Potential Risks to watch out for

Secondary traumatic stress

Secondary traumatic stress results when an individual hears about the first-hand trauma experiences of another on at least one occasion. The term compassion fatigue is often used interchangeably.

Its symptoms mimic those of post-traumatic stress disorder (PTSD). Accordingly, individuals  may find themselves re-experiencing personal trauma or notice an increase in arousal and avoidance reactions related to the indirect trauma exposure.

Symptoms include:

  • Hypervigilance
  • Hopelessness
  • Inability to embrace complexity
  • Inability to listen, avoidance of clients
  • Anger and cynicism
  • Sleeplessness
  • Fear
  • Chronic exhaustion
  • Physical ailments
  • Minimizing
  • Guilt

Further reading

A wealth of useful resources and guidance on prevention and intervention have been produced by the National Child Traumatic Stress Center in the US

Vicarious trauma

Vicarious trauma  is the negative response to exposure to work-related trauma. It results from the cumulative exposure of staff to stories of trauma on an ongoing basis. Importantly, it is used when exposure to trauma has resulted in an altered view of self / others / the wider world.

This video explains more about vicarious trauma and the importance of awareness, balance and connection in addressing the risks.

Vicarious trauma presents as:

  • 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).


Burnout is characterised by emotional exhaustion, depersonalisation, and a reduced feeling of personal accomplishment. While it is work-related, burnout develops as a result of general occupational stress; too much work or impossible standards. The term is not used to describe the effects of indirect trauma exposure specifically.

Who is most at risk of secondary trauma?

Employees and volunteers may be more vulnerable to secondary trauma when they have:

  • had prior traumatic experiences;
  • experienced social isolation, both on and off the job;
  • difficulty expressing feelings;
  • lack of preparation, orientation, training, and supervision in their jobs;
  • joined the organisation or profession recently and have less experience;
  • heavy workloads, skipping breaks or annual leave
  • 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.

Source: The Vicarious Trauma Toolkit

This resource provides a wealth of useful and practical advice and guidance on this topic.

Further reading

The British Medical Association has produced brief guidance on the signs and strategies for vicarious trauma. It applies equally well to work with survivors.

Living Well have produced a training module on vicarious trauma including how to identify and strategies to prevent and alleviate.

Awareness and identification of secondary trauma stress or vicarious trauma

Play Video

In this video, Laura van Dernoot Lipsky describes the impact that vicarious trauma can have, how to identify it and strategies to prevent and alleviate it.

Examples of common signs include:

  • Becoming overly involved emotionally with a client
  • Experiencing bystander guilt, shame, feelings of self-doubt
  • Being preoccupied with thoughts of clients outside of the work situation
  • Over identification with the client (having horror and rescue fantasies)
  • Loss of hope, pessimism, cynicism
  • Distancing, numbing, detachment, cutting clients off…. Avoiding listening to client's story of traumatic experiences
  • Difficulty in maintaining professional boundaries with the client, such as overextending self (trying to do more than is in the role to help the patient)
  • Catastrophising
  • Urgency of work that never ends – it also spreads to other parts of your life
  • Broken record to others
  • Our work problem is everywhere – e.g. see cases and perpetrators everywhere


Why is wellbeing important?


How to support a colleague you are concerned about