Understanding Vicarious Trauma as an Occupational Hazard: 3 Things We Can Do To Mitigate It
When I was in my early 20s, keen to begin my journey toward being a psychologist, I worked my way through a number of frontline jobs in the helping profession, often holding several at the same time. These included crisis support lines, shelters, and group homes, and involved overnight shifts. In these roles, I would often work with marginalized communities facing significant barriers, often with little to no structural support due to the nature of frontline work. In the beginning, I was excited and energetic enough about my work as a frontline staff to push through the challenges. However, by the time I turned 27, the effects of constantly pushing through were starting to wear on me. At that time, my health started to suffer and my body finally said stop – I was forced to slow down due to chronic pain, whether I wanted to or not.
This is a story I’ve heard repeated by colleagues and supervisees. Often, when asked about they developed good boundaries, people relate how they were forced to due to their health. When asked about how they regulate their nervous systems so well, people relate times of great dysregulation. I wonder how many of you reading now have experiences that mirror these ones?
What I want to underline is that I learned about the risk factors of this type of helping work by experiencing them firsthand. Surprisingly, during my six years of schooling, my practicum, and even under supervision while training to become a fully registered psychologist, I was never taught about burnout or vicarious trauma—its signs, symptoms, or how to protect myself from it. I’d like to invite you, reader, to ask yourself how prepared you felt going into this work? What kind of formal or informal training did you receive on VT? If you did feel prepared, what helped you? If you didn’t, what do you wish had been taught?
I ask these questions because I work primarily from a feminist perspective in therapy, which involves considering the context in which we live and work. This means recognizing that many psychological issues, including vicarious trauma, are tied to personal or societal circumstances rather than being caused by individual failings or weaknesses.
In this way, we need to think about vicarious trauma as an occupational hazard. If you work in fields like healthcare, social work, shelters, settlement work, or as a frontline responder (e.g., firefighters, ambulance workers), or if you see clients through therapy, you're more likely to take on the trauma of those you help. Exposure to traumatic stories can activate our fight, flight, freeze, or other survival responses, just the same in our nervous systems as if we had experienced those events directly. Consistent exposure to traumatic stories can also lead to a profound shift in our worldview, making us feel like the world isn't safe or that people are inherently evil—part of what we call a trauma mentality.
As I hope is now becoming clear, we can say that the cause of vicarious trauma for therapists and other helping professionals primarily stems from work factors—the more exposure to traumatic incidents, the higher the risk. For example, having back-to-back cases of trauma clients without breaks or having an unbalanced caseload may exacerbate the risk of VT. Additionally, our risk can be increased if there's little support from colleagues or a lack of structural support.
Environmental factors also play a role. It's harder to witness someone else's trauma when you're going through traumatic times yourself, such as job loss, financial difficulties, or a pandemic. Systemic factors, like systemic racism or homophobia, can also contribute to a sense of greater horror and the feeling that the world being a terrible place. Constantly hearing about these events in the news can bring a sense of vicarious trauma into our lives.
The more these factors converge, the higher the risk of vicarious trauma. For instance, if you have a lot of clients dealing with trauma, coupled with a stressful personal life and systemic issues, it compounds the risk.
If we think of VT as a workplace hazard, then we can also understand that receiving training and support about addressing it is crucial for those in helping professions. Start by considering these foundational elements that help mitigate risk of VT: our level of exposure to trauma, the level of support that’s available, and access to activities and practices that are nourishing/life-giving. Here’s what we can do:
1. Reduce exposure to trauma:
How are caseloads managed? Is there time for breaks to decompress, connect with other therapists, and focus on regulating the nervous system?
If you work in an agency that focuses primarily on treating trauma, could you consider balancing your workload so that direct client hours are reduced, and time is made for other, perhaps more sustaining projects? If not possible in your current agency, could you work part time with trauma, and also see clients at another agency that has more variety in presenting issue?
2. Increase the level of support:
How might you be able to bring in or advocate for initial training and ongoing support on VT, so that people are reminded of the signs and strategies?
What are your options for peer support or supervision?
3. Access activities that nourish us:
What do you find most regulating and grounding while at work?
What do you find nourishing outside work?
What are the ways to stay connected with colleagues that you find most affirming and helpful?
All of these questions are meant to invite some curiosity about what we need as therapists, to help mitigate the impact of VT, and allow us to continue doing the important work we are passionate about. For more on this topic, including courses and worksheets, please visit embodiedpsychology.ca.
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Nicole Perry is a Registered Psychologist who works from a somatic, relational, experiential, and feminist viewpoint. She specializes in shame resilience, healing trauma, and setting boundaries. She is also the author of a new book, The Boundaried Therapist: Sustaining Ourselves in the Counselling Profession.