The Impact of Trauma Work On General Health Perceptions of Clinical Social Workers: The Mediating Role of Secondary Traumatic Stress
Given the nature of social work practice, social workers are regularly in contact with those who may be suffering from traumatic events and often are the professionals providing intensive services related to these traumata. Such exposure to traumatic material puts workers at risk for developing secondary traumatic stress (STS). Numerous studies have documented the occurrence of STS in social workers. However, none have specifically examined the impact of trauma work on social workers’ perceived health. As such, the purpose of this study was to investigate the relationship between exposure to traumatized clinical populations and social worker health. In particular, we sought to determine if STS mediates the relationship between secondary exposure to trauma and health perceptions.
The present study used a cross-sectional, self-administered mailed survey design. A survey packet was mailed to random sample of 2,500 NASW members holding a degree. A total of 731 responses were returned, representing a response rate of 29%, which is consistent with other studies of NASW members. These analyses were limited to 539 respondents whose work involved direct practice at the time of the survey. General health perceptions was measured by the general health subscale of the Medical Outcome Study Short Form-36 (5-items; alpha = .80). Secondary traumatic stress was measured with the Secondary Traumatic Stress Scale (STSS; 17 items; alpha = .92). Exposure to traumatized clients was operationalized as the percentage of respondents’ caseload that met the criteria for PTSD. Because they have been associated with STSS and health outcomes in previous studies, we also included age, gender, experience (years), and weekly hours worked as control variables. Hayes’ PROCESS macro for SPSS was used to perform mediation analyses.
The percentage of caseloads that met the criteria for PTSD ranged from 0 to 100 with a mean of 25.31 (s.d. = 23.8). STSS scores ranged from 17 to 54 with a mean of 28 (s.d. = 8.67); 15% scored above the “clinical cut-off” of 38. General health scores ranged from 7 to 25 with a mean of 19.67 (s.d. = 3.88). Mediation analysis revealed that the relationship between social workers’ exposure to traumatized clients and their general health perceptions were fully mediated by STS. More specifically, a higher percentage of clients who meet the criteria for PTSD is associated with higher levels of STS, and in turn, higher levels of STS are associated with perceptions of poorer health.
This study supports the notion that trauma work can have great impact upon social workers. Indeed, findings underscore the need for increased attention to the assessment, prevention, and mitigation of STS symptoms among social workers. Implications for social work education, practice, policy, and research will be provided.