Essential Standard: Your agency educates and implements policies to care for residential staff on the effects of this work, which may take a toll on mental, emotional, physical, and spiritual health
NTSA recognizes that residential staff working with survivors of human trafficking and in the anti-trafficking field are exposed to intense and emotional cases and circumstances that may negatively impact their mental, emotional, physical, and spiritual health, if not properly cared for. Within this field, we understand the need for trauma-informed care when working with survivors, and we must also acknowledge that being trauma-informed means recognizing and addressing that staff’s exposure to the suffering and injustices that accompany human trafficking will impact their own health as well.
To adequately provide services and care for survivors, agencies must care for themselves and their employees. It is essential to be intentional about both educating staff on the risk of vicarious trauma in this work and implementing policies that seek to properly care for staff’s health and wellness. Below are the aspects of educational training and policies that NTSA regards as necessary for your agency to be vicarious trauma-informed, along with recommendations your agency should consider beyond the base requirements.
This table specifies both required and recommended attributes that are evaluated during the accreditation process. Those attributes labeled as required must be present for accreditation. Attributes labeled as recommended could be reviewed, but are not necessarily required, during the accreditation process. Each requirement and recommendation is further explained in the sections below.
Required
- Education on the impact of this work in new staff orientation
- On-going education on vicarious trauma and agency’s strategies to address risk
- Public and easily accessible agency policy detailing response to signs / impacts of staff vicarious trauma
- Policy for seeking out and supporting staff, particularly after a traumatic incident
- On-going assessment of the impact of vicarious trauma on your organization and its employees, such as through informal staff discussions/ debriefings or assessment tools
Recommended
- Scheduled or readily available staff debriefings with clinicians
- Free or significantly subsidized external counseling opportunities for staff
- Scheduled supervision of direct staff by leadership and creation of admin time system
- Implementation of Paid Time Off policies for staff
- Implementation of self-care practices and procedures into work environment and/or education on self-care practices
- Opportunities for staff to participate in positive peer group activities
- Referrals to outside educational opportunities, such as workshops and conferences on vicarious trauma, self-care, and organizational or staff health and wellness
The Risk and Impact of Vicarious Trauma
Vicarious trauma is defined as the impact of exposure to the trauma experiences of others. This impact may include negative changes in an individual’s view of themselves, others, and the world, as a result of engaging with somebody else’s trauma-related thoughts, emotions, and experiences. In fact, the signs and symptoms of secondary traumatic stress can be identical to those of Post-Traumatic Stress Disorder, and in some cases, secondary traumatic stress merits a full PTSD diagnosis.
Education of Staff on Vicarious Trauma
The first and crucial step to creating a vicarious trauma-informed organization is recognizing the challenges and risks that accompany working in the anti-trafficking field and educating your staff on them. This should include training on vicarious trauma during new staff orientation, as well as the use of ongoing staff training on vicarious trauma and your agency’s strategies for addressing vicarious trauma. Providing staff with education on vicarious trauma will allow them to name their experience and understand how to respond to it. Your agency can also encourage and support employees in participating in outside educational opportunities, such as workshops and conferences on vicarious trauma, self-care, and organizational or staff health and wellness.
Individual Symptoms of Vicarious Trauma
It is important that all staff working with survivors are educated on the following common signs of vicarious trauma:
General Symptoms/ Signs:
- Generalized fear
- Sleep disturbance
- Change in worldview
- Changes in feelings of trust
- Diminished sense of hope
- Intrusive memories or thoughts
- Pervasive cynicism/pessimism
- Intimacy and/or relationship issues
- Decreased feeling of safety
- Social withdrawal
- Irritability, low frustration tolerance
Specific Symptoms/Signs Related to Client Care:
- Decreased interest in client’s care (compassion fatigue)
- Lingering feelings of anger, rage, and sadness about client’s victimization
- Becoming overly emotionally involved with a client
- Bystander guilt, shame, or feelings of self-doubt
- Preoccupied with thoughts of clients, outside of the work situation
- Over-identifying with a client (especially to the detriment of one’s individuality or objectivity)
- Distancing, numbing, or cutting clients off to avoid listening to client stories of traumatic experiences
- Difficulty maintaining professional boundaries with client, such as overextending self
Organizational Impacts of Vicarious Trauma
Your staff should also be educated on the organizational impacts that vicarious trauma can have on the agency overall and the connections to individual impacts and quality of care.
These organizational impacts include:
- Work burnout, especially without the necessary and proper amount of sleep, exercise, time-off, and nutrition
- Productivity issues
- Low staff morale
- Increased absenteeism
- Increased errors in care delivery
- Decreased client satisfaction
- Declined organizational and staff health
- Increased staff turnover
Central to these negative organizational consequences are that exposure to vicarious trauma can cause or increase employee levels of stress and depression, as well as physical impacts like fatigue, irritability, and lack of self-care. The increased risk and presence of negative impacts on individual employees working with survivors can impact your agency’s ability to do your work effectively and provide high quality care for survivors. Not only are these impacts costly to the overall operations of the agency, but they increase the likelihood of the retraumatization of clients.
These risks and potential consequences of vicarious trauma highlight the critical need to intentionally and actively address the risk of vicarious trauma within your agency, provide resources, and implement policies that support your staff.
Addressing & Anticipating Vicarious Trauma
Protective Practices & Characteristics
Research has indicated that the following practices and principles can help counteract or prevent the impacts of vicarious trauma:
- Countering isolation (in professional, personal, and spiritual realms)
- Developing mindful self-awareness
- Consciously expanding perspective to embrace complexity
- Active optimism
- Holistic self-care
- Maintaining clear boundaries and honoring limits
- Exquisite empathy
- Professional satisfaction
- Creating meaning
- Reasonable levels of responsibility and manageable caseload
- Fair compensation
- Team meetings with open communication and opportunities to express concerns to supervisors and management
- Regular points of celebration, recognition, and rewards
- Rituals that build and strengthen community
Your agency should seek to provide opportunities where these practices and principles can be fostered within the work environment. Research suggests that these protective characteristics can be developed and nurtured through organizational structure and culture, staff empowerment, social support, and self-care.
The Role of Leadership in Organizational Culture
In order to implement policies to care for and educate staff, leadership needs to be vicarious trauma-informed themselves and be able to recognize and understand what their staff is experiencing and know how to intervene. Research findings indicate that regularly scheduled supervision can be critical to combating and decreasing the risk of and impact of vicarious trauma. Specifically, a supervisor who is engaged and aware of the signs of vicarious trauma is able to assist a worker at risk of vicarious trauma to feel both more competent and supported in their role. Research additionally supports that staff feel cared for and want to retain their position when leadership anticipates and addresses their needs and creates a work space that prioritizes communication and care. This entails not only having open communication to identify and respond to staff vicarious trauma and burnout as it arises, but also proactively integrating strategies to care for staff into workplace policies, practices, and values. This care may take the form of providing free external counseling opportunities for staff, implementing Paid Time off policies for staff, and/or the use of self-care practices within the work environment.
Leadership at your agency should additionally have a standard procedure in place for reaching out to and debriefing with staff following a traumatic experience on the job or after any sign of distress in an employee. It is the responsibility of agency leadership to take the initiative to create an environment where staff are comfortable, feel appreciated, and are able to ask for and find resources to support their own health and wellness.
Importance of Self-Care and Peer Supports
Research supports that self-care can be essential to managing the risk of vicarious trauma. Practicing self-care, including spiritual practices, mindful self-awareness, and meditation, have been found to be effective protective and preventive measures against vicarious trauma. Your agency should take measures to educate staff on the importance of self-care and provide opportunities for staff to engage in self-care mechanisms, when possible.
Additionally, peer support has been found to be one of the most significant factors in combating vicarious trauma, alongside supervision and organizational practices. Your agency can provide opportunities for staff to participate in positive peer group activities to mitigate vicarious trauma, such as team building activities, team debrief groups, and reading groups. Community meals are also a powerful way to build connections and extend peer networks at your agency.
Key Principles of a Vicarious-Trauma Informed Organization
Your agency must identify what policies and practices for creating a vicarious trauma-informed environment would best serve your workplace and staff population. Regardless of the specific policies and strategies used, there are key principles that should be uplifted by your agency:
- Open Communication
- Open communication within your agency is considered a cornerstone to creating a trauma-informed and supportive environment for staff and clients.
- This may include the practice of scheduled or readily available staff debriefings with clinicals, when they feel stressed or overwhelmed. This practice makes asking for help and getting subsequent resources easily accessible and available for staff.
- Supportive Relationships & Employee Empowerment
- It is essential that your agency fosters supportive relationships within your organization that are based on mutual respect, inclusivity, and trust. Creating an environment where staff feel safe, respected, and emotionally and socially supported helps them to better manage the stress of the work itself and the risk of vicarious trauma.
- This includes promoting policies and practices that seek out and support staff, particularly after a traumatic incident, and utilizes regular discussions regarding vicarious trauma with staff.
- Your agency can also seek to educate staff on both professional and personal self-care strategies that can be practiced on and off work time.
- Continuous Evaluations
- Your agency should continuously assess the impact of vicarious trauma on your organization and its employees and evaluate what interventions would best fit your organization’s needs.
- Evaluations of the impact of vicarious trauma can take the form of informal discussions or debriefings with staff or assessment tools like the Professional Quality of Life Scale (ProQOL) or Secondary Traumatic Stress Scale (STSS).
- Additionally, your agency can assess the impact of your policies aimed at reducing the negative consequences of vicarious trauma. This assessment can include staff perceptions of your agency’s efforts and allow for input on what interventions or practices would improve organizational and staff health and well-being.
Relevant Resources
“Vicarious Trauma Toolkit” from the Office of Victim Service. https://ovc.ojp.gov/program/vtt/tools-for-victim-services#6xq8gm
“Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others” by Laura van Dernoot Lipsky and Connie Burk (May 2009)
“Professional Quality of Life: Compassion Satisfaction and Fatigue Subscales-III”, 1995 -2002, http://www.isu.edu/~bhstamm.
“Wellness Inventory” from National Wellness Institute. https://nationalwellness.org/wp-content/uploads/2020/09/NWI_Wellness_Inventory.pdf
“Self-Care Assessment Worksheet” from Transforming the Pain: A Workbook on Vicarious Traumatization. Saakvitne, Pearlman & Staff of TSI/CAAP (Norton, 1996). https://www.mentoring.org/wp-content/uploads/2020/03/MARCH_2015_Self_Care_Assessment.pdf
