Can organizational efforts lead to less secondary traumatic stress? A longitudinal investigation of change.

Objectives: Current best practice approaches suggest that to address secondary traumatic stress (STS) a two-pronged perspective that considers individual and organizational factors over time is warranted. However, research documenting the impact of organizational efforts on individual experience with STS is lacking. In this study, it was hypothesized that as an organization becomes more STS informed, there would be decreases in reported levels of STS and burnout (BO) in individuals over time; and these changes would be associated with higher levels of implementation activity and increased use of interventions to improve physical and psychological safety. Methods: This study uses data from 2,345 responses, representing 7 groups involved in an organizational change process aimed at creating STS informed organizations in a department of health and human services. The Secondary Traumatic Stress Informed Organizational Assessment (STSI-OA), the Secondary Traumatic Stress Scale (STSS), and the Professional Quality of Life-5 BO subscales measured variables of interest. Using a longitudinal design, baseline, post, and follow-up data were collected. Results: One-way ANOVAs revealed significant improvements in STSI-OA, STSS, and BO scores across time (p-value < .05). Linear mixed models reveal that significant declines in STSS scores were associated with improved STSI-OA scores (p = <.001), after adjusting for age, gender, time, and level of implementation activity. Implications: These results support the hypothesis that organizational efforts can improve an individual’s perceived level of distress, and that focused attention to the issue of secondary trauma in an organization can improve organizational and individual outcomes using a data-driven change approach. Public Policy Relevance of the Study—Secondary traumatic stress is an expected occupational hazard for workers who provide services to persons who are suffering from trauma conditions. It can lead to a wide range of poor outcomes for organizations, employees, and those served by them. The literature recommends a two-pronged approach to addressing secondary traumatic stress, but there have been few investigations as to whether organizational efforts can impact individual outcomes over time. This study investigates this question in a large sample of publicly funded employees and organizations. There are few organizational-level interventions identified in the literature to drive change. In this study, the organizational activities operationalized by the STSI-OA including resilience building, promotion of the psychological and physical safety, leader and organizational practices, and implementation of STS informed policies drove significant, positive improvement over time in organizational and individual outcomes. There is literature that suggests how you do something is an important accompaniment to what you do. The level of team engagement in the change process operationalized as implementation activity was significantly related to positive outcomes in individuals and organizations. Once established, high implementers were able to sustain progress beyond the structure of the Breakthrough Series Collaborative process. This suggests that higher levels of engagement during the change process, including the involvement of senior leaders, can assist in the sustainment of gains after the action periods are complete.