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: Individual Indicators of Distress

There are "individual indicators of distress" which can tell us all that we are at increased risk for developing secondary trauma. Examples of distressing emotions we might feel include anger, sadness, rage, depression or anxiety. The list of these emotional reactions is almost endless. Other indicators of distress could include physical complaints (e.g. headaches, stomachaches, and lethargy), nightmares, avoidance of certain clients and impaired work habits (eg. tardiness or missed appointments).

Individual Indicators of Distress

Emotional Indicators



Prolonged grief



Physical Indicators


Stomach aches



Personal Indicators



Mood swings

Irritability with spouse/family

Workplace Indicators

Avoidance of certain clients

Missed appointments


Lack of motivation

Think about it

Take a moment to consider some of the indicators you may currently be experiencing or have experienced in the past.  Jot down the indicators on a notepad.  In Lesson 4, we will review a variety of ways to combat Secondary Trauma.  Understanding your own limitations and needs is key to mediating the effects of this stress.  In the meantime, answering the questions on the next page will help you gauge your response to the daily stressors you face at work.



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