Human Service Organizations: Management, Leadership

& Governance

ISSN: 2330-3131 (Print) 2330-314X (Online) Journal homepage: https://www.tandfonline.com/loi/wasw21

Ineffective Organizational Responses to Workers’

Secondary Traumatic Stress: A Case Study of the
Effects of an Unhealthy Organizational Culture

Sarah L. Jirek

To cite this article: Sarah L. Jirek (2020): Ineffective Organizational Responses to Workers’
Secondary Traumatic Stress: A Case Study of the Effects of an Unhealthy Organizational
Culture, Human Service Organizations: Management, Leadership & Governance, DOI:
10.1080/23303131.2020.1722302

To link to this article: https://doi.org/10.1080/23303131.2020.1722302

Published online: 05 Feb 2020.

Submit your article to this journal

Article views: 41

View related articles

View Crossmark data

Full Terms & Conditions of access and use can be found at

https://www.tandfonline.com/action/journalInformation?journalCode=wasw21
HUMAN SERVICE ORGANIZATIONS: MANAGEMENT, LEADERSHIP & GOVERNANCE
https://doi.org/10.1080/23303131.2020.1722302

Ineffective Organizational Responses to Workers’ Secondary

Traumatic Stress: A Case Study of the Effects of an Unhealthy
Organizational Culture
Sarah L. Jirek
Department of Sociology and Anthropology, Westmont College, Santa Barbara, California, USA

ABSTRACT KEYWORDS
Organizations play a vital role in preventing or ameliorating secondary Secondary traumatic stress;
traumatic stress (STS) among helping professionals. This qualitative case vicarious trauma;
study investigated one organization’s response to workers’ STS, why its organizational culture;
response was ineffective, and how its organizational structure and organizational structure;
organizational culture negatively impacted its response to employees’ organizational effectiveness
trauma-related distress. Data included 29 in-depth interviews with staff
members serving survivors of domestic violence and sexual assault,
ethnographic fieldnotes, and the employee handbook. Key findings
were that the organization’s approach was overly individualistic, that
employees needed additional resources and education to engage in
effective self-care, and that the organizational culture undermined
workers’ well-being.

Secondary traumatic stress, vicarious trauma, and other related forms of worker distress affect
hundreds of thousands of helping professionals in the U.S. today.1 The well-being of helping
professionals is particularly at-risk when they work with survivors of trauma because indirect
exposure to trauma may produce symptoms similar to posttraumatic stress disorder (PTSD) or
even the full disorder itself (American Psychiatric Association, 2013).
As with PTSD, individual helpers may experience intrusive symptoms, avoidant symptoms, and
hyper-arousal (American Psychiatric Association, 2013; Figley, 1995). Other aspects of workers’ well-
being may also be impacted, including changes in their basic beliefs about the self, other people, and
the world around them (McCann & Pearlman, 1990), emotional numbing, compassion fatigue, an
array of negative physical and emotional reactions, and decreased quality of life (Caringi et al., 2017;
Kulkarni, Bell, Hartman, & Herman-Smith, 2013). Some researchers have even documented effects
on workers’ spiritual lives (e.g., Jirek, 2015).
Although individual helping professionals can take steps to reduce the negative effects of
trauma-related work upon their lives, organizations also play a vital role. In fact, I argue that
organizations have an ethical responsibility to create healthy and trauma-informed organiza-
tional cultures that protect the well-being of their workers. Such efforts are likely to also
promote the organizational mission by enhancing the effectiveness of interventions and the
quality of services provided.

CONTACT Sarah L. Jirek sjirek@westmont.edu Department of Sociology and Anthropology, Westmont College, 955 La Paz
Rd., Santa Barbara, CA 93108
1
To calculate this conservative estimate, I summed the total number of only seven groups of helping professionals (i.e., social
workers, psychologists, mental health counselors, social and human service assistants, police and sheriff’s patrol officers,
firefighters, and registered nurses), using data from the U.S. Department of Labor’s Occupational Outlook Handbook (2018),
and multiplied the total number of helping professionals (5,322,150) by the lowest prevalence estimate (15%; see Lee et al.,
2017) of STS reported among a nationally representative sample (which totaled 798,322 professionals affected by STS).
© 2020 Taylor & Francis Group, LLC
2 S. L. JIREK

Literature review
Secondary traumatic stress
It has long been recognized that the effects of trauma may extend to those who assist its victims. Early
research on this topic most commonly referred to these effects as compassion fatigue (Figley, 1995),
secondary traumatic stress (Stamm, 1995), or vicarious traumatization (McCann & Pearlman, 1990;
Pearlman & MacIan, 1995). Subtle differences between these constructs have developed, and some
researchers have begun disentangling these terms (e.g., Newell, Nelson-Gardell, & MacNeil, 2015).
However, because much of the literature reviewed here used the terms secondary traumatic stress and
vicarious trauma interchangeably, and because the research participants in this study exhibited
symptoms of both phenomena (see Jirek, 2015), I have used the term secondary traumatic stress
(STS) throughout this article to refer to the full range of negative effects that indirect trauma exposure
may have upon helping professionals.
Estimates vary widely regarding the prevalence of STS among helping professionals, including 15%
of a national sample of clinical social workers (Lee, Gottfried, & Bride, 2017), 25% of law enforcement
investigators (Brady, 2017), 23 to 27% of mental health professionals (Ivicic & Motta, 2017), and 34%
of child protective services workers (Bride, Jones, & Macmaster, 2007). Despite differences in defini-
tions and measurement among prevalence reports, these studies clearly demonstrate that STS is
relatively common among helping professionals and that this form of distress negatively and sub-
stantively affects many workers’ lives.
In the past two decades or so, as awareness regarding the potential hazards of working in the
helping professions has grown, the number of research studies on STS has increased exponentially.
In their recent meta-analysis, Hensel, Ruiz, Finney, and Dewa (2015) identified 1,973 published
studies of helping professionals indirectly exposed to trauma through their work, although only 38 of
these studies met all of the criteria to be included in their analyses. Hensel et al. (2015) examined 17
commonly reported risk factors for STS among professionals; they found small but significant
positive effect sizes for several measures of trauma caseload (i.e., volume, frequency, and ratio), as
well as having a personal trauma history. They also found small but significant negative effect sizes
for work support and social support. Hensel et al. (2015, p. 88) noted that more studies are needed
that examine “a number of work factors, such as role, job demands, and organizational culture.”

Individual-level strategies to address secondary traumatic stress

The majority of research on preventing or mitigating STS has emphasized individual-level efforts. General
self-care is the most commonly cited prevention or remedy for the potentially negative side effects of
working with traumatized populations. Neumann and Gamble (1995, p. 346) defined self-care as giving
adequate “attention to one’s interpersonal, emotional, physical, and spiritual needs.” The types of self-care
activities that are frequently discussed in the STS literature include healthy eating, sufficient sleep, exercise,
leisure activities, meditation, mindfulness, spiritual practices, stress management, and self-soothing tech-
niques (Berceli & Napoli, 2006; Brady, 2017; Caringi et al., 2017; Figley, 2002; Hesse, 2002; McCann &
Pearlman, 1990; Posluns & Gall, 2019; Sprang, Craig, & Clark, 2011; Stamm, 1995; Storlie & Baltrinic, 2015;
Trippany, Kress, & Wilcoxon, 2004).
Other studies have focused upon additional individual strategies, such as reducing one’s exposure to
disturbing materials and traumatized clients (Brady, 2017; Lee et al., 2017; McCann & Pearlman, 1990),
engaging in cognitive reappraisal (Mairean, 2016), improving role competence (Ben-Porat, 2015), and
developing a strong personal and professional social support system (Bell, Kulkarni, & Dalton, 2003;
Brady, 2017; Choi, 2011; Trippany et al., 2004). In their qualitative research, Harrison and Westwood
(2009) found that protective factors for preventing STS among mental health therapists included
reducing one’s isolation, developing mindful self-awareness, embracing complexity, retaining
 HUMAN SERVICE ORGANIZATIONS: MANAGEMENT, LEADERSHIP & GOVERNANCE 3

optimism, engaging in holistic self-care, maintaining clear boundaries, empathically engaging with
one’s clients, cultivating professional satisfaction, and creating meaning from clients’ traumas.
However, the effectiveness of using solely individual strategies to address STS has been ques-
tioned. For example, in their study of 259 professionals who provide mental health counseling, Bober
and Regehr (2006) found that there was no association between the amount of time that helping
professionals devoted to coping strategies (i.e., leisure activities, self-care activities, and supervision)
and the level of trauma symptoms they experienced. Similarly, Kulkarni et al. (2013) found that the
frequency of engagement in self-care activities was not significantly correlated with STS. In short,
although our understanding of STS has increased, the research literature has been overly individua-
listic in its focus on the correlates of and potential responses to this phenomenon.

Organizational factors and secondary traumatic stress

A handful of scholars have conducted research that acknowledges that an individualistic approach
is problematic and insufficient for understanding and addressing STS. Research on organizational
or workplace factors has found that STS is negatively correlated with support from coworkers,
supervisors, and work teams (Caringi et al., 2017; Choi, 2011; Townsend & Campbell, 2009),
levels of agency-wide supervision (Dworkin, Sorell, & Allen, 2016), and organizational support
(Brady, 2017). Secondary traumatic stress is positively correlated with the average size of client
caseloads across the agency, program, or organization (Dworkin et al., 2016; Townsend &
Campbell, 2009).
For example, Kulkarni et al. (2013) examined individual and organizational factors that contributed
to STS among 236 service providers working in domestic violence agencies. They found that “indivi-
dual-organizational mismatch” in the work life areas of workload and control was a significant risk
factor for STS. However, the greatest predictor of STS was advocates’ perceptions that their workload
was unreasonable. Organizational factors were more important than individual risk and protective
factors, with none of the individual factors remaining significant in the full models.
Workers’ empowerment has also been demonstrated to be a key organizational protective factor
against worker distress. In their study of STS among 148 domestic violence advocates, Slattery and
Goodman (2009) found that shared power – whose components included equality, voice, represen-
tation, shared leadership, and respect – was the only workplace variable negatively correlated with
STS once individual factors were included in their model. Similarly, Choi (2011) found that workers
who had access to their organization’s strategic information experienced lower levels of STS. This
included having effective communication channels, understanding the organization’s vision, strate-
gies, and agency processes, and having input regarding the organization’s mission, goals, and
decision-making. Furthermore, Schuler, Bessaha, and Moon (2016) found that social workers who
felt psychologically empowered in the workplace (i.e., having self-efficacy, participating in decision-
making, and feeling connected to their work) experienced lower levels of STS.
In order to reduce STS, researchers have recommended that organizations provide workers with
increased professional development and continuing education opportunities (Bell et al., 2003;
Schuler et al., 2016), enhance workers’ empowerment (Schuler et al., 2016), promote effective
communication (Slattery & Goodman, 2009), provide ongoing education and staff training regarding
STS (Bell et al., 2003; Choi, 2011), acknowledge that STS is an occupational hazard for those working
with trauma survivors (Caringi et al., 2017), foster supportive relationships among employees (Bell
et al., 2003), assign reasonable caseloads (Dworkin et al., 2016; Kulkarni et al., 2013; Townsend &
Campbell, 2009), create safe and comfortable facilities (Bell et al., 2003), provide greater and more
effective supervision regarding STS (Bell et al., 2003; Dworkin et al., 2016), and ensure that
counseling resources are available to all staff members (Bell et al., 2003). In sum, this small but
growing research literature has demonstrated that an organizational response to STS is not only
possible, but crucial to protecting the well-being of workers.
4 S. L. JIREK

Organizational life: Organizational structure and organizational culture

To better understand the organizational factors that may impact workers’ well-being and STS, it is
important to distinguish between two key components of organizational life: organizational structure
and organizational culture. Organizational structure may be defined as the formal ways in which
power, responsibilities, relationships, resources, and information are configured, coordinated, and
distributed within an organization (James & Jones, 1976; Mintzberg, 1979; Tolbert & Hall, 2008).
According to Tolbert and Hall (2008, p. 21), the core function of organizational structure involves
“regulating the influence of individual differences on organizational outcomes … to ensure reliable,
standard organizational outputs and to achieve organizational goals.” Organizational structure
includes such components of organizational life as the bureaucratic hierarchy, official policies,
formal flow of information, and distribution of power, work, and resources. The elements of
organizational structure that have most frequently been examined in the research literature are its
formalization, centralization, and complexity (Paoline & Sloan, 2003; Pertusa-Ortega, Zaragoza-Sáez,
& Claver-Cortés, 2010; Tolbert & Hall, 2008).
Regarding organizational culture, a commonly cited definition of this aspect of organizational life
was developed by Schein (2004, p. 3):
“Organizational culture is the pattern of basic assumptions that a group has invented, or discovered, in learning
to cope with its problems of external adaptation and internal integration, and that have worked well enough to
be considered valid and, therefore, to be taught to new members as the correct way to perceive, think, and feel
in relation to those problems.“

Organizational culture includes such components as values, beliefs, behavioral norms, ideologies,
underlying assumptions, routines, rituals, informal expectations, interaction patterns, organizational
stories, language and jargon, emotional intensity, taboos, and observable artifacts (Glisson &
Williams, 2015; Hemmelgarn, Glisson, & James, 2006; Loomis, Epstein, Dauria, & Dolce, 2019;
Martin, 1992; Ravasi & Schultz, 2006; Schein, 1990, 2004). As a dynamic social construction,
organizational culture develops over time and is continuously evolving. New organizational mem-
bers are socialized into the organizational culture via observation, modeling, reinforcement, and
sanctions, which then guide their individual beliefs, expectations, interpretations, decisions, and
actions (Hemmelgarn et al., 2006).
Organizational structure and organizational culture are highly interconnected components of
organizational life. Organizational culture may be thought of as both the day-to-day lived experi-
ences created by organizational structure, as well as the symbolic meanings that develop in response
to organizational structure. Organizational structure also evolves in response to organizational
culture; for example, formal policies may be created to affirm or provide a corrective to existing
behavioral norms. As a result, the process of organizational change typically necessitates modifica-
tions to both organizational structure and organizational culture.

Organizational culture and secondary traumatic stress: An understudied organizational

factor
Despite a growing awareness regarding the importance of organizational factors, the research
literature on STS has thus far paid minimal attention to an organization’s culture. Organizational
culture is positively correlated with the effectiveness of interventions, the quality of services pro-
vided, the relationships and interactions between service providers and recipients, and the imple-
mentation of evidence-based treatments; it is negatively correlated with the level of staff turnover
(Glisson & Williams, 2015; Hall & Jones, 2018; Hemmelgarn et al., 2006). In addition, organizational
culture impacts employees’ work attitudes (Glisson & Williams, 2015), commitment to the work and
organization (Findler, Wind, & Mor Barak, 2007; Hemmelgarn et al., 2006), job satisfaction (Findler
et al., 2007; Hemmelgarn et al., 2006), and health and well-being (Findler et al., 2007; Kangas,
Muotka, Huhtala, Mäkikangas, & Feldt, 2017).
 HUMAN SERVICE ORGANIZATIONS: MANAGEMENT, LEADERSHIP & GOVERNANCE 5

For example, Hall and Jones (2018) examined the implementation of a trauma-informed model
that, in the pilot project, successfully strengthened the relationships of foster youth with supportive
adults. They found that the organizational culture’s emphasis upon staff members’ well-being was
a key component of the success of the program. This included administrators modeling self-care and
evaluating employee well-being, requiring staff members to develop a self-care plan, creating an
emotionally supportive workplace, implementing an employee buddy system for peer support, and
scheduling regular training sessions and retreats.
In short, the culture of an organization plays a significant role in a variety of service- and client-
related outcomes, as well as in workers’ job satisfaction and well-being. Nonetheless, with few
exceptions (e.g., Bell et al., 2003; Caringi et al., 2017; Kulkarni et al., 2013; Loomis et al., 2019),
researchers examining STS have overlooked this crucial organizational factor. Given the existing
research, it seems likely that the culture of an organization has a substantial impact upon the
prevention or amelioration of STS. Encouragingly, there is evidence that organizational cultures
can be purposefully changed in ways that benefit the organization, its clients, and its workers
(Glisson & Williams, 2015; Loomis et al., 2019). Organizations have an ethical responsibility to
protect workers’ well-being, create workplaces that enable their employees to thrive, and enhance
client outcomes.
In sum, hundreds of thousands of helping professionals in the U.S. experience distress as a result
of working with traumatized populations. Individualistic approaches fall short in explaining and
reducing STS. Nonetheless, the majority of research on STS overlooks the vital role that organiza-
tions play in preventing and ameliorating this form of worker distress. Moreover, the impact of
organizational culture upon helping professionals’ well-being has rarely been examined, particularly
with regard to workers’ experiences of STS. Finally, few studies on organizational strategies for
mitigating STS have used qualitative research methods, which are necessary to explore in-depth the
many factors that influence workers’ well-being in an organization. Specifically, qualitative methods
provide the means to examine the processes through which an organizational culture may bolster or
harm workers’ well-being. The purpose of this study is to address these important gaps in our
knowledge.

Methods
This research utilized a qualitative case study approach because this method is well-suited for
obtaining a holistic and in-depth understanding of a phenomenon – such as an organization, its
organizational culture, and its response to workers’ trauma-related distress (Creswell, 2007).
Specifically, I employed a single, instrumental case study design, as this type of case study focuses
upon a particular issue and uses the case to thoroughly examine it (Stake, 1995, 2005).

Case context and sample

The sample for this study was recruited from among the staff members of an agency that provides
services to survivors of domestic violence and sexual assault (DV/SA). I will refer to this nonprofit
organization using the pseudonym “Safe Haven.” Safe Haven is an all-female agency, with approxi-
mately 40 employees, located in a small city in the Midwestern United States. It is one of the largest
DV/SA organizations in the state and its services include an on-site shelter, a children’s program,
counseling, legal advocacy, a crisis and informational hotline, domestic violence and sexual assault
crisis response teams, and community outreach.
Due to the research questions being investigated (see below), Safe Haven staff members were only
eligible to participate as interviewees in this study if their current or former position in the
organization involved directly working with survivors of violence. Over 80% of eligible employees
at Safe Haven chose to be interviewed for this study. Table 1 describes the demographic character-
istics of this sample of 29 staff members.
6 S. L. JIREK

Table 1. Demographic characteristics.

Characteristic N = 29 %
Sex
Female 29 100
Male 0 0
Race/Ethnicity
Caucasian 18 62
African American 6 21
Latina 3 10
Other 2 7
Age, years (Mean = 31.03; SD = 10.53)
21–25 12 41
26–29 8 28
30–39 3 10
40 or older 6 21
Educational Level
Less than bachelor’s degree 4 14
Bachelor’s degree 15 52
Some graduate school classes 2 7
Master’s degree 8 28
Length of Employment (Mean = 34.47 mos.; SD = 54.68 mos.)
Less than 6 months 8 28
6–12 months 8 28
13–23 months 4 14
2–5 years 3 10
More than 5 years 6 21
Position in the Organization
Advocate 23 79
Program Coordinator/Supervisor 6 21
Percentages may not total 100% due to rounding.

As documented in previously published work, the vast majority (93%) of Safe Haven’s direct
service staff members regularly experienced multiple symptoms of STS, vicarious trauma, and a
concept that I termed “soul pain“ (Jirek, 2015). The most common symptoms of employee distress
included headaches, nightmares, anxiety, physical and emotional exhaustion, emotional numbness,
a cessation of hobbies, feeling disconnected from friends and family members, negatively altered
cognitive schemas (e.g., cynicism regarding men and relationships, fear regarding personal safety, the
belief that the world was a brutal and hopeless place), a deep level of existential pain, and spiritual
unrest. These symptoms demonstrated Safe Haven staff members’ decreased physical, mental,
emotional, and spiritual well-being, and they took a significant toll on various areas of the employ-
ees’ professional and personal lives.

Research questions
This study sought to address three interrelated research questions: 1) What was Safe Haven’s
organizational response to preventing or addressing workers’ trauma-related distress? 2) How
effective was Safe Haven’s organizational response and why? and 3) How did Safe Haven’s organiza-
tional culture impact its organizational response to workers’ trauma-related distress?

Data collection
This article is part of a larger research project that examined workers’ experiences of STS, as well as
how individuals and the organization as a whole responded to employees’ trauma-related distress.
Consistent with a qualitative case study approach, I used multiple sources of data and sought
a variety of perspectives on the topics being investigated (Creswell, 2007; Stake, 1995, 2005). The
four data sources included: in-depth, semi-structured qualitative interviews with 29 staff members;
 HUMAN SERVICE ORGANIZATIONS: MANAGEMENT, LEADERSHIP & GOVERNANCE 7

detailed fieldnotes following each interview; ethnographic fieldnotes from five monthly staff meet-
ings, one meeting of the board of directors, and numerous informal conversations with staff
members; and Safe Haven’s staff handbook.2
Interviewees were recruited from among the agency’s staff members during my participant
observation activities and via personalized voicemail messages to all eligible employees. The inter-
views, which averaged 1.75 hours in length, generally consisted of four sections: 1) An overview of
the interviewee’s background and work at Safe Haven; 2) Questions regarding the work’s impact
upon various aspects of the worker’s life and well-being; 3) An exploration of her coping skills and
strategies; and 4) The interviewee’s experiences with, and thoughts regarding, Safe Haven’s preven-
tion of and response to worker distress. With respondents’ permission, all interviews were digitally
recorded and then transcribed verbatim. Informed consent was obtained from all interviewees and
meeting attendees. Interviewees were compensated $20 for their participation. Ethical oversight for
this study was provided by the University’s Institutional Review Board; all names used in this article
are pseudonyms.

Data analysis
To begin the data analysis process, I repeatedly listened to the interview audio files and immersed myself
in the interview transcripts, fieldnotes, and staff handbook, to get a clear sense of the data set as a whole.
I next used a combination of open-coding and focused coding, using NVivo software, as well as the
writing of initial and integrative memos, to aggregate the data into categories, collapse the categories into
major themes and sub-themes, interpret the data, and establish patterns (Creswell, 2007; Emerson, Fretz,
& Shaw, 2011; Stake, 1995, 2005). Consistent with the case study analytic methods promoted by Stake
(1995, 2005) and Creswell (2007), I triangulated key observations amongst multiple sources and inter-
viewees, looked for alternative explanations and disconfirming evidence, and developed assertions and
generalizations. This article focuses upon two of the major themes in the data: Safe Haven’s organiza-
tional response to workers’ trauma-related distress, and Safe Haven’s organizational culture. All but one
interviewee made significant references to both of these themes.

Results
When asked to describe Safe Haven’s organizational response to preventing or addressing workers’
distress, over half of the interviewees (52%) were either unsure of Safe Haven’s response to issues of
STS or they did not think that Safe Haven had any organizational response. Keanna stated, “I don’t
think there is a response; I don’t think there’s a lot in place or anything in place, really.” Similarly,
Jessica, a program coordinator, observed: “It’s not proactive by any means; it’s reactive. Almost to
the point where someone has to be visibly broken down or someone has to seek out help.” Janice’s
response to this interview topic was representative of that of numerous employees: “Do they have
a response to that?” she queried with apparent curiosity. This finding was not a mere byproduct of
having numerous newer staff members, as half of the program coordinators interviewed and several
other longer-term employees concurred with this assessment. Moreover, the staff handbook did not
mention anything related to these topics (Safe Haven, n.d.). I therefore concluded that the organiza-
tional structure of Safe Haven did not address STS – for example, via established policies or the
formal distribution of information. Rather, staff members utilized a hodge-podge of miscellaneous,
individual strategies in an effort to address the stressors involved in working with survivors of
physical and sexual violence. Moreover, as documented below, the organizational culture developed
in myriad unhealthy ways in response to this void in the organizational structure.
2
I did not engage in participant observation while services were being provided to survivors (e.g., in the shelter, in counseling
sessions, or while accompanying the crisis response teams) due to concerns that this might compromise clients’ confidentiality
or add to their distress.
8 S. L. JIREK

The rhetoric of self-care

In lieu of an official, proactive, organizational response, Safe Haven placed the responsibility to
prevent or address STS largely, if not exclusively, on the individual herself. This was most commonly
accomplished via rhetoric emphasizing the importance of self-care. When asked regarding Safe
Haven’s organizational response to STS, Becky, a program coordinator, asserted: “It’s kind of one
of those things where it’s up to the person to figure out what works for them. And you can’t
institutionalize that.” Emily similarly observed:
I think they definitely try to get us to take care of ourselves before we burn out, and they stress self-care a lot.
They give us suggestions for ways of self-care and talk about it when we’re being trained. But when it comes to
the actual effects [of STS], I don’t know what they can do. (emphasis added)

Keanna further explained, “You kind of have to make friends and find your support within your
department, and hopefully you can bond with a few people and you guys can figure out how to deal
with it.” Annie, a program coordinator, similarly looked to her coworkers to assist her coping efforts:
“I’ve always been really lucky that I’ve worked with supervisors and staff who provided a place to
process, a lot of support, a lot of camaraderie. But that has not always been the case in other
departments.” Other interviewees indicated that they felt like they were on their own regarding
preventing STS. Li, who had previously worked at a DV organization in another country, noted that
her prior agency “spent a lot of time and energy taking care of staff” but that Safe Haven did not. As
a result, she concluded that “I better find some way to take care of myself.”
The above quotes illustrate Safe Haven’s individualistic approach to STS and the burden this
placed upon its staff members. To recap, the organizational culture included the beliefs that an
organization could not be expected to play an active role in reducing the negative effects of trauma-
related work, that each staff member had to “figure out what works for them,” that “hopefully” an
advocate would “bond” with a few coworkers who could then provide mutual support, that receiving
emotional support from your coworkers made you “really lucky,” and that it was enough for an
organization to simply tell its workers to take care of themselves. In short, the clear emphasis at Safe
Haven was on individual coping strategies, rather than on an organizational response or collabora-
tive endeavor involving both Safe Haven and its employees.

Organizational culture
Safe Haven’s rhetoric regarding the importance of self-care was continuously contradicted by four
problematic aspects of its organizational culture, which undermined staff members’ abilities to
engage in adequate self-care and, ultimately, increased workers’ STS. This was further compounded
by two aspects of the organizational structure: the distribution of work responsibilities and the
distribution of financial resources.
First, Safe Haven employees felt overburdened with work. Keanna stated, “As an organization,
I think they overwork people. I think people are overworked, overstressed.” Jessica similarly asserted
that Safe Haven had “an unreasonable standard of how many people we can help and how many
things we can do for people.” During a staff meeting, when the facilitator realized that the expected
guest speakers were not coming, she decided to end the meeting early with this proclamation: “I’m
sure everyone has too much to do – this is Safe Haven after all!”
Second, in addition to overworking its employees, Safe Haven’s organizational culture exerted
a subtle pressure upon staff members to overextend themselves on behalf of the organization and to
feel guilty if they did not do so. Mindy described the internal struggle she experienced when, despite
needing a break from work after a long day, she nonetheless agreed to be on-call (i.e., responding, in-
person, to crisis calls) overnight:
There’s definitely like this attitude where it’s like “you have to do this.” You could say no. But you don’t want to
say no because you’re going to feel guilty because you know one of your other coworkers is going to have to
 HUMAN SERVICE ORGANIZATIONS: MANAGEMENT, LEADERSHIP & GOVERNANCE 9

take this [shift]. So it’s kind of like a taking-one-for-the-team kind of attitude, you know? And, if you’re like,
“well, I really need a break,” then you’re like, “well, look at this person … ” You can always compare yourself to
someone who’s having a worse time.

Feeling uneasy or abashed for taking time off, going on vacation, or simply saying no to an extra
shift was a common sentiment among interviewees.
The third problematic aspect of Safe Haven’s organizational culture was that staff members
perceived that the organization prioritized the well-being of its clients over the well-being of its
employees. Emily noted the discrepancy between Safe Haven’s orientation toward its clients versus
its workers: “We talk a lot about doing things for survivors, but we need to think about treating
ourselves as well as we treat survivors.” Li discussed Safe Haven’s use of its limited funds in ways that
demonstrated the primacy of clients’ needs over staff members’ needs:
I remember this one time, I’m sharing with one of my coworkers and my supervisor that it was so stressful to
work there and maybe sometime we should arrange for some massage or something like that for the staff. And
my supervisor said that something really needs to happen, but we don’t have any funds for that. Every penny
we have will be spent on survivors, not on ourselves.

Similarly, Jessica made the following observations:

Sometimes we’re treating the survivors that we work with better than we are treating our staff. I think we’re
very hypocritical about that, a lot of times. It’s like we can pull in all sorts of resources from God-knows-where
for the clients. Why can’t we do the same thing for the staff that are working here? Because, in the long run,
they’ll be here longer and they’ll do better work if they’re a little bit less stressed out.

In this quote, Jessica recognized the “hypocritical” nature of Safe Haven’s treatment of its staff
members and the minimal resources provided to them as compared to its clients. She also empha-
sized that the organizational stressors had consequences: higher staff turnover and lower quality of
work. In short, spending the requisite time and money to support staff members’ well-being was
viewed as a luxury that the agency could not afford.
The final problematic aspect of Safe Haven’s organizational culture was intricately connected to
the first three organizational norms. Self-sacrifice and exhaustion were viewed as badges of honor –
as indicators that an employee was a team-player who prioritized the needs of survivors and the
organization above her own. This was evident in Mindy’s quote, above, when she described “taking-
one-for-the-team” by accepting an extra shift despite her own weariness. Marta simultaneously
recognized that Safe Haven did not deliberately harm its staff members by overworking them, but
that the well-being of staff members was neglected nonetheless. She explained, “The intention is
good, it is just that we are so busy taking care of the survivors that we’re not taking care of ourselves.
The emphasis right now is provide, provide, provide. And what about us?” Given that self-sacrifice,
even at the expense of personal well-being, was an organizational norm, it was not surprising that
experiencing substantial STS was commonplace at Safe Haven.

Resources and education: Deficits in the organizational structure

In addition to the four problematic aspects of Safe Haven’s organizational culture, Safe Haven’s
organizational structure failed to provide the resources and education that its staff members needed
in order to practice good self-care. Tracy, a program coordinator, expressed her frustration with the
discrepancy between the organizational rhetoric of self-care and the resources available to her as
follows: “So you can say I need to take care of myself, but give me the tools to take care of myself!”
The lack of four resources were discussed by numerous Safe Haven advocates as they articulated how
their work negatively impacted their well-being and voiced their recommendations for organiza-
tional change.
First, Safe Haven did not employ a sufficient number of staff members, which resulted in heavy
workloads. As documented above, Safe Haven advocates felt that they were overburdened with work
10 S. L. JIREK

and that the organization had “an unreasonable standard” regarding the amount of work a single
advocate, and the organization as a whole, could accomplish. “That’s my chief complaint,” Cynthia
noted, “I just wish there were more of us to do the work.” Without a specific interview question
prompt, nearly one-quarter of interviewees (24%) recommended that Safe Haven reduce advocates’
workloads, even if this required hiring additional staff members.
Safe Haven’s understaffing also made it difficult for staff members to actually use their accrued
paid time off (PTO) benefits. This was a particular challenge for workers in departments providing
around-the-clock services (e.g., shelter workers, crisis line workers), as well as for program coordi-
nators. Tracy explained her frustration with one aspect of her role as a supervisor:
We have this mechanism that we accrue all this PTO, but no realistic way to use it. Because as coordinators, we
have to be available 24/7 and 365 [days per year]. So, there’s no realistic way that we can really make that work.
Plus, for some of us that are covering 24-hour services, it’s not feasible.

During one staff meeting, a program coordinator announced that “Since there have been new
hires, current staff in [a specific department] are finally going to be able to take time off!” This lifting
of a temporary moratorium on PTO usage elicited cheers from several advocates. In short, Safe
Haven workers who could not freely leave their work responsibilities behind to take a sick day or
a vacation struggled to engage in adequate self-care.
The second resource that Safe Haven failed to provide its workers was a living wage. The entry-
level pay for full-time advocates was less than $28,000 per year. This was consistent with the
organization’s cultural norm, discussed above, of spending “every penny” it could on its clients.
While the intentions of Safe Haven’s administrators may have been noble, the low pay was an
additional burden borne by their staff members. Emily expressed her frustration:
The pay is sh*t! I mean it’s a stepping-stone job. It’s the kind of job that you take so that you can put it on
a résumé and get something better. Because no one can afford to live on that. I mean doing the job is hard
enough by itself, but then having to live off of such small pay is like ten times more stressful. And like, you can’t
combine that many stressful factors into someone’s life and not have them burn out.

Rachel voiced a common belief:

I think one of the biggest reasons people leave [Safe Haven] is to support themselves. At the advocate level, this
isn’t something that most people could just do, you know, for a long time because it just doesn’t pay. I mean,
you can’t really live, you know, with kids and do anything. If I had to buy a car, we’d really be in trouble.

In short, the low pay at Safe Haven increased employees’ stress levels, decreased staff members’
sense of well-being, and contributed to the agency’s high turnover rate.
Third, Safe Haven did not provide its workers with adequate access to mental health services. The
staff handbook’s list of benefits for employees included medical insurance (Safe Haven, n.d.), but
advocates reported that this did not include any mental health coverage. Emily asserted, “I think they
should have therapists that come in and talk to the workers. I mean, it’s ridiculous! We need
therapists just as bad [as the clients].” This lack of access to affordable mental health services
impeded staff members’ self-care efforts.
Finally, the official responsibilities of supervisors at Safe Haven did not include modeling effective
self-care for their staff members. Given that Safe Haven was an organization that relied upon the
rhetoric of self-care as its primary means of dealing with STS, it was noteworthy that not a single
interviewee pointed to a particular staff member as a healthy role-model or as someone whose self-
care efforts they wished to emulate. When asked for their recommendations on ways that Safe Haven
could better address workers’ STS, two advocates stated that it would be easier for them to practice
good self-care if their supervisors also engaged in it. Lynn described the universality of distress at
Safe Haven, including the program coordinators: “Everyone’s burned out. So it’s hard for you to
acknowledge or care for other people’s stress when you’re dealing with your own. There’s no one at
that job who isn’t exhausted.” With such widespread symptoms of STS, program coordinators were
ineffective role models for their staff.
 HUMAN SERVICE ORGANIZATIONS: MANAGEMENT, LEADERSHIP & GOVERNANCE 11

Along with the aforementioned resources, Safe Haven staff members would have benefited from
additional information regarding STS. Li asserted, “This agency needs to spend more time educating
staff and taking care of themselves.” Similarly, Emily recommended that Safe Haven “should get
a clear definition of what [STS] looks like, what the symptoms are, and educate the staff about it.”
And Annie observed, “It’s something that we talk about, but we don’t really do a good job giving
people concrete ways to cope with it.”
In sum, Safe Haven’s employees would have benefited from additional resources – including
increased staff members to share the workload and to facilitate the use of paid time off, a living wage,
sufficient access to mental health services, and supervisors who served as good role-models – to
make it possible for its workers to engage in effective self-care. Moreover, Safe Haven could better
promote the well-being of its staff members by training them regarding how to prevent STS,
recognize the symptoms, and take practical steps to manage the trauma-related distress they
experienced in their work.

The costs of an unhealthy organizational culture

The problematic aspects of Safe Haven’s organizational structure (i.e., having no formal response to
STS, the distribution of work and funding, and deficits in resources and training) led to unhealthy
developments in its organizational culture (i.e., the rhetoric of self-care, an intense emotional
climate, and various behavioral norms, beliefs, values, and expectations). This organizational culture,
in turn, had four crucial and deleterious consequences. First, as discussed previously, nearly all of
Safe Haven’s direct service staff members experienced multiple symptoms of STS (Jirek, 2015).
Employees’ physical, emotional, psychological, and spiritual well-being were negatively impacted by
their work with survivors of physical and sexual violence.
Second, when Safe Haven employees experienced distress as a result of their work with trauma-
tized clients, it led to a subtle form of victim-blaming among staff members. Because Safe Haven’s
rhetoric regarding self-care was highly individualistic, it logically followed that it was the individual’s
fault if she experienced STS. As quoted earlier, Becky asserted that preventing STS was “one of those
things where it’s up to the person to figure out what works for them. And you can’t institutionalize
that.” Similarly, Rachel claimed, “You can’t control the stress. What you control is the way you
handle it, and I think that’s individual for everybody.” Marta went so far as to state: “It’s sad to say,
but I guess it’s really up to different personalities, how you want to be affected. If you want to see it
in a positive way, it’s up to you to turn it to be that way.”
These quotes reflect the individualistic perspective that dominated Safe Haven’s organizational
culture: that controlling reactions to stress was purely individual, that an organization could not be
expected to play a role in reducing the effects of working with trauma survivors, and that being
negatively impacted by the work was, at best, a lack of adequate self-care or, at worst, a personality
flaw or individual failure to positively reframe one’s experiences. The common denominator among
these explanations is that they blamed the victim of STS for her own suffering.
This individualistic perspective regarding STS was particularly ironic because Safe Haven was an
organization providing services to survivors of domestic violence and sexual assault from an
empowering, feminist framework. The first irony was that several Safe Haven staff members, without
an interview question on the topic, disclosed that they themselves were survivors of violence against
women. This made the discrepancy between how clients and staff members were treated particularly
poignant, as the victim-blaming of clients would have never been tolerated. The second irony was
that Safe Haven’s response to its workers’ STS mirrored the problematic way in which U.S. society
has historically viewed violence against women: as a micro-level, individual problem, rather than as
an ecological problem (i.e., having interconnected micro-, meso-, and macro-level factors) with
substantial structural components. Safe Haven administrators and advocates alike failed to see that,
just as with violence against women, the effective prevention and treatment of STS involves more
than micro-level, individual solutions.
12 S. L. JIREK

The third consequence of Safe Haven’s unhealthy organizational culture was that STS was viewed
as an unavoidable and career-ending outcome. Becky contended: “I think Safe Haven is very
concerned about it [STS]. I think they recognize it’s there and that it’s inevitable.” This quote
reflected a widespread belief in Safe Haven’s organizational culture that most direct service staff
members’ career trajectories would involve working long and harried hours at Safe Haven, becoming
burned out, and leaving the agency within a few years of being hired. When Mindy was asked if she
could envision herself working at Safe Haven in five years, she replied “No. I hope to God I’m not!”
When asked why, she stated, “Because I’ll be burned out by then. I know I will.” In response to this
same question, 67% of interviewees said they could not imagine working at Safe Haven five years in
the future. These staff members most frequently referenced the low pay, a desire to attend graduate
school, or the stress-related effects of the job as their rationale for planning to leave Safe Haven.
Tracy was the only interviewee who voiced her disagreement with the prevailing belief that
trauma-related, job-ending distress was “inevitable” for Safe Haven workers, although she still
seemed to place the responsibility upon employees to prevent their own distress. Tracy asserted:
I think it’s important to realize that there are good advocates that can do this work long-term, and that you can
do this work without getting burned out or numb. We have to encourage workers to do that, and to strive for
that, and to try to figure that out.

Unfortunately, other than this notable exception, it was widely believed that debilitating and
irreversible STS was an inescapable outcome of the job.
Finally, the perceived inevitability of career-ending STS led to the expectation, among both direct
service staff and administrators, that high staff turnover rates were also unavoidable. This, in turn,
led Safe Haven administrators to view and treat Safe Haven staff members as expendable. Rachel
explained:
Advocates are treated as though they’re more disposable than higher-up folks and that’s reflected in a lot of
ways. That’s really counterproductive to the organization. And you hear all the moaning and groaning when
[new staff member] training’s coming around. They hate doing training! So wouldn’t it just make sense to keep
the people you’ve trained longer? I mean, isn’t that logical? But that’s not the way it’s set up. It’s set up for the
place to be disposable. It really, really is.

In short, the organizational myth that STS and high staff turnover were “inevitable” prevented
Safe Haven from developing a proactive stance regarding workers’ trauma-related distress, while also
sending the demoralizing message to employees that they were disposable.

Discussion
To recap, I sought to address several interrelated research questions: 1) What was Safe Haven’s
organizational response to preventing or addressing workers’ trauma-related distress? 2) How
effective was Safe Haven’s organizational response and why? and 3) How did Safe Haven’s organiza-
tional culture impact its organizational response to workers’ trauma-related distress?
As has been documented in numerous studies (e.g., Figley, 2002; Jirek, 2015; Lee et al., 2017;
McCann & Pearlman, 1990), STS – which may have physical, psychological, emotional, and even
spiritual effects – is an occupational hazard of working with trauma survivors. Nonetheless, the
negative effects of doing trauma-related work can be reduced and ameliorated (Choi, 2011; Kulkarni
et al., 2013; Schuler et al., 2016). This is particularly true if there is a joint collaboration between
workers and their employers to take both preventative and restorative action (Harrison &
Westwood, 2009; Loomis et al., 2019; Schuler et al., 2016).
In this study, I demonstrated that Safe Haven failed to provide an adequate and effective
organizational response to workers’ STS. Indeed, over half of Safe Haven advocates stated that
Safe Haven did not have an organizational response to STS or that they were unsure what that
response might entail. As a result, the majority of Safe Haven workers experienced various symp-
toms of STS.
 HUMAN SERVICE ORGANIZATIONS: MANAGEMENT, LEADERSHIP & GOVERNANCE 13

Safe Haven’s organizational response to STS was inadequate and ineffective for several reasons.
The agency placed the emphasis, responsibility, and burden for dealing with staff members’ trauma-
related distress directly upon the workers themselves – taking a highly individualistic approach that
led to a subtle form of victim-blaming when advocates were negatively affected by their work. Safe
Haven did not provide their staff members with the necessary resources and education to practice
good self-care. Moreover, because a debilitating level of STS was viewed as inevitable, and because
experiencing trauma-related distress was viewed as personal – not organizational – failure, staff
members were viewed and treated as expendable.
Finally, there were several problematic aspects of Safe Haven’s organizational structure: a lack of
policies regarding STS, the distribution of funding and work responsibilities, and multiple deficits
in resources and education. These, in turn, led to dysfunctional adaptations within the organiza-
tional culture which negatively impacted its organizational response to workers’ trauma-related
distress. Rather than develop a trauma-informed and STS-healing organizational culture, Safe
Haven developed an unhealthy and trauma-perpetuating culture. Specifically, several components
of Safe Haven’s organizational culture contradicted the agency’s message that self-care was
important. Safe Haven’s cultural norms included staff members feeling overburdened by unrea-
sonable workloads, being encouraged to overextend themselves, and feeling guilty if they took time
off. Safe Haven’s organizational culture valued self-sacrifice, even at the expense of employees’
well-being. Clients’ needs were perceived to be valued over those of staff members. A common
belief in Safe Haven’s organizational culture was that STS was the unavoidable ending point of
a staff member’s relatively brief employment trajectory at the agency. In short, Safe Haven’s
organizational structure and organizational culture undermined the well-being of its staff
members.
In this study, it is clear that some elements of the organizational structure – such as the limited
financial resources, the lack of information formally disseminated regarding STS, and the distribu-
tion of responsibilities that resulted in high caseloads for direct service staff members – had both
pragmatic and symbolic ramifications. In practical terms, staff members did not receive adequate
compensation to work at Safe Haven long-term, the organization was understaffed, it was difficult to
use accrued paid time off benefits, advocates were largely unaware of how to prevent or respond
effectively to STS, and the staff members felt overburdened by the amount of work. These aspects of
the organizational structure were interpreted by advocates as having specific meanings, which
became a part of the organizational culture. In symbolic terms, staff members came to believe that
their needs and well-being were not important to administrators, and, more starkly, that they
themselves were not valued. The end result was that, at Safe Haven, certain elements of the
organizational structure shaped the organizational culture in ways that magnified the effects of
STS on its staff members.
These findings are significant for three primary reasons. First, they document the numerous and
problematic consequences of an organization relying upon an individualistic approach to STS that
merely emphasizes workers’ need to engage in self-care. Second, they highlight the interconnected
relationship between an organization’s structure and its organizational culture, demonstrating how
dysfunctions within this relationship may actually increase workers’ STS. And finally, they illuminate
some of the processes through which an organizational culture can impact an organizational
response to STS and, thus, workers’ well-being. Although there is growing awareness that both
individual and organizational factors affect employees’ STS, few studies examine the role of an
organizational culture in preventing and ameliorating STS among helping professionals. This study
begins to address these important gaps in the research literature.
The point of this research project was not to rebuke or disparage Safe Haven. Rather, the purpose
of analyzing this case study was to challenge and equip administrators, supervisors, and staff
members to evaluate the extent to which their own organization prevents and addresses STS; this,
in turn, might enable them to create a more effective organizational response to worker’s trauma-
related distress and a healthier organizational culture.
14 S. L. JIREK

Prior research has documented that protecting and enhancing workers’ well-being is not only
beneficial for employees, it is also in the best interest of organizations themselves. Secondary
traumatic stress is associated with negative outcomes regarding workers’ job satisfaction (Bride &
Kintzle, 2011), productivity (Najjar, Davis, Beck-Coon, & Carney Doebbeling, 2009), professional
judgment (Regehr, LeBlanc, Shlonsky, & Bogo, 2010), quality of work (Regehr et al., 2010),
therapeutic relationship with clients (Pearlman & Saakvitne, 1995), perceived physical health (Lee
et al., 2017), and turnover intentions (Perez, Jones, Englert, & Sachau, 2010). In their meta-analysis
of 111 independent samples, Ford, Cerasoli, Higgins, and Decesare (2011) found that workers’
physical and psychological health were positively correlated with their work performance.
Workers’ job satisfaction and psychological well-being were also predictors of workplace turnover
(Wright & Bonett, 2007). And high staff turnover rates have been found to be both financially costly
for organizations and detrimental to the clients they strive to serve (Garner, Funk, & Hunter, 2013;
Li & Jones, 2013; Tilden, Thompson, Gajewski, & Bott, 2012). Therefore, taking measures to reduce
staff members’ STS and support their physical and psychological well-being will likely yield long-
term benefits for organizations and their clients by promoting healthier and more productive staff
members, who provide higher-quality services and remain at the organization longer. Indeed,
enhancing staff members’ well-being is advantageous for everyone involved!

Implications
Organizations have an ethical responsibility to create a safe working environment and to take all
reasonable and appropriate steps to protect the well-being of their employees. In the helping
professions, where workers engage in emotionally challenging work that can deeply impact every
aspect of their lives, it is crucial that organizations take this responsibility seriously. As highlighted
previously, organizational efforts to promote staff members’ well-being are also likely to enhance the
quality and effectiveness of the services provided to clients (Ford et al., 2011; Hall & Jones, 2018;
Regehr et al., 2010).
To this end, an important first step is for organizations to assess their organizational response to
STS. Sprang, Ross, Miller, Blackshear, and Ascienzo (2017) developed the 40-item Secondary
Traumatic Stress-Informed Organizational Assessment (STSI-OA), which includes five domains:
resilience-building, promotion of safety, STS-informed organizational practices, STS-informed lea-
dership practices, and STS-informed organizational policies. Using an instrument like the STSI-OA
will allow organizations to evaluate the support they currently provide to workers to reduce the
impact of STS, identify agency strengths and deficiencies, and prioritize appropriate interventions. In
a similar vein, organizations may benefit from an evaluation of their organizational culture, using
methods such as qualitative interviews, focus groups, or Glisson and Williams’ (2015) Organizational
Social Context measure. This type of assessment may provide administrators with valuable insights
regarding the ways in which their organizational culture impacts their organization’s response to
workers’ trauma-related distress and their overall well-being.
Once administrators have taken stock of their organizational response to STS and their organiza-
tional culture, the next step is to make positive changes, as needed. Although more research is
needed in this area, there are a few examples in the research literature of organizations implementing
trauma-informed policies and practices, successfully addressing STS, and changing their organiza-
tional cultures in positive ways (e.g., Hall & Jones, 2018; Loomis et al., 2019). These types of changes
involve a collaboration between individual workers, departments or teams, and the organization as
a whole. Needless to say, workers’ self-care alone is not sufficient. There are also a handful of
empirically-supported models designed to improve organizational cultures and counteract STS (e.g.,
Esaki et al., 2013; Glisson & Williams, 2015; Loomis et al., 2019). It should be noted that these
models involve changes to both the organizational structure (e.g., policies, the dissemination of
information, and distribution of resources) and organizational culture (e.g., values, beliefs, and
behavioral norms).
 HUMAN SERVICE ORGANIZATIONS: MANAGEMENT, LEADERSHIP & GOVERNANCE 15

For example, Loomis et al. (2019) reported upon the development and implementation of the
Trauma-Informed Systems (TIS) Initiative in the San Francisco Department of Public Health, which
is an intervention designed to address trauma at the systems level by intentionally changing the
organizational culture. Examples of change efforts in the TIS Initiative included mandatory work-
force training on stress and trauma, creating a staff wellness lounge, developing an incentive system
for staff self-care activities, monthly team-building exercises, discussing one trauma-informed
systems principle at each staff meeting, and hosting “town hall” meetings to gather and address
staff members’ safety-related concerns. The authors concluded that the TIS Initiative “is creating
a healing organizational culture through its innovative response to the impact of trauma” (Loomis
et al., 2019, p. 257).
As evidenced in the current study, there are several practical steps that organizations such as Safe
Haven could take to better prevent, reduce, and address workers’ trauma-related distress.
Organizations might consider providing additional support to staff members, including trauma-
specific supervision and affordable access to mental health services. In addition, organizations might
strive to ensure that staff members’ workloads are reasonable, that workers’ needs are prioritized as
highly as clients’ needs, that employees are paid a living wage, and that staff members receive
training in recognizing, preventing, and ameliorating STS. Furthermore, organizations could proac-
tively foster an organizational culture that prioritizes, protects, and promotes staff members’ well-
being.
Finally, it is essential that social work education includes training regarding how to prevent,
recognize, and address STS in oneself and in others. It is equally critical that social work students,
who are the next generation of agency supervisors and administrators, are taught the important roles
that organizational factors, responses, structures, and cultures play in reducing helping professionals’
STS and increasing their well-being.

Limitations and suggestions for future research

As with any research, there are limitations to this study that should be considered when interpreting
the findings. First, this study is based upon the experiences of 29 employees from a single nonprofit
organization serving survivors of domestic violence and sexual assault. Second, due to the high
turnover rate among Safe Haven staff, over half (16 workers; 55%) of the staff members who
participated in this study had been employed by Safe Haven for one year or less, although several
of them had previously worked in other human services-related organizations. Thus, the experiences
and perspectives of this sample are not necessarily representative of the general population of
helping professionals working with survivors of physical and sexual violence or, more broadly,
trauma survivors. Finally, this study is based solely upon the experiences and perceptions of current
or former direct service staff members. Safe Haven administrators may have a different perspective
regarding the dynamics of the organization, the organizational response to STS, the resources
provided to staff members, and the micro-, meso-, and macro-level challenges to implementing
staff members’ recommendations and creating a healthier organizational culture.
Further research is needed to address the above limitations and to continue filling in the gaps in
the empirical literature on the topics addressed by this study. First, case studies and other qualitative
research is needed to highlight exemplars among organizations serving trauma survivors that have
created healthy organizational cultures and developed effective and proactive organizational
responses to staff members’ STS. These types of studies will provide in-depth, “thick descriptions”
of agencies that can serve as models for other organizations. Second, quantitative, multi-site
research, ideally with a nationally-representative sample of helping professionals who work with
trauma survivors within agency settings, would provide vital data regarding the relationships
between organizational structures, organizational cultures, and STS; these important organizational
factors have been largely overlooked in the current research literature on STS. Third, additional
research is needed regarding the best practices that organizations could implement in order to
16 S. L. JIREK

prevent and ameliorate STS among their workers. Finally, research which includes the perspectives
of both administrators and direct service workers may yield invaluable insights regarding the root
causes of unhealthy organizational cultures, as well as the challenges in creating organizational
structures and organizational cultures that effectively address workers’ STS. Such studies may
provide a more holistic view of the context in which human service organizations such as Safe
Haven operate.
In conclusion, whether they recognize it or not, organizations play a vital role in preventing or
ameliorating the negative effects of STS in the lives of their employees. STS affects the well-being of
hundreds of thousands of helping professionals in the U.S., which, in turn, negatively impacts the
diverse populations they aim to serve. An individualistic approach to this issue is both problematic
and insufficient. Taking steps to create a healthy and trauma-informed organizational culture, as well
as to protect and promote the well-being of staff members, is likely to reduce employee turnover,
create a more supportive environment for staff members, enhance services for trauma survivors, and
assist organizations to more effectively enact social change.

Disclosure statement
No potential conflict of interest was reported by the author.

Funding
Support for this study was provided by grants from the University of Michigan’s Horace H. Rackham School of
Graduate Studies, Department of Sociology, and Center for the Education of Women.

Practice Points
● Staff members’ self-care alone is not a sufficient response to STS. An individualistic approach
to workers’ STS places an additional burden on staff members.
● Administrators at organizations providing services to trauma survivors should develop an
effective organizational response to STS, as well as assess the strengths and weaknesses of
their organizational culture.
● Organizations should provide supportive services for staff members, ensure that workloads are
reasonable, prioritize staff members’ needs as highly as clients’ needs, pay a living wage, train
staff members regarding STS, and proactively foster a trauma-informed organizational culture
that promotes staff members’ well-being.

ORCID
Sarah L. Jirek http://orcid.org/0000-0002-1737-7643

References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington,
DC: Author.
Bell, H., Kulkarni, S., & Dalton, L. (2003). Organizational prevention of vicarious trauma. Families in Society, 84,
463–470. doi:10.1606/1044-3894.131
Ben-Porat, A. (2015). Competence of trauma social workers: The relationship between field of practice and secondary
traumatization, personal and environmental variables. Journal of Interpersonal Violence, 32(8), 1291–1309.
doi:10.1177/0886260515588536
Berceli, D., & Napoli, M. (2006). A proposal for a mindfulness-based trauma prevention program for social work
professionals. Complementary Health Practice Review, 11(3), 153–165. doi:10.1177/1533210106297989
 HUMAN SERVICE ORGANIZATIONS: MANAGEMENT, LEADERSHIP & GOVERNANCE 17

Bober, T., & Regehr, C. (2006). Strategies for reducing secondary or vicarious trauma: Do they work? Brief Treatment
and Crisis Intervention, 6(1), 1–9. doi:10.1093/brief-treatment/mhj001
Brady, P. Q. (2017). Crimes against caring: Exploring the risk of secondary traumatic stress, burnout, and compassion
satisfaction among child exploitation investigators. Journal of Police and Criminal Psychology, 32(4), 305–318.
doi:10.1007/s11896-016-9223-8
Bride, B. E., Jones, J. L., & Macmaster, S. A. (2007). Correlates of secondary traumatic stress in child protective services
workers. Journal of Evidence-Based Social Work, 4(3–4), 69–80. doi:10.1300/J394v04n03_05
Bride, B. E., & Kintzle, S. (2011). Secondary traumatic stress, job satisfaction, and occupational commitment in
substance abuse counselors. Traumatology: An International Journal, 17(1), 22–28. doi:10.1177/1534765610395617
Caringi, J. C., Hardiman, E. R., Weldon, P., Fletcher, S., Devlin, M., & Stanick, C. (2017). Secondary traumatic stress
and licensed clinical social workers. Traumatology: An International Journal, 23(2), 186–195. doi:10.1037/
trm0000061
Choi, G.-Y. (2011). Organizational impacts on the secondary traumatic stress of social workers assisting family
violence or sexual assault survivors. Administration in Social Work, 35(3), 225–242. doi:10.1080/
03643107.2011.575333
Creswell, J. W. (2007). Qualitative inquiry and research design: Choosing among five approaches (2nd ed.). Thousand
Oaks, CA: Sage.
Dworkin, E. R., Sorell, N. R., & Allen, N. E. (2016). Individual- and setting-level correlates of secondary traumatic
stress in rape crisis center staff. Journal of Interpersonal Violence, 31(4), 743–752. doi:10.1177/0886260514556111
Emerson, R. M., Fretz, R. I., & Shaw, L. L. (2011). Writing ethnographic fieldnotes (2nd ed.). Chicago, IL: The
University of Chicago Press.
Esaki, N., Benamati, J., Yanosy, S., Middleton, J. S., Hopson, L. M., Hummer, V. L., & Bloom, S. L. (2013). The
sanctuary model: Theoretical framework. Families in Society, 94(2), 87. doi:10.1606/1044-3894.4287
Figley, C. R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the
traumatized. New York, NY: Brunner/Mazel.
Figley, C. R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self-care. Psychotherapy in Practice, 58,
1433–1441.
Findler, L., Wind, L. H., & Mor Barak, M. E. (2007). The challenge of workforce management in a global society:
Modeling the relationship between diversity, inclusion, organizational culture, and employee well-being, job
satisfaction and organizational commitment. Administration in Social Work, 31(3), 63–94. doi:10.1300/
J147v31n03_05
Ford, M. T., Cerasoli, C. P., Higgins, J. A., & Decesare, A. L. (2011). Relationships between psychological, physical, and
behavioural health and work performance: A review and meta-analysis. Work & Stress, 25(3), 185–204. doi:10.1080/
02678373.2011.609035
Garner, B. R., Funk, R. R., & Hunter, B. D. (2013). The relationship between clinician turnover and adolescent
treatment outcomes: An examination from the client perspective. Journal of Substance Abuse Treatment, 44(4),
444–448. doi:10.1016/j.jsat.2012.09.004
Glisson, C., & Williams, N. J. (2015). Assessing and changing organizational social contexts for effective mental health
services. Annual Review of Public Health, 36(1), 507–523. doi:10.1146/annurev-publhealth-031914-122435
Hall, S. F., & Jones, A. S. (2018). Implementation of intensive permanence services: A trauma-informed approach to
preparing foster youth for supportive relationships. Child & Adolescent Social Work Journal, 35(6), 587–598.
doi:10.1007/s10560-018-0550-8
Harrison, R. L., & Westwood, M. J. (2009). Preventing vicarious traumatization of mental health therapists: Identifying
protective practices. Psychotherapy, 46(2), 203–219. doi:10.1037/a0016081
Hemmelgarn, A. L., Glisson, C., & James, L. R. (2006). Organizational culture and climate: Implications for services
and interventions research. Clinical Psychology: Science & Practice, 13(1), 73–89.
Hensel, J. M., Ruiz, C., Finney, C., & Dewa, C. S. (2015). Meta-analysis of risk factors for secondary traumatic stress in
therapeutic work with trauma victims. Journal of Traumatic Stress, 28(2), 83–91. doi:10.1002/jts.21998
Hesse, A. R. (2002). Secondary trauma: How working with trauma survivors affects therapists. Clinical Social Work
Journal, 30, 293–309. doi:10.1023/A:1016049632545
Ivicic, R., & Motta, R. (2017). Variables associated with secondary traumatic stress among mental health professionals.
Traumatology: An International Journal, 23(2), 196–204. doi:10.1037/trm0000065
James, L. R., & Jones, A. P. (1976). Organizational structure: A review of structural dimensions and their conceptual
relationships with individual attitudes and behavior. Organizational Behavior and Human Performance, 16, 74–113.
doi:10.1016/0030-5073(76)90008-8
Jirek, S. L. (2015). Soul pain: The hidden toll of working with survivors of physical and sexual violence. SAGE Open, 5
(3), 1–13. doi:10.1177/2158244015597905
Kangas, M., Muotka, J., Huhtala, M., Mäkikangas, A., & Feldt, T. (2017). Is the ethical culture of the organization
associated with sickness absence? A multilevel analysis in a public sector organization. Journal of Business Ethics,
140(1), 131–145. doi:10.1007/s10551-015-2644-y
18 S. L. JIREK

Kulkarni, S., Bell, H., Hartman, J. L., & Herman-Smith, R. L. (2013). Exploring individual and organizational factors
contributing to compassion satisfaction, secondary traumatic stress, and burnout in domestic violence service
providers. Journal of the Society for Social Work and Research, 4(2), 114–130. doi:10.5243/jsswr.2013.8
Lee, J. J., Gottfried, R., & Bride, B. E. (2017). Exposure to client trauma, secondary traumatic stress, and the health of
clinical social workers: A mediation analysis. Clinical Social Work Journal, 46(3), 1–8. doi:10.1007/s10615-017-
0638-1
Li, Y., & Jones, C. B. (2013). A literature review of nursing turnover costs. Journal of Nursing Management, 21(3),
405–418. doi:10.1111/j.1365-2834.2012.01411.x
Loomis, B., Epstein, K., Dauria, E. F., & Dolce, L. (2019). Implementing a trauma-informed public health system in
San Francisco, California. Health Education and Behavior, 46(2), 251–259. doi:10.1177/1090198118806942
Mairean, C. (2016). Emotion regulation strategies, secondary traumatic stress, and compassion satisfaction in health-
care providers. The Journal of Psychology, 150(8), 961–975. doi:10.1080/00223980.2016.1225659
Martin, J. (1992). Cultures in organizations: Three perspectives. New York, NY: Oxford University Press.
McCann, L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological
effects of working with victims. Journal of Traumatic Stress, 3, 131–149. doi:10.1007/BF00975140
Mintzberg, H. (1979). The structuring of organizations. Englewood Cliffs, NJ: Prentice Hall.
Najjar, N., Davis, L. W., Beck-Coon, K., & Carney Doebbeling, C. (2009). Compassion fatigue: A review of the research
to date and relevance to cancer-care providers. Journal of Health Psychology, 14(2), 267–277. doi:10.1177/
1359105308100211
Neumann, D. A., & Gamble, S. J. (1995). Issues in the professional development of psychotherapists:
Countertransference and vicarious traumatization in the new trauma therapist. Psychotherapy, 32, 341–347.
doi:10.1037/0033-3204.32.2.341
Newell, J. M., Nelson-Gardell, D., & MacNeil, G. (2015). Clinician responses to client traumas: A chronological review
of constructs and terminology. Trauma, Violence, & Abuse, 17(3), 306–313. doi:10.1177/1524838015584365
Paoline, E. A., & Sloan, J. J. (2003). Variability in the organizational structure of contemporary campus law
enforcement agencies: A national-level analysis. Policing, 26(4), 612–639. doi:10.1108/13639510310503541
Pearlman, L. A., & MacIan, P. S. (1995). Vicarious traumatization: An empirical study of the effects of trauma work on
trauma therapists. Professional Psychology, 26, 558–565. doi:10.1037/0735-7028.26.6.558
Pearlman, L. A., & Saakvitne, K. W. (1995). Trauma and the therapist: Countertransference and vicarious traumatiza-
tion in psychotherapy with incest survivors. New York, NY: W. W. Norton & Co.
Perez, L. M., Jones, J., Englert, D. R., & Sachau, D. (2010). Secondary traumatic stress and burnout among law
enforcement investigators exposed to disturbing media images. Journal of Police and Criminal Psychology, 25(2),
113–124. doi:10.1007/s11896-010-9066-7
Pertusa-Ortega, E. M., Zaragoza-Sáez, P., & Claver-Cortés, E. (2010). Can formalization, complexity, and centraliza-
tion influence knowledge performance? Journal of Business Research, 63(3), 310–320. doi:10.1016/j.
jbusres.2009.03.015
Posluns, K., & Gall, T. L. (2019). Dear mental health practitioners, take care of yourselves: A literature review on
self-care. International Journal for the Advancement of Counselling. doi:10.1007/s10447-019-09382-w
Ravasi, D., & Schultz, M. (2006). Responding to organizational identity threats: Exploring the role of organizational
culture. Academy of Management Journal, 49(3), 433–458. doi:10.5465/amj.2006.21794663
Regehr, C., LeBlanc, V., Shlonsky, A., & Bogo, M. (2010). The influence of clinicians’ previous trauma exposure on
their assessment of child abuse risk. Journal of Nervous and Mental Disease, 198(9), 614–618. doi:10.1097/
NMD.0b013e3181ef349e
Safe Haven. (n.d.). Staff handbook. Anonymous City, MI: Safe Haven.
Schein, E. H. (1990). Organizational culture. American Psychologist, 45(2), 109–119. doi:10.1037/0003-066X.45.2.109
Schein, E. H. (2004). Organizational culture and leadership (3rd ed.). San Francisco, CA: Jossey-Bass.
Schuler, B. R., Bessaha, M. L., & Moon, C. A. (2016). Addressing secondary traumatic stress in the human services:
A comparison of public and private sectors. Human Service Organizations: Management, Leadership & Governance,
40(2), 94–106.
Slattery, S. M., & Goodman, L. A. (2009). Secondary traumatic stress among domestic violence advocates: Workplace
risk and protective factors. Violence Against Women, 15(11), 1358–1379. doi:10.1177/1077801209347469
Sprang, G., Craig, C., & Clark, J. (2011). Secondary traumatic stress and burnout in child welfare workers:
A comparative analysis of occupational distress across professional groups. Child Welfare, 90(6), 149–168.
Sprang, G., Ross, L., Miller, B. C., Blackshear, K., & Ascienzo, S. (2017). Psychometric properties of the Secondary
Traumatic Stress–Informed Organizational Assessment. Traumatology: An International Journal, 23(2), 165–171.
doi:10.1037/trm0000108
Stake, R. E. (1995). The art of case study research. Thousand Oaks, CA: Sage.
Stake, R. E. (2005). Qualitative case studies. In Y. S. Lincoln & N. K. Denzin (Eds.), Handbook of qualitative research
(3rd ed., pp. 443–466). Thousand Oaks, CA: Sage.
Stamm, B. H. (Ed.). (1995). Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators.
Baltimore, MD: Sidran Press.
 HUMAN SERVICE ORGANIZATIONS: MANAGEMENT, LEADERSHIP & GOVERNANCE 19

Storlie, C. A., & Baltrinic, E. R. (2015). Counseling children with cystic fibrosis: Recommendations for practice and
counselor self-care. The Professional Counselor, 5(2), 293–303. doi:10.15241/cas.5.2.293
Tilden, V. P., Thompson, S. A., Gajewski, B. J., & Bott, M. J. (2012). End-of-life care in nursing homes: The high cost
of staff turnover. Nursing Economics, 30(3), 163–166. (1021056825; 22849015).
Tolbert, P. S., & Hall, R. H. (2008). Organizations: Structures, processes, and outcomes (10th ed.). New York, NY:
Routledge.
Townsend, S. M., & Campbell, R. (2009). Organizational correlates of secondary traumatic stress and burnout among
sexual assault nurse examiners. Journal of Forensic Nursing, 5, 97–106. doi:10.1111/j.1939-3938.2009.01040.x
Trippany, R. L., Kress, V. E. W., & Wilcoxon, S. A. (2004). Preventing vicarious trauma: What counselors should know
when working with trauma survivors. Journal of Counseling and Development, 82, 31–37. doi:10.1002/jcad.2004.82.
issue-1
U.S. Department of Labor, Bureau of Labor Statistics. (2018). Occupational outlook handbook. Retrieved from https://
www.bls.gov/ooh/home.htm
Wright, T. A., & Bonett, D. G. (2007). Job satisfaction and psychological well-being as nonadditive predictors of
workplace turnover. Journal of Management, 33(2), 141–160. doi:10.1177/0149206306297582