Leadership and Staff Safety As Mediators of the Relationship Between Secondary Traumatic Stress and Turnover

Background and Purpose: In implementing and sustaining quality services to children and families affected by substance abuse, human service organizations commonly face workforce capacity challenges. Challenges such as high caseload ratios, work absences, and turnover are often due to the secondary trauma professionals experience from daily exposure to severe forms of substance abuse and trauma. Specifically, professionals providing services to drug affected babies and their families often work directly with traumatized and resistive clients. The nature of the work can have a significant impact on emotional well-being and job performance, potentially limiting quality service delivery and contributing to overall workforce capacity issues. While leadership and organizational factors are thought to play an important role in mitigating the impact of secondary trauma and retaining healthy and competent workers, minimal research has been conducted to explore potential mediators of the impact of secondary trauma on professionals’ intent to leave.

Methods: This quantitative study utilized cross-sectional data to examine the mediating impact of multiple organizational factors on the relationship between secondary trauma and turnover among 101 service providers working with drug affected babies and their families.  The three organizations included in the study are implementing an evidence-supported, trauma-informed organizational intervention in a rural New England state with the highest opioid addiction rate in the nation.  The study utilized a self-administered, web-based survey instrument and all professional staff within the organizations were invited to participate.  Propositions from Constructivist Self Development Theory were utilized to examine factors influencing the impact of secondary trauma on professionals’ intent to leave their organization, including aspects of a trauma-informed organizational culture (e.g., staff safety, staff empowerment) and transformational leadership outcomes (e.g., satisfaction, effectiveness, and extra effort; LS, LE, and LEE).  Multiple mediation analyses with bootstrapping were performed to examine the indirect effects of secondary traumatic stress (STS) on intent to leave (IL), via potential mediators: staff safety (SS) paired with three leadership outcomes (LS; LE, LEE).

Results: Findings from the initial regression analyses revealed a significant relationship between STS and IL (b=0.980, p<.001), with 20% of the variance in IL explained by STS.  However, findings from the multiple mediation analyses revealed that this relationship is fully mediated by LS and SS (indirect effect of STS on IL through LS: b=0.303, p<.05; SS: b=0.999, p<.001; total variance explained in IL: 50%), LE and SS (total variance explained in IL: 55%), and LEE and SS (total variance explained in IL: 56%).  Results indicate that while professionals experiencing significantly higher rates of secondary trauma were more likely to leave their organization, perceptions of staff safety and leadership mediate this relationship.

Implications for Practice: Findings indicate secondary trauma is a significant contributor to professionals’ intention to leave their jobs and suggest the importance of developing and expanding leadership and trauma-informed support services, resources, training, and research for professionals in the field.  Implications regarding how organizations can help to mitigate the impact of secondary trauma on professionals, thereby increasing workforce retention, will be discussed.