Coping Strategies and Well-Being of Emergency Room Social Workers: A Phenomenological Study on Secondary Traumatic Stress

Background and Purpose: Emergency room social workers (ERSWs) are at high risk of secondary traumatic stress (STS) due to their frequent exposure to trauma and crisis situations. Chronic STS can lead to symptoms similar to post-traumatic stress disorder (PTSD) and negatively impact an individual's well-being. Despite the high prevalence of STS among ERSWs, research on interventions and support programs remains limited. Drawing on Ludick and Figley's (2017) theory of secondary traumatic stress and Masten's (2011) trauma and resilience theory, this study explores the coping strategies of ERSWs in response to STS and their impact on well-being and resilience.

Methods: A qualitative, phenomenological study was conducted using in-depth, semi-structured interviews with 23 ERSWs working in Level 1 trauma centers. Participants were purposively sampled based on the following criteria: ERSWs working at Level 1 trauma centers and having at least one year of experience. Thematic analysis was used to identify patterns and themes related to coping strategies for STS. Ethical principles of confidentiality, respect, and anonymity were adhered to throughout the study.

Results: Findings revealed several themes and categories of coping strategies employed by ERSWs at the personal, interpersonal, and organizational levels, along with the role of meaning-making in coping. Coping strategies were organized into proactive and reactive measures, acknowledging that the line between them can sometimes be blurred. Proactive strategies, such as physical and emotional self-care, cognitive coping skills, and meaning-making, serve to build resilience and prevent stress accumulation. These strategies can be employed at the personal and interpersonal levels, where self-care and supportive relationships help build resilience. Reactive strategies, including processing traumatic material, supportive relationships, and peer and management support, aid in managing stress as it arises and in its aftermath. These strategies operate at interpersonal and organizational levels, highlighting the importance of a comprehensive approach.

Conclusions and Implications: This study underscores the need for a comprehensive approach to addressing STS in ERSWs and other helping professionals at risk of STS. The findings can inform the development of interventions and support programs aimed at promoting the well-being and resilience of ERSWs. The study contributes to the understanding of the lived experiences of ERSWs in relation to STS and offers insights into how they can maintain emotional resilience in their demanding work environment. Furthermore, the study emphasizes the need for organizations to implement policies and procedures that promote the well-being of helping professionals, such as debriefing protocols, encouraging self-care, and developing support systems. These findings have implications not only for ERSWs but also for other helping professionals, such as counselors, therapists, and healthcare professionals, who may be at risk of STS. Overall, this study highlights the critical need to prioritize the mental health and well-being of ERSW.