Individual and Organizational Correlates

of Secondary Traumatic Stress Among

MSW Students

Michael Clarkson-Hendrix, PhD Candidate, MSW

Lynn A. Warner, PhD, MSW

Upstate New York-Mental and Behavioral Health

Consortium Members (UNY-MBHEC)

University at Albany

Katharine Briar-Lawson

Estella Williamson

University at Buffalo

Nancy Smyth

Diane Elze

Laura Lewis

Binghamton University

Laura Bronstein

Paul Gould

Nazareth College-College at

Brockport

Virginia David

Debra Fromm-Faria

Roberts Wesleyan College

David Skiff

Laura Ribbing

Syracuse University

Carrie Jefferson Smith

Kristin Esposito

HRSA Grant Number: M01HP25193

Background

• Secondary traumatic stress (STS)– A negative feeling driven by fear and work-related trauma (Stamm, 2010)

– STS among current practitioners has been studied, especially child welfare workers

– Little attention to STS among MSW students

• For practitioners – Interferes with their efficacy and productivity, possibly increases

burnout

• For students– Hampers competency development

• For clients– Impedes quality of care

Purpose

• Examine factors associated with secondary traumatic stress among a group of MSW students

– Factors include individual student, placement, and supervision characteristics

• Students are in advanced clinical field placements where exposure to traumatic stress is a particular concern

Methods

• Sample

– Voluntary sample of MSW students in interprofessional field placements

• 10-12 students competitively selected each year from 2013-2015 for HRSA-funded traineeship

• Clients are Veterans and/or underserved rural populations

• Sample characteristics (n=29)

– 79.3% female

– 96.6% white

– 48.3% under the age of 25

– 44.8% no prior paid human service experience (mean years 1.94)

Procedures– Data collected via online survey

– Univariate analysis to assess normality and scale reliability

– Bivariate analysis to select variables for inclusion in multivariate analysis

• Due to small sample size, only variables significantly associated with STS at the bivariate level (p < .05) were included in multivariate analyses

– Ordered logistic regression was used to test significance of association between correlates and STS

Measures

Secondary traumatic stress

Prompt: Select the response that honestly reflects the

frequency of this experience in the last 30 days.

“I feel as though I am experiencing the trauma of

someone I have helped”

Responses range from 1 (Never) to 6 (Very often)

– Never 76%

– Rarely 14%

– A few times 10%

Measures

INDIVIDUAL CORRELATESMean

Index of Interdisciplinary Collaboration (IIC) Subscales

Interdependence (thirteen items; α = .68) 3.51

Newly created professional activities (six items; α = .75) 3.81

Flexibility (five items; α = .67) 3.84

Collective ownership of goals (eight items; α = .70) 3.61

Reflection on process (ten items; α = .78) 3.48

Role stress: Role Ambiguity (five items; α = .88) 2.69

Role stress: Role Overload (three items; α = .29) 2.57

ORGANIZATIONAL CORRELATES %Field Instructor Role in Agency: Direct practitioner 65%

Client Population Focus: Veterans 66%

Results – Significant Bivariate Associations

with Secondary Traumatic Stress

INDIVIDUAL CORRELATES

Index of Interdisciplinary Collaboration (IIC) Subscales

Interdependence (thirteen items; α = .68)

Newly created professional activities (six items; α = .75)

Flexibility (five items; α = .67) ✔

Collective ownership of goals (eight items; α = .70)

Reflection on process (ten items; α = .78)

Role stress: Role Ambiguity (five items; α = .88)

Role stress: Role Overload (three items; α = .29)

ORGANIZATIONAL CORRELATESField Instructor Role in Agency: direct practitioner

Client Population Focus: Veterans ✔

Secondary Traumatic Stress

Multivariate Ordered Logistic Regression Results

Variables OR CI OR CI OR CI

Flexibility 1.53 1.05-1.22 1.72 1.08-2.73

Veterans 0.07 0.01-0.53 0.04 0.00-0.50

-2 log

likelihood

35.34 33.83 26.76

Pseudo R2 0.15 0.19 0.36

p 0.012 0.005 < .001

OR = Odds Ratio; CI = 95% Confidence Interval

Limitations

• Small and unique sample

– Sample size limits estimating multiple measures simultaneously

– Replication with students in a range of settings is warranted

• Survey administered to students early in their

placements; replication at the end of the placements is

planned

• Additional measures of trauma exposure at field

placement sites could provide more ability to capture

variation

ConclusionsIndividual factors

The flexibility subscale was the only individual correlate significantly

associated with STS

The items in the subscale suggest greater STS when:

– MSW students report willingness to take on tasks outside of their

placement responsibilities

– MSW students’ perceive professionals from other disciplines

performing duties outside their scope of practice

Secondary

traumatic stress

Exposure to traumatic

stress likely

Role confusion

Engaging in

tasks outside of

placement

responsibilities

Witnessing

intentional role

blurring

Conclusions

Organizational factors

Students in VA behavioral health placements were much less

likely to experience STS than students in other behavioral health

placements

As a field placement setting where traumatic stress treatment is

more common, Veteran placements may have more awareness

and may more readily work towards prevention of STS

Practice Implications

• Teach field instructors about intentional role blurring in

interprofessional practice and how to assist students

in navigating it without strain

• Teach students skills in clarifying role expectations

with field instructors

• Partner with local VAs in colloquia on strategies to

improve recognition of STS and its prevention in the

field