Evidence in Action Research Brief- Can Organizational Efforts Reduce Individual STS?

April 2021|Volume 9, Issue 2

EVIDENCE IN ACTION

A quarterly research brief from the

Center on Trauma and Children

Can Organizational Efforts Lead to Less Secondary Traumatic Stress? A Longitudinal Investigation of Change

Sprang, G., Lei, F., and Bush, H. (forthcoming). Can Organizational Efforts Lead to Less Secondary Traumatic Stress? A Longitudinal Investigation of Change,

American Journal of Orthopsychiatry

Introduction

For professionals frequently exposed to indirect trauma, secondary traumatic stress (STS) is an expected occupational hazard; however, strategies for addressing it have historically almost exclusively focused on the individual, prescribing self-care and self-help methods without considering the role that workplace factors play. Responding to the well-documented phenomenon of STS many scholars have called for a bifocal perspective that, like a pair of bifocal lenses, keeps two distinct points in clear focus and considers individual and the organizational outcomes over time to address STS (Sprang et al., 2019; Molnar, Sprang, Killian, Gottfried, Emery, & Bride, 2017; Salanova, Bakker & Llorens, 2006).

The Study

This study used a bifocal, data-driven approach to address STS at the individual and organizational level. Professionals included in the study represent child welfare services, community mental health and substance abuse treatment services, public health workers, social service providers, and other publicly funded adult and child professionals, providing 2345 responses. All employees in the represented organizations were invited to participate in surveys at the beginning and end of the initiative as well as at five-month follow up to study whether organizations becoming more STS-informed had an impact on overall worker well-being and individual reports of symptoms related to STS and burnout.

Each organization elected a team of 5-10 volunteers who, with support from STS and organizational change experts, used survey results to create goals toward becoming more STS informed and monitored progress toward completing those goals. This change process was structured using a Breakthrough Series Collaborative approach, which brings together teams from an organization to pursue improvement in a specific area (Bate, Robert, & McLeod, 2002). Using baseline data to determine areas that needed attention, teams selected from a range of micro-interventions within the bifocal framework.

The Secondary Traumatic Stress Informed Organizational Assessment (STSI-OA) (Sprang, Ross, Miller, et al., 2017) is a 40-item measure that assesses the degree to which an organization is STS-informed and the Secondary Traumatic Stress Scale (STSS) for DSM-5 (Bride, 2017) is used to assess professionals’ self-reported symptoms of STS. A five-item Implementation Activity scale was created to determine the team’s implementation behavior based on whether there was engagement in all the implementation activities, including leadership engagement, the level of champions activity, degree of interface with external change agents and number of reflecting and evaluation activities.

Findings

Statistically significant improvement in levels of organizational STS, were observed across time. On an individual level, measurements related to STS and burnout illustrated significant improvement over time. Distinctly lower estimated STSS scores were observed in organizations with very high implementation activity (engagement in activities) compared to those with lower engagement. Similarly, burnout scores were shown to decrease significantly alongside higher implementation activity levels. These results support the hypothesis that organizational efforts can improve an individual’s perceived level of distress, and that focused attention to the issue of secondary trauma in an organization can improve organizational and individual outcomes. Even after the end of the study, survey results demonstrated that improved organizational and individual scores were sustained or increased further in the moderate and high implementer’s groups. Since the relationship between individual and organizational outcomes is thought to be reciprocal and transactional (Nielsen et al., 2010), it could be expected that positive, incremental changes at one level could bring about a cascade of improvements at another. Results of this study support this notion with increase in organizational activity producing a notable decrease in the individuals’ reported STS.

Translational Tips

STSS is a significant issue for workers exposed to indirect trauma. Providers should have the tools to self-assess and monitor so they can access support and intervention as needed.
The organization has a role to play in addressing secondary traumatic stress and by engaging champions to lead the efforts, organizational change toward becoming more STS informed is possible.
It is not just about showing up. High levels of employee engagement with STS change efforts is a predictive factor in how successful they will be.

Addressing activities reflected in the STSI-OA: resilience building, the promotion of safety, developing STS informed policies, leadership commitment and modeling of STS informed practices, general STS targeted organizational procedures, and evaluation and monitoring of STS can produce a healthier workforce.
The STSI-OA is available at no cost at www.uky.edu/CTAC/stsioa. Note a pandemic version, as well as Spanish and French versions of the tool are also available.

References

Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social work, 52(1), 63-70.

Molnar, B. E., Sprang, G., Killian, K. D., Gottfried, R., Emery, V., & Bride, B. E. (2017). Advancing science and practice for vicarious traumatization/secondary traumatic stress: A research agenda. Traumatology, 23(2), 129.

Nielsen, K., Taris, T. W., & Cox, T. (2010). The future of organizational interventions: Addressing the challenges of today's organizations. Work & Stress, 24(3), 219-233.

Salanova, M., Bakker, A., and Llorens, S. (2006). Flow at work: Evidence for a gain spiral of personal and organizational resources, Journal of Happiness Studies, 7, 1-22.

Sprang, G., Ross, L. A., & Miller, B. (2018). A data-driven, implementation-focused, organizational change approach to addressing secondary traumatic stress. European Journal for Person Centered Healthcare, 6(1), 62-68.

Sprang, G., Ford, J., Kerig, P., & Bride, B. (2019). Defining secondary traumatic stress and developing targeted assessments and interventions: Lessons learned from research and leading experts. Traumatology, 25(2), 72.

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