Secondary Traumatic Stress and Staff Well-being: Understanding compassion fatigue, vicarious trauma and burnout in therapeutic care – practice guide

Download PDF

Jun 2022

Written by Noel MacNamara

This guide has been developed to support organisational congruence and in the provision of trauma informed therapeutic care and the critical need for a well-supported, capable, and stable staff group to deliver this vision. Effective therapeutic care is situated within a relationship-based approach to practice. Thus, the health and well-being of staff involved in this work are central to their ability to engage in relationships of care that have therapeutic intent. This guide provides staff and managers with information about secondary traumatic stress, vicarious trauma, compassion fatigue, and burnout. It describes organisational, client-related, and personal risk and protective factors and provides strategies for assessing and addressing staff support and well-being.

 

Key Messages

  • The care of children and young people who have experienced trauma is complex and challenging work.
  • The development of secondary traumatic stress, vicarious trauma, compassion fatigue, and burnout is recognised as a common occupational hazard for staff and carers looking after traumatised children and
    young people.
  • Organisational variables such as lack of role clarity and high client demands combined with insufficient supervision with little feedback and reduced opportunity to participate in decision making can lead to increased risk of burnout among staff and carers.
  • There are many personal risks and protective factors that play an important role in the susceptibility for burnout, compassion fatigue, secondary traumatic stress, and vicarious trauma.
  • Vicarious trauma, compassion fatigue, and secondary traumatic stress can be resolved successfully with self-care practices and/or professional support should staff, and carers experience them.
  • There are a range of effective strategies that organisations and individuals can be used to assess and support staff well-being.

 

You may be interested in: Self care Trauma-informed care

An emerging paradigm - Welcome to our new Therapeutic Care Blog
An emerging paradigm - Welcome to our new Therapeutic Care Blog Written by: Janise Mitchell
Over the past two decades, the term therapeutic care has emerged as a new paradigm used to integrate constructs that had traditionally been considered separate – therapeutic processes and the...
Read more
What is Effective Therapeutic Care? - research brief
What is Effective Therapeutic Care? - research brief Written by: Lynne McPherson Kathomi Gatwiri Nadine Cameron Natalie Parmenter
This research briefing is an introduction to therapeutic care as a preferred response for children and young people who have experienced complex trauma and are unable to live at home....
Read more
The evidence base for therapeutic group  care A systematic scoping review - research brief
The evidence base for therapeutic group care A systematic scoping review - research brief Written by: Lynne McPherson Kathomi Gatwiri Nadine Cameron Natalie Parmenter
The NSW Government has undertaken major reforms over the past two years aimed at improving outcomes for children and young people in out-of-home care. Following a review by Verso Consulting...
Read more
The role of emotions in therapeutic care
The role of emotions in therapeutic care Written by: Noel MacNamara
The role of emotions within human service work may at first glance appear to be intuitively obvious and incontestable. Indeed, Howe (2008) described the day of a human service worker...
Read more
The needs of LGBTIQ young people in out of home care -research brief
The needs of LGBTIQ young people in out of home care -research brief Written by: Nadine Cameron Lynne McPherson Kathomi Gatwiri Natalie Parmenter
Young people who are same sex attracted, trans or gender diverse – a population who will be referred to in this document as LGBTIQ (lesbian, gay, bisexual, transgender, intersex and...
Read more
Safety from the outside to the inside
Safety from the outside to the inside Written by: Noel MacNamara
At the recent Therapeutic Specialist’s forum, there was lots of discussion about the concept of physical and relational safety in Intensive Therapeutic Care (ITC). We all agreed that it is...
Read more
Understanding and supporting young people who self-harm in residential care
Understanding and supporting young people who self-harm in residential care Written by: Noel MacNamara
Some of the young people we care for in the ITC programs deal with emotional distress and pain by hurting themselves physically. Young people hurting themselves is distressing to them...
Read more
The role of praise in working with young people
The role of praise in working with young people Written by: Noel MacNamara
We can see each of our daily interactions with each of the young people we care for as bids for connection.  By choosing to turn toward, to turn away, or...
Read more
The healing power of friendship
The healing power of friendship Written by: Noel MacNamara
Can the friendships and connections that can develop in Intensive Residential Care be nurtured and grown rather than feared? I would like you to take a moment to think back...
Read more
Preventing self-harm among young people in out-of-home care - research brief
Preventing self-harm among young people in out-of-home care - research brief Written by: Nadine Cameron Lynne McPherson Kathomi Gatwiri Noel MacNamara Natalie Parmenter
Many young people in out-of-home care are at an elevated risk of self-harm and suicidality. The reasons range from early exposure to abuse, disconnection from family, instability of their living...
Read more
‘Tis the Season to be Jolly’ – but not for everyone
‘Tis the Season to be Jolly’ – but not for everyone Written by: Noel MacNamara
It’s all too easy to get wrapped up in the fun and happiness of Christmas and forget that, for others, the season isn’t necessarily a joyful one. For some the...
Read more
How do you support staff feeling defeated and powerless? A Case Study
How do you support staff feeling defeated and powerless? A Case Study Written by: Tram Nguyen
My work as a Therapeutic Specialist is about finding ways to equip and support staff to provide high-quality therapeutic care for young people living in Intensive Therapeutic Care homes. It...
Read more
Vicarious Trauma and Secondary Stress in Therapeutic Residential Care - research brief
Vicarious Trauma and Secondary Stress in Therapeutic Residential Care - research brief Written by: Lynne McPherson Kathomi Gatwiri Natalie Parmenter
It is generally accepted that child welfare professionals are at high risk of experiencing vicarious trauma: the manifestation of traumatic symptoms resulting from working with individuals who, themselves, have encountered...
Read more
Understanding vicarious trauma and compassion fatigue
Understanding vicarious trauma and compassion fatigue Written by: Noel MacNamara
Research shows how profoundly influenced we are by other people’s emotional states and how rapidly our interpersonal affective responses occur, and how dynamically our physiology responds to others’ emotional states....
Read more
What works? Promising practices to support young people who self-harm
What works? Promising practices to support young people who self-harm Written by: Kelly Royds
Why do young people in out of home care self-harm? What are the best predictors of suicide and self-harm? What really works when supporting young people who self-harm in out-of-home...
Read more
Q&A with Cate Keady from the Elver Program
Q&A with Cate Keady from the Elver Program Written by: Kelly Royds
Since 2018, Cate Keady has worked within the Department of Communities and Justice to establish and manage the Intensive Support Services Elver Program - in partnership with South Western Sydney...
Read more
A story you may recognise
A story you may recognise Written by: Noel MacNamara
Peta had worked in residential care for 18 months. She took the position because she had had a difficult childhood and she felt that she had a lot to offer...
Read more
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 2
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 2 Written by: Peter Le Breton
In the first part of the Blog, we explored limit and expectation setting, maintaining a state of occupancy and the planning process for a successful transition. In part two of...
Read more
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 1
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 1 Written by: Peter Le Breton
This is a two-part blog and will focus on the transition of young people into an Intensive Therapeutic Care house; however, most of the content is transferrable to other placement...
Read more
Changing your practice to being trauma informed in therapeutic residential care
Changing your practice to being trauma informed in therapeutic residential care Written by: Glenys Bristow Noel MacNamara
Whilst the following Arabian proverb takes a bit to get your head around it leads rather nicely into this blog and our brief introduction on the relevance of the conscious...
Read more
Supporting children in out-of-home care to cope with ambiguous loss
Supporting children in out-of-home care to cope with ambiguous loss Written by: Kenny Kor Jodie Park
When you think of grief and loss, what comes to your mind? You may think of the immense sorrow one may experience. For some of us, we can seek solace...
Read more
Trauma Informed Care - research brief
Trauma Informed Care - research brief
This research briefing aims to define and clarify what trauma, complex trauma and trauma informed care are. Extensive literature has now surmised that exposure to adverse experiences such as child...
Read more
Trauma Informed Relationship-Based Recovery Reflection Tool
Trauma Informed Relationship-Based Recovery Reflection Tool
“Childhood trauma has the potential to interrupt the normal physical, physiological, emotional, mental and intellectual development, of children and can have wide-ranging, and often life-long implications for their health and...
Read more
How to develop your own self-care protocol
How to develop your own self-care protocol Written by: Kelly Royds Noel MacNamara
When someone says ‘self-care’, what image comes to mind?What are the positive and negative aspects of this image?Do you have clear intentions for self-care and your self-care protocol?Last month, we...
Read more
Frequently asked questions by foster carers: Behaviours that challenge
Frequently asked questions by foster carers: Behaviours that challenge Written by: Noel MacNamara
On any given night there are about 18000 children and young people are in foster care in Australia. Most foster carers will be the first to tell you how rewarding...
Read more
“If you don’t feed the staff, they’ll eat the kids” Kevin Creeden on self-care and harmful sexual behaviours
“If you don’t feed the staff, they’ll eat the kids” Kevin Creeden on self-care and harmful sexual behaviours Written by: Cyra Fernandes
Kevin Creeden, Director of Assessment and Research at Whitney Academy Massachusetts and a speaker at the 2022 International Child Trauma Conference said in recent training, “If you don’t feed the...
Read more