Risk and Protective Factors of Secondary Traumatic Stress for Social Workers

Background:Social workers serve many clients who have experienced trauma from man-made and/or natural disasters. Those who empathically engage with their clients' traumatic recollections sometimes exhibit strong emotional reactions, including grief or rage. Such negative reactions resulting from the knowledge of traumatized events of others may reflect secondary traumatic stress (STS). Many clinical social workers in New York City who provided counseling and support to 9/11 witnesses, survivors, victims' family members, and rescue workers faced a higher probability of developing symptoms of STS. This study explored the predictive factors of STS, including the extent of exposure to traumatized clients, for social workers assisting 9/11 clients. It also examined direct and interactive (buffering) protective factors, controlling for demographics (age, marital status, income, hours per week in the field, and years in the field). Findings provide a better understanding of STS in social workers who treat victims of trauma. Theories of psychological trauma, stress and coping, and social support, along with STS literature, indicate that the risk factors of STS include the degree of exposure to traumatized clients, while protective factors include supervision, peer support, family and friend support, and degree of disaster training.

Method:Data were drawn from the Post 9/11/01 Quality of Professional Practice Survey (Tosone & Moore, 2007). This survey explored how social workers dealt with the personal and professional stress of trauma in the post-9/11-practice environment. Doctoral and MSW level members (N=1,257) of the Manhattan Chapter of the National Association of Social Workers were surveyed, yielding a 38% return rate (N=481). The Professional Quality of Life Compassion Fatigue/Secondary Traumatic Stress Subscale assessed STS. Three indicators measured the primary independent variable - exposure to trauma in practice: total hours of exposure to 9/11 related events, percentage of time working with traumatized clients, and number of different types of trauma clients served. Hierarchical multiple regression included a block of controls and the exposure block; additional protective variables (receiving supervision, peer support, family and friend support, 9/11 specific training, general disaster training) were examined separately for their direct and interactive effects with exposure.

Results:Results showed that social workers' level of exposure to different types of traumatized clients, including 9/11/01 victims and victims of sexual assault and domestic violence, significantly increased STS (F[3, 364]=4.74, p<.01, Rē=.037), whereas 9/11/01 trauma exposure alone did not (F[2,212]=1.69, p=.19, Rē=.015). Peer support had a buffering effect only in the STS analysis; receiving peer support was a partially significant predictor of STS symptoms(F[2, 210]=2.36, p=.097, Rē=.021). A follow-up analysis found that age and years of field experience by social workers might act as moderators for the trauma exposure-STS relationship (age:F(3,174)=3.78, p=.01, Rē=.059; years of field experience:F[3,166]=4.78, p=.00, Rē=.078)., i.e. older and more experienced social workers were vulnerable to experiencing greater levels of STS.

Conclusions:These results have implications for administrators and practitioners in agencies providing services to traumatized populations. Such providers should consider reducing caseloads for workers treating victims of trauma and providing peer support, particularly for older, more experienced practitioners.