The STS Blueprint focuses on providing guidance on how to address STS at the organizational level. This focus is needed because STS is a set of trauma responses that result from working in trauma-exposed workplaces. Because staff are being exposed to trauma as part of their work, organizations have an ethical responsibility to protect the well-being of their staff, which requires organizational-level responses.18-19
Individual Risk and Protective Factors for STS
While the research shows the importance of viewing STS as an organizational responsibility,20-22 individual variations in STS responses mean that a one-size-fits-all approach will not be effective for all staff. It is important to take these variations into account when considering how to provide organizational support to the workforce.
Depending on the individual, the following factors can be protective or can put an individual at greater risk of being impacted by work-related trauma exposure:
- Nature of exposure (for example, the type, severity, and dosage/amount).23-24
- Personal risk factors, including:
- Prior or current trauma history.25-28
- Personal life factors/stressors.29
- History of anxiety and/or depression.30-33
- Socioenvironmental context—for example, historical/community trauma, racism;34 discrimination;35 disproportionality; social support.11, 36
- Organizational factors—for example, the nature of the work and how STS-informed the organization is. This includes factors such as the level of team support from peers and/or supervisors, level of leadership support, work conditions, organizational culture, and how the organization supports staff around broader system issues related to being part of an MDT.20, 21, 37
- Co-existing conditions—moral distress and burnout. Moral distress occurs when one believes they know the right thing to do, but institutional or other constraints make it difficult to pursue the desired course of action; burnout can be the result of a high workload coupled with little support and few resources.16-17
- Protective and response factors—individual resilience traits (for example, self-efficacy, adaptability to change, and secure attachment to others),38-40 intervention and practice strategies (for example, grounding/centering skills, reframing/narrative skills, confidence in in one’s professional abilities),41 and professional competence.42
Based on Existing Research
The information contained in the STS Blueprint is research informed. While the research on the efficacy of strategies to address STS is still scarce, especially research specific to strategies for CACs, there was a concerted effort to base all of the information in this guide on the research that is available. The suggested strategies included within each of the domains have been borrowed from research that has shown promising interventions for STS, including psychoeducation and/or mindfulness, in related professional settings such as mental health and first responders,43 and healthcare.44-46
Language and Terminology
Since language within the CAC world may differ from organization to organization, the authors made some decisions on terminology to be consistent throughout the STS Blueprint.
- “Staff” refers to anyone who is working in the CAC including those in direct service roles as well as administrative and support staff.
- “Leader” refers to anyone who is in an operational role of leading the agency. This role is administrative and managerial and may include directors, program managers, etc.
- “Supervisor” refers to anyone in a role of providing direct supervision to staff.
It is also acknowledged that in some CACs people may be in multiple roles (leader and supervisor, for instance).
The following terms will be used frequently throughout this product, therefore, we have provided definitions for clarity.
Definitions of STS and Related Terms
- Adaptive coping skills relieve stress in the short term and in the long run and include taking an active or solution-focused approach to addressing the problem rather than coping through avoidance, disengagement, or rumination.
- Burnout is a term that is often used interchangeably with some of the above terminology; it is not a term specific to working in the field of trauma. Burnout can occur in any job as the result of chronic workplace stress characterized by a high workload coupled with little support and few resources.16-17
- Compassion satisfaction is used to describe the rewards, benefits, and inspiration we derive from being able to help others and make a meaningful contribution to society.
- Empathic strain (formerly referred to as compassion fatigue) is the amount of labor required to appear empathic when the provider is not experiencing genuine empathy.
- Moral distress occurs when one believes they know the right thing to do, but institutional or other constraints make it difficult to pursue the desired course of action.
- Secondary traumatic stress (STS) is the emotional distress that results when an individual hears about the firsthand trauma experiences of another, or as the stress placed on a person when exposed to trauma descriptions, trauma images, or the reactions and responses of persons who have experienced primary trauma.
- Vicarious traumatization (VT) describes changes in the inner experience of the provider related to trauma exposure, such as expectations for trust, safety, control, esteem, or intimacy that result from cumulative exposure. It is sometimes used synonymously with STS.
Intended Audience
All CAC staff can become “STS champions.” Regardless of who is leading the organization in the use of the STS Blueprint, the process of identifying areas of strength and weakness and implementing strategies to address these areas will be most successful if there is a cross-section of staff from the organization involved in the change process. Even CAC leaders (directors, managers, and supervisors) may not have power to make all decisions. Therefore, this STS Blueprint includes tips on educating boards of directors, advisory boards, and/or umbrella organizations about STS and its impact and how to advocate for staff’s needs and well-being.