Listen to a short summary of this research brief (1:13)
VOLUME 14, ISSUE 3 July 2026 - Evidence in Action Research Brief Evidence in Action A quarterly research brief from the Center on Trauma and Children
Flipping the Script: Addressing Occupational Distress to Sustain Trauma-Informed Care
Sprang. G. & Whitt, A. (2026). Flipping the Script: Addressing Occupational Distress to Sustain Trauma-Informed Care, Child and Adolescent Psychiatric Clinics of North America. https://doi.org/10.1016/j.chc.2025.11.005
Published in Child and Adolescent Psychiatric Clinics of North America (April 2026) as part of the Special Issue on Assessing and Treating Children and Adolescents Exposed to Trauma edited by Lisa Amaya-Jackson, Ruth S. Gerson, Sarah Y. Vinson. This issue provides an updated overview of evidence-based strategies for evaluating, treating, and preventing child trauma, as well as improving organizational practices to support sustainable trauma-informed care.
Article Summary
As trauma-informed care (TIC) expands across health care, social services, and child welfare systems, organizations face a nationwide shortage of trained mental health providers and a critical sustainability crisis. In addition to this notable resource shortage, providers of trauma-informed care are at risk for numerous trauma-related threats to their own well-being. The tendency to focus entirely outward on the trauma of clients while neglecting the psychological well-being of the professional workforce is often a foundational flaw in traditional TIC implementation. Expecting a workforce burdened by unaddressed occupational distress to effectively and consistently deliver trauma-informed care is structurally unsustainable. This is especially problematic in systems designed to serve children impacted by trauma, as these groups of professionals often report the highest rates of distress including secondary traumatic stress (STS), vicarious trauma and moral distress. High rates of STS, for example, directly correlate with clinical burnout, high turnover, and a diminished capacity to deliver empathic care with fidelity. Rather than treating workforce distress as an individual failure to practice adequate "self-care," it should be reframed as an organizational risk requiring structural prevention and intervention efforts.
To operationalize this paradigm shift, an evidence-based, bifocal approach is proposed to address Individual/Micro Level factors (addressing acute occupational distress among individual practitioners) and Structural/Macro Level factors (reshaping the organizational infrastructure, policies, and climate to minimize chronic stressors and protect the workforce). The "Four Cs" framework is also introduced to guide systems in enacting these changes. This includes individual and organizational strategies aimed at calming, cognitive coping, enhancing supportive connections, and building competency that can attenuate the impact of occupational distress. In summary, trauma-informed care is not just a client-centered practice- it is the blueprint for workforce protection and development that supports the work of the organization.
Translational Tips
Implement "Bifocal" Supervision: Move clinical supervision beyond administrative tracking or case review to include a focus on both micro-level individual impacts (assessing for STS symptoms) and macro-level system navigation (identifying workflow or policies causing distress).
De-individualize Wellness by Auditing Workplace Culture: Shift the language within your team from individual resilience ("Are you doing enough self-care?") to collective accountability. Advocate for or implement periodic, anonymous workforce climate assessments to identify patterns of STS and burnout to inform organizational adjustments.
Integrate the "Four Cs" into Team Operations: Integrate individual and organizational strategies aimed at calming, cognitive coping, enhancing supportive connections, and building competency.
Promote Low-Barrier, STS Screenings: Normalize the use of evidence-based self-assessment tools (Access Here)
Advocate for Structural Predictability and Policy Safeguards: Because systemic instability worsens secondary trauma, practitioners and leadership should collaborate to build operational predictability wherever possible and enforce protective policies like monitoring caseload mix and volume and providing support for high exposure activities.
Subscribe to the Evidence in Action Research Brief
Sign up here if you want to receive Evidence in Action in your inbox!