You may have studied countless theories, landed good grades and even aced your way through uni placements, but what you haven’t yet experienced is the cumulative effect of working alongside people, day in and day out, who are experiencing and recounting distressing events. The impact of this shouldn’t be underestimated.
You’ve no doubt heard about vicarious trauma, and maybe even talked about coping strategies too, but have you given this topic the time it deserves? Without giving social work a bad rap, our hope is that you:
There are several terms used in this sphere, notably secondary trauma, vicarious trauma/traumatisation, compassion stress, compassion fatigue, burnout and more recently, the updated definition of post-traumatic stress disorder (PTSD). While the meaning of these vary slightly, in social work they can all be used to describe how a worker’s second-hand exposure to trauma or distress experienced by clients, can have a deep and unsettling impact on the worker’s life.
When you sign up for social work, you know you’re going to hear about or witness some confronting situations. Your aim is to be engaged, empathetic, and of service, without having your everyday life disrupted by the content of the work. That said, there’s bound to be times where you’ll experience emotional stress.
The sudden onset of helplessness or confusion is natural reactions that anyone (not just workers) might experience when learning of another person’s trauma. This type of reaction is called compassion stress, and with debriefing and self-care it can usually be alleviated. Similar to this, but perhaps more intense, is secondary traumatic stress. Again this is a typical reaction you might have towards any friend, family member or client experiencing trauma. It can look like PTSD, presenting as intrusive thoughts or avoidance of places or topics. Both of these usually relate to a particular scenario.
Vicarious trauma and compassion fatigue are more severe forms of emotional stress, with an identifying factor being that they describe the cumulative effect of second-hand exposure to trauma. This prolonged exposure (through weeks, months and years of social work) manifests as more holistic exhaustion or mental shift in the worker. Whereas vicarious trauma describes a change in a person’s spirituality, such as a losing of hope and meaning, or a doubting of personal belief systems, compassion fatigue relates to a state of dysfunction where the worker is overwhelmingly exhausted on a physical, emotional and spiritual level.
And then there’s burnout.
Burnout describes a complete mental and physical exhaustion related to work, not necessarily related to trauma. In this way, teachers and computer technicians can experience burnout too. In social work it looks much like vicarious trauma or compassion fatigue and can lead to workers needing time off, switching sectors or leaving the profession altogether.
The impact of clients’ lived experiences on a worker comes in many shapes and sizes, ranging from a change in a worker’s inner feelings and beliefs to behavioural and physical manifestations of distress. Of course, working with people in a social work capacity has positive experiences too: witnessing the incredible strength and resilience of a client, marvelling at the way a community bands together, gaining an appreciation of life, and feeling proud of the meaningful work that you do.
Here, we’ll discuss the not-so-great effects of secondary trauma.
Secondary trauma has the potential to leave workers feeling irritable, depressed, anxious, helpless, isolated and/or in a state of despair. Their sense of purpose and belief in the world may deflate, and feelings of failure and unworthiness may rise. Physically, workers can pick up colds and flus, and experience headaches, a loss of appetite, sweats and nausea.
Behaviourally, the impact of secondary trauma may present as a worker becoming isolated, avoiding certain duties, working extra long hours, or using stimulants to self medicate. This could coincide with having flash-back experiences, problems with clear thinking, reduced productivity, cynicism, an inability to stop thinking about a client or an inability to empathise.
There is no set way that vicarious trauma is experienced. One worker may feel like they no longer care about the lives of their clients, while another will feel that they can no longer communicate with other people or complete the simplest of tasks without feeling anxious.
The key is that you recognise that these are not your typical feelings or behaviours.
There are many tools that social workers use both as preventative measures and to assist them when they’re in the thick of compassion fatigue. Most of these fall under the umbrella of self-care.
The problem with the term ‘self-care’, is that it gives the impression that it’s entirely the worker's responsibility to ensure that they’re not adversely impacted by the trauma of others. Or that as long as they take care of themselves, they won’t experience indirect trauma. This is not the case!
Self care should involve an organisations responsibility to put caring practices into place, the responsibility of training institutions to care about the professional integrity of their students and equip them with information, and an individual's professional obligation to use techniques to care for themselves, acknowledge concerns, and reach out when need be. Perhaps a better term is ‘caring practices’.
Let’s take a look at some of these tools.
We know there’s lots of productive things you could be doing in this time, but never underestimate the transformative power of dissecting your practice in a supervisory session. It’s an opportunity to let down your guard, ask for help, discover why you might be feeling a certain way and collaborate on strategies to move forward.
There are several ways supervision is offered: as regular or as-you-need-it sessions with senior members of your team, externally with trained parties, and/or peer supervision where you meet with other workers for mutual benefit, problem solving, and self-directed learning.
If supervision isn’t immediately offered in your workplace, raise the topic with superiors and create your own peer sessions.
Having strong boundaries is an integral part of the job, but unfortunately you don’t always know where they are until you hit them!
Setting up healthy boundaries includes knowing when your caseload is too large and seeking assistance to manage this. Even if you can’t reduce your numbers, you might be able to share the trauma cases. It also includes knowing how long you can work before you just need to switch off, maintaining a healthy work-life balance, and thinking about how much of your personal life you’re willing to share with clients.
Healthy boundaries also involves knowing which cases might trigger distressing situations from your own life, and either choosing not to work in these fields, or having a workplace understanding that other workers will take these cases. You won’t be at your best for your clients if you’re continually triggering your own experiences of (e.g.) sexual violence, through indirect exposure to their trauma. First and foremost look after yourself. There are other professionals that can take these cases.
When faced with the risks of compassion fatigue, it’s not enough to bring in a bunch of caring strategies the day an issue arises. That’s the equivalent of starting to brush your teeth after you get decay! You need to try and prevent the situation in the first place. In social work, this means creating a life full of caring practices that’ll make you feel balanced, happy, proactive, inspired, worthy, and with purpose. These act as your protective factors.
Finding humour in your life can act as a great release for any heavy content you might be exposed to at work. So catch up with mates and have a good laugh, choose the romantic comedy movie over the drama, or head out for a night of stand-up entertainment. Releasing endorphins through exercise is also a great way to stay positive, and getting outdoors for some fresh air and nature tends to have a restorative and rejuvenative effect too. Make a pact to do something fun & social every week: connect with family, watch a game of sport, take up a hobby or allow yourself a little pampering time. The benefits are immeasurable.
Lots of professionals also see therapists as part of their individual caring strategies, which provides an opportunity to debrief and regroup.
Everyone is bound to have their own strategies, but the key is to diligently and routinely implement these into your working week, even when you’re feeling great. Hold yourself accountable by writing a list. If you’re starting to experience distress, this list can act as a reference point allowing you to easily work out what techniques you’ve already employed, and where you could up the ante.
The most important thing to remember is that you have not failed.
Unfortunately, despite all the care in the world, sometimes compassion fatigue or vicarious trauma will rear its head anyway. There’s no rhyme or reason, and it’s nothing to be ashamed of. The empathy that drew you to working with vulnerable people in the first place is unfortunately the same empathy that leaves you susceptible to feeling traumatised by their experiences. So:
Always talk to you supervisor/manager and let them know what’s going on. They’ll have protocols that need to be followed, and they might be able to switch up your professional duties for a while to make things a little smoother.
Re-look at all the tools we’ve mentioned. Re-assess your boundaries, boost your self care activities and use supervision sessions to your advantage. If you’re not comfortable with your supervisor, speak up and make changes. This is your well-being.
Therapy. Having someone to assist you through this journey, who you can speak freely to and who isn’t aligned with your organisation, is of great benefit. Therapists are trained to support people through these very experiences, so utilise their skills!
Take time out. Whether it’s sitting at home bingeing on netflix, using the time to connect with support systems, or going away on a relaxing holiday, give your mind and body the chance to de-stress and rejuvenate. You may just need a few days, or you might need to move away from direct client work for a period of time. You may even realise you need to take a hiatus from social work altogether. All of these are okay.
Lastly, reconnect with why you got into social work in the first place. If after a little break you’re still feeling passionate about the industry, then return with a greater awareness of your own needs and limits, and some new coping strategies to assist you in your future work.
Take care out there.