Prevalence of Secondary Traumatic Stress Among Social Workers‪.‬

In the United States, the lifetime prevalence of exposure to traumatic events ranges from 40 percent to 81 percent, with 60.7 percent of men and 51.2 percent of women having been exposed to one or more traumas and 19.7 percent of men and 11.4 percent of women reporting exposure to three or more such events (Breslau, Davis, Peterson, & Schultz, 1997; Kessler, Sonnega, Bromet, & Nelson, 1995; Stein, Walker, Hazen, & Forde, 1997). Although exposure to traumatic events is high in the general population, it is even higher in subpopulations to whom social workers are likely to provide services. For example, 84 percent of psychiatric inpatients have experienced at least one traumatic event and 45 percent have experienced three such events or more (Escalona, Tupler, Saur, Krishnan, & Davidson, 1997). Between 82 percent and 94 percent of outpatient mental health clients reported a history of exposure to traumatic events, with 31 percent to 42 percent fulfilling criteria for PTSD (Davidson & Smith, 1990; Switzer et al., 1999). Among treatment-seeking substance abusers, 60 percent to 90 percent have a history of sexual or physical abuse (Cohen & Densen-Gerber, 1982; Dansky et al., 1996; Dansky, Roitzsch, Brady, & Saladin, 1997;Yandow, 1989), and 30 percent to 50 percent meet the criteria for a diagnosis of post traumatic stress disorder (PTSD) (Dansky, Brady, et al.; Najavits, Weiss, & Shaw, 1997). Furthermore, 87 percent of homeless women with mental illnesses reported both childhood and adult abuse, and 97 percent reported some form of abuse over the lifespan (Goodman, Dutton, & Harris, 1997). Although not exhaustive of the populations with whom social workers practice, these examples illustrate that social workers face a high rate of professional contact with traumatized people. Social workers are increasingly being called on to assist survivors of childhood abuse, domestic violence, violent crime, disasters, and war and terrorism. It has become increasingly apparent that the psychological effects of traumatic events extend beyond those directly affected. The term "secondary traumatic stress" (STS) refers to the observation that people, such as family, friends, and human services personnel, who come into continued, close contact with trauma survivors may also experience emotional disruption, becoming indirect victims of the trauma (Figley, 1995). Figley (1999) defined secondary traumatic stress as "the natural, consequent behaviors and emotions resulting from knowledge about a traumatizing event experienced by a significant other. It is the stress resulting from helping or wanting to help a traumatized or suffering person" (p.10). Chrestman (1999) noted that secondary traumatization includes symptoms parallel to those observed in people directly exposed to trauma such as intrusive imagery related to clients' traumatic disclosures (Courtois, 1988; Danieli, 1988; Herman, 1992; McCann & Pearlman, 1990); avoidant responses (Courtois; Haley, 1974); and physiological arousal (Figley, 1995; McCann & Pearlman, 1990). Thus, STS is a syndrome of symptoms identical to those of PTSD, the characteristic symptoms of which are intrusion, avoidance, and arousal (Figley, 1999).