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The Exhausted Woman
with Christine Hammond, MS, LMHC

Can Therapists Have Secondary Traumatic Stress (STS)?

Yes. According to a study reported in March 2019 of US News and World Report, mental health counselors are listed as one of the most stressful jobs next to attorneys and surgeons. The burnout rate for counselors is between 25-67% (depending on the study and type of practice) with a turnover rate of one in three. It’s not just the clients experiencing stress, the therapist is feeling it as well.

Effective therapy includes actively listening to a client, empathizing with unconditional positive regard, thinking critically without being judgmental, and offering alternative responses to emotional, mental, and behavioral situations that empower a client. As such stories of abuse, fear, anxiety, and trauma are often recalled by the client so a new perspective might minimize the impact. Some stories are told by the abused, while others are told by the abuser.

A therapist is not just listening to a traumatic story, they are also attempting to see and feel it from the storyteller’s point of view. This perspective allows the therapist to provide new insights to help the client move forward in a healthy manner. However, it also increases the possibility of the therapist might experience some secondary trauma as a result of listening. Listening to multiple stories in a day can cause repeated traumatization and might decrease a therapist’s ability to empathize, remain objective, and participate in active listening. It can also increase depersonalization, dissociation, and desensitization.

So yes, therapists can suffer from Secondary Traumatic Stress (STS) from listening to these traumatic and abusive stories told by victims and perpetrators. STS is the emotional duress that results when an individual hears about the firsthand trauma experiences of another. Its symptoms mimic those of Post-Traumatic Stress Disorder (PTSD). Who does and does not experience STS is as individualized as the therapist. Just like PTSD impacts some and not others, so does STS.

Those therapists, especially at risk for STS, include:

  • Therapists who have experienced a similar trauma like the one being told by the client.
  • Therapists who have close family members or friends who have experienced similar trauma.
  • Therapists who hear the traumatic story told by the perpetrator and not the victim.

Symptoms of STS include:

  • Intrusive thoughts of the event at random times,
  • Sadness that comes and goes,
  • Poor ability to concentrate yet there is a strong desire to try to focus,
  • Second-guessing even simple decisions with an inability to think clearly,
  • Detachment from the event,
  • Hypervigilance to loud noises, shouts, sirens, helicopters, and screams,
  • Feeling hopeless and helpless yet wanting to be hopeful and helpful,
  • Inability to embrace the complexity of the circumstance and wanting things to be more simple,
  • Inability to listen to one more story,
  • Anger and cynicism over things that did not bother before (projecting anger into a safer target),
  • Sleeplessness, waking up and unable to return to sleep,
  • Fear of what will happen next as the entire week was filled with other traumatic events,
  • Chronic exhaustion that is not relieved by rest,
  • Physical ailments that appear out of nowhere or are reoccurrences of past injuries,
  • Minimizing what happened, and
  • Misplaced feelings of guilt.

There are several ways to prevent the effects of STS. They include:

  • Psychoeducation: reading and understanding the effects of STS on therapists,
  • Informal and formal self-screening for increases in stress, anxiety and depression levels,
  • Workplace self-care groups such as group sessions, drinks after work, or sharing a meal together,
  • Taking adequate breaks during the day including some time to get outside for a few minutes,
  • Flexible scheduling after having been traumatized,
  • Self-care accountability to another therapist about progress or lack thereof, and
  • Exercise, meditation, good nutrition, sleep, breathing exercises, relaxation exercises, and hydration.

For many therapists, just recognizing the effects of STS is enough to minimize the impact. It takes time to recover from STS so patience is imperative. Increasing the positivity to overshadow the negativity can also be beneficial. However, if these ideas are ineffective, it is time to seek professional help.

 

Can Therapists Have Secondary Traumatic Stress (STS)?

 


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APA Reference
Hammond, C. (2019). Can Therapists Have Secondary Traumatic Stress (STS)?. Psych Central. Retrieved on June 26, 2019, from https://pro.psychcentral.com/exhausted-woman/2019/06/can-therapists-have-secondary-traumatic-stress-sts/