Preventing secondary trauma and maintaining hope

Adapted from Zimering and Gulliver (2003)

What is secondary trauma?

  • Unlike primary trauma, which occurs when an individual has been directly affected by an event, secondary trauma can occur from indirect exposure to trauma through listening to a narrative or firsthand account.

  • Providing care to individuals who have experienced trauma is important and ongoing work. It is very important for providers to continue to address their own needs during this time to prevent secondary and vicarious trauma.

  • The vivid recounting of trauma or repeated exposure to individuals who have been affected by primary trauma can result in subsequent reactions and emotions that parallel PTSD.

  • Secondary trauma can be seen in healthcare professions. It is important to prevent this by taking a few essential steps when providing care.

How to prevent secondary trauma

Risk factors for secondary trauma include insufficient training, having a personal identification with survivors, not having enough support in the workplace, and not having sufficient interpersonal support outside of the workplace.

Training

Seek training in how to deliver trauma-informed care, such as resources on this website.

Identification

Take time to recognize that you are caring for humans just like yourself. Think about how you are alike and different. Make personal distinctions between yourself and your patients. Recognize your role and professional boundaries, while maintaining compassion and care for these individuals. 

Recognize

Take a moment to recognize that by seeking resources such as this, you are becoming a more informed provider of care. No one is going to provide perfect trauma-informed care, so be patient with yourself in the process of learning to be more sensitive and informed. Recognize that this area of care is emotionally heavy, and that it is acceptable to feel these emotions.

One technique to recognize the weight of this topic is to have a special place that you can go to alone. Go to this place after work, or after particular interactions that require reflection, and think about how your work has affected you. After exploring these thoughts, envision a box, where you can safely store and cherish these interactions and individuals. This is not the same as burying emotions, but rather, it is recognizing them as meaningful, giving them due attention, and then allowing yourself to step away for periods of time.

Professional strategies

Focus on balancing caseloads and seeking accessible supervision.

Personal strategies

Respect your own limits, determine your best general coping strategies such as physical exercise, journaling, or expressive art. Find a person that you trust to explore your emotions with. Therapy is a wonderful resource for individuals seeking a safe place to explore thoughts and emotions.

The role of hope

Survivors of human trafficking have experienced trauma, which can be very troubling. As a healthcare provider, it is valuable to see the strengths of these individuals, and the incredible hope that manifests. You will be exposed to individuals with unbelievable resiliency, amazing stories, and redemption from hardship. By being informed and compassionate, you can play a part in making a positive impact in the health and well being of these individuals, which is something to be celebrated.

Recognizing the signs of secondary trauma

Across the resource literature, several signs and symptoms appear consistent throughout individuals who experience secondary trauma:

  • Physical warning signs: exhaustion, headaches, grinding teeth at night, heart palpitations, increased illness

  • Behavioral signs: substance use, anger and irritability, avoiding social events, feelings of helplessness when hearing a difficult story, lack of empathy for clients

  • Emotional signs: increased anxiety, depersonalization, intrusive imagery, depression 

If you are experiencing secondary trauma:

  • Seek help and treatment through mental health services in your area and medical professionals—it is perfectly acceptable to start this conversation with your primary healthcare provider, who may refer you to other trained professionals

  • Discuss your concerns with your supervisor to make adjustments in caseloads

  • Think about taking a break from your specific work to equip yourself with the tools and resources for trauma and provide for a season to refresh

  • Encourage regular staff meetings or case review times with the staff to discuss issues, hard feelings, personal concerns, errors, and/or areas of improvement