Development and Factor Analysis of the Protective Factors Index: A Report Card Section Related to the Work of School Counselors

Gwen Bass, Ji Hee Lee, Craig Wells, John C. Carey, Sangmin Lee

The scale development and exploratory and confirmatory factor analyses of the Protective Factor Index (PFI) is described. The PFI is a 13-item component of elementary students’ report cards that replaces typical items associated with student behavior. The PFI is based on the Construct-Based Approach (CBA) to school counseling, which proposes that primary and secondary prevention activities of school counseling programs should focus on socio-emotional, development-related psychological constructs that are associated with students’ academic achievement and well-being, that have been demonstrated to be malleable, and that are within the range of expertise of school counselors. Teachers use the PFI to rate students’ skills in four construct-based domains that are predictive of school success. School counselors use teachers’ ratings to monitor student development and plan data-driven interventions.

 

Keywords: protective factors, factor analysis, school counselors, construct-based approach, student development

 

Contemporary models for school counseling practice (ASCA, 2012) emphasize the importance of school counselors using quantitative data related to students’ academic achievement to support professional decisions (Poynton & Carey, 2006), to demonstrate accountability (Sink, 2009), to evaluate activities and programs (Dimmitt, Carey, & Hatch, 2007), to advocate for school improvement (House & Martin, 1998) and to advocate for increased program support (Martin & Carey, 2014). While schools are data-rich environments and great emphasis is now placed on the use of data by educators, the readily available quantitative data elements (e.g., achievement test scores) are much better aligned with the work of classroom teachers than with the work of school counselors (Dimmitt et al., 2007). While teachers are responsible for students’ acquisition of knowledge, counselors are responsible for the improvement of students’ socio-emotional development in ways that promote achievement. Counselors need data related to students’ socio-emotional states (e.g., self-efficacy) and abilities (e.g., self-direction) that predispose them toward achievement so that they are better able to help students profit from classroom instruction and make sound educational and career decisions (Squier, Nailor, & Carey, 2014). Measures directly associated with constructs related to socio-emotional development are not routinely collected or used in schools. The development of sound and useful measures of salient socio-emotional factors that are aligned with the work of school counselors and that are strongly related to students’ academic success and well-being would greatly contribute to the ability of counselors to identify students who need help, use data-based decision making in planning interventions, evaluate the effectiveness of interventions, demonstrate accountability for results, and advocate for students and for program improvements (Squier et al., 2014).

 

Toward this end, we developed the Protective Factors Index (PFI) and describe herein the development and initial exploratory and confirmatory factors analyses of the PFI. The PFI is a 13-item component of elementary students’ report cards that replaces typical items associated with student deportment. The PFI is based on the Construct-Based Approach (CBA) to school counseling (Squier et al., 2014), which is based on the premise that primary and secondary prevention activities of school counseling programs should be focused on socio-emotional development-related psychological constructs that have been identified by research to be associated strongly with students’ academic achievement and well-being, that have been demonstrated to be malleable, and that are within the range of expertise of school counselors. The CBA clusters these constructs into four areas reflecting motivation, self-direction, self-knowledge and relationship competence.

 

The present study was conducted as collaboration between the Ronald H. Fredrickson Center for School Counseling Outcome Research and Evaluation and an urban district in the Northeastern United States. As described below, the development of the PFI was guided by the CBA-identified clusters of psychological states and processes (Squier et al., 2014). With input from elementary counselors and teachers, a 13-item report card and a scoring rubric were developed, such that teachers could rate each student on school counseling-related dimensions that have been demonstrated to underlie achievement and well-being. This brief measure was created with considerable input from the school personnel who would be implementing it, with the goal of targeting developmentally appropriate skills in a way that is efficient for teachers and useful for counselors. By incorporating the PFI into the student report card, we ensured that important and useful student-level achievement-related data could be easily collected multiple times per year for use by counselors. The purpose of this study was to explore relationships between the variables that are measured by the scale and to assess the factor structure of the instrument as the first step in establishing its validity. The PFI has the potential to become an efficient and accurate way for school counselors to collect data from teachers about student performance.

 

Method

 

Initial Scale Development

The PFI was developed as a tool to gather data on students’ socio-emotional development from classroom teachers. The PFI includes 13 items on which teachers rate students’ abilities related to four construct-based standards: motivation, self-direction, self-knowledge and relationships (Squier et al., 2014). These four construct clusters are believed to be foundational for school success (Squier et al., 2014). Specific items within a cluster reflect constructs that have been identified by research to be strongly associated with achievement and success.

 

The PFI assessment was developed through a collaborative effort between the research team and a group of district-level elementary school administrators and teachers. The process of creating the instrument involved an extensive review of existing standards-based report cards, socio-emotional indicators related to different student developmental level, and rating scales measuring identified socio-emotional constructs. In addition, representatives from the district and members of the research team participated in a two-day summer workshop in August of 2013. These sessions included school counselors and teachers from each grade level, as well as a teacher of English language learners, a special education representative, and principals. All participants, except the principals, were paid for their time. Once the draft PFI instrument was completed, a panel of elementary teachers reviewed the items for developmental appropriateness and utility. The scale was then adopted across the district and piloted at all four (K–5) elementary schools during the 2013–2014 school year as a component of students’ report cards.

 

The PFI component of the report card consists of 13 questions, which are organized into four segments, based on the construct-based standards: motivation (4 items), self-direction (2 items), self-knowledge (3 items) and relationships (4 items). The items address developmentally appropriate skills in each of these domains (e.g., demonstrates perseverance in completing tasks, seeks assistance when needed, works collaboratively in groups of various sizes). The format for teachers to evaluate their students includes dichotomous response options: “on target” and “struggling.” All classroom teachers receive the assessment and the scoring rubric that corresponds to their grade level. The rubric outlines the observable behaviors and criteria that teachers should use to determine whether or not a student demonstrates expected, age-appropriate skills in each domain. Because the PFI instrument is tailored to address developmentally meaningful competencies, three rubrics were developed to guide teacher ratings at kindergarten and first grade, second and third grade, and fourth and fifth grade.

 

At the same time that the PFI scale was developed, the district began using a computer-based system to enter report card data. Classroom teachers complete the social-emotional section of the standards-based report card electronically at the close of each marking period, when they also evaluate students’ academic performance. The data collected can be accessed and analyzed electronically by school administrators and counselors. Additionally, data from two marking periods during the 2013–2014 school year were exported to the research team for analysis (with appropriate steps taken to protect students’ confidentiality). These data were used in the exploratory and confirmatory factor analyses described in this paper.

 

Sample

The PFI was adopted across all of the school district’s four elementary schools, housing grades kindergarten through fifth. All elementary-level classroom teachers completed the PFI for each of the students in their classes. The assessment was filled out three times during the 2013–2014 school year, namely in December, March and June. The data collected in the fall and winter terms were divided into two sections for analysis. Data from the December collection (N = 1,158) was used for the exploratory factor analysis (EFA) and data from the March collection was randomly divided into two subsamples (subsample A = 599 students and subsample B = 591 students) in order to perform the confirmatory factor analysis (CFA).

 

The sample for this study was highly diverse: 52% were African American, 17% were Asian, 11% were Hispanic, 16% were Caucasian, and the remaining students identified as multi-racial, Pacific Islander, Native Hawaiian, or Native American. In the EFA, 53.2% (n = 633) of the sample were male and 46.8% (n = 557) of the sample were female. Forty-seven kindergarten students (3.9%), 242 first-grade students (20.3%), 216 second-grade students (18.2%), 222 third-grade students (18.7%), 220 fourth-grade students (18.5%), and 243 fifth-grade students (20.4%) contributed data to the EFA.

 

The first CFA included data from 599 students, 328 males (54.8%) and 271 females (45.2%). The data included 23 kindergarten students (3.8%), 136 first-grade students (22.7%), 100 second-grade students (16.7%), 107 third-grade students (17.9%), 102 fourth-grade students (17.0%), and 131 fifth-grade students (21.9%). The data analyzed for the second CFA included assessments of 591 students, 305 males (51.6%) and 286 females (48.4%). The data consisted of PFI assessments from 24 kindergarten students (4.1%), 106 first-grade students (17.9%), 116 second-grade students (19.6%), 115 third-grade students (19.5%), 118 fourth-grade students (20.0%), and 112 fifth-grade students (19.0%).

 

Procedures

Classroom teachers completed PFI assessments for all students in their class at the close of each marking period using the rubrics described above. Extracting the data from the district’s electronic student data management system was orchestrated by the district’s information technology specialist in collaboration with members of the research team. This process included establishing mechanisms to ensure confidentiality, and identifying information was extracted from student records.

 

Data Analyses

The PFI report card data was analyzed in three phases. The first phase involved conducting an EFA at the conclusion of the first marking period. The second phase was to randomly select half of the data compiled during the second marking period and perform a confirmatory factor analysis. Finally, the remaining half of the data from the second marking period was analyzed through another CFA.

 

Phase 1. Exploratory factor analysis. An initial EFA of the 13 items on the survey instrument was conducted using the weighted least squares mean adjusted (WLSM) estimation with the oblique rotation of Geomin. The WLSM estimator appropriately uses tetrachoric correlation matrices if items are categorical (Muthén, du Toit, & Spisic, 1997). The EFA was conducted using Mplus version 5 (Muthén & Muthén, 1998–2007).

 

Model fit was assessed using several goodness-of-fit indices: comparative fit index (CFI), Tucker-Lewis Index (TLI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR). We assessed model fit based on the following recommended cutoff values from Hu and Bentler (1999): CFI and TLI values greater than 0.95, RMSEA value less than 0.06, and SRMR value less than 0.08.

 

     Phase 2. First confirmatory factor analysis. An initial CFA was conducted on the 13 items from the instrument survey to assess a three-factor measurement model that was based on theory and on the results yielded through the exploratory analysis. Figure 1 provides the conceptual path diagram for the measurement model. Six items (3, 4, 6, 7, 11 and 13) loaded on factor one (C1), which is named “academic temperament.” Three items (8, 9 and 12) loaded on factor two (C2), which is referred to as “self-knowledge.” Four items (1, 2, 5 and 10) loaded on factor three (C3), which is titled “motivation.” All three latent variables were expected to be correlated in the measurement model.

 

This CFA was used to assess the measurement model with respect to fit as well as convergent and discriminant validity. Large standardized factor loadings, which indicate strong inter-correlations among items associated with the same latent variable, support convergent validity. Discriminant validity is evidenced by correlations among the latent variables that are less than the standardized factor loadings; that is, the latent variables are distinct, albeit correlated (see Brown, 2006; Kline, 2011; Schumacker & Lomax, 2010).

 

The computer program Mplus 5 (Muthén & Muthén, 1998-2007) was used to conduct the CFA with weighted least square mean and variance adjusted (WLSMV) estimation. This is a robust estimator for categorical data in a CFA (Brown, 2006). For the CFA, Mplus software provides fit indices of a given dimensional structure that can be interpreted in the same way as they are interpreted when conducting an EFA.

 

     Phase 3. Second confirmatory factor analysis. A second CFA was conducted for cross-validation. This second CFA was conducted on the 13 items from the instrument survey to assess a three-factor measurement model that was based on the results yielded through the first confirmatory factor analysis. The same computer program and estimation tactics were used to conduct the second CFA.


Results

 

Phase 1. Exploratory Factor Analysis

Complete descriptive statistics for the responses to each of the 13 items are presented in Table 1. The response categories for all questions are dichotomous and also identified in Table 1 as “On Target” or “Struggling,” while incomplete data are labeled “Missing.” A total of 1,158 surveys were analyzed through the EFA. The decision to retain factors was initially guided by visually inspecting the scree plot and eigenvalues. The EFA resulted in two factors with eigenvalues greater than one (one-factor = 8.055, two-factor = 1.666, and three-factor = 0.869). In addition, the scree test also supported the idea that two factors were retained because two factors were left of the point where the scree plot approached asymptote. However, considering goodness-of-fit indices, the models specifying a three-factor structure and four-factor structure fit the data well. Methodologists have suggested that “underfactoring” is more problematic than “overfactoring” (Wood, Tataryn, & Gorsuch, 1996). Thus, there was a need to arrive at a factor solution that balanced plausibility and parsimony (Fabrigar, Wegener, MacCallum, & Strahan, 1999).

Methodologists (e.g., Costello & Osborne, 2005; Fabrigar et al., 1999) have indicated that when the number of factors to retain is unclear, conducting a series of analyses is appropriate. Therefore, two-, three-, and four-factor models were evaluated and compared to determine which model might best explain the data in the most parsimonious and interpretable fashion. In this case, the two-factor model was eliminated because it did not lend itself to meaningful interpretability. The four-factor model was excluded because one of the factors was related to only one item, which is not recommended (Fabrigar et al., 1999). Researchers evaluated models based on model fit indices, item loadings above 0.40 (Kahn, 2006), and interpretability (Fabrigar et al., 1999).

 

The three-factor measurement model fit the data well (RMSEA = 0.052, SRMR = 0.036, CFA = 0.994, TLI = 0.988, χ2 = 173.802, df = 42, p < 0.001). As shown in Table 2, the standardized factor loadings were large, ranging from 0.58 to 0.97. The first factor included six items. Items reflected students’ abilities at emotional self-control and students’ abilities to maintain good social relationships in school (e.g., demonstrates resilience after setbacks and works collaboratively in groups of various sizes). This first factor was named “academic temperament.”
The second factor included three items. All of the items reflected the understanding that students have about their own abilities, values, preferences and skills (e.g., identifies academic strengths and abilities and identifies things the student is interested in learning). This second factor was named “self-knowledge.” The third factor included four items. All of the items reflected personal characteristics that help students succeed academically by focusing and maintaining energies on goal-directed activities (e.g., demonstrates an eagerness to learn and engages in class activities). This third factor was named “motivation.” The three-factor measurement model proved to have parsimony and interpretability.

 

The two-factor model did not fit the data as well as the three-factor model (RMSEA = 0.072, SRMR = 0.058, CFA = 0.985, TLI = 0.978, χ2 = 371.126, df = 53, p < 0.001). As shown in Table 2, the standardized factor loadings were large, ranging from 0.59 to 0.94. The first factor included seven items. This first factor reflected self-knowledge and motivation. It was more appropriate to differentiate self-knowledge and motivation considering interpretability. The two-factor model provided relatively poor goodness-of-fit indices and interpretability.

 

The four-factor model fit the data slightly better than the three-factor model (RMSEA = 0.035, SRMR = 0.023, CFA = 0.998, TLI = 0.995, χ2 = 76.955, df = 32, p < 0.001). As shown in Table 2, the standardized factor loadings were large, ranging from 0.54 to 1.01. The first factor included one item, however, and retained factors should include at least three items that load 0.05 or greater (Fabrigar et al., 1999), so the first factor was removed. The second factor was comprised of six items that all relate to the construct of academic temperament. The third factor includes four items that reflect motivation. The fourth factor is composed of three items that relate to self-knowledge. The four-factor model was strong in terms of goodness-of-fit indices, though it was not possible to retain the first factor methodologically, due to the fact that it only involved one item. Therefore, given a series of analyses, the three-factor model was selected as the most appropriate.

 

Phase 2. First Confirmatory Factor Analysis

Complete descriptive statistics for the items are presented in Table 3. The responses for all items were dichotomous. A total of 569 (95.0%) of 599 surveys were completed and were used in the first CFA.

 

 

 

 

The three-factor measurement model provided good fit to the data (RMSEA = 0.059, CFI = 0.974, TLI = 0.984, χ2 = 104.849, df = 35, p < 0.001). Table 4 reports the standardized factor loadings, which

can be interpreted as correlation coefficients, for the three-factor model. The standardized factor loadings were statistically significant (p < 0.001) and sizeable, ranging from 0.72 to 0.94. The large standardized factor loadings support convergent validity in that each indicator was primarily related to the respective underlying latent variable. Table 5 reports the correlation coefficients among the three latent variables. The correlation coefficients were less than the standardized factor loadings, thus supporting discriminant validity.

 

 

 

Phase 3. Second Confirmatory Factor Analysis

Complete descriptive statistics for the items are presented in Table 3. The type of responses for all items was dichotomous. A total of 564 (95.4%) of 591 surveys had all the items complete and were used in the first CFA.

 

The second CFA was conducted on the three-factor measurement model to cross-validate the results from the first CFA. The three-factor model provided acceptable fit to the data in this second CFA (RMSEA = 0.055, CFI = 0.976, TLI = 0.983, χ2 = 100.032, df = 37, p < 0.001). Table 4 reports the standardized factor loadings, which can be interpreted as correlation coefficients, for the three-factor model. The standardized factor loadings were significantly large, ranging from 0.70 to 0.93. These large standardized factor loadings support convergent validity in that each indicator was largely related to the respective underlying latent variable. Table 5 reports the correlation coefficients among the three latent variables. The correlation coefficients were less than the standardized factor loadings so that discriminant validity was supported. Given these results, it appears that the three-factor model is the most reasonable solution.

 

Discussion

 

The ASCA National Model (2012) for school counseling programs underscores the value of using student achievement data to guide intervention planning and evaluation. This requires schools to find ways to collect valid and reliable information that provides a clear illustration of students’ skills in areas that are known to influence academic achievement. The purpose of developing the PFI was to identify and evaluate socio-emotional factors that relate to students’ academic success and emotional health, and to use the findings to inform the efforts of school counselors. The factor analyses in this study were used to explore how teachers’ ratings of students’ behavior on the 13-item PFI scale clustered around specific constructs that research has shown are connected to achievement and underlie many school counseling interventions. Because the scoring rubrics are organized into three grade levels (kindergarten and first grade, second and third grade, and fourth and fifth grade), the behaviors associated with each skill are focused at an appropriate developmental level. This level of detail allows teachers to respond to questions about socio-emotional factors in ways that are consistent with behaviors that students are expected to exhibit at different ages and grade levels.

 

Considering parsimony and interpretability, the EFA and two CFAs both resulted in the selection of a three-factor model as the best fit for the data. Through the EFA, we compared two-, three- and four-factor models. The three-factor model showed appropriate goodness-of-fit indices, item loadings and interpretability. Additionally, the two CFAs demonstrated cross-validation of the three-factor model. In this model, the fundamental constructs associated with students’ academic behavior identified are “academic temperament,” “self-knowledge,” and “motivation.” “Self-knowledge” and “motivation” correspond to two of the four construct clusters identified by Squier et al. (2014) as critical socio-emotional dimensions related to achievement. The “academic temperament” items reflected either self-regulation skills or the ability to engage in productive relationships in school. Squier et al. (2014) differentiated between self-direction (including emotional self-regulation constructs) and relationship skills clusters.

 

Although not perfectly aligned, this factor structure of the PFI is consistent with the CBA model for clustering student competencies and corresponds to previous research on the links between construct-based skills and academic achievement. Teacher ratings on the PFI seemed to reflect their perceptions that self-regulation abilities and good relationship skills are closely related constructs. These results indicate that the PFI may be a useful instrument for identifying elementary students’ strengths and needs in terms of exhibiting developmentally appropriate skills that are known to influence academic achievement and personal well-being.

 

Utility of Results

The factor analysis conducted in this study suggests that the PFI results in meaningful data that can allow for data-based decision making and evaluation. This tool has possible implications for school counselors in their efforts to provide targeted support, addressing the academic and socio-emotional needs of elementary school students. The PFI can be completed in conjunction with the academic report card and it is minimally time-intensive for teachers. In addition to school-based applications, the socio-emotional information yielded is provided to parents along with their child’s academic report card. This has the potential to support school–home connections that could prove useful in engaging families in interventions, which is known to be beneficial. Finally, the instrument can help school counselors identify struggling students, create small, developmentally appropriate groups based on specific needs, work with teachers to address student challenges that are prevalent in their classrooms, evaluate the success of interventions, advocate for program support, and share their work with district-level administrators. The PFI could come to be used like an early warning indicator to identify students who are showing socio-emotional development issues that predispose toward disengagement and underachievement.

 

The PFI also may prove useful as a school counseling evaluation measure. Changes on PFI items (and perhaps on subscales related to the three underlying dimensions identified in the present study) could be used as data in the evaluation of school counseling interventions and programs. Such evaluations would be tremendously facilitated by the availability of data that is both within the domain of school counselors’ work and that is known to be strongly related to achievement.

 

The findings offer great promise in terms of practical implications for school personnel and parents. This analysis quite clearly illustrates “academic temperament,” “self-knowledge” and “motivation” as factors that are demonstrated to be foundational to school success. The results indicate that the teachers’ ratings of students’ behavior align with findings of existing research and, thus, that the instrument is evaluating appropriate skills and constructs.

 

Implications for School Counselors

The PFI was developed as a data collection tool that could be easily integrated into schools for the purpose of assessing students’ development of skills that correspond to achievement-related constructs. Obtaining information about competencies that underlie achievement is critical for school counselors, who typically lead interventions that target such skills in an effort to improve academic outcomes. Many developmental school counseling curricula address skills that fall within the domains of “academic temperament,” “self-knowledge,” and “motivation” (see: http://www.casel.org/guide/programs for a complete list of socio-emotional learning programs). Teachers can complete the PFI electronically, at the same intervals as report cards and in a similarly user-friendly format. Therefore, the PFI facilitates communication between teachers and school counselors regularly throughout the school year. Counselors can use the data to identify appropriate interventions and to monitor students’ responsiveness to school counseling curricula over time and across settings. Although not included in this analysis, school counselors could also measure correlations between PFI competencies and achievement to demonstrate how academic outcomes are impacted by school counseling interventions and curricula.

 

Limitations and Further Study

Despite the promising findings on these factor analyses, further research is needed to confirm these results and to address the limitations of the present study. Clearly, additional studies are needed to confirm the reliability of PFI teacher ratings and future research should explore inter-rater reliability. Further research also is needed to determine if reliable and valid PFI subscales can be created based on the three dimensions found in the present study. Test-retest reliability, construct validity and subscale inter-correlations should be conducted to determine if PFI subscales with adequate psychometric characteristics can be created. Subsequent studies should consider whether students identified by the PFI as being in need of intervention also are found by other measures to be in need of support. Another important direction for future research is to examine the relationships between teachers’ ratings of students’ socio-emotional skills on the PFI and the students’ academic performance. Establishing a strong link between the PFI and actual academic achievement is an essential step to documenting the potential utility of the index as a screening tool. As this measure was developed to enhance data collection for data-based decision making, future research should explore school counselors’ experiences with implementation as well as qualitative reporting on the utility of PFI results for informing programming.

 

Although the present study suggests that the PFI in its current iteration is quite useful, practically speaking, researchers may consider altering the tool in subsequent iterations. One possible revision involves changing the format from dichotomous ratings to a Likert scale, which could allow for teachers to evaluate student behavior with greater specificity and which would benefit subscale construction. Another change that could be considered is evaluating the rubrics to improve the examples of student behavior that correspond to each rating on the scale and to ensure that each relates accurately to expectations at each developmental level. Furthermore, most of the items on the current PFI examine externalizing behaviors, which poses the possibility that students who achieve at an academically average level, but who experience more internalizing behaviors (such as anxiety), might not be identified for intervention. Subsequent iterations of the PFI could include additional areas of assessment, such as rating school behavior that is indicative of internalized challenges. Finally, it will be important to evaluate school counselors’ use of the PFI to determine if it actually provides necessary information for program planning and evaluation in an efficient, cost-effective fashion as is intended.

Conflict of Interest and Funding Disclosure

The authors reported no conflict of interest

or funding contributions for the development

of this manuscript.

 

 


References

 

American School Counselor Association. (2012). The ASCA National Model: A Framework for School Counseling
Programs
(3rd ed.). Alexandria, VA: Author.

Brown, T. A. (2006). Confirmatory factor analysis for applied research. New York, NY: Guilford.

Costello, A. B., & Osborne, J. W. (2005). Best practices in exploratory factor analysis: Four recommendations for
getting the most from your analysis. Practical Assessment, Research & Evaluation, 10(7), 1–9.

Dimmitt, C., Carey, J. C., & Hatch, T. (Eds.) (2007). Evidence-based school counseling: Making a difference with data-driven practices. Thousand Oaks, CA: Corwin.

Fabrigar, L. R., Wegener, D. T., MacCallum, R. C., & Strahan, E. J. (1999). Evaluating the use of exploratory
factor analysis in psychological research. Psychological Methods4, 272–299.
doi:10.1037//1082-989X.4.3.272

House, R. M., & Martin, P. J. (1998). Advocating for better futures for all students: A new vision for school
counselors. Education, 119, 284–291.

Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional
criteria versus new alternatives. Structural Equation Modeling6, 1–55. doi:10.1080/10705519909540118

Kahn, J. H. (2006). Factor analysis in counseling psychology research, training, and practice – principles,
advances, and applications. The Counseling Psychologist34, 684–718. doi:10.1177/0011000006286347

Kline, R. B. (2011). Principles and practice of structural equation modeling (3rd ed.). New York, NY: Guilford.

Martin, I., & Carey, J. (2014). Development of a logic model to guide evaluations of the ASCA National Model
for School Counseling Programs. The Professional Counselor, 4, 455–466. doi:10.15241/im.4.5.455

Muthén, B. O., du Toit, S. H. C., & Spisic, D. (1997). Robust inference using weighted least squares and
quadratic estimating equations in latent variable modeling with categorical and continuous
outcomes. Psychometrika75, 1–45.

Muthén, L. K., & Muthén, B. O. (1998–2007). Mplus user’s guide (5th ed.). Los Angeles, CA: Muthén & Muthén.

Poynton, T. A., & Carey, J. C. (2006). An integrative model of data-based decision making for school
counseling. Professional School Counseling10, 121–130.

Schumacker, R. E., & Lomax, R. G. (2010). A beginner’s guide to structural equation modeling (3rd ed.). New York,
NY: Routledge.

Sink, C. A. (2009). School counselors as accountability leaders: Another call for action. Professional School
Counseling
13, 68–74. doi:10.5330/PSC.n.2010-13.68

Squier, K. L., Nailor, P., & Carey, J. C. (2014). Achieving excellence in school counseling through motivation, self-
direction, self-knowledge and relationships
. Thousand Oaks, CA: Corwin.

Wood, J. M., Tataryn, D. J., & Gorsuch, R. L. (1996). Effects of under-and overextraction on principle axis factor
analysis with varimax rotation. Psychological methods1, 354–365. doi:10.1037//1082-989X.1.4.354

 

 

Gwen Bass is a doctoral researcher at the Ronald H. Fredrickson Center for School Counseling Outcome Research at the University of Massachusetts. Ji Hee Lee is a doctoral student at Korea University in South Korea and Center Fellow of the Ronald H. Frederickson Center for School Counseling Outcome Research at the University of Massachusetts. Craig Wells is an Associate Professor at the University of Massachusetts. John C. Carey is a Professor of School Counseling and the Director of the Ronald H. Frederickson Center for School Counseling Outcome Research at the University of Massachusetts. Sangmin Lee is an Associate Professor at Korea University. Correspondence can be addressed to Gwen Bass, School of Cognitive Science, Adele Simmons Hall, Hampshire College, 893 West Street, Amherst, MA 01002, gjbass@gmail.com.

 

Exploring School Counselors’ Perceptions of Vicarious Trauma: A Qualitative Study

Mashone Parker, Malik S. Henfield

The purpose of this qualitative study was to examine school counselors’ perceptions of vicarious trauma. Consensual qualitative research (CQR) methodology was used. Six school counselors were interviewed. Three primary domains emerged from the data: (a) ambiguous vicarious trauma, (b) support system significance, and (c) importance of level of experience. Supervision, discrepancies with burnout, and implications for counselor educations and school counselors are discussed.

Keywords: vicarious trauma, consensual qualitative research (CQR), school counselors, support system, counseling experience

Trauma occurs after a person experiences an event that involves or threatens death or serious injury, or a threat to self or other’s well-being (Trippany, White Kress, & Wilcoxin, 2004). Exposure to traumatic events and psychological stress has been found to be associated with significant physical and mental health concerns (Briggs-Gowan et al., 2010). Children and adolescents, particularly those growing up in poverty-stricken areas, are increasingly susceptible to traumatic events such as bullying (Lawrence & Adams, 2006; Newman, Holden, & Delville, 2005), community violence (Fowler, Tompsett, Braciszewski, Jacques-Tiura, & Baltes, 2009), and abuse (Reilly & D’Amico, 2011). For example, children ages 12–17 have been found to be more than twice as likely as adults to be victims of serious violent crimes (Snyder & Sickmund, 2006). Furthermore, every year millions of children and adolescents in the U.S. are exposed to violence in their homes, schools and communities (Finkelhor, Turner, Ormrod, Hamby, & Kracke, 2009). In addition, according to recent reports, homicide and suicide were found to be the second and third leading causes of death for persons ages 15–24 (U.S. Department of Health and Human Services, 2008–09).

Whether working in a school or mental health setting, there is a chance that a professional counselor will work with an individual who has experienced trauma (Trippany et al., 2004). School counselors, however, by virtue of working in schools, have even more direct contact with youth who may have been exposed to traumatic events. As a result, they are likely to be the first counseling professionals with whom traumatized students come into contact. Functioning as the first line of intervention for students in crisis makes the school counseling position one of vital importance to students’ positive development (Chambers, Zyromski, Asner-Self, & Kimemia, 2010). Exposure to students who have experienced trauma puts school counselors at particular risk for internalizing students’ emotions associated with traumatic events. This process of internalization is otherwise known as vicarious trauma (VT), which is associated with professionals developing harmful changes in their view of themselves, others and the world (Baird & Kracen, 2006).

If a counselor begins to over-identify with a client’s issues they can experience the client’s pain, sadness or distress (Skovholt, 2001). McCann and Pearlman (1990) found that some counselors experienced symptoms similar to those associated with Post-Traumatic Stress Disorder (PTSD) such as nightmares, anger and sadness related to their clients’ traumatic experiences. Clinicians working with sexual abuse victims, for example, may experience feelings of stigmatization and isolation which may be closely aligned with clients, the actual victims of the abuse (Canfield, 2005). Little is known about counselors’ ability to manage VT (Harrison & Westwood, 2009), but some extant literature can be reviewed.

For example, factors such as level of experience (Way, VanDeusen, Martin, Applegate, & Jandle, 2004) and educational training (Adams & Riggs, 2008) impact the prevalence of VT. Seminal articles examining VT concluded that counselors with more clinical experience have a buffer in preventing VT (Pearlman & Mac Ian, 1995). Adams and Riggs (2008) conducted a study with 129 therapist trainees. The purpose of their study was to explore the relationship between vicarious traumatization among trainees and variables recognized as potentially influential in this process among practicing therapists (i.e., history of trauma, clinical experience, trauma-specific training), and to explore the relationship between defense style and vicarious traumatization symptoms, as well as its possible interaction with the previous three factors in relation to reported symptoms. Consistent with previous research, the researchers found that novice therapists/counselors may be more vulnerable to experiencing VT (Adams & Riggs, 2008).

Level of peer support and supervision also play a role in buffering symptoms of VT (McCann & Pearlman, 1990). Supervision practices that address VT have been encouraged (Woodard, Meyers, & Cornille, 2002). Specifically, trauma-sensitive supervision is seen as helpful in minimizing the effects of vicarious exposure to trauma (Sommer & Cox, 2005). As Sommer and Cox (2005) conclude, multiple perspectives, collaboration, a calming presence and attention to self-care are most helpful when examining the supervisee’s perspective of adequate supervision. Clinicians must work through painful experiences in a supportive environment. McCann and Pearlman (1990) have suggested that weekly case conferences can be helpful for clinicians that use two-hour weekly support groups aimed at conceptualizing difficult victim cases (with client consent) and exploring personal meaning for themselves related to how they respond to the painful experiences of their clients. Other studies have identified coherence and organizational support as being linked to positive responses to stress (Linley & Joseph, 2007).

There is some overlap between conceptualizations of VT and burnout (McCann & Pearlman, 1990). Burnout is described as the result of the stress that working with difficult clients can produce, and is seen as having three content domains: emotional exhaustion, depersonalization and reduced personal accomplishments (Jenkins & Baird, 2002). There lies a feeling of complete overload which in turn may affect the counselor’s work performance. Burnout also can be described as a general reaction to feeling overwhelmed, where vicarious trauma is related to specific traumatic events. Moreover, Trippany et al. (2004) shared that many counselors who work with trauma patients may experience burnout and vicarious trauma simultaneously.

Most research related to VT focuses on mental health counselors and social workers. Little, if any, published research literature has examined this phenomenon among school counseling professionals. Exposure to a child’s trauma is usually described as more challenging for professionals when compared to adult trauma (Figley, 1995). Therefore, school counselors, by virtue of their work setting, may be at great risk for experiencing VT.

The primary purpose of this study was to investigate counselors’ knowledge and perceptions of VT. The information gathered in this project will increase the level of understanding and awareness of vicarious trauma on school counseling professionals, allowing school counselors to implement strategies to ameliorate the effects of vicarious trauma.

Method

Participants
Participants were individuals who met either one of two criteria: (a) persons licensed or certified as a school counselor, and/or (b) individuals endorsed as a school counselor and currently working in a school. Six school counselors ranging in age from 27 to 54 were recruited from schools located in a midwestern state (3 females and 3 males). Participants worked at least part-time with 3 to 14 years of counseling experience. Four of the six participants graduated from a master’s degree program accredited by the Council for Accreditation of Counseling and Related Educational Programs. All participants were European-American. In addition to school counseling experiences, participants had a range of other work experiences including mental health and social work.

Procedures
Due to the exploratory nature of the study, convenience sampling procedures were used to recruit participants (Marshall, 1996). A recruitment e-mail was sent to individuals on listservs serving school counselors in a midwestern state. Those interested in participating in the study replied to the e-mail indicating their desire. Once the e-mail was received by the primary researcher, participants were e-mailed a consent form and asked to sign and return it to the primary researcher. A verbal consent was then given at the beginning of each interview.

One phone or Skype interview was conducted with each participant. Each participant was emailed a copy of their transcriptions verbatim (member checking) to ensure participants’ voices were being heard and interpretations were accurate. Through member checking, participants were able to identify areas that may have been neglected or misconstrued (Lietz, Langer, & Furman, 2006); all participants verified the interviews were accurate. Asking for participant feedback helps build rapport between the researcher and participants and establishes trustworthiness (Williams & Morrow, 2009).

Researchers
As Patton (2002) writes, qualitative researchers are the major instrument of data collection, and their credibility is critical. The research team consisted of two individuals: a counselor education doctoral student (primary researcher) and an assistant professor in counselor education. An advanced counselor education doctoral candidate served as an auditor, whose role was to verify findings developed by the research team (Patton, 2002). One researcher had prior experience performing CQR investigations.

Trustworthiness refers to the quality or validity in qualitative research (Morrow, 2005). Staying aware of biases related to being a human instrument (Patton, 2002), as well as avoiding getting enmeshed in the data are important for qualitative researchers. Biases may arise from demographic characteristics of the researchers or values and beliefs about the topic. One potential bias for the study was one team member being familiar with the research on VT and possibly having preconceived expectations before analyzing data. The use of a research team of two researchers helped foster multiple perspectives (Hill et al., 2005). An external auditor and member checking strategies also were employed to ensure trustworthiness of the data (Patton, 2002).

The purpose of the external auditor in CQR is to ensure that the research team did not overlook important facts in the data (Hill, Knox, Thompson, & Nutt-Williams, 1997). During the data analysis process, the researcher engaged in an audit trail that described the specific research steps. An audit trail is an important part of establishing rigor in qualitative work as it describes the research procedures (Johnson & Waterfield, 2004). This audit trail was given to the external auditor who verified domains and core ideas.

Interview Protocol

Based on a review of current literature on vicarious trauma, a semi-structured interview guide was constructed. The interview guide included demographic questions as well as open-ended topics related to participants’ perceptions and understanding of trauma in relation to its impact on school counselors. Some examples of interview questions used are as follows: How do you define Vicarious Trauma (VT) of counselors? To what degree is VT a problem in the counseling profession? And, who do you believe to be at greater risk for experiencing VT? Specifically, the study was concerned with gaining an understanding of how participants perceived the importance of VT as an issue in the school counseling profession. Interviews were conducted by either Skype or telephone as a cost-effective means of collecting data (Hill et al., 1997). Each interview lasted 30 to 60 minutes. All interviews were taped and transcribed verbatim.

Data Analysis

The data were analyzed according to CQR methodology (Hill et al., 1997). In CQR, the goal is to arrive at a consensus along with other research team members regarding data classification and meaning. Grounded theory was the most influential theory in developing CQR. Although CQR combines aspects of various qualitative approaches, there are some factors that differ and provide its uniqueness. For example, unlike grounded theory, CQR emphasizes the use of research teams rather than one judge (Hill et al., 1997). CQR researchers also code data in domains (i.e., themes), then abstract the core ideas of each participant. Coding of the data was completed individually by the research team. Each researcher read all transcribed interviews and wrote what he or she thought to be the core ideas that captured each interview. Categories were developed from core ideas across all participants within each domain (Hill et al., 2005). These core ideas were identified as pertinent in the lives of these school counselors and were verified by the external auditor. Categories mentioned by all participants (i.e., all six counselors) were thought to be “general.” Those categories with more than half, but not all of the respondents were considered “typical” (i.e., 4–5 out of 6 counselors); those with half or fewer respondents were considered “variant” (i.e., 2–3 out of 6 counselors). Next, a consensus was reached regarding the core ideas captured from the data, followed by the auditor examining the resulting consensus and assessing the accuracy of the coding and core ideas. Finally, the research team reviewed the auditor’s comments to verify all findings (Hill et al., 1997).

Results

This section outlines three domains that emerged from the data: (a) ambiguous VT, (b) support system significance and, (c) importance of level of experience. These findings shed light on participants’ perceptions of the meaning of VT, as well as ways to avoid it and effectively respond to it should it occur.

Vicarious Trauma Ambiguity
In general, participants had an idea of what VT entailed, but for the most part it was ambiguously defined. One participant referred to it as taking on the issues that students or clients have and “carrying those things home.” Also, the counselor explained it was about living the experiences clients are living. Another counselor reported that VT occurs without realization.

Participants’ past experience was indicative of their understanding of trauma and VT. Specifically, those individuals who had previous social work careers (two participants) or a mental health background (one participant) had a greater knowledge of VT and its effects. They reported having more trauma training in their previous graduate programs when compared to their school counseling programs.

Typically, participants stated that they did not know much about VT, with three counselors reporting it to be synonymous with burnout. One counselor shared that VT was learned after participating in a research study exploring the topic. Another counselor shared that he did not have a clear understanding of VT, but assumes it refers to how he reacts to students with serious issues. Burnout was mentioned sporadically, but for some the concept served as a key feature of their understanding of VT. For example, one participant stated not knowing a ton about the topic, but understanding it as burnout, as did another participant. One counselor shared that VT was viewed as transference and that transference was something often discussed in graduate school.

Support System Significance
In general, school counselors reported that support systems are significant and needed to help alleviate vicarious trauma symptoms, or prevent it from occurring. Typical reports suggested they viewed peer supervision as quite useful for dealing effectively with VT. For example, one participant stated the importance of having others around who are willing to tell you when you are too close to a case. Another participant responded that counselors also have to be willing to accept an evaluation from staff members and others with similar career experience. Similarly, one participant discussed obtaining ongoing support from various avenues within the school environment to prevent her from experiencing VT. This counselor noted providing time for counselors to be with one other in a group setting or one-on-one consulting as a particularly good way to garner support for school counselors. This participant thought supervision would be helpful, but was not sure how to go about seeking it. Essentially, finding time to talk through issues was the most helpful thing to do according to this participant.

Someone or something to help unwind was viewed as a significant means of support. Participants explained that support also can come in the form of family or those not involved with the mental health profession at all. Furthermore, one participant noted that having an outlet such as an athletic or creative activity could be viewed as a form of support as well.

In addition, another participant shared the importance of a supportive work environment. According to this individual, without a healthy work environment VT can easily occur. Other participants also spoke of experiences with administrators and other staff at their workplace. For example, one participant addressed this support, sharing the fortune of having an administrative team to watch one another. They discussed keeping an eye out on issues and problems that colleagues may be experiencing, including VT.

Interestingly, participants also suggested that separation between work and home also has the potential to help alleviate these symptoms. According to one participant, “you must leave your hat at the door,” while another stated that once home, it was necessary to decompress and separate from work. Another school counselor felt as though technology created a hindrance in the separation of school and work. This participant felt that counselors should give themselves permission to separate themselves from work if they so desire. It was recommended that school counselors be given permission to separate themselves from work by not being forced to respond to e-mails and other forms of communication once arriving at home. As this school counselor noted, people have the ability to make contact at any time of day if they are allowed. This participant felt it is important not to give out phone numbers, or only give a personal number to those you trust will not abuse it.

Level of Experience
Generally, participants agreed that level of experience determined counselors’ risks of experiencing VT. Experience was perceived in a number of different ways ranging from formal training to work/life experience, with all participants mentioning how either life or work experiences helped them avoid or overcome VT.

Relatedly, many participants also discussed how either a lack of training or the need for more training could be related to how school counselors experience VT. Five out of six participants discussed the importance of receiving more training, or having an open discussion about their negative reactions to other colleagues or supervisors. Three out of six counselors shared that they had no classes related to trauma from their school counseling training. As one participant stated, not much training was offered and they wished more classes could have been taken on VT. A lack of life experience also was said to place a novice counselor at great risk for VT. One participant voiced concern about a student going straight into a master’s program with little life experience. Concern was voiced about students that go straight from a baccalaureate to a master’s program without taking time to live and work. According to this participant, inexperienced school counselors are unaware of the challenges they will face upon entering the counseling profession and may be more susceptible to VT. Similarly, another participant talked about how her relationship to the profession changed after four years as a school counselor. This school counselor discussed going home really frustrated or angry, feeling like more should have been done for students when starting out as a school counselor. Eventually, this counselor noted that work as a school counselor started to come together and that patience was important when working with children. This school counselor discussed frustration and anger as being signs of VT. This individual also felt that after more experience in the counseling field, symptoms such as these begin to vanish.

One participant mentioned a desire to save the world after graduation, which is typical of most new school counselors, but did not always work in the counselor’s favor. This individual felt that it only made the job more difficult when he realized he could not save every child he encountered. Another participant shared that new school counselors are often shocked because they haven’t seen as many issues as more seasoned counselors. However, this participant also shared that working with the issues kids face became easier each year, and the shock associated with hearing students’ issues decreased.

Discussion

The purpose of this study was to explore school counselors’ knowledge and perceptions of VT. Consistent with the literature regarding preventive and protective measures of VT (Adams & Riggs, 2008), these counselors named newer helping professionals as particularly susceptible to VT. They also discussed factors such as types of support systems and amount of experience with VT as playing a role in preventing VT. This finding is consistent with the research as well, which concludes that as level of support and work experience increase, the counselor is less likely to suffer from VT (Chrestman, 1999; Skovholt & Ronnestad, 2003; Sommer & Cox, 2005). All participants mentioned collaboration with other counselors as a primary means of averting VT. This finding suggests that counselors look to one another for assistance. Forming peer groups and having consultations with other staff within the school environment appeared to be vital in the lives of these participants. McCann and Pearlman (1990) support this notion and have stated the importance of counselors seeking potential sources of support in their professional networks, and that activities such as case conferences can be beneficial to counselors.

Participants proposed that lack of training on the topic made them more susceptible to experiencing VT, which is supported by literature on VT (Pearlman & Saakvitne, 1995). Studies have indicated that as level of experience, education and post-graduate training increases, trauma symptoms in counselors decrease (Adams & Riggs, 2008; Sommers, 2008).

School counselors discussed the difficulty associated with being a beginner counselor and how, with experience, one learns to set boundaries as a method of protecting oneself from VT. They also shared the strong relationship between life experience and being an effective counselor, which is vital to warding off VT symptomology. This finding is consistent with the literature that concludes that newer, more novice therapists may be more vulnerable to experiencing VT (Adams & Riggs, 2008). Many participants discussed how their level of confidence in their work increased over time. Previous literature and findings from the current study suggest that newer professionals may need more support for VT when starting their careers. Scholars have referred to helpful practices such as conferences (McCann & Pearlman, 1990), support groups or supervision (Sommers & Cox, 2005) as useful.

Supervision, although discussed in the literature as an alleviating factor in preventing VT (Sommers & Cox, 2005), was not salient in the current study. Only one participant discussed supervision as playing a role in preventing VT. The other school counselors did discuss that support from peers and administrators were helpful, but not supervision practices. This is worth mentioning, as supervision is one of the key methods counselor educators use to train counselors. It is not known if these counselors viewed support as part of supervision or if they do not see this as being available to them. For example, one participant spoke about an interest in forming peer supervision groups, but did not feel knowledgeable enough to do so.

Some participants stated they did not know much about VT, while others assumed it was similar to burnout. Vicarious trauma and burnout, although sometimes used simultaneously throughout the literature, have some differences in how each is displayed. Burnout may progress gradually, whereas vicarious traumatization can sometimes seem abrupt in onset with little or no knowledge of early recognition (Jenkins & Baird, 2002). Participants who compared VT to burnout did not distinguish any differences in the two constructs. Although not the focus on this study, one participant mentioned personally experienced symptoms related to VT (which this participant described as burnout). This finding suggests that counselors are aware of both VT and burnout. Burnout is a term documented throughout the literature, making it more accessible to counselors’ understanding of occupational stress and hazards.

The findings suggest that counselors feel unprepared to work with trauma cases due to lack of training in their master’s programs. Although the counselors in this study were able to form a working definition of what VT entailed, they wished they possessed more knowledge on the topic. What is important is that these counselors reported that with adequate support from one another they can help prevent or alleviate symptoms of VT. These school counselors also felt that as they become more settled in their profession, they are more apt in dealing with difficult case loads. This suggests that novice counselors should receive more support from colleagues, administrators and others in their professional network. The changes that occur when a counselor experiences VT may have a direct impact on the students they serve, therefore making it salient to address in both the school counseling profession as well training programs.

Implications for Counselor Educators and School Counselors

School counselors make an outstanding contribution to our society through serving our children. An awareness of VT may allow school counselors to implement strategies to ameliorate its effects. The information gathered in this project will increase the level of understanding and awareness of VT on school counseling professionals. VT is a phenomenon that has gained increasing attention in the counseling literature (Hafkenscheid, 2005; Harrison & Westwood, 2009; Sommer, 2008; Way et al., 2004). The findings seem to suggest school counselors feel they lack adequate knowledge and training regarding VT.

Findings from this study also suggest that it would be useful for counselors, especially those working with trauma survivors, to gain more knowledge and awareness on the topic. Counselor educators should offer more training in their counseling programs to increase awareness of VT and other trauma-related topics. For instance, school counselors in the current study expressed a need for more specific training related to VT or trauma in general. Courses related to trauma may be useful for fostering counselor growth (Sommer, 2008). Supervision also can be a reliable source for providing awareness of VT (Sommer & Cox, 2005) since supervision is used to monitor supervisees’ level of functioning and growth (McCann & Pearlman, 1990; Woodard Meyers, & Cornille, 2002).

The counselors in this study expressed the need for support in their work environments. School counselors should maintain collegial relationships as well as offer support to peers within their work environments. Peer groups, weekly case conferences and consultation may be useful for counselors to maintain their wellness and avoid experiencing VT (McCann & Pearlman, 1990). School counselors are in a good position to initiate support for students in their learning environments because they have direct access to children. Therefore, adequate training of school counselors is essential.

Limitations and Future Research

As with all research, there were limitations associated with the current study. First, Skype interviews may have generated pertinent information; however, such interviews were not feasible or accessible to all participants. Subtleties in body language cannot be accounted for during phone interviews. Future studies could include all Skype or face-to-face interviews. Second, given the limited understanding most participants in this study had on the topic, it may have been difficult for them to understand the prevalence of VT in the counseling field. It is possible that what they described as being VT in other school counselors can actually be symptoms of burnout, which the research concludes is different (Jenkins & Baird, 2002).

Conclusion

The current study provided an overview of the phenomenon and also some implications for both school counselors and counselor educators. There has not been much research supporting specific forms of treatment for VT and it should be examined further in the future. Research examining how individuals overcome symptoms of VT may be helpful for counseling professionals. Such research would provide others in the counseling field with a knowledge base that may be helpful in preventing the phenomenon. Since research on VT tended to focus on mental health professionals, social workers or trauma workers, future studies could specifically focus on preventative strategies for school counselors. Such information may elicit responses that capture how school counselors understand and experience VT, which could offer a clearer picture of what training programs can do to recognize and prepare for combating VT prior to entering the profession.

References

Adams, K. B., & Riggs, S. A. (2008). An exploratory study of vicarious trauma among therapist trainees. Training and Education in Professional Psychology, 2, 26–34.
Briggs-Gowan, M., Carter, A., Clark, R., Augustyn, M., McCarthy, K., & Ford, J. (2010). Exposure to potentially traumatic events in early childhood: differential links to emergent psychopathology. Journal of Children Psychology & Psychiatry, 51, 1132–1140.
Baird, K., & Kracen, A. (2006). Vicarious traumatization and secondary traumatic stress: A research synthesis. Journal of Counseling Psychology Quarterly, 19, 181–188.
Canfield, J. (2005). Secondary traumatization, burnout, and vicarious traumatization. Smith College Studies in Social Work, 75, 81–101.
Chambers, R. A., Zyromski, B., Asner-Self, K. K., & Kimemia, M. (2010). Prepared for school violence: School counselors’ perceptions of preparedness for responding to acts of school violence. Journal of School Counseling, 8, 1–35.
Chrestman, K. (1999). Secondary exposure to trauma and self-reported distress among therapists. In B. H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators (2nd ed., pp. 29–36). Lutherville, MD: Sidran Press.
Figley, C. R. (1995) Compassion fatigue as secondary traumatic stress disorder: An overview. In: Figley, C.R. (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 1–20). Philadelphia, PA: Brunner/Mazel.
Finkelhor, D. Turner, H. Ormrod, R., Hamby, S., & Kracke, K. (2009). Children’s exposure to violence: A comprehensive national survey. Juvenile Justice Bulletin, 1–11.
Fowler, P., Tompsett, C., Braciszewski, J., Jacques-Tiura, A., & Baltes, B. (2009). Community violence: A meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Development and Psychopathology, 21, 227–259.
Hafkenscheid, A. (2005). Event countertransference and vicarious traumatization: Theoretically valid and clinically useful concepts. European Journal of Psychotherapy, Counseling and Health, 7, 159–168.
Harrison, R., & Westwood, M. (2009). Preventing vicarious traumatization of mental health therapists: Identifying protective practices. Psychotherapy: Theory, Research, Practice, Training, 46, 203–219. doi: 10.1037/a0016081.
Hill, C. E., Knox, S., Thompson, B. J., & Nutt-Williams, E. (1997). A guide to conducting consensual qualitative research. The Counseling Psychologist, 25, 517–572.
Hill, C. E., Knox, S., Thompson, B. J. Nutt-Williams, E., Hess, S., & Ladany , N. (2005). Consensual qualitative research: An update. Journal of Counseling Psychology, 52, 196–205.
Jenkins, S., & Baird, S. (2002). Secondary traumatic stress and vicarious trauma: A validation study. Journal of Traumatic Stress, 15, 423–432.
Johnson, R., & Waterfield, J. (2004) Making words count: The value of qualitative research. Physiotherapy Research International 9, 121–131.
Lawrence, G., & Adams, F. D. (2006). For every bully there is a victim. American Secondary Education, 35, 66–71.
Lietz, C., Langer, C. L., & Furman, R. (2006). Establishing trustworthiness in qualitative research in social work: Implications from a study on spirituality. Qualitative Social Work, 5, 441–458.
Linley, P., & Joseph, S. (2007). Therapy work and therapists’ positive and negative well-being. Journal of Social and Clinical Psychology, 26, 385–403.
Marshall, M. (1996). Sampling for qualitative research. Family Practice, 13, 522–526. doi: 10.1093/fampra/13.6.522.
McCann, L., & Pearlman, A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3, 131–149.
Morrow, S. L. (2005). Quality and trustworthiness in qualitative research in counseling psychology. Journal of Counseling Psychology, 52, 250–260.
Newman, M. L., Holden, G. W., & Delville, Y. (2005). Isolation and the stress of being bullied. Journal of Adolescence, 28, 343–357. doi:10.1016/j.adolescence.2004.08.002.
Patton, M. (2002). Qualitative research & evaluation methods. Thousand Oaks, CA: Sage.
Pearlman, L. A., & Mac Ian, P. S. (1995). Vicarious traumatization: An empirical study of the effects of trauma work on trauma therapists. Professional Psychology: Research and Practice, 26, 558–565.
Pearlman, L. A., & Saakvitne, K. W. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors. New York, NY: W.W. Norton.
Reilly, R., &D’Amico, M. (2011). Mentoring undergraduate women survivors of childhood abuse and intimate partner violence. The Journal of College Student Development, 52, 409–424.
Skovholt, T. M. (2001). The resilient practitioner: Burnout prevention and self-care strategies for counselors, therapists, teachers, and health professionals. Boston, MA: Allyn & Bacon
Skovholt, T., & Rønnestad, M. (2003). Struggles of the novice counselor and therapist. Journal of Career Development, 30, 45–58, doi: 10.1023/A:1025125624919.
Sommer, C. (2008). Vicarious traumatization, trauma sensitive supervision, and counselor preparation. Journal of Counselor Education & Supervision, 48, 61–71.
Sommer, C., & Cox, J. (2005). Elements of supervision in sexual violence counselors’ narratives: A qualitative analysis. Counselor Education and Supervision, 45, 119–134.
Snyder, H. N., & Sickmund, M. (2006). Juvenile offenders and victims: 2006 national report. Washington, DC: Office of Juvenile Justice and Delinquency Prevention.
Trippany, R., White Kress, V., & Wilcoxin, A. (2004). Preventing vicarious trauma: What counselors should know when working with trauma survivors. Journal of Counseling & Development, 82, 31–37
U.S. Department of Health and Human Services (2008-2009). Child health USA. Rockville, MD: U.S. Department of Health and Human Services.
Way, I., VanDeusen, K. M., Martin, G., Applegate, B., & Jandle, D. (2004). Vicarious trauma: A comparison of clinicians who treat survivors of sexual abuse and sexual offenders. Journal of Interpersonal Violence, 19, 49–71.
Williams, E., & Morrow, S. (2009). Achieving trustworthiness in qualitative research: A pan-paradigmatic perspective. Psychotherapy Research, 19, 576–582.
Woodard Meyers, T., & Cornille, T, (2002). The trauma of working with traumatized children. In C. R. Figley (Ed.), Treating compassion fatigue (pp. 39–55). New York, NY: Brunner-Routledge.

Mashone Parker, NCC, is a doctoral candidate in the counselor education program at the University of Iowa. Malik S. Henfield is an Associate Professor in the counselor education program at the University of Iowa. Correspondence can be addressed to Mashone Parker, University of Iowa, RCE N338 Lindquist Center, Iowa City, IA 52242, mashone-parker@uiowa.edu.