The Cost of Caring:
Secondary Traumatic Stress and the Impact of Working with High-Risk Children and Families


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Lesson 2: Post-Traumatic Stress Disorders and Secondary Trauma

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Secondary Trauma: Who is at risk?

Generally speaking, persons at risk for developing secondary trauma are those who have the responsibility of providing care to a person who has had some type of crisis. Historically, persons at greatest risk were those in the emergency services professions: police officers, fire fighters, emergency medical technicians, police officers, fire fighters, nurse crisis workers, and clergy. In recent years that list has expanded to include a wide range of professionals who work with children and families in crisis. Included in that list are pediatricians, psychologists, psychiatrists, family lawyers, adult mental health professionals, child protective services workers, prison guards, juvenile probation officers, foster parents, and teachers.

There are several reasons why professionals working with maltreated or traumatized children are at increased risk of developing secondary trauma.

1) Empathy is a valuable tool used by mental health workers, educators, childcare providers and other professionals working with traumatized children. Children get better in therapy not because we talk to them or at them, but because we are emotionally there for them. However, by empathizing with a child or "feeling their pain" the professional becomes vulnerable to internalize some of the child’s trauma-related pain.

2) Insufficient Recovery Time: Professionals working with children and families are often required to listen to children describe some very horrific situations they have experienced. These same professionals are secondarily traumatized by having to listen to the same or similar stories over and over again without sufficient recovery time.

3) Unresolved Personal Trauma: Many professionals have had some personal loss or even traumatic experience in their own life (e.g., loss of a family member, death of a close friend). To some extent, the pain of experiences can be "re-activated." Therefore, when professionals work with an individual who has suffered a similar trauma, the experience often triggers painful reminders of their own trauma.

4) Children are the Most Vulnerable Members of Our Society: Young children are completely dependent on adults for their emotional and physical needs. When adults maltreat these vulnerable persons, it evokes a strong reaction in any person with a sense of decency and morality. At times, the senseless and almost evil nature of some of the trauma inflicted on children shakes one’s sense of humanity.

5) Isolation and Systemic Fragmentation: New research and clinical wisdom point to the important role of group cohesiveness in regulating individual stress reactions. When individuals feel valued and are in the presence of others who respect and care for them, they are more capable of tolerating extreme stressors. Clearly this means that the current practices in child protection, mental health, probation and education - specifically, individual service delivery rather than team-oriented practice within a fragmented system with high-turnover - are a set up for increased stress for individuals working in that system.

6) Lack of Systemic Resources: A lack of economic and personnel investment in front-line services for high-risk children exacerbate each of the problems listed above. In our current socio-political climate, no public system is likely to address adequately the issues related to development of secondary trauma in front-line personnel. The task of addressing these problems then falls to the mid-level leader, supervisors, program directors and others who are working to create a positive work-climate for their co-workers.


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