Moving Beyond Self-Care To Address the Roots of Vicarious Trauma

When I worked in a rape crisis center, certain images of clients’ traumatic experiences troubled me. Weaving their way into my nightmares, these memories didn’t leave me easily, even though they were not my own.

I was experiencing vicarious, or secondary, trauma, which causes symptoms of PTSD in those who hear or witness others’ traumatic experiences. Because of the nature of their work, helping professionals such as social workers and paraprofessionals are particularly vulnerable to vicarious trauma. This is especially so after helping others navigate and endure a year like 2020.

Self-care has been touted for its potential to alleviate vicarious trauma, workplace stress, and high turnover — and for good reason. But self-care is not enough.

Addressing vicarious trauma among service providers also requires structural, cultural, and relational shifts toward collective care within organizations. The benefits of these shifts reach far beyond your staff and into the community you serve.

Causes and Manifestations of Vicarious Trauma

Although clinicians have received training on managing their own emotional responses to clients, this past year has left all of us exposed to trauma in new and overwhelming ways. The extent of what therapists have heard may outpace their capacity. Other helping professionals have likely received no training to prepare them for the grief, stress, and isolation of their clients, which compounds their own issues.

Even in an ordinary year, helping professionals are vulnerable to secondary trauma. Some social workers refer to it as an occupational hazard, and one-third of child protective services workers have symptoms of post-traumatic stress disorder.

Because vicarious trauma is so common among social services professionals, effective organizational leaders learn to watch for it in their staff.  The symptoms of vicarious trauma include:

  • Feeling numb or shut down.
  • Having sleep difficulties.
  • Detaching from social networks.
  • Avoidance behaviors while working with clients.

According to researchers, vicarious trauma also causes changes in core beliefs, cognitions, and connections to others. These transformed worldviews, in turn, negatively impact clients and the agency as a whole. Staff living with vicarious trauma develop negative feelings toward clients, harm client relationships, miss work at high rates, and contribute disproportionately to high turnover.

Traumatic Stress and Its Effects on the Organization

More insidious still is the impact of traumatic stress on organizational culture. Colleagues and I have observed that when many staff members are coping with burnout and trauma, their resulting feelings of powerlessness seem to create less effective agencies. Simply put, when staff members believe that their efforts won’t matter, they don’t work as creatively or effectively to meet clients’ needs.

These damaging feelings of powerlessness are cyclical. Providers feel powerless because they work within systems that fall short of fully meeting their clients’ needs. As we discussed in our webinar on compassion fatigue, secondary trauma, and self-care, anything that impedes the helper’s ability to support their traumatized client can lead to vicarious trauma.

In other words, powerlessness is both a central cause and effect of secondary trauma, and clients and colleagues are impacted by it too.

Addressing Vicarious Trauma: Moving Beyond Self-Care

Because the causes and effects of vicarious trauma extend far beyond the individual, its solution is also systemic. Encouraging self-care in your staff is critical, but research shows that it is not enough. When organizational leaders build a trauma-informed organization, they safeguard the well-being of their team in the face of demands and scarcity.

The table below identifies ways you can scaffold self-care strategies with meaningful organizational change.

Strategy Self-Care Intervention Organizational Intervention
Assessment is an excellent starting point for change at any level. You can give your staff the Professional Quality of Life Assessment, or ProQOL, as a starting point for conversations in their professional and personal lives. We recommend that you don’t mandate that staff discuss their results with you. They can use this tool on their own terms for growth. Becoming a trauma-informed organization is an iterative process. These tools, and perhaps the support of a guide or consultant, can help you find and meet benchmarks along the way.
Empowerment is an antidote to the powerlessness at the heart of vicarious trauma. It’s important for folks in the helping professions to be attuned to their own boundaries and to assert them when needed. Offer opportunities for staff members to share feedback. Shift power in meaningful ways so that staff shape agency policies, procedures, and culture.
Work-life balance reminds providers of their identities and sources of meaning outside the workplace. Support your staff in taking time off when they need a break. Have systems in place so that this doesn’t disrupt client satisfaction. Guarantee reasonable workloads, generous pay, and enough paid time off. At worst, self-care isn’t possible without these safeguards in place, and at best, it only goes so far. Research shows that social workers who are more financially stable are much better able to practice self-care.
Connections and relationships are vital for mental well-being, as vicarious trauma can be isolating. Strong relationships in and outside the office can ground employees through the emotional storms of human services work. Although one-on-one work with clients can be isolating, collaboration helps providers do their best work. Foster collaborative environments through strategies like case conferences and Balint groups. Also create spaces for colleagues to connect over topics unrelated to work.
Self-compassion eases suffering. If providers can find compassion for themselves, they can better navigate the gap between what they want to offer clients and what is possible. The best way to foster compassion in staff is to express compassion toward them. Hire and train supervisors to be empathetic and supportive.

 

With the support of a trauma-informed system in place, your team will be better equipped to practice self-care, overcome vicarious trauma, and meet the needs of our changing world.

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Anole Halper

Social Worker and Writer

Anole Halper is a genderqueer neurodivergent social worker and writer. They are dedicated to individual and collective healing from trauma and violence, and have worked toward that in many spheres including writing, facilitation, teaching, activism, and program design. They have a dual master's from UNC in social work and public health, but they obsess about interior design.

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