Risk and protective factors for psychotherapists in regions of crisis: what do psychotherapists need to face the danger of secondary traumatization in Kurdish Iraq?

Front Public Health. 2026 Oct 13;14:1959666. doi: 10.3389/fpubh.2026.1959666. eCollection 2026.

ABSTRACT

Transgenerational and secondary traumatization are key aspects to be addressed when aiming for sustainable psychosocial support in post-war regions. Within this context, the primary goal of the Institute for Psychotherapy and Psychotraumatology (IPP) is to establish sustainable structures for psychotherapy, acknowledging that psychological distress does not simply vanish with the end of a war. Rather, it only becomes fully visible when considering not only the consequences for beneficiaries but also for helpers and subsequent generations. Because mental health workers themselves face a high risk of suffering from secondary traumatization, deliberate measures must be implemented to ensure that helpers do not become secondarily traumatized during and/or after their service. Using the IPP as a community case study, this article analyzes both general and context-specific risk factors for its students and local staff. Furthermore, it identifies universal protective factors that mitigate these risks and outlines culturally specific protective factors against secondary trauma. It also presents critical reflections on how a far-sighted and realistic understanding of cultural dynamics can contribute to the systemic protection of aid workers. Ultimately, the article suggests that providing helpers with comprehensive psychosocial support, physical and operational safety, structured peer support, transparent financial frameworks, clear future career prospects, and institutional recognition of their work are of paramount importance in sustaining long-term psychological wellbeing for psychotherapists.

PMID:42947830 | PMC:PMC13710063 | DOI:10.3389/fpubh.2026.1959666