Reclaiming Resilience: Coping Strategies for Secondary Trauma in Behavioral & Mental Health Care

Professionals working in the field of behavioral and mental health care are no strangers to secondary trauma. It is a phenomenon that affects many of them in this line of work, as they bear witness to the pain and suffering of their clients daily. Despite their best efforts to provide adequate care and support, the constant exposure to trauma can take a toll on their mental and emotional well-being. This can lead to feelings of burnout, compassion fatigue, and even post-traumatic stress disorder. However, mental health professionals must maintain their resilience and continue to provide quality care to those who need it.

Understanding Secondary Traumatic Stress

Secondary traumatic stress (STS) is the emotional and behavioral changes that healthcare workers and mental health professionals experience due to their exposure to trauma through their work. This type of trauma can manifest in various ways, such as cognitive, emotional, behavioral, and physical symptoms. It is essential to recognize and address secondary traumatic stress to maintain a healthy work culture and ensure the well-being of mental health professionals.

The Importance of Empathy and the Risks of Compassion Fatigue

Since empathy is linked to creating a successful therapeutic partnership and treatment results, it is essential for helping professionals. Elliott, Bohart, Watson, and Greenberg conducted a meta-analysis and showed that empathic understanding significantly predicts therapeutic success. As Carl Rogers described, empathy is the capacity to put oneself in another person’s shoes without losing the “as if” aspect. A mental health professional’s job is to assist people through difficult times, including listening to their clients and feeling what they feel. However, service providers may be at greater risk for developing secondary traumatic stress due to their work with trauma survivors because they actively participate in the healing process alongside those they serve.

The adverse effects of STS on an individual’s mental health and well-being include difficulties maintaining relationships, trouble sleeping or maintaining good sleep hygiene, and severe depressive disorder. Researchers have shown that mental health professionals, including clinical psychologists, counselors, psychotherapists, psychiatric social workers, and psychiatric nurses, experience significant levels of burnout and secondary traumatic stress; there is a spectrum of symptom intensity. 

Compassion fatigue is the combined symptomology of secondary traumatic stress disorder and burnout. Chronic physical and emotional exhaustion, depersonalization, feelings of inequity, touchiness, headaches, weight loss, and negative feelings toward work, life, and others outside the therapeutic relationship are all symptoms of compassion fatigue, which could be defined as “stress resulting from exposure to a traumatized individual.” Other adverse effects for mental health professionals dealing with the precarious dynamics of empathetic understanding and safeguarding one’s well-being include self-loathing, dissatisfaction on the job, psychosomatic symptoms, tardiness or absence from work, and drug addiction.

The Link Between Burnout and Secondary Traumatic Stress

It is generally accepted that exhaustion, cynicism, and a loss of belief in one’s ability to make a difference at work are the defining characteristics of burnout. Researchers can’t agree on how much weight to give each factor individually or how those factors interact over time. However, ineffective boundary setting between the provider and client, guilt, lack of motivation, and sorrow are common symptoms of burnout among those in the caring professions.

Indirect exposure to trauma, such as working with trauma survivors, may cause adverse physical, emotional, and cognitive consequences under secondary traumatic stress. Secondary traumatic stress may cause symptoms similar to PTSD, such as reoccurring nightmares or flashbacks to the traumatic event, an inability to cope with even neutral thoughts about the event, and a shift in one’s core values and sense of identity.

Research suggests that job burnout and secondary traumatic stress are highly interrelated, with some experts considering STS to be a type of burnout that specifically arises from exposure to traumatic stressors. Burnout and STS symptoms can overlap, involving emotional exhaustion, feelings of cynicism or detachment, and a reduced sense of personal accomplishment. Mental health workers who experience high levels of burnout and STS may be at risk for compassion fatigue and other mental health concerns, making it crucial to recognize and address the relationship between these two constructs.

Signs of Secondary Trauma Stress

While helping professionals may not have directly experienced the traumatic event, they can still experience emotional, cognitive, behavioral, and physical symptoms due to hearing about or witnessing the trauma of others. By recognizing these symptoms, mental health professionals can seek appropriate support.

Cognitive Signs

  • Lowered concentration
  • Apathy
  • Rigid thinking
  • Perfectionism
  • Preoccupation with trauma

Emotional Signs

  • Guilt
  • Anger
  • Numbness
  • Sadness
  • Helplessness

Behavioral Signs

  • Withdrawal
  • Sleep disturbance
  • Appetite change
  • Hyper-vigilance
  • Elevated startle response

Physical Signs

  • Increased heart rate
  • Difficulty breathing
  • Muscle and joint pain
  • Impaired immune system
  • Increased severity of medical concerns

The Importance of Compassion Satisfaction

Compassion satisfaction is the positive aspect of the impact that helping others can have on mental health professionals. It refers to individuals’ fulfillment and satisfaction from helping others and positively impacting their lives. Compassion satisfaction can be a protective factor against the harmful effects of secondary trauma and other stressors in the workplace.

Studies have found that mental health professionals who experience high levels of compassion satisfaction are less likely to experience burnout and STS. On the other hand, those who experience low levels of compassion satisfaction are at increased risk of experiencing burnout, secondary traumatic stress, and other adverse mental health outcomes.

It’s important to note that compassion satisfaction is just one aspect of a mental health professional’s well-being. Other factors, such as self-care practices, organizational support, and access to resources, also play essential roles in mitigating the impact of secondary trauma and stress in the workplace.

Managers and team leaders must be aware of the risks of burnout among mental health workers and the variables that reduce their capacity for compassion. It is generally accepted that low compassion satisfaction, compassion fatigue, and burnout adversely affect productivity and retention in the workplace. Managers can support their staff’s mental health by creating safe and healthy work environments, facilitating regular communication between employees and upper management, holding regular team meetings, and implementing other measures to minimize the potential for stress at work. Future uncertainty is another factor that must be carefully considered since it may impact the prevalence of burnout and STS compared to compassion satisfaction.

Coping Strategies and Prevention of Secondary Traumatic Stress

Caregivers’ susceptibility to developing secondary traumatic stress may be affected by the coping mechanisms they use. For example, one study found that domestic violence psychotherapists who expressed low levels of stress additionally reported higher levels of belief in their ability to cope with challenging circumstances, an objective motivation for their work, healing of personal traumas, exposure to examples of successful methods of coping at an early age, and personal beliefs that mitigated the damaging impacts of trauma exposure.

Researchers also have found that practitioners who have strong social networks, practice mindfulness, are open to new experiences, are optimistic, set healthy boundaries with their clients, are professionally fulfilled, and can find meaning in their patients’ tragedies are less likely to suffer from secondary traumatic stress.

Practice Self-Care

Engaging in self-care activities is crucial for maintaining mental health and resilience. Some self-care practices include:

  • Eating nutritious meals
  • Getting enough rest
  • Engaging in physical activity
  • Participating in hobbies and leisure activities
  • Practicing relaxation techniques, such as deep breathing or meditation

Seek Support

Developing a support network of trusted friends, colleagues, or a therapist can help professionals navigate the recovery process from secondary traumatic stress. Connecting with others provides a space to discuss feelings and receive support.

Establish Boundaries

Setting healthy boundaries allows professionals to separate themselves from the source of distress and prioritize their needs and well-being. This can involve avoiding excessive demands, delegating tasks, and maintaining a healthy work-life balance.

Reflect and Process

Journaling, engaging in mindfulness practices, and participating in therapy or support groups can help professionals process their emotions and thoughts related to secondary traumatic stress. Reflecting on experiences can promote healing and personal growth.

Use Trauma-Informed Care Approaches

Adopting trauma-informed care approaches in the workplace can help mental health professionals mitigate the effects of secondary traumatic stress. This involves understanding the impact of trauma on individuals, creating a safe and supportive work environment, and integrating trauma knowledge into daily practice.

Mental health workers should obtain professional training on trauma and coping with secondary traumatic stress to recognize warning signs and know when to seek help.

Building Resilience

By prioritizing their mental health and well-being, mental health workers can effectively support their clients and prevent secondary traumatic stress. Mental health workers must recognize the importance of building personal resilience and seek resources and strategies to help them cope with the challenging demands of their profession.

Organizations should promote mental health awareness and foster a supportive work culture to reduce the prevalence of STS, burnout, and compassion fatigue. This can involve:

  • Providing training and resources on effective coping strategies and resilience building
  • Encouraging self-care practices and work-life balance
  • Implementing trauma-informed care approaches in the workplace
  • Offering support services, such as peer support groups or access to mental health professionals

Secondary traumatic stress, burnout, and compassion fatigue are significant issues that mental health professionals face. The adverse effects of these conditions can be detrimental to personal and professional well-being. Mental health organizations must prioritize mental health awareness and foster a supportive work culture promoting self-care and trauma-informed care approaches. This includes establishing healthy boundaries, developing a support network, and encouraging self-care practices such as exercise and meditation. By taking these steps, mental health professionals can maintain their resilience and provide adequate care to those in need. Ultimately, it is crucial to recognize the impact of STS and implement strategies to mitigate its effects on the well-being of behavioral and mental health professionals.