“Pouring From an Empty Cup”: Manifestations, Drivers, and Protective Factors of Occupational Stress Among Healthcare Providers of Trauma-Informed Care

Abstract

In the United States alone, 10 million people are affected by family and domestic violence (DV). DV survivors experience many forms of victimization, including physical, psychological, and sexual abuse resulting in trauma. The DV workforce, including healthcare providers, social workers, advocates, and other providers, utilize trauma-informed care in a variety of settings to help DV survivors heal and recover from their traumatic experiences. Given the intensity of DV work and occupational stressors associated with navigating complex survivor cases and systems of care, health and mental health professionals can experience burnout, compassion fatigue, and secondary traumatic stress. The purpose of this qualitative study was to explore how professionals in the DV workforce, including healthcare and mental health professionals, experience and mitigate occupational stress. Twenty in-depth interviews were conducted with DV professionals, who worked in medical settings like urban hospitals as well as DV shelters and rape crisis centers in Boston, MA. A semistructured interview guide was developed, and pilot tested and addressed the following topics including experiences of occupational stress, and mitigators of occupational stress. The interviews were audio recorded, transcribed, and analyzed using a thematic analysis approach. Codes were organized into themes and subthemes, which were reviewed and refined during research team discussions. Risk factors of occupational stress included caseload quantity and intensity, workplace isolation, and length of time in the field. Protective factors spanned individual, interpersonal, and organizational level factors. Participants described various strategies for mitigating occupational stress, including training, supervision, and self-care. Findings from this study have the potential to inform policies and practices among healthcare organizations that support professionals in the DV workforce who work with DV survivors.