Understanding Differences in Work-Related Trauma-Exposure: FSPSF Research Brief

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CONTACT US

Questions or comments can be directed to the Florida Study of Professionals for Safe Families Principal Investigator, Dr. Dina Wilke: dwilke@fsu.edu, or to project researcher, Dr. Erin King: eking1@uwf.edu

METHODS

UNDERSTANDING DIFFERENCES IN WORK-RELATED TRAUMA-EXPOSURE

OCTOBER 2022

INTRODUCTION AND CONTEXT

Trauma-exposure of child welfare workers is recognized as a potential factor in workers’ intentions to leave the field. There appear to be specific types of trauma that workers experience, including client violence, secondary trauma, and primary trauma, such as the death of a child on a caseload. This more nuanced view of the term “trauma-exposure” is necessary to better understand workers’ experiences and mitigate potential negative impacts.

The Florida Study of Professionals for Safe Families is a longitudinal study of newly hired case managers and child protective investigators (N = 1,500). Baseline information was collected during pre-service training and workers were surveyed every 6-months for 3.5 years. This analysis examines workers’ experiences of primary trauma experiences such as client violence or the death of a child, and secondary traumatic stress. Workers were included in this analysis if they remained working in a child welfare position with a caseload at 18-months post-baseline.

FINDINGS

PRIMARY EXPERIENCES: CASELOAD TRAUMA

One potential source of work-related primary traumatic experiences is caseload trauma, which is not well understood. Caseload trauma is differentiated from secondary trauma in that the traumatic experience does not result from witnessing the trauma of others, but in directly experiencing a traumatic event related to one’s caseload. Examples include the severe injury or death of a child on a worker’s caseload. Workers often feel a sense of responsibility for the children on their caseload and may feel guilt or shame when a child is injured or killed while on their “watch” or find themselves “scapegoated” for severe negative outcomes on their caseloads.1 The burden of responsibility, in addition to public and media criticism when particularly violent or traumatic abuse or neglect of a child occurs, is likely to cause stress, and may be experienced as trauma by the worker.2

In this sample, by the time workers were on the job for 18 months, 16.7 percent (n = 106) reported the death of a child on their caseload due to accident or illness; 7.7 percent (n = 49) reported the death of a child on their caseload due to maltreatment; and 29.4 percent (n = 187) reported at least one child on their caseload experienced a severe illness or injury.

PRIMARY EXPERIENCES: CLIENT VIOLENCE

A second area of work-related primary trauma is client violence, which can be defined as any incident where a worker is verbally abused, threatened, or assaulted by a client or family member.3,4 For client violence to be considered traumatic, it must be perceived by the worker as violent or abusive in some way, whether it is verbal abuse such as yelling or swearing at the worker; making specific threats to the worker, worker’s family, or agency; or

a physical assault such as punching, slapping, or throwing an object at a worker.1 Because of the nature of the work, and the settings in which client interactions take place, child protective service workers are at a higher risk for client violence compared to other human services workers. Among the child welfare workers in this sample, 80.1 percent (n = 495) reported at least one incident of verbal abuse, 47.2 percent (n = 293) reported at least one threat against themselves or their families, and 5.8% (n = 35) reported experiencing at least one assault by a client or a member of a clients’ household during the preceding six months.

Figure 2:

Experiences

SECONDARY TRAUMA

Another potential source of work-related trauma is exposure to the trauma of others, whether by verbal re-telling of an event or history of abuse, or by seeing the results of violence or abuse on another human being. It is inevitable that child welfare workers will both see and hear the results of abuse or neglect on vulnerable children, and some workers may develop psychological and physical symptomatology (i.e., avoidance behaviors, intrusive imagery, and sleep disturbance), also known as secondary trauma, because of their exposure to the trauma of others.5 Examples of incidents that may result in secondary trauma include: investigating a severe abuse/neglect report; chronic exposure to emotional and detailed accounts of trauma from children; photographic images of the results of child abuse/neglect; working with families where abuse, intimate partner violence, or sexual abuse is occurring or is thought to be occurring; and exposure/provision of services to family members where a child died.6

Workers were asked a series of questions related to the severity of certain symptoms associated with secondary traumatic stress such as “reminders of my work with clients upset me” and “I had disturbing dreams about my work with clients”.7 Among this sample, 26 percent of workers reported moderate to severe levels of secondary traumatic stress symptomatology at 18-months on the job.

RECOMMENDATIONS

It is inevitable that workers will encounter at least one type of work-related trauma, and therefore a proactive approach to mitigate negative responses to work-related trauma exposure is required. These results indicate that experiences of trauma, both primary and secondary, are common within Florida’s child welfare workforce and should be a part of the discussion about the well-being of workers. When considering the effects of trauma exposure on workers it is vital to understand that there are different types of trauma that have varying effects on workers. Our understanding of the types of trauma workers may face should be considered when providing supervision for workers and in determining agency policies and protocol surrounding reporting of traumatic experiences and provision of support for workers who may struggle with work-related trauma exposure. Additional areas of education and support can include pre-service and in-service training and interventions developed specifically for mitigating the negative effects of trauma exposure. Some examples of proactive measures include clear reporting guidelines for incidents of violence experienced on the job as well as policies for addressing these events that acknowledge each worker’s unique experience and an understanding that what is perceived as traumatic for some may not be experienced as traumatic for others. Leadership commitment to safety and a non-judgmental response to reporting of client violence or workers’ acknowledgment of mental health challenges indicates that the safety and wellbeing of workers is a priority and can therefore influence overall organizational culture and psychological climate.

REFERENCES

1 Geoffrion, S., Morselli, C., & Guaym S. (2016). Rethinking compassion fatigue through the lens of professional identity: The case of childprotection workers. Trauma, Violence, & Abuse, 17, 270-283. doi: 10.1177/1524838015584362

2 Dagan, S. W., Ben-Porat, A., & Itzhaky, H. (2016). Child protection workers dealing with child abuse: The contribution of personal, social and organizational resources to secondary traumatization. Child Abuse & Neglect, 51, 203-211.

3 Enosh, G., Tzafrir, S. S., & Stolovy, T. (2015). The development of Client Violence Questionnaire (CVQ). Journal of Mixed Methods, 9, 273290. doi: 10/1177/1558689814525263

4 Lamothe, J., Geoffrion, S., & Couvrette, A., Guay, S. (2021). Supervisor support and emotional labor in the context of client aggression. Children and Youth Services Review, 127, 1-9.

doi: 10.1016/j.childyouth.2021.106105

5 Salloum, A., Kondrat, D. C., Johnco, C., & Olson, K. R. (2015). The role of self-care on compassion satisfaction, burnout and secondary trauma among child welfare workers. Children and Youth Services Review, 49, 54–61. https://doi.org/10.1016/j.childyouth.2014.12.023

6 Bonack, K., & Heckert, A. (2012). Predictors of secondary traumatic stress among children’s advocacy center forensic interviewers. Journal of Child Sexual Abuse, 21, 295-314.

doi: 10.1080/10538712.2012.647263

7 Bride, B. E., Robinson, M. M., Yegidis, B., & Figley, C. R. (2004). Development and validation of the Secondary Traumatic Stress Scale. Research on Social Work Practice, 14, 27-35.

doi: 10.1177/1049731503254106