Vicarious trauma is an occupational challenge for people working and volunteering in the fields of victim services, law enforcement, emergency medical services, fire services, and other allied professions, due to their continuous exposure to victims of trauma and violence. This work-related trauma exposure can occur from such experiences as listening to individual clients recount their victimization; looking at videos of exploited children; reviewing case files; hearing about or responding to the aftermath of violence and other traumatic events day after day; and responding to mass violence incidents that have resulted in numerous injuries and deaths.
What Happens to Those Exposed to Vicarious Trauma?
The Vicarious Trauma Toolkit (VTT) introduces a new model for examining and conceptualizing the impact of vicarious trauma and the reactions and experiences of victim service providers and first responders. The VTT also introduces the roles and responsibilities of organizations in addressing the negative impact of this occupational challenge on their employees.
While individuals respond to vicarious trauma in a number of ways, a change in their world-view is considered inevitable—people can either become more cynical or fearful, or they can become more appreciative of what they have, or both. Responses to vicarious trauma can be negative, neutral, or positive; can change over time; and can vary from individual to individual, particularly with prolonged exposure. The chart below illustrates the VTT Model.
- Vicarious traumatization is a negative reaction to trauma exposure and includes a range of psychosocial symptoms. (In the VTT, the term “vicarious traumatization” is used broadly to include other related terms such as secondary traumatic stress (STS), compassion fatigue (CF), and critical incident stress (CIS). These terms, often used interchangeably, have distinct and overlapping definitions, as illustrated in the Glossary of Terms.)
- A neutral reaction signifies the ways that an individual's resilience, experiences, support, and coping strategies manage the traumatic material, not that it has no effect.
- Vicarious resilience and vicarious transformation are newer concepts reflecting the positive effects of this work. For instance, individuals may draw inspiration from a victim’s resilience that strengthens their own mental and emotional fortitude. Just as victims can be transformed in positive ways by their trauma, so can victim service providers and first responders.
- Compassion satisfaction reflects the sense of meaning that is gained from working in the fields of victim services and first responders. Such positive outcomes can motivate and, in turn, protect against the negative effects of trauma exposure.
Who Is at Risk of Being Affected by Vicarious Trauma?
Anyone working with survivors of trauma and violence is at risk of being negatively impacted by the varied effects of vicarious trauma. Factors that may make employees or volunteers more vulnerable to this occupational risk include—
- prior traumatic experiences;
- social isolation, both on and off the job;
- a tendency to avoid feelings, withdraw, or assign blame to others in stressful situations;
- difficulty expressing feelings;
- lack of preparation, orientation, training, and supervision in their jobs;
- being newer employees and less experienced at their jobs;
- constant and intense exposure to trauma with little or no variation in work tasks; and
- lack of an effective and supportive process for discussing traumatic content of the work.
What Are Some Common Negative Reactions to Vicarious Trauma?
Each individual may experience the effects of vicarious trauma differently. Some of the potential negative reactions include, but are not limited to—
- difficulty managing emotions;
- feeling emotionally numb or shut down;
- fatigue, sleepiness, or difficulty falling asleep;
- physical problems or complaints, such as aches, pains, and decreased resistance to illness;
- being easily distracted, which can increase one’s risk of accidents;
- loss of a sense of meaning in life and/or feeling hopeless about the future;
- relationship problems (e.g., withdrawing from friends and family, increased interpersonal conflicts, avoiding intimacy);
- feeling vulnerable or worrying excessively about potential dangers in the world and loved ones’ safety;
- increased irritability; aggressive, explosive, or violent outbursts and behavior;
- destructive coping or addictive behaviors (e.g., over/under eating, substance abuse, gambling, taking undue risks in sports or driving);
- lack of or decreased participation in activities that used to be enjoyable;
- avoiding work and interactions with clients or constituents; and
- a combination of symptoms that comprise a diagnosis of Posttraumatic Stress Disorder (PTSD).
Suggestions for Coworkers
If you believe a coworker might be experiencing negative reactions to vicarious trauma, consider—
- reaching out and talking to them individually about the impact of the work;
- helping them establish a consistent work-to-home transition that creates an important boundary and safe place outside the workplace;
- encouraging them to attend to the basics—sleep, healthy eating, hygiene, and exercise;
- supporting connections with family, friends, and coworkers;
- referring them to organizational supports such as a peer support team, employee assistance program, or chaplain; and
- encouraging them to discuss their experience with their supervisor.
Suggestions for Supervisors
The VTT includes a number of suggestions for supervisors of individuals who may be experiencing vicarious trauma, including—
- discussing vicarious trauma as part of supervision;
- allowing flexible work schedules, recognizing the need for and protecting down time, while staying attuned to the possibility of withdrawal or isolation;
- creating time and a physical space at work for reflection through reading, writing, prayer, and meditation, among other activities; and
- referring to therapeutic and professional assistance, when appropriate.
Suggestions for Family Members
Family members of victim service providers and first responders are also often affected by work-related trauma exposure. In addition to the suggestions offered above, consider these additional ways to address your own needs and those of your family:
- Share your concerns and develop supportive strategies with your loved one.
- Do your best not to take your loved one’s reactions personally; remind yourself that what your loved one may be experiencing is related to the job, not you.
- Maintain daily life routines (predictability helps).
- Stay connected with family and friends.
- Discuss the demands of your loved one’s job and its impact with other family members, including responding to children’s questions in an age-appropriate manner.
- Take time to engage in social, creative, and self-care activities such as reading, writing, prayer, and meditation.
- Seek therapeutic or professional assistance, when needed.
For More Information About Vicarious Trauma
The VTT has a number of resources to help you further understand vicarious trauma, its prevalence, and its impact on those working in victim services, emergency medical services, fire services, law enforcement, and other allied professions. The following is just a small sample of the nearly 500 resources in the VTT Compendium of Resources.
Education and Awareness
- Introduction to Vicarious Trauma for Emergency Medical Services
- Introduction to Vicarious Trauma for Fire Services
- Introduction to Vicarious Trauma for Law Enforcement
- Introduction to Vicarious Trauma for Victim Services
- The Secondary Effects of Helping Others: A Comprehensive Bibliography of 2,017 Scholarly Publications Using the Terms Compassion Fatigue, Compassion Satisfaction, Secondary Traumatic Stress, Vicarious Traumatization, Vicarious Transformation and ProQol
- Vicarious Trauma and Resilience
- Office for Victims of Crime Training and Technical Assistance Center (OVC TTAC)
- Headington Institute
- The Vicarious Trauma Institute
- Trauma Information Pages
Prevalence and Risk Factors
- Organizational Factors Leading to Vicarious Trauma or Burnout
- The Effect of Childhood Trauma, Personal Wellness, Supervisory Working Alliance, and Organizational Factors on Vicarious Traumatization
- The Prevalence of Post-Traumatic Growth in Emergency Ambulance Personnel
- Trauma Exposure and Symptoms of Post-Traumatic Stress Disorder in Emergency Medical Services Personnel in Hawaii
- Vicarious Trauma Among Sexual Assault Nurse Examiners
- Vicarious Traumatisation: Risk and Resilience Among Crisis Support Volunteers in a Community Organisation
- Vicarious Traumatization, Secondary Traumatic Stress and Burnout in Sexual Assault and Domestic Violence Agency Staff
- Secondary Traumatization, Burnout, and Vicarious Traumatization: A Review of the Literature as it Relates to Therapists Who Treat Trauma
- Making the Business Case for a Vicarious Trauma-Informed Organization
- Guidebook on Vicarious Trauma: Recommended Solutions for Anti-Violence Workers
- Official Blog of the International Association of Chiefs of Police: A Personal Account from a Law Enforcement Officer
- The Hidden Price of Repeated Exposure
- the Mindfit Resiliency Project
- Work-Related Stress and Posttraumatic Stress in Emergency Medical Services