Considering the global trend towards the dissemination and implementation of trauma-focused treatments in the majority of the world, it is imperative to ascertain the contextual factors which affect the treatment of traumatic stress, especially in low- and middle-income countries characterised by ongoing adversity such as poverty and increased levels of trauma exposure. We explored the experiences of non-specialist health workers whose work involved providing trauma-focused services in low-resource communities in South Africa. Participants (n = 18) worked at four non-governmental organisations in the Eastern Cape and Western Cape of South Africa. Semi-structured individual interviews were conducted and analysed using a phenomenologically informed thematic analysis. Two superordinate themes were identified, namely, adjusting to trauma-focused work and trauma in the social context. Five themes that made up the superordinate themes were Encountering Trauma Narratives, Support and Resilience, Going the Extra Mile, Helplessness, and Social Factors. The findings are not only in keeping with the psychological risks of trauma-focused work (e.g., vicarious traumatisation) but also highlighting the impact of the social context on the provision of trauma-focused work. Participants reported experiencing an added burden of helplessness due to social factors, such as poverty and high levels of trauma exposure, which affect the process of treating traumatic stress in low-resource settings. We discuss how these findings can contribute to efforts to implement trauma-focused services in low- and middle-income countries.

考虑到世界上大多数国家以创伤为重点的治疗方法的传播和实施的全球趋势，必须确定影响创伤性压力治疗的背景因素，尤其是在持续处于困境的中低收入国家中例如贫困和增加的创伤暴露水平。我们探索了非专业卫生工作者的经验，他们的工作涉及在南非的资源贫乏的社区中提供针对创伤的服务。参加人数 = 18）在南非东开普省和西开普省的四个非政府组织工作。进行了半结构化的个人访谈，并使用了从现象学角度出发的主题分析方法进行了分析。确定了两个上级主题，即适应以创伤为主的工作和社会背景下的创伤。构成上级主题的五个主题是：遭遇创伤叙事，支持与抵御力，加倍努力，无助和社会因素。这些发现不仅符合以创伤为中心的工作的心理风险（例如，替代性创伤），还强调了社会背景对以创伤为中心的工作提供的影响。参与者报告称，由于社会因素，无助感增加了，例如贫困和高水平的外伤暴露，这会影响在资源贫乏地区处理外伤压力的过程。我们讨论了这些发现如何有助于在中低收入国家实施针对创伤的服务。