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Indirect Trauma in the Field Practicum: Secondary Traumatic Stress, Vicarious Trauma, and Compassion Fatigue Among Social Work Students and Their Field Instructors

Carolyn Knight

A sample of BSW students and their field instructors was assessed for the presence of indirect trauma, including secondary traumatic stress, vicarious trauma, and compassion fatigue. Results indicated that students were at greater risk of experi- encing vicarious trauma than their field instructors and research participants in previous studies. Risk factors for students and social workers included age, experi- ence, gender, and placement in a child welfare setting. Race was a risk factor only for students. The results underscore the protective effects of advance preparation, agency support, and agency supervision, but also suggest that specific education about indirect trauma is lacking. Also discussed are the links among indirect trauma, burnout, and students’ career aspirations, as well as suggestions for future research.

Keywords: indirect trauma, vicarious trauma, secondary traumatic stress, compassion fatigue, field practicum

It is increasingly recognized that helping professionals are likely to be trauma- tized as a result of their work with challenging clients, such as those with his- tories of trauma. Stamm notes, “The great controversy about helping- induced trauma is not ‘Can it happen?’ but ‘What shall we call it?’” (1997, p. 1). In this article the term indirect trauma will be used (Knight, 2009), which refers to the range of reactions that clinicians can experience as a result of their work, such as secondary traumatic stress (STS), vicarious trauma (VT), and compassion fatigue (CF).

STS refers to “symptoms nearly identical to PTSD [posttraumatic stress dis- order] except that exposure to a traumatizing event experienced by one person

Carolyn Knight, PhD, MSW, is professor at the University of Maryland, Baltimore County.

Journal of Baccalaureate Social Work32

becomes a traumatizing event for the second person” (Stamm, 1999, p. 11). VT involves changes in the clinician’s views of self and others that result from hearing clients’ stories of victimization and witnessing clients’ pain firsthand (McCann & Pearlman, 1990). Prac titioners are at risk of developing a world- view characterized by suspicion and personal vulnerability (Pearlman & Saakvitne, 1995). CF can occur with any client and refers to the practitioner’s inability to empathize (Collins & Long, 2003).

Numerous studies have documented a relationship between a client’s trau- ma history and indirect trauma (Bober & Regehr, 2006). Previous research also has documented positive connections among difficult- to- engage clients, CF, and STS (Figley, 1995). Professionals with less education and those who are newer to their jobs appear to be at greater risk of indirect trauma, as are those with the most and least experience working with trauma survivors (Baird & Jenkins, 2003; Meyers & Cornille, 2002; Steed & Bicknell, 2001). Pro - fessionals who report feeling supported in their work experience fewer symp- toms, whereas those who describe feeling unsupported appear to be at greater risk (Ortlepp & Friedman, 2002).

Women may be more likely to experience indirect trauma than men, but this may reflect their greater willingness to acknowledge these reactions (Kassam- Adams, 1999). Women may be more vulnerable because they are more likely to have experienced trauma themselves, a factor that has been found to increase the risk of indirect trauma in some studies (Baird & Kracen, 2006; Nelson- Gardell & Harris, 2003).

Indirect trauma is not the same as burnout, which is defined as “feelings of hopelessness and difficulties in dealing with work and in doing [one’s] job effectively” (Stamm, 2005, p. 12). There is evidence, however, that similar var - iables influence both burnout and indirect trauma and that a practitioner’s risk of burnout increases when she or he experiences indirect trauma (Bell, Kulkarni, & Dalton, 2003; Salston & Figley, 2003).

Study Rationale

Indirect trauma among social workers has been less widely studied, but available research has generated findings consistent with those noted previously. A recent study of licensed social workers in one state found that almost all of the respon- dents exhibited at least one symptom of STS, and a minority met the criteria for PTSD (Bride, 2007). Further, a study of child welfare workers in one state, most of whom were social workers, indicated that rates of CF were relatively high (Conrad & Kellar- Guenther, 2006). Further, indirect trauma and burnout among social workers appear to be distinct but related phenomena (Perron & Hiltz, 2006; Siebert, 2005). In one study, indirect trauma was more likely to occur among younger, less experienced social workers (Adams, Matto, &

Harrington, 2001). In this same study, there was no association between indirect trauma and the amount of time spent with traumatized clients. Cunningham, on the other hand, found that interpersonal victimization of clients, especially sexual abuse, produced more symptoms of indirect trauma (2003).

The relationship between education and risk of indirect trauma has received insufficient empirical attention. There is some evidence that prepar- ing clinicians in advance for the challenges associated with working with trau- ma survivors may have a protective effect (Bell et al., 2003; Dane, 2000). How - ever, research indicates that few professionals receive adequate preparation for working with trauma survivors (Knight, 1997; Shackelford, 2007). Finally, virtually no attention has been paid to the existence and implications of indi- rect trauma among students in any mental health discipline— including social work— in field practicum and internship experiences.

Research Questions

The exploratory study described in this article examined the existence of indi- rect trauma among a nonmatched sample of baccalaureate social work stu- dents and their field instructors. In addition to ascertaining the extent to which participants exhibited three manifestations of indirect trauma, the pur- pose of the study was threefold.

First, the author was interested in determining the role of educational and supervisory variables in mitigating or intensifying the effects of indirect trau- ma. Based on the limited research available, it was anticipated that respon- dents who reported learning about or being prepared for indirect trauma would evidence fewer signs of it. It also was anticipated that supervisory support— from the field instructor for students and from the agency supervisor or peers for field instructors— would serve as a protective effect. Second, the author sought to substantiate previous findings regarding the influence of per- sonal, client, professional, and organizational variables on the risk of indirect trauma. Third, the author examined the relationship between indirect trauma and burnout among both students and field instructors, and between indirect trauma and career aspirations among students.

Research Design

Selection of Subjects

All students from one undergraduate program who were in the field placement and their field instructors were included in the study. A total of 81 students and 72 field instructors received the surveys (some field instructors supervised more than one student).

Indirect Trauma in the Field Practicum 33

Research Instruments

All respondents were asked to complete three instruments, two of which meas- ure indirect trauma. The author developed the third instrument, which col- lected background details on respondents.

The Professional Quality- of- Life Scale (ProQOL) This 30-item self- report instrument is the most widely used measure of secondary traumatic stress, compassion satisfaction, and burnout among mental health professionals. Respondents are asked how frequently they experienced a variety of reactions within the last 30 days on a 6-point Likert scale (Stamm, 2005).

Three subscale scores are generated. The compassion satisfaction subscale measures “the pleasure [that is] derive[d] from being able to do [one’s] work well” (Stamm, 2005, p. 5). The lower the score, the greater the risk of CF. Burnout is defined as “feelings of hopelessness, and difficulties in dealing with work or in doing [one’s] job effectively” (p. 5). Higher scores indicated a high- er risk of burnout. The STS subscale is “about . . . work- related, secondary exposure to extremely stressful events [which may include] being afraid, hav- ing difficulty sleeping, having images of the upsetting event pop into [one’s] mind, or avoiding things that remind one of the event” (p. 5). Higher scores indicate a heightened risk of STS.

Good alpha reliabilities have been found for each subscale: compassion sat- isfaction, .87; secondary traumatic stress, .80; burnout: .72. The construct validity of the instrument also has been documented (Stamm, 2005). Fol - lowing the recommendation of Stamm, the author substituted “social worker” for “helper.”

Trauma and Attachment Belief Scale (TABS) The TABS also is a self- report and is the most widely used measure of VT among professionals and psycho- logical trauma among clinical and nonclinical samples (Pearlman, 2003). Respondents are asked to agree or disagree with 84 items, using a 6-point Likert scale. An overall score is generated, as well as scores on 10 different sub- scales. The overall score has been found to have good internal consistency (α =.96). The average alpha score for the 10 subscales is .79 and ranges from .67 to .87 (Pearlman, 2003). The TABS has good face and construct validity, although intercorrelations between the subscales can be fairly high, ranging from .22 to .75.

The overall TABS score “provides an index of the respondent’s overall level of disruption in areas that are important to maintaining healthy relation- ships” (Pearlman, 2003, p. 14). Pearlman (p. 16) defines each of the subscales as follows:

• Self- safety: the need to feel secure and reasonably invulnerable to harm inflicted by oneself or others

• Other- safety: the need to feel that cherished others are reasonably protect- ed from harm inflicted by oneself or others

Journal of Baccalaureate Social Work34

• Self- trust: the need to have confidence in one’s own perceptions and judgment • Other- trust: the need to depend or rely on others • Self- esteem: the need to feel valuable and worthy or respect • Other- esteem: the need to value and respect others • Self- intimacy: the need to feel connected to one’s own experiences • Other- intimacy: the need to feel connected to others • Self- control: the need to manage one’s feelings • Other- control: the need to manage interpersonal situations

Raw scores are converted to standardized T- scores. In all cases, higher scores indicate a greater risk of VT.

Background details Respondents supplied basic demographic information about themselves. They also were asked a variety of questions that previous research indicated might be associated with indirect trauma. Each question used a 3-point Likert scale. Respondents were asked the extent to which they worked with four types of clients: “mandated,” “aggressive,” “difficult to en - gage,” and “with histories of trauma.” They also were asked whether their education prepared them for “negative personal reactions to clients”—the def- inition of indirect trauma in this study— and whether their agencies assisted staff in dealing with negative personal reactions. Students were asked how much they had learned about negative reactions in social work classes and how often they discussed them in class and with peers. Field instructors were asked whether their agencies provided them with any preparation for negative reactions they might encounter in their work.

In addition, students were asked to evaluate the helpfulness of their field instructor in assisting them with negative personal reactions and how fre- quently they discussed negative reactions in supervision. Field instructors were asked how frequently they talked in supervision, with colleagues, and with family and friends about negative personal reactions they experienced. Finally, students were asked the extent to which their field experience strength- ened or lessened their desire to be a social worker and to estimate the likelihood that they would seek employment in a setting similar to their field placement.

Method

Students received the research packet in their social work methods course, taken concurrent with the field practicum. Distribution occurred in late April, approximately 3 weeks before the end of the year- long practicum experience. Students were asked to complete the instruments outside of class and to return them to the author’s campus mailbox or to their methods instructor. The author sent e- mail reminders, and methods instructors also reminded students to complete the instruments.

Field instructors received the research packet via regular mail and were asked to complete the instruments and return them in the postage- paid envelope that

Indirect Trauma in the Field Practicum 35

Journal of Baccalaureate Social Work36

was provided. The author sent an e- mail to all field instructors in advance informing them about the study. Follow- up e- mail reminders also were sent.

A cover letter accompanied the surveys and explained the purpose of the research as the author’s interest in understanding social workers’ negative personal reactions. The letter assured confidentiality, explained that all responses were anonymous and confidential, and confirmed that the research project had been approved by the author’s institutional review board.

Results

Characteristics of Participants and Field Settings

Forty- two students completed and returned the research instruments, repre- senting 51.8% of all seniors in field placement. Thirty- nine were female. Twenty- two described themselves as White; 14 indicated they were African American. The average age of the students was 32.3 years, and their ages ranged from 20 to 54. Twenty- six reported having less than 1 year or no prior experience in social work or a related discipline.

Fifty- one (70.8%) of the field instructors completed and returned the instruments. Forty- four were female. Forty- two described themselves as White; seven described themselves as African American. The average age of the supervisors was 50.4 years, and their ages ranged from 26 to 68. Each had an MSW. Twenty- five field instructors indicated they had 15 or more years of practice experience, and six had practiced less than 5 years. Thirty- two indi- cated they had 5 or more years of experience in the field agency.

Students were most likely to report they worked in an education or school setting (n=13) or in child welfare (n=12). More than one quarter reported they worked with difficult- to- engage clients “a great deal” (n=16). A number of students reported having no experience with three of the client groups (trau- ma histories: n=11; mandated: n=17; aggressive: n=10).

Field instructors also were most likely to report they worked in an educa- tional/school setting (n=12) or child welfare agency (n=11). Forty of the field instructors reported working with clients with trauma histories “a great deal.” Fewer field instructors reported working with the other client groups “a great deal”: mandated: n=15; difficult to engage: n=20; aggressive: n=17.

Manifestations of Indirect Trauma Among Participants

Virtually all students and their field instructors reported some negative reac- tions associated with their work with clients (students: n=40; field instructors: n=50). Student and field instructor average scores on the compassion satisfac- tion subscale of the ProQOL were slightly higher than those of 1,000 mental health professionals in previous studies, as reported by Stamm (2005), indicat- ing a lower risk of CF (see Table 1). Compared to the same professionals, stu-

Indirect Trauma in the Field Practicum 37

dents and field instructors had lower average scores on the STS subscale. Difference of means tests between student and field instructor scores for STS and CF were nonsignificant.

Students’ scores on the TABS overall and for each subscale were lower than a sample of outpatient mental health clients without histories of trauma as reported by Pearlman (2003), but they were higher than or essentially equal to those of a sample of respondents who identified themselves as trauma ther- apists for all but one subscale, other safety (see Table 2). Field instructors’ aver- age scores generally were lower than both research samples.

Students’ VT scores were consistently higher than those of field instructors (see Table 2). Difference- of- means tests revealed significant differences between the two groups for the overall TABS score (t=–3.247, df=90, p≤.002) and 6 subscales (self- safety: t=–3.037, df=90, p≤.003; self- trust: t=–1.999,

Table 1 Mean scores for Professional Quality of Life (ProQOL) subscales:

BSW students, field instructors, and research participants

BSW BSW field Research

students instructors participantsa

Subscale N=42 N=51 N=1000

Compassion satisfaction 41.3 42.7 37.0

Secondary traumatic stress 11.2 10.3 13.0

Burnout 18.5 18.3 22.0

aStamm, 2005

Table 2 Trauma and Attachment Belief Scale (TABS) mean T-scores for

composite scale and 10 subscales: BSW students, field instructors, and two

research samples

BSW Field Outpatient Trauma

students instructors sample therapistsa

N=42 N=51 N=22 N=266

Composite TABS 48.3 41.8 54.6 44.0

Self-safety 46.4 38.4 53.9 45.4

Other safety 44.8 40.1 53.9 45.4

Self-trust 48.0 43.0 54.2 46.1

Other trust 44.4 36.0 52.1 44.9

Self-esteem 46.5 44.8 55.7 46.4

Other esteem 51.4 44.8 51.4 45.2

Self-intimacy 52.6 46.2 51.9 43.1

Other intimacy 48.7 43.1 56.6 47.7

Self-control 48.7 45.0 56.2 45.8

Other control 44.5 40.1 52.3 45.8

aPearlman, 2003

df=87, p≤.049; other trust: t=–3.669, df=86, p≤.000; other esteem: t=–3.285, df=89, p≤.001; self- intimacy: t=–2.948, df=89, p≤ .004; other intimacy: t=–2.658, df=89, p≤.009).

Manifestations of Burnout Among Participants

Student and field instructor average scores on the burnout subscale of the ProQOL were essentially equal (see Table 1). When compared to research par- ticipants in previous studies reported by Stamm (2005), both students and field instructors had lower scores, indicating a lower risk of burnout.

Agency Support, Supervision, and Education

Seventeen of the 42 students and 33 of the 51 field instructors reported they were “not at all” or “somewhat” prepared by their social work education for negative personal reactions. Ten students and 6 field instructors reported that the agency did not provide assistance with their negative reactions “at all,” whereas 17 students and 22 field instructors stated their agencies provided “some” assistance. Twenty- two students indicated they learned “some” about negative reactions in their social work classes. Sixteen instructors reported that their agencies did not prepare them “at all” for negative reactions they might experience in the setting, and 20 stated they received “some” preparation.

Four of the 40 students who reported experiencing negative reactions stat- ed they were unable to talk about these reactions in class, but 18 said they were able to talk “a great deal.” Twenty- four of these same students reported they talked with fellow students “a great deal.” Twenty- five indicated that they were able to talk with their field instructors “a great deal,” and 12 reported they talked “some.” Twenty- one indicated their instructors helped “a great deal”; 15 stated they received “some” help.

Among the 50 field instructors who reported experiencing negative reac- tions, 36 reported they talked with colleagues “a great deal.” Forty- six indicat- ed that they talked with family and friends “a great deal” or “some” about their reactions. Among the field instructors who experienced negative reactions and were in supervision (n=22), 4 indicated they “never” talked with their super- visors; 14 said they talked “some.” Among the 10 instructors who experienced negative reactions and were in peer supervision, 8 reported talking about their reactions “a great deal.”

Correlates of Indirect Trauma Among Students

Correlation analysis using Kendall’s tau- b as a measure of association for ordi- nal and rank- order variables examined the relationship between determinant and dependent measures. There were 13 dependent measures: the compassion

Journal of Baccalaureate Social Work38

Indirect Trauma in the Field Practicum 39

satisfaction and traumatic stress subscales of the ProQOL and the overall and 10 subscale scores on the TABS. There were a number of statistically signifi- cant associations, but these tended to be weak. Three of the VT subscales (self- safety, other safety, other trust) were not associated with any variables.

Intercorrelations among the CF, STS, and VT measures also were examined. To simplify this analysis, the composite TABS score was used as the sole meas- ure of vicarious trauma. CF was associated with VT (τ= .241, p≤ .020, n=42).

Personal characteristics Women scored higher on one VT subscale, self- trust (see Table 3). Students who described themselves as White scored lower on compassion satisfaction, indicating a greater risk of CF and also exhibited more signs of VT overall and on two subscales (self- trust and other esteem). Younger students and those with less experience also were at greater risk of CF and scored higher on one VT subscale (other control).

Client characteristics Students who reported more frequent contact with mandated clients had higher scores on 4 VT subscales (self- trust, self- intimacy, other intimacy, and self- control). Students who more frequently worked with aggressive clients had higher STS scores.

Education variables Students who reported they were not prepared by their education were at greater risk for CF, as were those who reported they did not learn about negative personal reactions in class and were not able to talk in class or with fellow students about their negative reactions. Not talking with fellow students also was associated with higher scores on two VT subscales (self- trust and other intimacy). Learning about negative reactions was associ- ated with a decreased likelihood of VT (overall, other intimacy, and self- control), as was the ability to talk in class (other intimacy).

Field instruction and agency variables Students who were unable to talk with their field instructors as well as those who believed their field instructors did not assist them with their personal reactions were at greater risk of CF. Field instructor assistance was positively associated with one measure of VT (self- esteem). Students who reported their field agencies did not provide assistance were at greater risk of CF and scored higher on one VT subscale (self- trust).

Agency type, categorized into child welfare settings and other, was associat- ed with three measures. Students who worked in child welfare settings had higher secondary traumatic stress scores and higher scores on the self- esteem and self- control subscales.

Association among indirect trauma, burnout, and career aspirations CF was associated with a diminished desire to practice social work, a decreased likeli- hood that the student would seek employment in a setting similar to the field practicum, and a higher risk of burnout. Those students with higher scores on the self- esteem subscale were less likely to report they would seek employment in a setting similar to their field site. Burnout itself was not associated with either career aspiration variable.

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Correlates of Indirect Trauma Among Field Instructors

Correlation matrices were constructed for field instructors using Kendall’s tau- b. There were a number of significant associations, but most were weak. None of the determinant variables was associated with STS. None of the client or supervision variables was associated with any of the dependent measures. CF was associated with the overall measure of VT (τ= –.333, p=.000, n=51).

Personal characteristics Younger instructors and those with less experi- ence as social workers and in the agency exhibited more signs of VT (overall, self- safety, self- trust, other esteem, self- intimacy, other intimacy, and self- control; see Table 4). Women had a higher score on the other- trust subscale.

Education and agency variables Field instructors who indicated their educa- tion did not prepare them exhibited more signs of VT (overall, other safety, other trust, self- esteem, other esteem, self- intimacy, other intimacy, self- control, and other control). Similarly, instructors who felt their agencies had not prepared them for negative reactions had higher scores on the self- trust and self- esteem subscales.

Field instructors who reported they frequently talked with colleagues had lower scores on the self- esteem and other control subscales, whereas field instructors who reported they frequently talked with their friends and family had higher scores on the other trust, self- intimacy, and other intimacy subscales. Field instructors who worked in child welfare settings exhibited more signs of CF and had higher scores on the self- esteem and other control subscales compared to instructors who indicated they worked in a setting other than child welfare.

Association between indirect trauma and burnout CF was associated with a greater risk of burnout. Field instructors at greater risk of STS also were at greater risk of burnout.

Discussion and Implications

The findings of this study are consistent with and expand the body of research that examines indirect trauma among helping professionals, generally, and social workers, specifically. Limitations of the study, however, necessitate cau- tious interpretation.

Limitations

Student participants in this study were similar to BSW students nationally with respect to age, race, and gender (Council on Social Work Education, 2007). However, the generalizability of the findings is unclear because student and field instructor participants were associated with only one large under- graduate program in a major metropolitan area. Further, it is unclear why al - most one half of the students opted out of the study. The possibility that students’ experiences in their agencies and with clients may have affected their willing- ness to participate in the study must be considered.

Indirect Trauma in the Field Practicum 43

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Indirect Trauma in the Field Practicum 45

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The self- report nature of the data also is a limitation. Of particular impor- tance is the fact that key terms such as “mandated clients,” “clients with his- tories of trauma,” and “agency support” may have been interpreted different- ly by individual respondents.

There were a number of statistically significant relationships, but these tended to be weak. Field instructor variables generally were not associated with the measures of CF and STS. Further, there were relatively few instances when student and field instructor variables were associated with the compos- ite TABS score, the most straightforward measure of VT. Whether the absence of significant associations is a legitimate finding or the result of the small sam- ple size or problems with the instruments themselves is unclear.

Participants’ Experiences With Indirect Trauma

Virtually all the participants in this study reported experiencing some negative reactions. In general, field instructors’ levels of STS, VT, and CF were lower than those of participants in previous studies that employed the ProQOL and TABS (Pearlman, 2003; Stamm, 2005). Students tended to exhibit more signs of indirect trauma than their field instructors. In fact, students were signifi- cantly more likely than their field instructors to manifest signs of VT overall and on 6 subscales. Students’ scores also were higher than those of trauma therapists from prior studies (Pearlman, 2003).

Impact of Personal Characteristics

There was limited evidence that younger students and field instructors exhib- ited more signs of indirect trauma, especially VT. Students and field instructors with less experience, and, for field instructors, less experience in the agency, also exhibited more signs of VT, as did female participants and White students. White students also evidenced more signs of CF.

This set of findings supports the documented risk that less experienced, younger social workers and students may face with respect to developing distor- tions in thinking characteristic of VT (Baird & Jenkins, 2003; Steed & Bicknell, 2001). The findings also underscore the role that gender plays, but they do not explain why women may be more negatively affected by their work. As noted previously, women simply may be more willing to acknowledge their reactions (Kassam- Adams, 1999). Further study of this relationship is warranted.

The role that race may play also warrants further study because heretofore it has not been identified as a determinant of indirect trauma. It is possible that White students may have had less personal experience with or understanding of the sorts of clients and client situations that they encountered in their prac- tice than their African American counterparts, leaving them more vulnerable to the effects of indirect trauma.

Journal of Baccalaureate Social Work46

Impact of Client Characteristics

Although some studies have found that practitioners who work with trauma survivors are at increased risk of indirect trauma (Baird & Jenkins, 2003; Cunningham, 2003), others have found no such relationship (Adams et al., 2001). In the present study there was no relationship between a client’s histo- ry of trauma and indirect trauma among either students or field instructors. There also was no relationship between difficult- to- engage clients and CF and STS for either students or field instructors. However, the more the student reported working with mandated clients, the more likely she or he was to man- ifest signs of VT; working with aggressive clients also led to a greater risk of CF and STS among students.

The findings might reflect the way client type was measured in this study or the differing definitions of indirect trauma that have been employed in previous research. However, they do underscore the need for further study of the role that client characteristics— beyond just those with histories of trauma— play in explaining social workers’ and students’ experiences with indirect trauma.

Impact of Education and Advance Preparation

Although not widely studied, there is some evidence that education and train- ing may mitigate the effects of indirect trauma (Bell et al., 2003; Dane, 2000). The findings of this study support this possibility. Students who felt unpre- pared by their education or reported they did not learn about negative reac- tions in class experienced more CF and VT, as did those who reported they were unable to talk about their reactions in their classes. Similarly, field instructors who reported being unprepared by their education had higher scores on most of the measures of VT. In contrast, those field instructors who reported they received some advance preparation from their agency for negative personal reactions they might experience had lower scores on two VT subscales.

Findings in this area are cause for concern, because so many of the partic- ipants indicated that they did not receive any preparation for the negative reac- tions they experienced, either in their formal education or, in the case of field instructors, in their agencies. But the findings also are cause for optimism, because students were less likely than their field instructors to report being unprepared, suggesting that contemporary social work education may be doing more to include content on indirect trauma.

Continued study is indicated because it is unclear whether this preparation should take place in the classroom or in the agency. For example, Cunningham (2004) cautions that discussing indirect trauma in the classroom can actual- ly lead to indirect trauma. At minimum, course content can identify, normal- ize, and validate students’ reactions, as well as help them identify ways to man- age and cope with negative reactions when they surface.

Indirect Trauma in the Field Practicum 47

Impact of Agency and Supervisory Support

In general, students and their field instructors reported that their agencies pro- vided support to employees regarding negative personal reactions they might experience. Yet, agency support had no impact on any measure of indirect trauma for field instructors and only limited impact on indirect trauma among students. Students who reported their agencies were not supportive were more likely to manifest CF and had higher scores on two VT subscales. These find- ings are at odds with the results of previous research that has found that a sup- portive organizational climate can mitigate the effects of indirect trauma (Ortlepp & Friedman, 2002). The findings do suggest that students, who are newer to their roles as social workers, may benefit from an organizational cli- mate that is supportive of their work.

Student respondents reported they could talk with their field instructors about their reactions and generally believed their field instructors were helpful. CF was higher for students who reported they did not talk with their field instructors and who felt their field instructors were not helpful. One somewhat anomalous finding was that students who reported their field instructors assisted them with their reactions had a higher score on one VT subscale. It is possible that talking with one’s supervisor might serve only to intensify nega- tive reactions, underscoring Cunningham’s cautionary note discussed previ- ously. It also is possible that students with a greater sense of urgency regard- ing their negative reactions were more compelled to talk with their field instructors.

In contrast to their students, the field instructors in this study did not use supervision to manage their negative reactions. This is consistent with a sepa- rate body of research on supervision, not reviewed for the present study, which suggests that clinicians often avoid talking about sensitive subjects in supervi- sion (Ladany, Hill, Corbett, & Nutt, 1996; Yourman, 2003). Contrary to expec- tations, supervision did not influence any of the dependent measures. It is not clear why this was the case, although prior research suggests that unless the supervisor understands the nature of indirect trauma as well as how to respond in ways that are consistent with the supervisory role, her or his input is not particularly useful (Bober & Regehr, 2006).

Field instructors appeared to rely more on colleagues and/or friends and family to assist them in dealing with their negative reactions. In general, how- ever, these variables were not associated with any of the indirect trauma meas- ures. The exception to this was that talking with friends and family was asso- ciated with higher scores on three VT subscales, suggesting that those individ- uals who experienced distress in their work relied more on friends and family for support. Several authors have cautioned that mental health professionals must be proactive in taking care of themselves so that their work will not intrude on their personal lives in negative ways (Bell et al., 2003; Saakvitne, 2002). These findings suggest that this cautionary note is warranted.

Journal of Baccalaureate Social Work48

The findings regarding supervision suggest the need for further study. Potentially, supervision of students and professional social workers could mit- igate the impact of indirect trauma. For this to be useful, however, supervisors need to understand the nature of indirect trauma, encourage constructive dis- cussion of this phenomenon, and provide suggestions for how to manage it. Evidence from this and other research suggests that informed supervision in this area may be lacking (Cunningham, 2003; Pearlman & Saak vitne, 1995).

Several studies have found that social workers who practice in child welfare settings may be particularly vulnerable to the effects of indirect trauma (Bednar, 2003; Conrad & Kellar- Guenther, 2006). The results of the present study support this possibility. When compared to their counterparts in other settings, both students and field instructors who reported working in child wel- fare exhibited more signs of VT. Field instructors in these same settings also exhibited more CF, whereas students exhibited more signs of secondary trau- matic stress.

These findings suggest that continuing study is needed on the relationship between agency context and the risk for indirect trauma among social work- ers. At minimum, social work educators, particularly in the field, should rec- ognize the heightened risk for indirect trauma that may exist for students in child welfare placements. Many undergraduate and graduate social work pro- grams, including the one represented in the present study, rely heavily on child welfare placements and receive Title IV- E funds to prepare students for careers in child welfare. As a result, this is of particular importance.

Association Among Indirect Trauma, Burnout, and Student Aspirations

Consistent with prior research (Bell et al., 2003), indirect trauma was associ- ated in limited ways with burnout for both students and field instructors. CF among both field instructors and students was associated with a higher risk of burnout. Field instructors at greater risk of STS also were more likely to exhib- it signs of burnout. Burnout was not associated with student aspirations.

Students who manifested signs of CF exhibited a decreased desire to practice social work and a greater reluctance to work in a setting comparable to their field agency. The lack of association among VT, STS, and career aspirations is encouraging but somewhat counterintuitive, because common sense might suggest that students who develop distortions in thinking about self and oth- ers or experience intrusive thoughts would become disillusioned about their career choices.

A number of students in this study did manifest all three signs of indirect trauma; therefore, further study of their effects on the students’ career aspi- rations is warranted. At minimum, the results of this study support the need for students to be helped with feelings of CF so that these reactions do not dis- courage them from pursuing careers in social work. Finally, they also indicate that to prevent burnout among students and practicing social workers, their

Indirect Trauma in the Field Practicum 49

experiences with indirect trauma, particularly CF and STS, must be addressed proactively and constructively.

Conclusion

The results of this study substantiate risk factors for indirect trauma among students and practicing social workers including age, experience, gender, and race. They also suggest that these two groups may experience indirect trauma differently. The results suggest that education and advance prepara- tion may moderate the effects of indirect trauma. Given the limitations in the present study, future research should focus on substantiating and fur- ther elucidating the risk and protective factors for social workers as well as the role that education and supervision can play in mitigating the effects of indirect trauma.

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