The Impact of Trauma on Addiction Workers: An Exploration of Vicarious Trauma and Vicarious Post-traumatic Growth

Round 1

Reviewer 1 Report

The manuscript "The Impact of Trauma on Addiction Workers" presents a well-conducted qualitative analysis exploring the vicarious trauma and vicarious posttraumatic growth experienced by addiction workers, enriching our understanding of their personal and professional impacts. The abstract, introduction, and discussion sections are informative, though there is room to enhance these by including more details about the methodological rationale, previous research findings, and a more thorough comparison with existing literature. The presentation of themes is clear, supported by compelling narrative evidence, though additional context around the quotes could enhance clarity. Editorial adjustments for consistency in formatting and typographical accuracy, alongside a more explicit discussion of the practical implications for supporting addiction workers, would strengthen the manuscript. These minor revisions would make a significant contribution to the addiction studies field, and I recommend resubmission within four weeks with these issues addressed.

The manuscript "The Impact of Trauma on Addiction Workers" presents a well-conducted qualitative analysis exploring the vicarious trauma and vicarious posttraumatic growth experienced by addiction workers, enriching our understanding of their personal and professional impacts. The abstract, introduction, and discussion sections are informative, though there is room to enhance these by including more details about the methodological rationale, previous research findings, and a more thorough comparison with existing literature. The presentation of themes is clear, supported by compelling narrative evidence, though additional context around the quotes could enhance clarity. Editorial adjustments for consistency in formatting and typographical accuracy, alongside a more explicit discussion of the practical implications for supporting addiction workers, would strengthen the manuscript. These minor revisions would make a significant contribution to the addiction studies field, and I recommend resubmission within four weeks with these issues addressed.

Author Response

The manuscript "The Impact of Trauma on Addiction Workers" presents a well-conducted qualitative analysis exploring the vicarious trauma and vicarious posttraumatic growth experienced by addiction workers, enriching our understanding of their personal and professional impacts. The abstract, introduction, and discussion sections are informative, though there is room to enhance these by including more details about the methodological rationale, previous research findings, and a more thorough comparison with existing literature. The presentation of themes is clear, supported by compelling narrative evidence, though additional context around the quotes could enhance clarity. Editorial adjustments for consistency in formatting and typographical accuracy, alongside a more explicit discussion of the practical implications for supporting addiction workers, would strengthen the manuscript. These minor revisions would make a significant contribution to the addiction studies field, and I recommend resubmission within four weeks with these issues addressed.

 

Thank you for your feedback. We have incorporated a more detailed rationale for the methodology employed in this study (lines 117-144). Regrettably, there is a paucity of studies on vicarious trauma (VT) and addiction workers, resulting in very limited previous research findings. Nevertheless, we have adjusted the introduction section with a few more pertinent previous findings. Moreover, we have conducted a more comprehensive comparison with existing literature in the discussion section. Additionally, we have provided additional context around the quotes.

Reviewer 2 Report

Thank you for the opportunity to review this study entitled “The impact of trauma on addiction workers: An exploration of Vicarious Trauma and Vicarious Posttraumatic Growth” (psycholint-3007960).

The paper focused  on the phenomena of vicarious trauma (VT) and vicarious posttraumatic growth (VPG) among addiction workers, exploring (counter)transference dynamics and the trauma addiction nexus. The participants were 6 addiction workers.

 

In my opinion, the research topic is relevant, and the study is interesting. The specificity of the sample of addiction workers is a strong point of the manuscript. Parallelly, some issues need to be addressed before the paper will be suitable for publication.

·       Abstract: Please, add information about the sample (Mean age, SD, percentage of men and women) to provide a clear picture of what will be presented in the paper.

·       Page 2, line 52. Please add a comma after reference [13].

·       Page 2, lines 56-58. Please, move this sentence near the section where the aims were defined (i.e., at the end of the introduction).

·       The “data analysis” section should be separated and enriched.

·       More suggestions for future research should be added.

·       The “Conclusions” section should be enriched by further discussing the practical implications of the results of this research.

·       Both the introduction and discussion sections should be enriched with more bibliographical references. Furthermore, authors should make an effort to find more recent research. Currently, the citations of studies with a publication date of less than 5 years are the minority in this manuscript.

 

Best wishes

Author Response

Abstract: Please, add information about the sample (Mean age, SD, percentage of men and women) to provide a clear picture of what will be presented in the paper.

• Page 2, line 52. Please add a comma after reference [13].
• Page 2, lines 56-58. Please, move this sentence near the section where the aims were defined (i.e., at the end of the introduction).
• The “data analysis” section should be separated and enriched.
• More suggestions for future research should be added.
• The “Conclusions” section should be enriched by further discussing the practical implications of the results of this research.

·   Both the introduction and discussion sections should be enriched with more bibliographical references. Furthermore, authors should make an effort to find more recent research. Currently, the citations of studies with a publication date of less than 5 years are the minority in this manuscript.

 

Thank you very much for your feedback. Please find below the changes made:

• We added the mean age and percentage of males and females (mean age = 33 years (SD ≈ 5.86), 33.33% men and 66.67% women) in the abstract.
• full stop added after reference 13 Page 2 line 52.
• Page 2, lines 56-58 sentences have been moved just before the aims.
• The “data analysis” section has been separated and enriched
• More suggestions for future research have been added.
• The “Conclusions” section has been enriched and a discussion for practical implications was added.

The introduction and discussion have been enhanced. A few more contemporary literature references have been added. E.g. Belfrage, A.; Mjølhus Njå, A.L.; Lunde, S.; Årstad, J.; Fodstad, E.C.; Lid, T.G.; Erga, A.H. Traumatic Experiences and PTSD Symptoms in Substance Use Disorder: A Comparison of Recovered Versus Current Users. Nordisk Alkohol Narkotikatidskrift 2023, 40, 61–75. doi:10.1177/14550725221122222

 

Reviewer 3 Report

This is very interesting research that truly adds to the field. I am pleased to see the work. As noted in my comments above, there are some methodological issues that need some clarity in the write up.

1. Be clear with the terminology 

2. Address why the all 10 people were not interviewed - the rationale for not do so is unconvincing 

3. Address why the person no longer in the field is included - this potentially is a confounding factor

As this is a qualitative study the worry about statistical data is  not there. The qualitative data is laid out appropriately

Author Response

There is a challenge with terminology - There appear to be three terms being used: 1 Addiction workers; 2 Health care workers and 3, Rehabilitation workers - I think this needs to be cleared up I think one term should be used.

In addition, the term addiction workers can have some confusion as it can mean professionals, those working in the field whose qualifications are life experience. It appears the term is somewhat diffuse as the sample seems to suggest a variety of professional qualifications - I am assuming the common ground is that these are healthcare workers from various professional backgrounds who work in the addictions field. Some clarity around that would really help

 

1. Be clear with the terminology 
2. Address why the all 10 people were not interviewed - the rationale for not do so is unconvincing 
3. Address why the person no longer in the field is included - this potentially is a confounding factor

Thank you for your feedback. That is a good suggestion, and we changed the terminology to “Addiction Treatment Professionals" and “Addiction Workers”. This encompasses all individuals working in the field of addiction treatment, regardless of their specific qualifications or backgrounds. This term acknowledges the diverse roles within the field while providing clarity and consistency in terminology.

 

Another good point about the rationale behind interviewing only 6 participants. Using six participants only was justified by the principle of data saturation, aiming to capture diverse perspectives until no new information emerged, while also balancing resource constraints and ensuring in-depth exploration of individual experiences within the research context.

 

Including a former addiction worker who experienced drug relapse but now in recovery and no longer works in the addiction field added valuable insight into the challenges and emotional toll of working in addiction treatment, highlighting the need for support systems. The choice to include them enhances the diversity of perspectives within the study, contributing to a comprehensive understanding of the experiences and dynamics within the addiction treatment field. We added this rationale under 2.2.1 Population and sample.

Round 2

Reviewer 3 Report

Thank you for the revisions - I do have a couple of other points arising from the revisions:

1. In terms of reaching saturation, which theoretically driven approach was used? Grounded theory?

2. The citations make reference to NVivo yet that is not discussed in methodology nor data analysis - how was that used for coding and analysis?

The balance of the revisions are nicely done and the article is stronger

My only recommendations are those just above

Author Response

Thank you for your insightful feedback. 
1. We chose to interview 6 out of the 10 participants based on the principle of saturation and pragmatic considerations. Qualitative research experts like Sandelowski and Morse suggest that sample sizes should be large enough to provide a richly textured understanding of the phenomenon but small enough to allow for deep, case-oriented analysis. Given the focused nature of our study, the quality of data collected, and the time and resource constraints typical of a master's thesis, we determined that 6 interviews would be sufficient to achieve data saturation without overburdening the analysis process.
Additionally, pragmatic considerations played a significant role in this decision. Time constraints and limited resources necessitated a smaller, more manageable sample size. This approach aligns with practices observed in other qualitative studies where sample size is often determined by practical factors such as time, financial resources, and the availability of participants. For instance, studies published in the BMJ and BJHP have justified their sample sizes based on similar pragmatic considerations such as time constraints and the difficulty of accessing certain study populations. By focusing on 6 participants, we ensured a thorough and detailed analysis that fits within the scope and limitations of a master's thesis project while still providing robust and meaningful insights into the research questions.   As such, we have added this statement to the manuscript as follows "This study used the qualitative standard proposed by both Sandelowski and Morse [22], whereby sample sizes should be large enough to provide a richly textured understanding of the phenomenon but small enough to allow for deep, case-oriented analysis. Given the focused nature of this study, the quality of data collected, and the time and resource constraints typical of a master's thesis, it was determined that 6 interviews would be sufficient to achieve data saturation without overburdening the analytic process."    2. We would like to clarify that our manuscript does not utilize NVivo for our data analysis. The citations that mention NVivo were included to support the broader methodological approach rather than to indicate our use of that specific software. In our study, we conducted thematic analysis through hand coding, not using any software tools like NVivo.   Thank you once again for your valuable comments.