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Supporting Staff Wellness - Secondary Traumatic Stress

Those of us who work on behalf of survivors are exposed to stories of violence and trauma firsthand, this exposure can diminish our health, our ability to work, and our quality of life (NCTSN).

Those of us who work on behalf of survivors are exposed to stories of violence and trauma firsthand, this exposure can diminish our health, our ability to work, and our quality of life (NCTSN). To ensure our own wellbeing and the quality of our work, it is crucial to recognize and address these impacts. These efforts must be made consciously and collectively – they cannot be done alone.

Trauma stewardship is not simply an idea. It can be defined as a daily practice through which individuals, organizations, and societies tend to the hardship, pain, or trauma experienced by humans, other living beings, or our planet itself.

Laura Van Dernoot Lipsky


Secondary Traumatic Stress:

Secondary traumatic stress (STS) is the suffering that results when an individual hears about the firsthand trauma experiences of another(NCTSN). Symptoms can include intrusive thoughts, trouble sleeping, social disconnection, and negative moods (Vega, 2019). STS can put us at risk for negative psychological and physical health outcomes and can weaken our efficacy as advocates for children and families. The terms vicarious trauma and STS are often used interchangeably.

Recognizing the Signs:

As a result of repeated exposure to the trauma of others, you may experience any of the following (Tend) (Administration for Children and Families):

  • Altered world view – the world seems like a darker, more dangerous place

  • Difficulty concentrating

  • Hopelessness – a feeling of “what’s the point?”

  • Feeling tired and/or irritable

  • Focusing more on negative outcomes

  • Hypervigilance

  • Struggling with boundaries

  • Becoming sick more often

  • Lack of sleep

Picture of Trauma Stewardship Institutes Tiny Survival Guide

We burn out not because we don’t care but because we don’t grieve. We burn out because we’ve allowed our hearts to become so filled with loss that we have no room left to care.

Rachel Naomi Remen

Burn out:

Unlike STS which results from exposure to others’ trauma, burn out is a syndrome caused by a wide variety of unmanaged workplace stressors (WHO, 2019). Burnout results in exhaustion (physical and emotional) as a result of professional overwhelm and low job satisfaction (Tend).

Recognizing the signs:

Common symptoms of burnout include the following:

  • Fatigue at home and/or work

  • Feelings of powerlessness in your job

  • Decreased work productivity

  • Feelings of negativity about your job

It is important to figure out whether you are experiencing STS or burnout (or both), as the solutions and strategies for each differ. The most important difference is that burnout can often resolve from a change in jobs, however this is not usually the case with STS (Tend). Also, burnout does not typically affect your ability to feel compassion for others, or fundamentally alter your world view.

Personal trauma history:

Having experienced trauma in your own life puts you at greater risk for experiencing traumatic stress as a result of second hand exposure to trauma in the workplace. It doesn’t matter whether you experienced the same type of trauma as the families you work with or an entirely different kind (Hensel et al., 2015).

Trauma-heavy caseload:

If your caseload is overwhelming to you in size, and if it contains a high number of cases involving trauma exposure, you are at increased risk of experiencing STS (NCTSN, 2011).

Intersectionality, racism and oppression:

Various types of oppression, such as racism, sexism, and classism do not occur separately within an individual, system, or culture.  Instead they are intertwined and impact us in different, unique ways. This has been termed intersectionality (Crenshaw, 1989). Oppressive experiences (McIntosh, 2019) can increase the likelihood of STS. Because of this, it is important to understand the ways in which STS intersects with issues of identity and lived experience.

Lack of social support and support in the workplace (Hensel et al., 2015):

Just as the impact of trauma exposure can be greater for someone that does not have a strong support system, STS symptoms can also be greater without supportive relationships.  In particular within the workplace, lack of supportive supervision, and the use of the reflective supervision model can increase STS (Weaver & McDonald, 2019).

Infographic of Trauma Stewardship Institute's Map for Managing One's Day

If we lived in a society where equity, respect, access, and justice were realized, and unearned privilege and inequality and oppression were transformed, the impact of trauma exposure in our lives would look dramatically different.

Laura Van Dernoot Lipsky

Demographic risk factors:

Females tend to be at higher risk for STS as well as those who are newer to the field (NCTSN, 2015).

Organizational tools:

It is imperative that organizations address STS. STS is a foreseeable occupational hazard for those working in the child trauma field. Having a plan that bolsters staff wellbeing and providing staff with reflective supervision on a consistent basis are important steps. Assuring that staff have balanced case loads as well as enough time in the work day to implement individual wellbeing strategies care can help protect staff against the effects of STS. In addition, senior leaders need to model the strategies and workplace culture that they espouse.

Individual tools:

Develop healthy habits within the workplace. Prioritize yourself by setting boundaries with work.  Take frequent breaks during the day.  Get fresh air. Do not bring work home with you. Prioritize your wellbeing above all else.

Create an individual STS plan (National Center on Safe Supportive Learning Environments). By learning more about STS, assessing your current level of impact, and then identifying strategies to employ, you will help to prevent STS and reduce the impact. By developing this plan and having it ready, you are learning what your own warning signs are and can respond with strategies you know will work.

Advocate for wellbeing strategies within your workplace. Addressing STS is not a one person job. It is the responsibility of the organization you work for. Be part of the solution and help your organization better address the workplace risk of STS which affects so many.

Strengthen your sources of support. Be sure to have people you can rely on to support you and provide connection.  Seek out activities with other people that bring you joy. Partner with other colleagues in the same field to connect with, who understand the challenges of the workplace. Ensure you have formal and informal opportunities to debrief safely about upsetting or stressful work events.

Seek professional support. Accessing therapy is a highly effective way of reducing STS.  Even short-term therapy can help resolve some of the symptoms and increase your tools to address future symptoms.

Not everything can be changed, but nothing can be changed until it is faced.

James Baldwin

Stories from the Field:

Working in the field of child trauma, I always knew I was at risk for STS. Sometimes I would notice subtle signs, like I would continue to think about the stories I heard from my clients even after the work day was finished.  It was only after I had children myself did I notice how it had truly impacted me.  The way it presented itself was through fear.  I had begun to feel that the world was not a safe place for my children. I feared constantly that they were unsafe or something bad was going to happen to them.  I began going to a therapist to work through these fears and also reduced my caseload so that the “dose” of trauma exposure I experienced was less.  I began taking better care of myself by taking walking breaks at work and trying to get better sleep.  All of these tools helped to reduce my STS.

As a young advocate working on behalf of survivors of domestic violence, I became increasingly disappointed with the ways in which the court system failed to meet the needs of children and their protective caregivers. After several years of this work, I grew to feel cynical and disillusioned about my role as advocate and the systems in place that were supposed to protect victims. Feelings of helplessness and hopelessness outnumbered those of passion, commitment, and service. I felt I had lost the original purpose that had brought me to the work. I was also frequently sick and had trouble sleeping. By engaging in weekly therapy I was able to name and explore my feelings about my work as well as the toll the work had taken on my personal life. This process allowed me to make more mindful career choices and to structure my professional life in a way that didn’t require me to sacrifice my own wellbeing. Nearly 10 years later, I continue to serve children and families and find balance in this work.

The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.

Rachel Naomi Remen

STS and Child/Family Outcomes:

Secondary Traumatic Stress jeopardizes outcomes for children and families by threatening the quality of work performed by the child and family workforce. When professionals experience STS, they experience a host of symptoms impacting their professional and personal wellbeing. In turn, impacted workers are typically not able to perform their job at the same capacity they would be able to operate at were they not experiencing symptoms of traumatic stress. In addition, because of STS, many talented professionals leave the field (NCTSN). To best serve children and families, the wellbeing of those that serve them must be supported.