July 2016Vol. 17, No. 5Addressing Secondary Traumatic Stress at the Worker, Peer Levels
Kelly Sullivan, Ph.D., Assistant Professor, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Licensed Psychologist, Center for Child and Family Health
This article is part of a series of guest articles on the topic of secondary traumatic stress (STS). Each article in the series focuses on STS at a different level of child welfare—the worker/peer level, manager/supervisor level, and organizational level.
In 2011, the North Carolina Division of Social Services (NCDSS), in partnership with the Center for Child and Family Health (CCFH) and the University of North Carolina at Chapel-Hill (UNC-CH) School of Social Work Jordan Institute, launched Project Broadcast, a 5-year initiative to develop a trauma-informed child welfare system through funding from the U.S. Department of Health and Human Services' Administration of Children and Families. NCDSS, serving in the role of child welfare experts, and CCFH, serving in the role of trauma experts, spent more than 700 hours developing (1) a Learning Collaborative on trauma-informed child welfare practice based on the National Child Traumatic Stress Network's Child Welfare Trauma Training Toolkit (CWTTT), and (2) a North Carolina-specific child welfare trauma screening tool. Eighty-four program managers, supervisors, and workers participated in county teams in the 9-month Learning Collaborative and were trained to complete the child welfare trauma screening tool. Since that time, NCDSS and CCFH have experimented with alternative versions of disseminating the CWTTT, reaching 21 counties and resulting in more than 9,000 completed trauma screens. Because workers are now exposed to even more child trauma (e.g., directly asking children trauma questions), addressing worker stress, in particular secondary traumatic stress, has emerged as paramount. Individual and peer-level strategies are an essential component of intervention.
Self-care is most commonly referenced as an individual intervention strategy. While the typical self-care strategies (e.g., eating well, exercising) are important, they may not feel like self-care to some. One specific strategy that many workers have found appealing is the "three good things" activity (Seligman, Steen, Park, & Peterson, 2003). This strategy consists of an individual documenting three good things that happened during the day and their role in bringing them about. If done nightly in the 2-hour period before going to sleep for 2 weeks, it increases happiness and decreases depressive symptoms long-term better than a placebo. This approach is being disseminated in various service systems to promote workforce resilience. Take a survey to determine your own level of compassion satisfaction, burnout, and secondary traumatic stress symptoms. [Find more information on identifying secondary traumatic stress symptoms and self-assessments on the National Child Traumatic Stress Network website.]
On the peer level, a simple strategy with a wide appeal is the use of low-impact debriefing to remedy "sliming," as described in The Compassion Fatigue Workbook by Françoise Mathieu. Sliming occurs when a professional, hoping to alleviate some of their mental/emotional burden, shares too much upsetting or disturbing detail of their client's stories with coworkers. When a coworker is not prepared to handle this burden, it can negatively impact his/her stress level. The terminology itself has resonated with workers who have felt slimed and who have recognized that they have slimed others. Instead, low-impact debriefing consists of first increasing one's self-awareness of the level of detail one typically shares. Then, when sharing is needed, the sharer provides the receiver with fair warning and an opportunity to consent or dissent and the sharer limits the disclosure to the details needed.
A good resource for individual and peer-level strategies is Mathieu's workbook mentioned above. These strategies are important, but supervisory, senior staff, and agency-wide approaches are essential for fully addressing the stress of those who, through their work, experience others' and their own trauma, suffering, and loss. Please see the other articles in this series for more information.
