Secondary Trauma In Mental Healthcare Providers In Alaska

Abstract

Secondary trauma (ST) is vicarious traumatization caused by empathetic engagement with another's trauma, which may lead to burnout/turnover for mental healthcare providers (MHPs). ST and associated risk or protective factors have not been studied in Alaska. This research explored the prevalence and predictors of ST. The study population was 450 licensed MHPs and 14 Behavioral Health Aides (BHAs) who were randomly selected to complete the Secondary Traumatic Stress Scale (STSS) and a questionnaire created for this research, which inquired into aspects of their work. Bivariate analyses, mediator analyses, and multiple regressions tested which variables were associated with levels of overall ST and three sub-types of ST labeled Intrusion, Avoidance, and Arousal. 4 of the MHPs who responded to the survey also participated in a focus group to explore the survey results in greater detail. In total, 232 (50% response rate) licensed professionals and BHAs (47.08% urban and 48.15% rural) responded to the online survey. The Total STSS score across all participants indicated a "mild" level of ST among the MHPs. Approximately 20% of the sample met criteria for posttraumatic stress disorder as a result of their work; 47.6% experienced intrusion, 32.9% experienced arousal, and 29.9% experienced avoidance symptoms. As hypothesized, MHPs who reported working in rural locations, treating long-term and casual acquaintances, being less satisfied with their social support and self-care levels, and feeling more embarrassed to discuss ST reported higher levels of ST. Spending a higher percentage of one's workweek providing direct client services, however, was associated with less ST. Other hypothesized predictors of ST, including being younger, time spent debriefing, having a trusted supervisor, hours spent in self-care, treating a family member or friend, having a similar trauma history as a client, and gender were not associated with ST. Focus group participants shared that all clinicians may be susceptible to ST, that MHPs cope with ST by emotionally withdrawing, and that organizations can help reduce ST by providing support that reduces overall job-related stress. The information obtained can assist training programs, organizations, and providers in addressing ST, which may help reduce burnout/turnover rate.