Valuing and Retaining Staff:
Being Trauma-Informed and Responsive Can Benefit Both Organizations and their Workforce
Published in Children’s Voice, Volume 32, Number 1
By Kathleen McGowan, Alix Rivière, Audrey Smolkin, and Melissa Threadgill
The Massachusetts Center on Child Wellbeing & Trauma’s (CCWT) mission is to support organizations in becoming more responsive to trauma and in reducing secondary traumatic stress in their workforce by fostering staff resiliency and well-being. This article explores how the CCWT addresses the challenge of burnout and turnover in human service organizations and suggests a framework for how being trauma-responsive can address this problem.
High rates of burnout and turnover are not new challenges for human service organizations, but the COVID-19 pandemic has worsened these challenges significantly. The scenario is well-known: staff who work with children and families experiencing trauma can feel hopeless, exhausted, or even angry. Over time, some of these staff members develop what experts call empathy-based stress—a condition that encompasses secondary traumatic stress (STS), compassion fatigue, and vicarious trauma.
Without proper supports, this “cost of caring” paid by individual workers can snowball into an organization-wide problem. Individual symptoms of empathy-based stress, such as anxiety, trouble concentrating, and mood changes, can lead to work-related problems such as decreased efficiency, lack of professionalism, and job dissatisfaction. This can then translate into organizational problems such as high rates of absenteeism, turnover, and poor service delivery. While individual strategies like self-care can be helpful for staff dealing with empathy-based stress, by themselves they are not sufficient to address organizational challenges. Instead, human service organizations need to address the root of the problem by adopting a trauma-informed and responsive organizational culture. Research shows that efforts to change an organization’s culture are necessary to increase staff performance and retention as well as improve the quality of- service delivery.
The Individual Cost of Caring and its Impact on Organizations Helping Families Who Experience Trauma
Working directly with children and families who have experienced the trauma of violence, abuse, poverty, and other adverse events is deeply meaningful work—but it can take a toll on professionals’ mental health. Repeated and prolonged exposure to the trauma of others leaves staff in the helping fields significantly more likely to experience empathy-based stress.
This problem is compounded by the fact that professionals in human service organizations are more likely to have personally experienced trauma than the general population. This experience puts them at an increased risk of developing secondary traumatic stress at work. These professionals are also more likely to be Black or Hispanic and earn less than the national average. For those who experience financial stress or racial trauma, working with children and families who have experienced trauma also increases their risk of suffering from empathy-based stress.
Being continually exposed to the trauma of others can have serious negative effects that are similar to those of direct exposure. These effects include intrusive thoughts, difficulty concentrating, anxiety, and negative changes in mood. Besides the impact this can have on employees’ personal lives, empathy-based stress can negatively impact the staff’s:
• Relationship with clients, as employees may become less responsive to the clients’ needs, treat them in a derogatory manner, and generally demonstrate less professional behavior. Staff with a personal history of trauma can be more sensitive to rejection and interpersonal conflict and may struggle to respond empathetically to frustrating client behavior. Without trauma-responsive training and support, staff may use inefficient and potentially harmful strategies focused on controlling behaviors.
• Cognitive functions, leading to lower levels of concentration and difficulty with decision-making. Empathy-based stress also increases the likelihood that staff may view the traumatic experiences of others through the lens of their own personal trauma, reducing their objectivity when making decisions.
• Job satisfaction, as professionals suffering from compassion fatigue report feeling less committed to and satisfied with the work.
This, in turn, can lead to negative outcomes at the organizational level, including:
• Reduced work performance: Not only does empathy-based stress affect staff ’s efficiency, but it can also impact their enthusiasm for and focus on caring for the individuals they are trying to help.
• High employee turnover: Studies have repeatedly shown that empathy-based stress plays a large role in staff turnover, which makes it more difficult for organizations to provide consistent, competent, and cost-effective services to the families they serve.
• Poor work environment: Compassion fatigue can lead to chronic tardiness and absenteeism, irritability towards clients, colleagues, and management, and avoidance, which all contribute to strained professional relationships and unhealthy work environments.
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Kathleen McGowan is passionate about expanding access to equal resources for all children. Before joining the Center on Child Wellbeing & Trauma, Kathleen worked at New York University’s (NYU) Steinhardt School’s Child and Family Policy Center. She supported the implementation of authentic assessment and developmental screening in preschool classrooms with the goal of improving education for preschool children and professional development for teachers and administrators. In prior roles, Kathleen coordinated and delivered behavioral health services to children and families.
Alix Rivière is a Research and Policy Analyst for the Massachusetts Office of the Child Advocate, where she analyzes issues related to child health and well-being to inform systems change. She has weaved her enthusiasm for children and families throughout her previous work teaching at the University of Texas- Brownsville and graduate studies in New Orleans. She received her PhD in History from Tulane University.
Melissa Threadgill is the Director of Strategic Innovation at the Massachusetts Office of the Child Advocate, where she leads the office’s research, policy and implementation work on issues related to childhood trauma, juvenile justice, and behavioral health.
Audrey Smolkin is the Executive Director of the Center on Child Wellbeing & Trauma, a partnership between ForHealth Consulting at University of Massachusetts Chan Medical School and the Massachusetts Office of the Child Advocate. The Center launched in 2021 and serves as a hub of information, trainings, and support toward building a more trauma-informed and responsive Massachusetts. Smolkin also develops new programs, research, and evidence-based policy initiatives related to children and families. This work includes partnering with the Massachusetts Department of Children and Families on medical care for children in the care of the department as well as management related to a statewide network of Family Resource Centers.