The Connection Between Social Work and Secondary Trauma

More than half of Americans report experiencing trauma, and 90% of people seeking mental health care have a trauma history.

Social workers are on the front lines of the trauma fight. Their support can help survivors live meaningful lives after catastrophic events. But chronic exposure to other people’s suffering is itself a form of trauma. Social workers can suffer secondary or vicarious trauma, which may trigger burnout, stymie their ability to support clients, and trigger chronic mental health issues. 

Vicarious vs. Secondary Trauma in Social Work: What’s the Difference?

Social workers inevitably work with people who have experienced trauma such as the death of a loved one, surviving a natural disaster, being in combat, living in an abusive marriage or family, or surviving a sexual assault. Over time, this traumatic exposure can cause social workers to experience symptoms of trauma such as anxiety, depression, and even posttraumatic stress (PTSD). 

Secondary trauma is a traumatized reaction to another person’s experience. It can happen suddenly, after a single exposure. Vicarious trauma happens when a person is exposed to the trauma of others on an ongoing basis. 

Over time, both secondary and vicarious trauma can cause compassion fatigue. People with compassion fatigue may feel numb and disconnected, struggle to empathize, and be less effective at supporting their clients.

Examples of Vicarious and Secondary Trauma in Social Work

Secondary trauma appears suddenly. Anyone can experience it. For example, a person who witnesses a natural disaster or who sees someone else get into a car wreck can face secondary trauma. In a social work context, a single session with a traumatized person may trigger symptoms of secondary trauma. This might happen when:

• A social worker listens to a client’s story of being raped, assaulted, or abused.
• A client or a client’s close family member dies or suffers a serious injury.
• A social worker witnesses abuse in the context of social work, such as when a parent verbally abuses a child in family therapy. 

Vicarious trauma is a longer-term reaction to the accumulation of exposure to traumatic events. It happens when a person faces continuous exposure to trauma. Some examples might include:

• A social worker in a community health clinic continually watches clients die of HIV/AIDS.
• A rape crisis counselor sees numerous rape survivors dismissed, disbelieved, or blamed for their abuse.
• A social worker at a domestic violence shelter routinely works with traumatized children.

When Social Workers Experience Trauma

Social workers are not immune to experiencing trauma of their own. When a social worker has a history of personal trauma, the trauma they experience at work may trigger this trauma, intensifying symptoms. For example, a social worker with a history of domestic violence may experience secondary trauma when counseling domestic violence survivors. 

Providers with a personal history of trauma must identify their triggers, decide whether they can confidently work with populations that may activate those triggers, and be mindful of the role secondary trauma plays in their relationship with clients. Providers who do not think carefully about their connection to a client’s trauma may project their own desires and experiences onto a client or make invalid assumptions about a client’s reactions or feelings.

Signs of Secondary and Vicarious Trauma in Social Work

Some signs of secondary and vicarious trauma include:

• Compassion fatigue, which can inhibit a provider’s ability to empathize with and support clients.
• Having nightmares about a client’s experiences.
• An increase in symptoms relating to a personal trauma, such as more flashbacks or anxiety.
• Feeling unable to support clients.
• Feeling exhausted, fatigued, overwhelmed, or burned out.
• Avoiding work or talking about work.
• Changes in eating or sleeping habits.
• Feeling jumpy or easily startled.
• New feelings of anxiety, fear, or anger.
• Difficulty talking about or identifying emotions.
• Increased conflict at work or at home.
• Feeling less interested in or invested in work.
• Feeling angry at your clients. 

How to Manage, Treat, and Prevent Vicarious and Secondary Trauma 

For many social workers, the primary barrier to treating vicarious and secondary trauma is identifying the symptoms. When someone is overworked or exhausted, they may blame their symptoms on fatigue and burnout. Working with a team or clinical supervisor may empower clinicians to recognize the symptoms of secondary trauma before they get worse. 

Some strategies that may help prevent vicarious and secondary trauma include:

• Actively managing and reducing a social worker’s caseload.
• Talking to team members or a clinical supervisor on a regular basis.
• Taking breaks in between clients.
• Seeking treatment for a personal history of trauma.
• Establishing good work-life boundaries, such as not taking work calls at home.
• Being mindful of your own trauma history and how it may interact with your clients’ trauma.
• Practicing good self-care, including taking lunch breaks, getting adequate sleep, and carving out spare time for hobbies, friends, and family. 

When trauma symptoms appear, it’s important to take them seriously and be proactive. Some tactics that may help include:

• Taking time away from work.
• Reassigning some clients to another team member.
• Temporarily reducing caseload.
• Addressing workplace issues such as an abusive manager or lack of support from other counselors.
• Asking for additional support from colleagues or supervisors.
• Adopting grounding and mindfulness exercises during the day.
• Seeking out small pleasures between clients. For example, you might go for a walk or watch a funny video. 

Clinicians who worry they are experiencing vicarious or secondary trauma may find support in therapy. A therapist can help a social worker manage their own trauma history while supporting them so they can better support their clients. To find a therapist who specializes in working with other professionals, click here. 

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References:

1. Devilly, G. J., Wright, R., & Varker, T. (2009, July 6). Vicarious trauma, secondary traumatic stress or simply burnout? Effect of trauma therapy on mental health professionals. Australian & New Zealand Journal Of Psychiatry, 43(4), 373-385. Retrieved from https://www.tandfonline.com/doi/abs/10.1080/00048670902721079?src=recsys&journalCode=ianp20
2. Pearlman, L. A., & McKay, L. (2008). Understanding and addressing vicarious trauma [Ebook]. Pasadena, CA: Headington Institute.
3. Trauma. (n.d.). Retrieved from https://www.integration.samhsa.gov/clinical-practice/trauma
4. Vicarious trauma. (n.d.). American Counseling Association. Retrieved from https://www.counseling.org/docs/trauma-disaster/fact-sheet-9---vicarious-trauma.pdf?sfvrsn=f0f03a27_2