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Issue 12 | April 2022
Addressing the Health and Well-Being of Children's Advocacy Center Staff and Partners
Staff members at children’s advocacy centers (CACs) and their multi-disciplinary team (MDT) partners are at the forefront of a community’s response to child abuse and neglect. While this work undoubtedly presents key intrinsic rewards, it can also take its toll. There have been many terms used to describe this impact, including vicarious trauma (VT), burnout, secondary traumatic stress (STS), and compassion fatigue. With the advent of COVID-19, employee stress and burnout have reached peak levels, leading many to re-think whether they want to continue working in this field. 

Children’s advocacy center (CAC) staff are particularly vulnerable to developing STS and/or VT. While the field of STS and VT (which will be combined as STS/VT for the purposes of the current article) has received great attention over the past several years, there continues to be a significant need in developing resources and supports specific to the CAC environment. Seeking to address this need, the Western Regional Children’s Advocacy Center (WRCAC) offers several cohorts of Building Resilient Teams (BRT), a seven-session online series that blends pre-work with facilitated peer discussions to build resilience within MDTs. The updated curriculum includes new information in the field of STS/VT as well as a greater focus on implementation of strategies within the broader MDT. In partnership with state chapters, WRCAC also offers Trauma-Informed Care and Practice in a CAC Setting, a 2.5-hour training that focuses on the impact of trauma and STS as well as organizational approaches to addressing STS, such as reflective supervision. Most recently, WRCAC released the product “Building Trauma-Informed Children's Advocacy Centers: Resource Guide,” which includes resources for understanding and addressing STS in CACs and MDTs. 
To further address the need for STS/VT resources in the CAC field, WRCAC has partnered with the other three Regional Children’s Advocacy Centers (RCACs) to form an STS workgroup designed to create specific supports and resources for CAC staff members and MDT partners, convened by staff at the Southern Regional Children’s Advocacy Center (SRCAC). The workgroup is using the Secondary Traumatic Stress Consortium Consensus Guidelines as its foundation. The STS Consortium is a group of researchers, trainers, practitioners, and advocates advancing the field of STS towards health. The STS Consortium promotes and supports organizational health and individual well-being in trauma-exposed work environments and makes several resources and tools available on their website, including the recently released consensus guidelines. According to this document, STS/VT can and should be addressed on both an individual and organizational level. The individual level refers to those actions targeted specifically to individual professionals in the workforce, while the organizational level refers to those actions undertaken by the larger organization that impact the entire workforce. The document lays out the following guidelines at each level aimed at reducing the occurrence and impact of STS/VT: 
INDIVIDUAL GUIDELINES 

  • Individual Professional Education: The professional possesses evidence-informed knowledge about risks and strategies for mitigating STS/VT. 

  • Skill Development: The professional develops the ability to employ specific strategies for remaining within a zone of tolerance during exposure and recovery after reactivity. 

  • Beliefs/Attitudes/Values: The professional cultivates and maintains beliefs that support their sense of well-being in their helping role. 

  • Reflection/Self-Awareness: The professional identifies their own personal profile of strengths and vulnerabilities to secondary trauma exposure for use in self-monitoring. 

  • Team Support: The professional collaborates on a team of trusted colleagues, peers, or a community of practice with whom they can share thoughts and feelings concerning secondary trauma exposure. 

  • Oversight of Well-Being: The professional possesses the willingness and capability to monitor their own well-being and uses strategies for mediating secondary trauma responses. 

  • External Professional Support: The professional determines when they would benefit from psychological counseling or other external support and knows how to access that support. 

ORGANIZATIONAL GUIDELINES  

  • Organizational Policies, Protocols, and Practices: The organization has policies and active practices, including structuring workflow to minimize secondary trauma exposure and active strategies for promoting workforce resilience, that demonstrate commitment to the well-being of its workforce. 

  • Organizational Training: The organization has processes in place for providing ongoing training concerning the nature of STS/VT, the causes, and strategies for mitigation of STS/VT. The training is culturally responsive and evidence-informed. The training process includes advanced training to enable supervisors to provide continuous support to workers. 

  • Workforce Support: The organization has structured workloads to mitigate STS/VT exposure in the workplace. This structure includes flexible time for supervision and peer support processing, wellness activities, and training. 

  • Organizational Culture: The organization explicitly nurtures a culture of psychological safety that acknowledges the hazards of working in a trauma-exposed environment and fosters team support and respect for personal boundaries. 

  • Supervision: The organization dedicates time and supports for the provision of qualified secondary trauma-informed supervision. 

  • Practices of Leaders: Organizational leaders model trauma and secondary trauma-informed behaviors and play an active role in developing a supportive and resilient workplace. 

  • Organizational Assessments and Monitoring: The organization demonstrates the prioritization of workforce wellness through defined metrics that are continuously monitored, safeguarded for privacy, and responded to with priority. 
In addition to the STS Consortium Consensus Guidelines, the RCAC workgroup is reviewing the following materials to inform the decision on what type of resource would best benefit the CAC field. 

  • The Vicarious Trauma Toolkit (VTT) - The VTT is a state-of-the-art repository of nearly 500 resources to assist victim services and first responder agencies in addressing the vicarious trauma needs of their staff. The VTT focuses on organizational responses to work-related exposure to trauma. 

  • Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others - This book by Laura van Dernoot Lipsky offers practical guidance on recognizing and addressing STS to professionals who “intend to make the world more sustainable and hopeful—all in all, a better place—and who are exposed through their work to the hardship, pain, crisis, trauma, or suffering of other living beings or the planet itself.”  


  • TEND Academy - Provides education and resources to helping professions, leadership, and organizations to help them stay healthy, effective, and engaged while doing challenging work. 


While STS/VT is, in many ways, an inherent part of responding to cases of child abuse, providing support and resources is essential to helping staff stay engaged in this important work. We invite you to review the resources shared above and will provide ongoing updates to the CAC field as gaps are identified and new resources are created. 

In the meantime, if you have any questions about addressing STS/VT among your CAC staff or MDT partners, please reach out to us at wrcac@rchsd.org.  
Lisa Conradi, PsyD
Executive Director
Chadwick Center for Children and Families
Lisa Conradi, Psy.D. is the Executive Director at the Chadwick Center for Children and Families at Rady Children’s Hospital - San Diego. In this role, she provides overall leadership support to the Chadwick Center, a children's advocacy center and one of the largest trauma treatment centers in the nation. She has multiple years of experience in the field of child trauma and in supporting service systems in their efforts to become more trauma-informed. She has authored and co-authored a variety of publications on trauma screening and assessment practices, creating trauma-informed systems and presented nationally on innovative practices designed to improve the service delivery system for children who have experienced trauma. She is a licensed Clinical Psychologist and has received training from the developers on multiple evidence-based trauma-focused treatment practices, including Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) and Child-Parent Psychotherapy (CPP). She is on the editorial board for the Journal of Aggression, Maltreatment and Trauma and a co-author of the upcoming book, Trauma-Informed Assessment with Children and Adolescents: Strategies to Support Clinicians.  
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WRCAC is funded through the U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention, Grant #2019-CI-FX-K002

The opinions, findings, and conclusions or recommendations expressed in this product are those of the authors and do not necessarily reflect those of the Department of Justice.