considerando a equivalência referencial e geral entre a TABS original e cada versão. Vinte e oito psiquiatras e psicólogos completaram um pré-teste. A versão final foi testada para confiabilidade através do alfa de Cronbach e para compreensão verbal através de uma escala verbal-numérica adaptada [variando de 0 (Eu não entendi nada) a 5 (Eu entendi perfeitamente e não tive qualquer dúvida)] em outros 64 profissionais de saúde. Resultados A adaptação transcultural demonstrou alta equivalência semântica, tanto para o significado geral (>95,0%) quanto referencial (>90,0%). O alfa de Cronbach total foi de 0,9173. Todos os 84 itens foram mantidos e contribuíram favoravelmente para a consistência interna da escala. Os valores médios da escala verbal-numérica adaptada para a compreensão verbal obtidos dos profissionais de saúde variaram de 4,2 a 4,9. Conclusão A versão brasileira da TABS demonstrou equivalência conceitual, de itens e semântica de alta qualidade com o instrumento original, bem como elevada aceitabilidade, consistência interna e compreensão verbal. A escala está atualmente disponível para uso.

Abstract Objective This article concerns the translation, cross-cultural adaptation, and apparent validation of the Trauma and Attachment Belief Scale (TABS), an instrument used to assess the psychological effects of traumatic life experiences and vicarious trauma. Methods This study involved literature review and evaluation of conceptual and item equivalences involving expert discussion groups focused on the existence and pertinence of the underlying theoretical concepts and corresponding items in a Brazilian context. Two translations and respective back-translations were performed during the evaluation of semantic equivalence, as well as an evaluation considering the referential and general equivalences between the original TABS and each version. Twenty-eight psychiatrists and psychologists completed a pretest. The final version was tested for reliability through the Cronbach’s alpha and for verbal comprehension through the adapted verbal-numeric scale (ranging from 0 [I didn’t understand anything] to 5 [I understood perfectly and I had no doubt]) in another 64 health professionals. Results The cross-cultural adaptation demonstrated high semantic equivalence for both the general (>95.0%) and the referential (>90.0%) meaning. The total Cronbach’s alpha was 0.9173. All 84 items were maintained, and they favorably contributed to the internal consistency of the scale. The mean values of the adapted verbal-numeric scale for verbal comprehension obtained from health professionals varied from 4.2 to 4.9. Conclusion The Brazilian version of the TABS demonstrated high-quality conceptual, item, and semantic equivalence with the original instrument, as well as high acceptability, internal consistency, and verbal comprehension. The scale is now available for use.

BACKGROUND: Despite the well-known impact of rape on mental health and the widespread problem of rape in South Africa, mental health services for rape victims are scant and not a priority for acute-phase services. Survivors encounter multiple mental health struggles in this period including adherence to the post-exposure prophylaxis drugs to prevent HIV and finding support from important others. We have little information on what mental health is provided, by whom and how it is integrated into the post-rape package of care. AIM: The aim of the study was to do a rapid appraisal of mental health services for rape survivors to gain a better understanding of the current acute and long-term (secondary) mental health services. METHOD: We conducted a qualitative study using a rapid assessment with a purposive sample of 14 rape survivors and 43 service providers recruited from post-rape sexual assault services in urban and rural Western Cape Province. Data were collected using semi-structured in-depth interviews and observations of survivor sessions with counsellors, nurses and doctors. The data were coded thematically for analysis. RESULTS: Survivors of rape experienced a range of emotional difficulties and presented varying levels of distress and various levels of coping. Receiving support and care from others assisted them, but the poor integration of mental health within post-rape services meant few received formal mental health support or effective referrals. Multiple factors contributed to the poor integration: mental health was not given the same level of priority as other rape services (i.e. clinical care, including forensic management), the inadequate capacity of service providers to provide mental healthcare, including mental health illiteracy, the lack of continuity of care, the poor linkages to ongoing mental healthcare, and the mental health challenges caused by vicarious trauma and compassion fatigue. CONCLUSION: Providing effective, compassionate mental health services should be seen as essential components of post-rape care. The strengthening of support for providers and linkages to ongoing mental healthcare are essential to improve mental health services within acute post-rape services.

Neste artigo, as autoras debatem os custos e benefícios do exercício da psicoterapia no próprio psicoterapeuta. Começam por assumir os benefícios da psicoterapia para o cliente, fundamentando o impacto positivo que falar sobre as experiências emocionalmente difíceis ou potencialmente traumáticas pode ter no seu crescimento e mudança. Por outro lado, não esquecendo o carácter relacional da psicoterapia, as autoras debatem o impacto negativo que o acto clínico de escutar relatos terríveis e/ou presenciar a expressão do sofrimento, pode ter no próprio terapeuta. Assumindo o carácter de risco que representa a profissão de psicoterapeuta, mas notando a resiliência de muitos terapeutas, as autoras discutem o outro lado da questão, sublinhando a oportunidade de crescimento e desenvolvimento pessoal e profissional que esta actividade também pode oferecer. Por fim, sugerem um conjunto de cuidados aos terapeutas, a ter em consideração consigo próprios, para prevenir os riscos e potenciar os benefícios do exercício da psicoterapia.

In this paper, the authors discuss therapist’s costs and benefits from to practice psychotherapy. Assuming the benefits of psychotherapy for clients, they justify the positive impact of talk about emotional hard full or potentially traumatic experiences on their growth and change. Nevertheless, not forgetting the relational character of psychotherapy, the authors discuss the negative impact that the clinical act of listen hard narrations and/or to witness the client’s suffering, can have on the therapist him self. Assuming psychotherapy as a risk job, but looking at resilient psychotherapists, the authors discuss the others side of question, and underline psychotherapy as an opportunity for personal growth and professional development. Finally they suggest some kinds of self-care indications for therapists, in order to prevent risks and to increased benefits from psychotherapy practice.

Occupational therapy today needs to re-position itself in context to be relevant to the traumatised psyche of the South African nation. The social atom of the profession needs to relate more congruently to groups, communities and populations. Addressing the secondary causal issues underlying impairment, means our practice will increasingly become multi-modal, using experience and theory from medical, social, environmental, phenomenological and ethnographic models. Occupational therapy in South Africa needs to take the imperative of contextual relevance forward by attending to the traumatic subtexts of practice. Four propositions are suggested. 1. Inclusive, holistic practice applies to both individuals and collectives. 2. Occupational therapy is located in a social atom that enables it to be a significant role-player for social change. 3. The social atom of occupational therapy paves the way for working with the traumatised individuals and communities. 4. Service providers should manage vicarious traumatisation proactively. My hope is that these four propositions will galvanise debate about the contribution of occupational therapy to the healing of a society traumatised by violence and other forms of oppression and abuse.

O objetivo deste artigo é revisar aspectos importantes da relação entre a contratransferência e o atendimento de pacientes vítimas de trauma psíquico. O tratamento de pessoas traumatizadas é potencialmente uma fonte de sofrimento psíquico também para os terapeutas, devido à grande carga emocional envolvida, bem como pelas chances de evocar fortes reações contratransferenciais. Um maior entendimento acerca deste processo poderá contribuir decisivamente para os resultados dos tratamentos, além de possibilitar a proteção e a prevenção da saúde mental dos terapeutas. Inicialmente, aborda-se o trauma a partir de seu conceito e definições, incluindo considerações sobre o transtorno de estresse pós-traumático, estendendo-se para a conceitualização de contratransferência e seu significado no contexto das situações traumáticas. O impacto de tratar pacientes vítimas de trauma será também exposto através da relevância do fenômeno de traumatização vicária, cuja compreensão vem sendo destacada como indispensável para um melhor atendimento de vítimas de traumas psicológicos.

This article aims at reviewing important aspects of the relationship between countertransference and care of patients who were victims of psychic trauma. The treatment of traumatized patients is a potential source of psychic suffering to their therapists as well, due to the emotional burden involved and to the chances of evoking strong countertransferential reactions. A better understanding of this process could be a valuable contribution to treatment outcome, besides promoting mental health protection and prevention for therapists. Firstly, psychic trauma will be approached from its concept and definitions, including considerations on posttraumatic stress disorder and extending to countertransference reactions and their meaning in the context of traumatic situations. The impact of treating trauma victims will also be discussed through the relevance of vicarious traumatization, a phenomenon whose comprehension has been pointed out as crucial to provide better care to psychological trauma victims.