Secondary traumatic stress is a concept developed by trauma specialists Beth Stamm, Charles Figley and others in the early 1990s. They sought to understand why professionals providing support services were exhibiting symptoms similar to post-traumatic stress disorder (PTSD) without having been directly exposed to traumatic experiences themselves. The National Child Traumatic Stress Network defines secondary traumatic stress as the emotional distress that results when an individual hears about the firsthand trauma experiences of another.1 Recognizing the effects of this indirect trauma exposure is crucial for safeguarding workers’ health and ensuring that children receive the best care possible.
Secondary Traumatic Stress and Its Impacts
Secondary traumatic stress occurs when individuals hear about or are exposed to others’ traumatic experiences. This may include hearing stories with traumatic details, reading accounts of trauma and abuse and processing a traumatic experience with someone. For professionals involved in the care of children who have experienced trauma and their families, the essential act of listening to trauma stories may take an emotional toll. The emotional strain mirrors the symptoms of PTSD, including re-experiencing trauma, heightened arousal and avoidance reactions. Workers may also experience changes in memory, self-efficacy and perceptions of safety and trust.
Symptoms associated with secondary traumatic stress include hypervigilance, hopelessness and difficulty embracing complexity, avoidance of clients, anger, sleeplessness, fear, exhaustion, physical ailments and minimization of emotions. These symptoms may range from mild, to moderate, to severe. Secondary traumatic stress may or may not impair day-to-day functioning depending on the level of symptoms. In the most severe form, individuals can develop PTSD from their indirect exposure.
Those at Risk of Secondary Traumatic Stress
Secondary traumatic stress is recognized as a form of occupational stress for individuals working with people who have experienced trauma. This can include teachers, therapists, social workers, child welfare workers, first responders, legal and correctional staff, and others. Several conditions are related to and can co-occur with secondary traumatic stress. Vicarious traumatization refers to changes in the provider’s inner experience, including shifts in expectations around trust, safety, control, esteem and intimacy, caused by cumulative exposure to trauma.
Compassion fatigue involves physical and emotional exhaustion that arises from caring for those in distress. Moral distress occurs when an individual knows the right course of action but feels constrained by institutional or external barriers that prevent them from acting on it. Burnout results from a heavy workload combined with limited support and resources, leading to emotional exhaustion, cynicism, depersonalization and a loss of job satisfaction. Although secondary traumatic stress is often discussed among professionals, recent research has indicated it can also extend to family members or loved ones of trauma survivors.
Trauma-Informed Support for Secondary Traumatic Stress
Various individual and organizational-level strategies can be implemented to promote staff self-care and resilience to help mitigate secondary traumatic stress. The National Child Traumatic Stress Network has identified the following as essential for creating a trauma-informed organization to address secondary traumatic stress. This network recommends a trauma-informed organization must:
- Recognize the impact of secondary trauma on the workplace.
- Recognize that exposure to trauma is a risk of the job of serving traumatized populations.
- Understand that trauma can shape the culture of organizations in the same way that trauma shapes the perspectives of individuals.
- Understand thatstaff impacted by trauma are less likely to effectively identify their clients’ past trauma or mitigate or prevent future trauma.
- Develop the capacity to translate trauma-related knowledge into meaningful action, policy and improvements in practice.
In addition, the National Child Traumatic Stress Network recommends the following actions for supervisors and managers to take:
- Know the signs, symptoms and risk factors of secondary traumatic stress and support options for team members.
- Self-assess, monitor and address your own secondary traumatic stress.
- Help team members safely share the emotional experience of working with people impacted by trauma through reflective supervision.
- Support the resilience of team members individually and collectively.
All suggestions described above should be integrated into direct services, programs, policies and procedures, staff development and training.
References:
1 National Child Traumatic Stress Network, Secondary Traumatic Stress Committee. (2011). Secondary traumatic stress: A fact sheet for child-serving professionals. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress.
2 Armes, S. E., Lee, J. J., Bride, B. E., & Seponski, D. M. (2020). Secondary trauma and impairment in clinical social workers. Child abuse & neglect, 110(Pt 3), 104540. https://doi.org/10.1016/j.chiabu.2020.104540
3 Bride, B.E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52, 63-70.