Shared Traumatic Stress during the COVID-19 Pandemic: Providers Dual Exposure to a Complex and Lasting Mental Health Crisis

Background and Purpose: Mental health providers during the COVID-19 pandemic experienced a specific, acute, and often under recognized type of trauma known as Shared Traumatic Stress (STS). This is defined as a provider’s dual exposure to a collective trauma, as professionals exposed to clients’ trauma narratives, and as citizens who are also experiencing that same traumatological environment. This study measured the extent and level of STS among licensed mental health providers in the United States during the COVID-19 pandemic. STS is a novel topic in the field of social work research, and its exploration during COVID-19 reinforces the value of supporting the mental health workforce. Highlighting STS research can recenter the wellbeing of social workers as critical to the field’s effectiveness during large-scale traumatic events.

Methods: A convenience sample of 3,184 licensed clinicians from across the United States were recruited to participate in a cross-sectional online survey about the impact of COVID-19 on their personal and professional lives. Data collected in this survey measured STS; PTSD using the Posttraumatic Checklist-5 (PCL-5), Resilience using the Brief Resilience Scale (BRS), attachment styles using the Adult Attachment Questionnaire (AAQ), exposure to a range of past traumas using the Life Events Checklist-5 (LEC-5), post traumatic growth using the Post-Traumatic Growth scale (PTG), secondary trauma, compassion satisfaction, and burnout using the Professional Quality of Life scale (ProQOL), as well as a single item gauging enduring stress from the pandemic. Consistent with prior research, STS was operationalized by the product of scores from the PCL-5 and the ProQOL secondary trauma subscale. All of the scales in this survey were open source and highly validated.

Data analysis consisted of structural equation modeling (SEM) that included resilience as a mediator as well as four independent variables: avoidant and ambivalent-anxious attachment styles, exposure to a traumatic life event, and a single item assessing enduring stress from the COVID-19 pandemic specifically. The SEM used regression coefficients and R² to estimate the impact of predictor variables on STS.

Results: The SEM results suggested small direct effects between the independent variables and their mediator, resilience (R²=.17). However, there were moderate direct effects detected between the independent variables and STS, with the overall R² in the model being .40. When examining each independent variable’s direct effect on either resilience or STS, each variable’s coefficient was statistically significant at p <.01. Finally, consistent with findings from previous STS research, clinicians’ resilience was found to have an inverse relationship to STS.

Implications: The findings contribute to knowledge of STS during the COVID-19 pandemic, and how these collective traumatological environments may affect those seeking mental healthcare as well as the social workers providing it. By doing so, it both recenters the importance of provider’s wellbeing as critical to the social work profession, while also expanding the scope of social work research to further consider the complex and emergent issues facing the workforce, such as STS. Future studies should aim to recruit more diverse samples and continue to compare levels of STS in distinct traumatological environments.