Secondary Trauma: Agency Intervention and Training Strategies

Defining Secondary Trauma: Cumulative Effects On Workers

The impact of human service work on the humans who do the work has not been fully understood until recently. Formerly described as job stress or burnout, a more accurate understanding confirms that the largest predictor of the effectiveness of human service work has to do with the health, resiliency and effectiveness of the humans who do the work.

This same effectiveness becomes compromised when workers are exposed repeatedly or poignantly to the suffering and traumatic experiences of their clients. In order to effectively engage clients, workers must establish relationships of listening, aligning, and helping. Exposure to the horrific content of many of the crimes, incidents of traumatic abuse and neglect, and overwhelming human suffering are potentially traumatizing events. Recently, the diagnostic manual for mental health workers was revised to include this type of trauma as a signifier of Post-Traumatic Stress Disorder.

It is often the most effective workers who are most deeply impacted by secondary trauma because they take the professional risk to come close to their client’s experiences in order to understand them more deeply. The mirror neuron system in the human brain that allows for empathy also conducts toxic trauma right into the physiology of workers. 

Agency Responsibility

Agencies that do not address secondary trauma, in effect, are not doing good resource management. It is the human resource that is the most important one in human service work. Unaddressed, secondary trauma contributes to the unsustainability of the workforce. This impacts the nature of the work environment as well as the home environment for a traumatized worker. Physiological distress such as chronic illness, neurological disease, weight gain, eating disorders, and early death are negative impacts of unaddressed secondary trauma. It also damages the energetic systems and emotional systems of workers and creates emotional disorders like anxiety and depression, conflict and anger in the home and work setting, and leads to disruption in social relationships including family and relationship discord.

Secondary trauma is also a large cause of the use of addictive substances by professionals in order to manage the regulatory distress created by secondary trauma.  

It is the largest predictor of work force recidivism.  

Our philosophy is that it is the responsibility of the agency to provide opportunities for workers to be trained in and to practice secondary trauma resiliency skills. They can then track the worker’s progress with this as they would any other work skill. Unfortunately, other models wait until workers are burned out and then encourage self-care to return to work healthy and ready to work.  We believe that secondary trauma resiliency is a shared responsibility between the agency and the worker.   

Manifestations Of Secondary Trauma In Workers

Secondary trauma is not merely an emotional disorder, although emotional distress is one aspect of its presentation. Rather, secondary trauma emerges from the way humans use brain and body functions to connect with other humans in effective collaborative relationships. Mirror neurons in the human brain allow the professional to deeply understand the experiences of those they serve.  

At the neurological level, this is better understood as the co-experiencing of distress. Mirror  neurons create a situation where one human can actually empathically understand the felt experience of the other as if this experience was held in their own body. Neuro-research is demonstrating how neurological brain patterns will light up similar areas of the professional’s brain while they are engaging a client with particular forms of traumatic distress. The sharing of traumatic content is a material, not a metaphoric or merely emotionally event. This distinction is best understood by the statement: “Secondary Trauma describes how we feel WITH a client, not that we feel FOR a client.”  

This feeling WITH the client means that the content of the client’s experience is recorded in all parts of the tri-partite brain of the professional worker. This means that thinking patterns are impacted, emotions are hijacked, and their body selves are activated by the traumatic content of the cases they work on. If the worker is not trained in the recognition of secondary trauma process and its antidotes, they begin an unsustainable erosion of their own personal and professional capacity. 

The Toolbox of Resiliency

Due to the fact that secondary trauma impacts the entire brain and body structure of the worker, secondary trauma interventions are designed to have maximal effectiveness in targeting all of the zones that are impacted by the induced trauma. This includes increased awareness of the body and conscious body practices, the development of boundaries between personal and professional world and the self and the client, and the development of supportive group processes in the work environment that legitimates the ubiquitous nature of secondary trauma.  

We have organized these resources into a Toolbox of Resiliency. Resiliency is the goal of secondary trauma work. It is to recognize the essential traumatic nature of doing effective human service work and then to develop a set of individualized resources that allow workers to effectively be resilient in the face of this traumatic onslaught. Resiliency does not just limit the toxicity of trauma, but it creates the potential to transform toxic distress into strength. The goal of resiliency practice is to create post-traumatic growth, meaning that the life and body of the worker is enhanced and strengthened, not merely salvaged from the toxicity of trauma.

 What Agencies Need To Know About Addressing Secondary Trauma In Their Unique Settings 

In order to begin the process of bringing responsible and effective secondary trauma recognition and the building of resiliency into the workforce, several key steps can be made. 

• Consultation about the nature of your work setting and the way in which the four facets can be uniquely applied to your setting. These consultations can usually take an hour and can also include data gathering from workers about the nature of their own secondary trauma and their perception of the agency’s support for their personal and professional capacities.

• Consider a Facet One Training for your staff in order to raise awareness about the issue of secondary trauma and to begin to give them skills to practice in the work setting.   These one-time trainings are very dynamic and can be a transformative layer in the change process.

• Identify resources in your counseling and psychotherapy community who could support your agency in doing a facet two and three intervention. In the Northwest Region, we are recruiting and training clinicians to do this work and we would be happy to support the workers in your region with curriculum and supervision training.

Do something now, don’t repress the needs of your staff. Many times, when the topic of trauma is brought up, administrators and workers go into their own dissociative states to cope with the distress raised by even the idea of trauma. We have seen that it takes multiple exposures to resiliency skill-building for workers and agencies to build these skills. As they grow, the impact on the reduction of human suffering, the strengthening of the workforce, and sustainability of our professions are profound.