How to Reduce the Risk of Secondary Trauma

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Avoiding or dealing with secondary traumatic stress requires action by both individual professionals and organizations as a whole:

Engage in self care. Counterbalance hearing victims’ stories, seeing troubling photos and retelling difficult details in court with self care activities such as exercise, spiritual activities, meditation or mindfulness approaches. Learn more at traumastewardship.com or compassionfatigue.ca.

Pay attention to caseloads. Managers should ensure caseload numbers are appropriate and the type of work is varied. There’s no research that definitively says how many cases are too many, said Dr. Sprang. The right number is specific to the setting, the types of cases, and other responsibilities the staff person has. For example, giving child welfare caseworkers a mix of abuse and neglect cases, or rotating workers between investigation and case management responsibilities. A manager may also allow a juvenile justice worker whose recent cases have involved serious felony offenses to participate in training or other work enrichment opportunities. A good supervisor can manage these issues for the benefit of their workers, said Dr. Sprang.

Be aware of past trauma. Workers with their own trauma histories need to pay attention to their mental health and make sure they are receiving psychotherapy (if needed) and are using their own coping mechanisms. Staff who are affected by their own past trauma need different case assignments, reflective supervision, or mental health treatment to resolve past trauma.

Develop agency-wide policies and practices to limit direct exposure to trauma. Agency managers should implement practices so workers can go into potentially difficult situations in pairs or with police escorts and provide immediate support when someone has been directly exposed to violence. This may include not only an opportunity to discuss the experience with a peer or supervisor, but use of a brief formal screening tool. Some agencies have staff self-administer and score measures such as the ProQOL (proqol.org) and offer general guidance on using the results.

Use evidence-based practices. In a study of mental health professionals, those who reported that they use evidence-based practices — as opposed to treatment methods that haven’t been proven scientifically — reported lower levels of secondary traumatic stress, said Dr. Sprang. This may be linked to greater feelings of effectiveness and competence. For information on evidence based practices, visit nrepp.samhsa.gov/.

Other youth-serving organizations should be aware of secondary stress too. Even in organizations that don’t primarily serve highly traumatized young people, managers should be aware that certain staff members may suffer from secondary trauma (e.g., the person who runs a support group for young people who have lost a family member to violence). These staff members also need additional training and support to combat secondary traumatic stress.

Designate a resource champion. Dr. Leslie Ross, vice president of the Leadership Center at the Children’s Institute, Inc. in Los Angeles, suggests that organizations should have a designated staff member to serve as the point person for bringing in resources on secondary traumatic stress. She also suggests forming workgroups comprised of staff and managers so that both groups are invested in the issue.

Engage in “low impact debriefing,” a concept developed by Dr. Françoise Mathieu. Ross also recommends that staff engage in low impact debriefing, which she described as advocates sharing traumatic experiences in as little detail as possible. This lets speakers benefit from discussing events, but allows listeners to limit their exposure. For example, the speaker might say that a client witnessed a suicide and it was very difficult for him, but would not give the details of how the suicide was committed. Low impact debriefing also requires initiators to recognize their own distress, to give listeners fair warning that difficult experiences will be discussed, and to receive consent from listeners to share those experiences.

Make sure staff know to ask for help. Less experienced workers should be reminded that they need to pay more attention to their levels of exposure and to talk to supervisors about how those experiences are affecting them, suggested Dr. Sprang. Whenever possible, offer “reflective supervision.” (To learn more, visit http://bit.ly/15FPyTY).  Both managers and workers have a role to play in addressing secondary traumatic stress.