WEEK6

Guidelines for a Vicarious Trauma-Informed Organization

Human Resources

WHAT IS A VICARIOUS TRAUMA- INFORMED ORGANIZATION? Vicarious trauma (VT), the exposure to the trauma experi- ences of others, is an occupational challenge for the fields of victim services, emergency medical services, fire services, law enforcement, and others. Working with victims of vio- lence and trauma changes the worldview of responders and puts individuals and organizations at risk for a range of negative consequences (Bell, Kulkarni, and Dalton, 2003; McCann and Pearlman, 1990; Newell and MacNeil, 2010; Vicarious Trauma Institute, 2015; Pearlman and Saakvitne, 1995; Knight, 2013). A vicarious trauma-informed orga- nization recognizes these challenges and proactively addresses the impact of vicarious trauma through policies, procedures, practices, and programs.

For more information on vicarious trauma and its effects, visit https://vtt.ovc.ojp.gov/.

The Role of Human Resources in Addressing Vicarious Trauma Experiencing VT may result in reduced work performance and productivity, increased absenteeism, and low morale, some or all of which may impact the quality of care individuals and organizations provide to those they serve (White, 2006). Human resources policies and procedures provide a frame- work for an agency to follow to become a vicarious trauma- informed organization.

Management and Supervision • Ensure that supportive, respectful, and effective supervision

includes open discussion of VT, strategies for addressing it, and compliance with relevant policies (Bell, Kulkarni, and Dalton, 2003; White, 2006; Bednar, 2003; Slatten, Carson, and Carson, 2011).

• Actively promote a flow of direct and clear communication between frontline employees and upper management.

• Provide positive and constructive feedback to staff; deliver it in a manner that is in the staff member’s interest.

• Explain employees’ roles and responsibilities and clar- ify performance expectations (Bednar, 2003; Adams, Shakespeare-Finch, and Armstrong, 2015).

Personnel Policies and Procedures Hiring Policies • During job interviews—

o educate applicants about VT to ensure that they are aware of the potential risks associated with working with victims of trauma (Bell, Kulkarni, and Dalton, 2003; Urquiza, Wyatt, and Goodlin-Jones, 1997); and

o incorporate questions for applicants that assess their knowledge of VT and their awareness and use of cop- ing strategies (Urquiza, Wyatt, and Goodlin-Jones, 1997).

• Assess the job candidates’ level of education, training, and preparation for their assigned role (Bednar, 2003).

Employee Health and Wellness • Raise employees’ awareness of professional and per-

sonal self-care strategies for addressing VT (Newell and MacNeil, 2010).

• Encourage employees to practice self-care both on and off work time (Bell, Kulkarni, and Dalton, 2003; Slatten, Carson, and Carson, 2011; Meichenbaum, 2007).

• Include coverage for mental health services in employee health benefits (Bell, Kulkarni, Dalton, 2003).

• Identify an experienced, trained, accessible, and approachable manager to provide employees with confi- dential support and referrals to helpful services.

Evaluation • Assess the negative impact vicarious trauma may have

across your organization and implement strategies to help reduce that impact (Bell, Kulkarni, and Dalton, 2003; Meichenbaum, 2007). You can do this through informal discussions with staff and in debriefing sessions, or by using assessment tools such as the Professional Quality of Life Scale (ProQOL) and the Secondary Traumatic Stress Scale (STSS) (Bride et al., 2004; Stamm, 2010).

• Evaluate interventions aimed at reducing the negative impact of VT among current and new personnel (Bell, Kulkarni, and Dalton, 2003; White, 2006; Meichenbaum, 2007).

• Regularly administer employee performance evalua- tions that include questions pertaining to VT and assess

employees’ perceptions of which organizational efforts to reduce the impact of VT are helpful.

• Implement a survey to elicit employees’ feedback, and assess their satisfaction with the organization.

• Conduct exit interviews, and inquire about recommenda- tions for improving the organization’s response to VT and its impact on employee well-being, turnover, and other aspects of the work (United States Fire Administration, 1999).

Variation of Job Responsibilities • Create opportunities and procedures for employees to vary

their duties and alleviate heavy caseloads (Bell, Kulkarni, and Dalton, 2003; White, 2006; Slatten, Carson, and Carson, 2011).

• Rotate frontline and coverage responsibilities (Bell, Kulkarni, and Dalton, 2003; White, 2006; Slatten, Carson, and Carson, 2011).

Employee Empowerment and Work Environment • Ensure that employees have a safe and comfortable physi-

cal environment in which to work (Bell, Kulkarni, and Dalton, 2003; White, 2006).

• Promote a culture of caring and emotional and social sup- port from peers and supervisors (Bell, Kulkarni, and Dalton, 2003; Meichenbaum, 2007).

• Implement support measures that foster connection and cohesion among employees. These may include formal debriefing (e.g., critical incident stress management), informal debriefing, peer or professionally facilitated peer support groups, and planned social interactions, among other activities (Bell, Kulkarni, and Dalton, 2003; Adams, Shakespeare-Finch, and Armstrong, 2015).

• Develop a diverse workforce whose members value and respect differences and enhance peer resources for employ- ees.

Training and Professional Development • Include education about VT during new staff orientation

(Bell, Kulkarni, and Dalton, 2003).

• Provide ongoing education to new and current employees about VT, including its negative consequences and strate- gies for addressing them (Bell, Kulkarni, Dalton, 2003; Newell and MacNeil, 2010; White, 2006; Meichenbaum, 2007; Guarino et al., 2009).

• Encourage and support employee participation in continuing education opportunities, including workshops and conferences to strengthen professional practices and to improve responses

to vicarious trauma (Bell, Kulkarni, and Dalton, 2003; Bell and Jenkins, 1993; Pearlman and McKay. 2008).

• Promote collaborations with other organizations working with victims of trauma and violence for additional information shar- ing and social support (McCann and Pearlman, 1990).

References Adams, Kaye, Jane Shakespeare-Finch, and Deanne Armstrong. 2015. “An Interpretative Phenomenological Analysis of Stress and Well-Being in Emergency Medical Dispatchers.” Journal of Loss and Trauma: International Perspectives on Stress & Coping 20(5): 430–448.

Bednar, Susan G. 2003. “Elements of Satisfying Organizational Climates in Child Welfare Agencies.” Families in Society 84(1): 7–12.

Bell, Carl C., and Esther J. Jenkins. 1993. “Community Violence and Children on Chicago's Southside.” Psychiatry 56(1): 46–54.

Bell, Holly, Shanti Kulkarni, and Lisa Dalton. 2003. “Organizational Prevention of Vicarious Trauma.” Families in Society: The Journal of Contemporary Social Services 84(4): 463–470.

Bride, Brian E., Margaret M. Robinson, Bonnie Yegidis, and Charles R. Figley. 2004. “Development and Validation of the Secondary Traumatic Stress Scale." Research on Social Work Practice 14(1): 27–35.

Guarino, Kathleen, Phoebe Soares, Kristina Konnath, Rose Clervil, and Ellen Bassuk. 2009. Trauma-Informed Organizational Toolkit. Washington, DC: U.S. Department of Health and Human Services, National Center on Family Homelessness. Accessed May 30, 2016. www.air.org/resource/ trauma-informed-organizational-toolkit.

Knight, Carolyn. 2013. “Indirect Trauma: Implications for Self-Care, Supervision, the Organization, and the Academic Institution.” The Clinical Supervisor 32(2): 224–243.

Meichenbaum, Donald C. 2007. “Self-Care for Trauma Psychotherapists and Caregivers: Individual, Social and Organizational Interventions.” Presented at the Annual Conference of the Melissa Institute for Violence Prevention and Treatment of Victims of Violence in Miami, Florida.

McCann, Lisa, and Laurie Anne Pearlman. 1990. “Vicarious Traumatization: A Framework for Understanding the Psychological Effects of Working With Victims.” Journal of Traumatic Stress 3(1): 131–149.

Newell, Jason M., and Gordan A. MacNeil. 2010. “Professional Burnout, Vicarious Trauma, Secondary Traumatic Stress, and Compassion Fatigue.” Best Practices in Mental Health 6(2): 57–68.

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Pearlman, Laurie Ann, and Karen Saakvitne. 1995. “Treating Therapists With Vicarious Traumatization and Secondary Traumatic Stress Disorders.” In Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized, edited by C. Figley, 150–177. New York: Brunner/Mazel.

Pearlman, Laurie Anne, and Lisa McKay. 2008. Vicarious Trauma: What Can Managers and Organizations Do? Accessed April 20, 2016. www.headington-institute.org/files/vicarious- trauma-handout_for-managers_85189.pdf.

Slatten, Lise Anne, K. David Carson, and Paula Phillips Carson. 2011. “Compassion Fatigue and Burnout: What Managers Should Know. The Health Care Manager 30(4): 325–333.

Stamm, Beth Hudnall. 2010. “The Concise ProQOL Manual," 2nd edition. Pocatello, ID: Proqol.org. www.proqol.org/ uploads/ProQOL_Concise_2ndEd_12-2010.pdf.

United States Fire Administration. 1999. Emergency Medical Services (EMS) Recruitment and Retention Manual. Washington, DC: Federal Emergency Management Agency. Accessed April 21, 2016. www.naemt.org/docs/default-source/ Member-Resources-Documents/Emergency_Medical_Services_ EMS_Recruitment_and_Retention_Manual.pdf.

Urquiza, Anthony J., Gail E. Wyatt, and B. L. Goodlin-Jones. 1997. “Clinical Interviewing With Trauma Victims: Managing Interviewer Risk.” Journal of Interpersonal Violence 12(5): 759–772.

Vicarious Trauma Institute. 2015. “What Is Vicarious Trauma?” Accessed April 26, 2016. www.vicarioustrauma.com/whatis.html.

White, Dawn. 2006. “The Hidden Costs of Caring: What Managers Need to Know.” The Health Care Manager (Frederick) 25(4): 341–347.

This product was produced by Northeastern University's Institute on Urban Health Research and Practice, in collaboration with William James College, and supported by grant number 2013-VF-GX-K011, awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this product are those of the contributors and do not necessarily represent the official posi tion or policies of the U.S. Department of Justice.

For more information about vicarious trauma, visit https://vtt.ovc.ojp.gov/.