Working with trauma populations also means that we are at risk of developing trauma-related stress conditions such as secondary traumatic stress, vicarious traumatisation, or compassion fatigue. All three conditions are grounded in what some researchers term as empathy-based stress, which is defined as an exposure to a traumatic event (i.e. through working with trauma populations) that combines with the experience of empathy that arises in a therapeutic relationship.
Although secondary traumatic stress, vicarious traumatisation, and compassion fatigue are sometimes interchangeably used, they are three related but different concepts. In secondary traumatic stress, we may experience symptoms that mirror the symptoms of post-traumatic stress disorder (PTSD) that are faced by our clients. This experience can include a range of PTSD symptoms such as intrusive, avoidance, and arousal symptoms. With vicarious traumatisation, we may develop cognitive shifts due to the nature of our empathic engagement with clients who have experienced traumatic events. Specifically, these cognitive shifts relate to our sense of self, aspects of our world view (safety, trust, and control), as well as changes in our spiritual beliefs. Lastly, when we develop compassion fatigue, we essentially experience symptoms of secondary traumatic stress in addition to professional burnout. The continual use of empathic engagement as well as the daily non-clinical administrative tasks that helping professionals are expected to complete, contribute to compassion fatigue.
Given that we are at risk of developing professional burnout and/or trauma-related stress conditions, what can we do to mitigate these? The answer has become a buzz word these days because of the current research that has been looking at the impact of Covid-19 on our mental health. Even before it was a buzz word, this was something we all probably talked to our clients about, with the goal of reducing overall stress. That’s right – it’s self-care!
Continual use of empathic engagement as well as the daily non-clinical administrative tasks that helping professionals are expected to complete, contribute to compassion fatigue.
Self-care is best thought of as a preventive practice – as we’re all aware of, you cannot pour from an empty cup! This is not only something for our clients to consider; practising self-care has been proven to reduce the impact of these conditions on helping professionals. Self-care practices such as maintaining personal relationships, making time for preferred activities, and ensuring adequate nutrition and rest, all serve to reduce the impact of trauma-related stress conditions*.
However, it is important to note that the onus of managing trauma-related stress conditions lies not only with the individual; it is very much an organisational responsibility as well. On an informal level, this could mean checking in with your supervisees or colleagues if you observe that they are overwhelmed. On an organisational level, this might mean that the organisation engages in promoting preventive self-care by regularly checking in with all employees (e.g., via scheduled check-ins with supervisors, administration of questionnaires that measure burnout, etc.), and encouraging employees to seek professional support, if needed**.
* For more information about self-care, refer to our Quick Bytes articles 45.
** For more information about how individuals and organisations can play a part in mitigating the effects of trauma-related stress conditions, check out this page https://www.healthxchange.sg/childtraumanetwork/Pages/Self-Care-for-Professionals.aspx on our TNC website!
This article is contributed by KK Women’s and Children’s Hospital. This article was first published on Trauma Network for Children’s Quick Bytes Newsletter and is republished with permission.
The Stay Prepared – Trauma Network for Children (TNC) programme is a joint collaboration between KK Women’s and Children’s Hospital (KKH) and Temasek Foundation. It aims to enhance the psychosocial capability of the Singapore community to support children and youth after crises or traumatic events. For more resources, visit the Trauma Network for Children Website at www.childtraumanetwork.sg.
Newell, J. M., & MacNeil, G. A. (2010). Professional burnout, vicarious trauma, secondary traumatic stress, and compassion fatigue: A review of theoretical terms, risk factors, and preventive methods for clinicians and researchers. Best Practices in Mental Health: An International Journal, 6, 57–68.
Rauvola, R.S., Vega, D.M., & Lavigne, K.N. (2019). Compassion fatigue, secondary traumatic stress, and vicarious traumatization: a qualitative review and research agenda. Occupational Health Science, 3, 297-336.