Shared Traumatic Stress and the Post 9/11 Quality of Professional Practice

Background and Purpose: The affective, cognitive, and behavioral impact of working with trauma survivors has been examined under several constructs, including compassion fatigue, secondary traumatic stress, vicarious traumatization, and burnout. Additionally, following the September 11th disaster the term shared trauma was introduced to describe narrative accounts of clinicians and clients exposed to a collective trauma, potentially resulting in clinician shared traumatic stress. Shared traumatic stress contains elements of compassion fatigue, but also takes into account the clinician's primary trauma exposure.

This paper presents the results of the Post 9/11 Quality of Professional Practice Survey (PQPPS) which explored the long-term impact of 9/11 on social work clinicians practicing and/or residing in Manhattan and examined potential predictors of, and protective factors for, the development of shared traumatic stress in a post-September 11th practice environment.

Methods: The research design for this study was a single-occasion, cross-sectional survey design. A recruitment letter, project statement, self addressed stamped envelope, and Post 9/11 Quality of Professional Practice Survey (PQPPS) was sent to 1275 masters and doctoral level social workers in direct practice who were members of the National Association of Social Workers (NASW) Manhattan Chapter.

The PQPPS consisted of several established research measures in the public domain, as well as demographic, practice, supervisory, training, and 9/11-related personal and professional experience questions. In regard to established instruments, attachment style was operationalized by the Adult Attachment Questionnaire, resiliency by the Connor-Davidson Resilience Scale, traumatic life events by the Life Events Checklist, compassion satisfaction by the Professional Quality of Life Compassion Satisfaction Subscale, and shared traumatic stress was operationalized by the product of scores for the PTSD Checklist-Civilian Version and Professional Quality of Life compassion fatigue/secondary traumatic stress subscale.

Results: A total of 481 members of the NASW Manhattan Chapter (38% response rate) replied to the PQPPS mail survey. On a bivariate level, shared traumatic stress was positively correlated with compassion fatigue, ambivalent attachment, avoidant attachment, traumatic life events, posttraumatic stress disorder, being currently affected by the events of 9/11 (all p<.0001), and perception of the likelihood of another 9/11 event within two years (p=.0004). It was negatively associated with resiliency, life change due to the events of 9/11 (both p<.0001), institute training (p=.0041), compassion satisfaction (p=.0166), and years in the field (p=.0344). On a multivariate level controlling for 21 variables, only compassion fatigue and posttraumatic stress (both p<.0001) were significant predictors of shared traumatic stress.

Conclusions: The results of the PQPPS potentially lays the groundwork for an empirical understanding of shared trauma as a distinct entity, as well as identifying the affective, cognitive, and behavioral-related themes associated with social work practice in a post 9/11 environment. The significance of the PQPPS extends to the agency and academic arenas. Less experienced clinicians were found to have the highest levels of shared trauma. These findings suggest a crucial role and responsibility for social work schools in trauma education.