Critical appraisal
Social work students and secondary traumatic stress—the contribution of personal, professional and environmental factors
In recent years, there has been an increased recognition of the negative implications for therapists who work with trauma victims. Figley (1995) proposed the term ‘Secondary Traumatic Stress’ (STS), which refers to a situation in which traumatic events affect not only the victims them- selves but also the people in their environment. According to the number of studies, different kinds of therapist populations have shown varying degrees of STS (Adams et al., 2006; Ben-Porat and Itzhaky, 2009; Weitcamp et al., 2014; Tavormina and Clossey, 2017; Quinn et al., 2019). However, only a few studies have examined the existence of STS among social work students. Social work students are at risk of developing emotional distress due to their young age and lack of experience and skills (Litvack et al., 2010). For this reason, raising student awareness of the risks involved in working with trauma victims is the ethical obligation of the academic
institutions that train them (Sommer, 2008). In an attempt to map the factors that contribute to STS, many studies
have pointed to the personal, alongside the environmental, factors in a therapist’s life (Hensel et al., 2015). In that vein, this study aimed to examine the rate of STS among social work students and the contribution of background variables (age, gender and past trauma), personal resources (mastery and self-differentiation) and environmental resources (supervision satisfaction and peer support) to STS.
STS and social work students
Figley (1995) proposed that therapists who are exposed to descriptions of traumatic experiences relayed by clients who have been directly exposed may, like the clients themselves, also suffer from posttraumatic symptoms. According to Figley (1995), therapists can be ‘infected’ by atrauma victim and can experience a range of posttraumatic symptoms
similar to those experienced by their clients, such as intrusive thoughts about the (clients’) traumatic event, avoiding traumatic content, feeling emotionally numb and experiencing increased irritability. Indeed, in the most recent edition of the American guide to psychiatric diagnosis (APA, 2013), the definition of posttraumatic stress disorder (PTSD) now
includes what is known as criterion A, described as ‘indirect exposure to aversive details of the trauma, usually in the course of professional duties’. During the course of their field placements, social work students come into contact with a variety of traumatised populations, including children at risk, abused women and adolescents in distress. They are also exposed to traumatic material via discussions and case studies that are presented in the classroom (Butler et al., 2017). In addition, the motivation to be- come a social worker, which often includes values such as making the world a better place, as well as the wish (perhaps) to heal a personal wound, may put social work students at greater risk of denial of the emotional price that the profession exacts (Lev-Wiesel, 2003). The existence of this phenomenon (to one degree or another) among social work students has been revealed previously (Knight, 2010; Zosky, 2013; Shannon et al., 2014; Butler et al., 2017). However, due to the scar- city of such studies regarding the factors that contribute to this phenom-
enon among social work students specifically, there is a need to continue investigating them: that is, the factors that affect STS among social work students, including personal and environmental resources.
Personal resources
Mastery refers to the extent to which people typically feel in control of their lives and the extent to which they perceive that their lives are under their control rather than being a matter of fate (Duffy, 2010). Pearlman and Saakvitne (1995) suggested that a sense of mastery, for trauma therapists, is manifested in the therapists’ ability to separate between their personal and professional lives, to make decisions independently, to limit caseload and to acquire sufficient resources. Studies among social work students have indicated the importance of mastery to beliefs about their abilities (Mackie and Anderson, 2011). Studies that have examined the correlation between mastery and STS reveal a mixed picture. On the one hand, studies conducted among family violence workers and social workers after 11 September 2001 found a
negative correlation between mastery and STS (Adams et al., 2006; BenPorat and Itzhaky, 2009). On the other hand, Weiss-Dagan et al. (2016) did not reveal any correlation between these variables among social workers. Self-differentiation, a concept that was developed by Bowen (1978), refers to the extent to which individuals see their feelings, thoughts and activities as being their own and not the others. This concept resembles the idea of emotional maturity. One’s level of self-differentiation in a therapeutic framework would imply a therapist’s ability to separate between him/herself and the client while also having empathy towards the client, an important element of self-regulation (Wilson and Lindy, 1999). With regard to social work students, Ben Shlomo et al. (2012) noted that those students who had a high degree of self-differentiation were likely to be more successful in displaying flexible responses in stressful situations and in their field work. Indeed, a study conducted among social workers in hospitals found a significant negative correlation between the social worker’s ability to emotionally separate from the clients and STS (Badger et al., 2008). In addition, among social workers working with a variety of different populations in Israel, it was found that the lower the level of self-differentiation, the higher the level of STS (FinziDottan and Berckovitch-Kormosh, 2016).
Environmental resources
It is clear that when students are required to treat trauma victims, supervision is of the utmost importance (Carello and Butler, 2014). Supervision can normalise the students’ feelings and offer them support and information about the nature of traumatic responses, as well as the tools to face distress (Walker, 2004). Despite the importance of supervision, the research findings regarding its contribution to STS are equivocal. For example, a negative correlation was found between supervision and STS among therapists working with populations such as abused children and terror victims (Walker, 2004; Cohen et al., 2006). On the other hand, studies conducted among therapists working in the areas of family violence, sexual assault victims and mental health did not find a correlation between these two variables (Dworkin et al., 2016; Ivicic and Motta, 2017; Rizkalla et al., 2017). In addition, Quinn et al. (2019) found a significant negative correlation between the supervisory relationship and STS, but did not find a significant correlation between supervision frequency and this variable. To the best of our knowledge, an empirical analysis of the correlation between supervision satisfaction and STS among social work students has not yet been conducted. However, there is one study that indicated a significant negative correlation between the supervisory working alliance and STS among counsellors-in-training (Toren, 2008). In addition, the unique contributions made by a student’s supervision and a student’s personal resources to his/her STS have not been examined, especially in regard to the student’s level of mastery, a resource which plays a special role in an individual’s ability to cope with trauma and distress. Colleague support refers to the therapist’s personal and psychological needs for inclusion and empathy. Collegial support also offers therapists
a framework for sharing professional dilemmas and a forum for exchanging knowledge and resources. Colleague support plays a particularly important role in preventing a therapist’s STS. Having colleagues who
identify with the therapist help normalise the therapist’s feelings (Munroe et al., 1995). Peer support, likewise, is an essential component of social work students’ education and it is for this reason that student often study together in small groups. There are in fact studies indicating that there is a correlation between colleagues’ support and STS among different therapist populations (Iliffe and Steed, 2000; Ben-Porat and Itzhaky, 2009). As for students, in a study conducted among student paramedics, it was found that inadequate support from peers contributed significantly to their negative feelings (Lowery and Stokes, 2005).
Research questions
In accordance with the preceding literature review, the following research questions were posed:
1. What rates and levels of STS will be found among social work students?
2. What contribution will the research variables make in explaining the STS variance among social work students?
3. Does the interaction between supervision satisfaction and mastery make a unique contribution to STS?
