Secondary Trauma: What is it and How to Avoid it

Secondary Trauma: What is it and How to Avoid it

The effects of secondary trauma stress are numerous and alarming. Learn more about what it is and how to avoid it.

Amanda Luzzader
Amanda Luzzader
Content Writer
Secondary Trauma: What is it and How to Avoid it

You've probably heard secondary trauma stress referred to by several different terms: "compassion fatigue," "caregiver stress," "vicarious trauma," or simply "burnout." According to information provided by the U.S. Administration for Children and Families (ACF), no matter what else you call it, secondary trauma stress is a "set of observable reactions to working with people who have been traumatized and mirrors the symptoms of post-traumatic stress disorder (PTSD)."

In other words, secondary trauma occurs when personnel of many types (such as medical professionals, health care workers, caregivers, and emergency-responders) are negatively affected by witnessing, discovering, and treating the trauma suffered by those they are responsible for.

The effects of secondary trauma stress are numerous and alarming. The ACF lists twenty symptoms in four categories:


Lowered Concentration


Rigid thinking


Preoccupation with trauma









Sleep disturbance

Appetite change


Elevated startle response


Increased heart rate

Difficulty breathing

Muscle and joint pain

Impaired immune system

Increased severity of medical concerns

Experiencing even a handful of such symptoms can be devastating, and could easily render an individual unable to function personally, let alone professionally. Fortunately, according to the ACF, once secondary trauma stress is understood and considered, the disorder "can be addressed and resolved and the caregiver or helper can heal and even grow from the experience."

For reasons that should be obvious, secondary trauma stress should be an important concern to nonprofit organizations that work with individuals who have experienced trauma.

According to a blog article by job-search firm ExactHire, annual turnover at nonprofit organizations is 19 percent--quite a bit higher than the 12 percent expected in an all-industry average. An article in Forbes predicted that 45 percent of all nonprofit workers will seek new positions by 2025. While not all nonprofit organizations are involved in work that involves secondary trauma stress, many nonprofit workers report overwork and stress as reasons that they quit.

And there are arguably even better reasons to address secondary trauma stress at nonprofit organizations. For instance, it doesn't make much sense to provide care and services to traumatized people and groups if you're simply passing that trauma and its effects along to the nonprofit organization's workers and staff.

What can be done to prevent secondary trauma stress? The ACF states that addressing secondary trauma stress falls into two categories: prevention and treatment. Further, the ACF suggests the problem should be approached at the organizational level (measures taken by the nonprofit itself) and the individual level. They then provide the following lengthy lists of suggested solutions:

Individual Prevention Strategies

  • Life balance -- work to establish and maintain a diversity of interests, activities and relationships.

  • Relaxation techniques -- ensure downtime by practicing meditation or guided imagery.

  • Contact with nature -- garden or hike to remain connected to the earth and help maintain perspective about the world.

  • Creative expression -- things like drawing, cooking, or photography expand emotional experiences.

  • Assertiveness training -- learn to be able to say "no" and to set limits when necessary.

  • Interpersonal communication skills -- improve written and verbal communication to enhance social and professional support.

  • Cognitive restructuring -- regularly evaluate experiences and apply problem-solving techniques to challenges.

Individual Treatment Strategies

  • Focusing on self-care -- making a healthy diet, exercise, and regular sleep priorities reduces adverse stress effects.

  • Journaling -- writing about feelings related to helping or care giving and about anything that has helped or been comforting can help make meaning out of negative experiences.

  • Seeking professional support -- working with a counselor who specializes in trauma to process distressing symptoms and experiences provides additional perspectives and ideas.

  • Joining a support group -- talking through experiences and coping strategies with others who have similar circumstances can enhance optimism and hope.

  • Learning new self-care strategies -- adopting a new stress management technique such as yoga or progressive muscle relaxation can reduce adverse physical stress symptoms.

  • Asking for help -- asking social supports or co-workers to assist with tasks or responsibilities can hasten healing.

  • Recognizing success and creating meaning -- identifying aspects of helping that have been positive and important to others assists with resolving trauma and distress.

  • Time management -- set priorities and remain productive and effective.

  • Plan for coping -- determine skills and strategies to adopt or enhance when signs of compassion fatigue begin to surface.

Organizational Prevention Strategies

  • Create an organizational culture that normalizes the effects of working with trauma survivors.

  • Adopt policies that promote and support staff self-care.

  • Allow for diversified workloads and encourage professional development.

  • Create opportunities for staff to participate in social change and community outreach.

  • Ensure a safe work environment.

  • Provide secondary trauma stress education to and encourage open discussion of secondary trauma stress among staff and administrators.

  • Make counseling resources and Employee Assistance Programs available to all staff.

Like many such problems, secondary trauma stress is something that nonprofit workers should be made well aware of, and anyone who is susceptible to secondary trauma stress should learn about the condition, its symptoms, and the various ways to prevent and treat it.