Volume 11, Issue 4, October, 2023 Evidence in Action A quarterly research brief from the Center on Trauma and Children

Individuals who are trafficked for sex have high rates of trauma exposure prior to and while being trafficked; therefore, professionals who work with this population are potentially exposed to high levels of trauma details increasing their risk of developing secondary traumatic stress (STS). STS can develop from the vicarious or indirect exposure to another’s trauma through hearing the stories and details of their experiences (Sprang et al., 2019). Symptoms of STS parallel those of posttraumatic stress disorder (PTSD), including intrusive thoughts/memories, avoidance of internal and external reminders, negative mood/cognitions, dissociation, and hypervigilance or arousal (Sprang et al., 2019). Although the symptoms of STS align with those of PTSD, it is distinct in that individuals may experience symptoms with or without functional impairment and may or may not meet full criteria for PTSD (Sprang et al., 2022).

This study investigated the STS symptoms of professionals working with survivors of sex trafficking utilizing a socioecological framework to guide the design and analysis. An online survey was completed by 583 respondents from a broad range of organizational settings who completed measures tapping into STS symptoms, lifetime trauma exposures, history of being sex-trafficked, dose of direct and indirect trauma exposure at work, use of emotional and instrumental support to cope, state report cards on sex trafficking policies, and organizational level practices toward being STS informed.

STS scores among professionals working with survivors of sex trafficking were high, with those in child welfare settings reporting the highest levels of STS. Hierarchical regression analysis indicates higher STS was associated with variables at all levels of the socioecological model except the macrosystem, with fewer years of experience, a history of being sex trafficked, higher dose of indirect exposure, less use of emotional support and lower organizational STS scores predictive of higher distress. Together, study findings indicate that STS is a significant concern in the anti-trafficking workforce and that a socioecological framework is useful for understanding STS impacts, highlighting the value of multiple response strategies across levels. This analysis suggests that organizational level strategies to ameliorate/buffer impacts of occupation-related trauma exposure among these professionals can be especially impactful.

• Professionals should not be expected to go it alone. This study underscores the need for both organizational and individual efforts to prevent and mitigate STS for professionals routinely engaging in work with survivors of sex trafficking.
• Important organizational strategies supported in the literature and implicated in this study include the use of increased training and peer and STS-informed supervisory supports especially for less experienced workers, conducting safety assessments to ensure the psychological and physical safety of workers, and targeted caseload assignment strategies to manage or limit indirect exposures to severe trauma (NCTSN, 2011; Sprang et al., 2021).
• Professionals working with sex trafficking survivors, especially those who have been a personal history of involvement in sex trafficking should be encouraged to self-monitor for symptoms of STS via access to the variety of free and anonymous screening tools and to utilize employee assistance programs and therapeutic resources for individual intervention when indicated. Check out the UK CTAC website for a list of free screeners https://ctac.uky.edu/projects-and-programs/wellwork/tier-3

Sprang, G., Ford, J., Kerig, P., & Bride, B. (2019). Defining secondary traumatic stress and developing targeted assessments and interventions: Lessons learned from research and leading experts. Traumatology, 25 (2), 1-10. http://dx.doi.org/10.1037/trm0000180

Sprang, G., Whitt-Woosley, A., & Eslinger, J. (2022). Diagnostic and Translational Utility of the Secondary Traumatic Stress Clinical Algorithm (STS-CA).Journal of interpersonal violence, 37(21-22), NP19811-NP19826. https://doi.org/10.1177/08862605211044961