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Graduate Student Journal of  Psychology 
2018, Vol. 17

Copyright 2018 by the Department of  Counseling and Clinical Psychology 
Teachers College, Columbia University

Secondary Traumatic Stress Among Mental Health Professionals: 
Implications for Graduate Training Programs

Alicia Key, M.A. and Katie Rider, M.A.
Ball State University

Secondary traumatic stress (STS), which involves symptoms that mimic post-traumatic stress disorder, results 
from indirect exposure to trauma through caring for or working with traumatized individuals. Not surprisingly, 
given their frequent provision of  services to trauma survivors, mental health professionals are among those at 
highest risk of  developing STS. Accordingly, the present review sought to fill a gap in the literature by addressing 
the implications of  STS for psychology graduate programs responsible for training mental health professionals. 
It is suggested that training programs can make three types of  changes—curricular, environmental, and direct 
service related—to reduce student risk for, and enhance resiliency in the face of, STS.

Indirect exposure to trauma, such as caring for 
or working with traumatized individuals, can lead to 
secondary traumatic stress (STS; Shoji et al., 2014). 
Given that provision of  services to trauma survivors is 
a common element of  the work performed by mental 
health professionals, it is not surprising these profes-
sionals are among those at highest risk of  developing 
STS (Cieslak et al., 2014). With up to 14% of  mental 
health professionals experiencing STS, the following 
review seeks to fill a gap in the literature by address-
ing the implications of  STS for psychology graduate 
programs responsible for training mental health profes-
sionals (Buchanan, Anderson, Uhlemann, & Horwitz, 
2006). To this end, STS will first be clearly defined and 
distinguished from similar terms. The symptoms of  
STS and resulting consequences, along with both risk 
and protective factors, will then be discussed. Finally, 
the implications of  STS for graduate training programs 
in applied forms of  psychology will be assessed. 
Specifically, it is suggested that training programs can 
make three types of  changes—curricular, environmen-
tal, and direct service related—to reduce student risk for, 
and enhance resiliency in the face of, STS.

STS: An Overview

Definitions and Characteristics
The terms STS, compassion fatigue, burn out, and 

vicarious traumatization have often been used inter-
changeably (Bell, 2003; Ben-Porat & Itzhaky, 2009; 

Salston & Figley, 2003). Nevertheless, while there is 
considerable overlap in terminology, there are subtle 
differences that distinguish these terms from one 
another. STS specifically refers to symptoms that 
mimic Post-Traumatic Stress Disorder (PTSD) in 
those professionals who work with victims of  trauma 
(Baird & Kracen, 2006; Bell, 2003), while compassion 
fatigue focuses on the depletion of  emotional, physi-
cal, and spiritual strength of  human service workers 
due to their great expense of  empathy for their client 
(Merriman, 2015). Essentially, the term STS focuses 
on specific symptoms, while compassion fatigue uses 
a broader definition to include the counselor’s over-
extension of  empathy as a source of  later symptoms. 
Alternatively, burn out is generally the term used to 
refer to emotional exhaustion, accompanied by reduced 
feelings of  personal accomplishment, and feelings of  
cynicism that interfere with an individual’s ability to 
adequately perform their job (Green, Albanese, Shapiro, 
& Aarons, 2014). Lastly, vicarious traumatization refers 
to broad and overarching negative changes in profes-
sionals’ views of  themselves, their work, and the world 
as a result of  being exposed to their clients’ traumatic 
experiences (Bell, 2003; Ben-Porat & Itzhaky, 2009; 
Buchanan et al., 2006). In essence, burn out focuses on 
the end result of  emotional exhaustion—not being able 
to perform one’s job—while vicarious traumatization 
refers to significant cognitive changes in professionals’ 
world views.

As STS, compassion fatigue, burn out, and vicari-
ous traumatization all refer to emotional distress and 
traumatization in some way, there is understandably 
some overlap. For instance, symptoms of  STS include 

Override (Hidden running head text):
Key, Rider
Secondary Traumatic Stress

Keywords: STS, Traumatic Stress, Graduate Training Programs
Please address correspondence regarding this article to: 

ambrooks4@bsu.edu



69

SECONDARY TRAUMATIC STRESS

intrusive memories of  a client’s trauma, hypervigilance, 
irritability, feelings of  grief  and sadness, difficulty 
sleeping, difficulty concentrating, avoidance of  trau-
matized clients and traumatic material, and reductions in 
compassion or empathy for traumatized clients (Collins 
& Long, 2003; Figley, 2002). Not surprisingly, mental 
health professionals who experience STS suffer from 
high rates of  burnout and dissatisfaction in their work 
(Collins & Long, 2003). Because of  these symptoms 
of  STS, they may also experience compassion fatigue 
(Figley, 1995).

It is not surprising that as a result of  these STS 
symptoms, mental health professionals may attempt 
to cope in destructive ways. For instance, they may 
detach from their clients in attempts to avoid further 
traumatization, or they may overly identify with clients, 
attempting to exert control over overwhelming mate-
rial and taking responsibility for their clients’ well-being 
(Collins & Long, 2003). Overly identifying with clients 
is particularly troublesome as it can lead to clients 
censoring what they share in attempts to protect their 
therapists from the pain of  their traumas.

Risk Factors
Several studies have indicated that a significant 

portion of  human service workers, mental health 
professionals in particular, experience STS (Birck, 2001; 
Cieslak et al., 2013). Cornille and Meyers (1999) found 
that 37% of  their sample of  183 child protective work-
ers showed clinical levels of  STS (Birck, 2001). Among 
126 master’s level outpatient and inpatient social work 
professionals, Alenkin (2011) found that 60% expe-
rienced symptoms of  STS (Kintzle, 2013). Kintzle, 
Yarvis, and Bride (2013) found that 59% of  their sample 
(n = 70) endorsed at least one symptom of  STS, with 
33% of  their sample endorsing 5 or more symptoms and 
8% endorsing symptoms at a moderate to severe level.

Because STS appears to be occurring at such an 
alarming rate and not only affects the mental health 
professional, but also can lead to residual effects on 
clients, it is important to note the risk factors involved. 
These risk factors include extreme empathy for clients 
(Baum, Rahav, & Sharon, 2014; Bell, 2003), emotional 
contagion (Baum et al., 2014), gender (Kassam-Adams, 
1995), a history of  trauma (Bell, 2003), a lack of  expe-
rience in working with trauma (Morrison, 2007), a 
large caseload of  traumatized clients (Buchanan et al., 

2006), and a lack of  workplace support (Schauben & 
Frazier, 1995).

Extreme empathy for clients can lead to STS, as the 
pain of  the client is deeply felt by the practitioner (Baum 
et al., 2014). While empathy for a client is generally 
thought to be a positive characteristic of  practitioners, it 
can become a problem when practitioners begin to place 
themselves in their traumatized client’s shoes and in so 
doing begin to exhibit PTSD-like symptoms (Bell, 2003). 
As it stands, “Educators have not been as effective in 
teaching students about the potential personal hazards 
in using empathy with clients who have experienced 
trauma” (Nelson-Gardell & Harris, 2003, p. 6). Teaching 
students and trainees about this potential hazard would 
conceivably allow trainees to become aware of  the risk 
and the symptoms should they begin to experience them.

Along with empathy, emotional contagion may also 
play a factor in increasing vulnerability to STS (Baum 
et al., 2014). Emotional contagion refers to the degree 
to which being around individuals with certain emotions 
causes one to begin feeling those same emotions. Thus, 
when a client experiences deep emotions after a trauma, 
the practitioner may begin to internalize some of  those 
emotions, developing STS.

Gender is another risk factor for the develop-
ment of  STS. Just as research has shown the female 
gender to be a risk factor for PTSD (Brewin, Andrews, 
& Valentine, 2000), researchers have also found that 
women are especially vulnerable to STS (Baum, 2014). 
It is theorized that in regards to STS, it is by virtue 
of  women consistently scoring higher on measures of  
empathy and emotional contagion than men that they 
are more vulnerable to developing STS (Baum, 2014; 
Kassam-Adams, 1995). Another reason women may be 
at higher risk of  developing STS is that many women 
have a personal history of  interpersonal trauma (Tang 
& Freyd, 2012).

Those with a history of  trauma, such as childhood 
abuse, may be at greater risk for experiencing symp-
toms of  STS (Bell, 2003; Cunningham, 2003). This is 
an important factor to consider given that it has been 
estimated more than one-third of  mental health profes-
sionals have experienced childhood abuse (Buchanan 
et al., 2006). The current literature on STS for those 
with a history of  trauma is somewhat limited, however 
(Zerubavel & Wright, 2012). Because the symptoms of  
STS are the same as PTSD, with the difference being the 



70

KEY, RIDER

origin of  the trauma, future research should take care to 
distinguish between STS and PTSD in providers with a 
history of  trauma. If  clinicians exhibit re-experiencing 
symptoms, such as nightmares or flashbacks, it is impor-
tant to assess if  these symptoms are related to a personal 
trauma or the trauma of  their client. If  the symptoms 
are related to the client’s trauma, this would be consid-
ered STS, and not PTSD (Collins & Long, 2003).

It is important to note that a history of  trauma does 
not necessarily lead to STS. In fact, Follette, Polusny, and 
Milbeck (1994) determined that mental health profes-
sionals who had dealt with personal trauma evidenced a 
higher degree of  positive coping skills when faced with 
client trauma than did those without a personal history 
of  trauma. The authors concluded that personal trauma 
experiences force people to develop the coping skills 
necessary to deal adaptively with traumatic material.

Not having developed coping skills to deal with 
trauma may be one reason that inexperience in work-
ing with traumatized individuals is a risk factor for STS. 
Accordingly, trainees and beginning mental health 
professionals are at heightened risk for STS (Schauben 
& Frazier, 1995). This is also why a lack of  support 
is a risk factor for STS. Without proper guidance and 
support, individuals who have never experienced 
working with traumatized clients may quickly become 
overwhelmed. Workplace support, in general, is very 
important in preventing STS and decreasing the feel-
ings of  isolation that often develop as a consequence 
(Schauben & Frazier, 1995). A workplace environment 
that discourages open communication about thera-
pist emotions, distress, and need for self-care greatly 
increases the odds of  STS (Schauben & Frazier, 1995).

The number of  traumatized individuals on any given 
mental health professional’s caseload is also related to 
the likelihood of  developing STS (Buchanan et al., 2006; 
Meyers & Cornille, 2002). Similarly, the severity of  the 
trauma clients have experienced may be related to the 
likelihood of  therapists developing symptoms. Indeed, 
as Buchanan and colleagues (2006) found, repeated 
exposure to the graphic details of  clients’ trauma stories, 
particularly those involving interpersonal violence, 
increases the likelihood of  mental health profession-
als developing STS (Bober & Regehr, 2005). Working 
with traumatized children may also put therapists at an 
even greater risk for STS symptoms than working with 
traumatized adults (Beaton & Murphy, 1995).

Because STS is defined by symptoms of  PTSD, it is 
reasonable to hypothesize that risk factors for PTSD may 
play a part in the development in STS. Future research 
is needed to fully assess this hypothesis; however, it may 
be wise for clinicians and those in charge of  training 
clinicians to bear in mind the risk factors for developing 
PTSD. These risk factors include socioeconomic status, 
age, type of  trauma experienced, exposure to general 
life stressors, tendency towards avoidance coping, level 
of  education, psychiatric history, and race (Brewin, 
Andrews, & Valentine, 2000; Sareen, 2014).

In sum, the research on STS indicates that extreme 
empathy (Baum et al., 2014; Bell, 2003), emotional 
contagion (Baum et al., 2014), gender (Kassam-Adams, 
1995), a personal history of  trauma (Bell, 2003), a lack 
of  experience in working with trauma (Morrison, 2007), 
a lack of  workplace support (Schauben & Frazier, 1995), 
and a large caseload of  traumatized clients (Buchanan 
et al., 2006) are all risk factors for developing STS.

Protective Factors
Though there are many risk factors for STS, there 

are also protective factors that may prevent STS (Baum 
et al., 2014; Bell, 2003; Buchanan et al., 2006; Schauben & 
Frazier, 1995). These factors include training and educa-
tion, experience in working with traumatized clients, and 
good supervision (Boscarino, Figley, & Adams, 2004; 
Collins & Long, 2003; Ortlepp & Friedman, 2002; 
Pearlman & Mac Ian, 1995).

Training mental health professionals regarding 
trauma work can prepare them for the difficulties they 
may not have expected. Specifically, training and educa-
tion regarding the importance of  self-care when working 
with traumatized clients, as well as the coping skills 
that can be employed to handle graphic and disturbing 
materials, can protect practitioners from becoming over-
whelmed in the face of  client trauma and developing 
STS (Eidelson, D’Allesio, & Eidelson, 2003).

In the same way that education and training can 
prepare mental health professionals to hear traumatic 
material, experience working with traumatized clients 
can serve as a protective factor against STS (Collins & 
Long, 2003). Clinicians who have already worked with 
traumatized clients may be aware of  what to expect 
and, consequently, may not become as overwhelmed 
as those who have not previously served traumatized 
clients (Pearlman & Mac Ian, 1995). Longer working 



71

SECONDARY TRAUMATIC STRESS

hours and larger caseloads, however, have shown to 
increase STS, as described previously (Birck, 2011). As 
such, having worked with a smaller caseload of  trauma-
tized clients consistently over a longer period of  time 
may be largely advantageous over a larger caseload of  
traumatized clients in a shorter period of  time.

Along with education and training for STS, supervi-
sion can play a protective role by normalizing STS for 
the supervisee (Morrison, 2007). After all, it has been 
argued that STS is almost inevitable for trauma work-
ers (Collins & Long, 2003). Researchers have shown 
that normalizing STS in the context of  supervision in 
such a way as to de-stigmatize those that struggle with 
STS symptoms can aid in their recovery (Morrison, 
2007). In addition, Salston and Figley (2013) suggest 
that having regularly scheduled supervision and the abil-
ity to consult with a supervisor as needed can prevent 
STS or even ameliorate its effects. Thus, quality supervi-
sion that would serve as protection against STS would 
include supervisor normalization of  STS symptoms, 
consistency of  regularly scheduled supervision, and 
supervision being used for consultation purposes.

Apart from training and education, experience in 
working with traumatized clients, and good supervi-
sion, there may be further protective factors against 
STS that research has yet to fully explore. Namely, as 
stated above in the discussion of  the risk factors for 
STS, the same protective factors against PTSD may play 
a role in protecting against STS. While future research 
should be conducted to support this notion, the protec-
tive factors related to PTSD can still be kept in mind. 
These factors include positive self-esteem, optimism, 
and social support (Frazier et al., 2011; Maercker & 
Horn, 2013).

Implications for Graduate Training Programs

Therefore, as is apparent, STS is a workplace 
risk for the mental health professional (Figley, 1995). 
Accordingly, considering that one of  the fundamental 
goals of  graduate training programs in applied forms 
of  psychology is to provide students with the knowl-
edge and skills necessary to excel as providers of  mental 
health services (American Psychological Association 
[APA], 2013), one might assume that consideration of  
STS has long been a standard element of  such gradu-
ate programs. However, even a quick perusal of  the 

relevant literature (Figley, 1995; Figley, 2002; Maslach & 
Goldberg, 1998) and training program standards (APA, 
2004, 2013) reveals this is not the case. Indeed, despite 
recognition over the years by leaders in the STS field of  
the critical role training programs could play in educat-
ing about and preventing STS (Figley, 1995, 2002), at 
present STS remains largely overlooked at the graduate 
training level. The remainder of  this paper will explore 
how this oversight might be remedied by examining 
three categories of  implications of  STS for the gradu-
ate programs in psychology responsible for training 
mental health professionals—curriculum implications, 
program environment implications, and departmental 
direct service experience implications.

Curriculum Implications
According to the APA’s (2010) Ethical Principles 

of  Psychologists and Code of  Conduct—the foremost 
ethics code in the mental health professions and the code 
to which all psychologists are held—it is the responsi-
bility of  graduate training programs in psychology to 

“take reasonable steps to ensure that the programs are 
designed to provide the appropriate knowledge” (p. 9). 
There is little question that knowledge of  STS is appro-
priate knowledge for any graduate student planning to 
pursue work in the clinical arena. Estimates indicate that 
among those most likely to seek mental health services, 
rates of  trauma exposure are high (Craine, Henson, 
Colliver, & MacLean, 1988; Hanson, Hesselbrock, 
Tworkowski, & Swan, 2002; Mauritz, Goossens, Draijer, 
& van Achterberg, 2013), and, as demonstrated above, 
routine provision of  mental health services to trauma-
tized individuals results in the development of  STS for 
a significant minority of  mental health professionals 
(Cieslak et al., 2014).

Consequently, one of  the foremost implications of  
STS for graduate training programs in psychology is 
the necessity of  incorporating teaching on STS into the 
curriculum (Figley, 1995). In regards to the form this 
teaching might take, several topic areas seem particularly 
relevant. For one, students should be informed of  the 
symptoms of  STS (Figley, 2002), as well as the risk and 
protective factors. Provision of  such information has 
the potential to markedly diminish the impact of  STS 
on mental health professionals, for clinicians equipped 
with knowledge of  STS during their graduate training 
would be better able to quickly recognize and address 



72

KEY, RIDER

the symptoms of  STS should they develop the condi-
tion. Moreover, knowledge of  the risk and protective 
factors would enable students to begin remediating any 
risk factors they might possess and enhancing their 
protective factors while still in training, in turn, lessen-
ing their chances of  developing STS upon their entrance 
into the field as licensed clinicians.

Another relevant topic area graduate training 
programs in psychology should consider incorpo-
rating into their teaching on STS involves the client 
factors associated with heightened risk of  mental health 
professionals developing STS. As mentioned previously, 
research suggests that client age matters, such that those 
mental health professionals who work with traumatized 
children are more likely to develop STS than are those 
who work with traumatized adults (Beaton & Murphy, 
1995). Further, there is evidence to suggest that risk 
of  STS varies by the etiology of  clients’ trauma. For 
example, a number of  studies have demonstrated that 
engagement with clients who are victims of  interper-
sonal violence (e.g., intimate partner violence, child 
abuse, rape, torture) is particularly likely to incite STS 
in mental health professionals (Bober & Regehr, 2005). 
Equipping students with this knowledge while in gradu-
ate school would permit them to make judicious choices 
as to the various types and combinations of  trauma 
survivors they elect to treat once operating in the field 
as licensed clinicians.

A final topic area graduate training programs 
in psychology would be remiss not to integrate into 
their teaching on STS concerns cultural considerations. 
There is a substantial body of  literature indicating that 
PTSD manifests differently in different cultural groups. 
Avoidance and numbing symptoms, for instance, have 
been found to be a relatively uncommon manifestation 
of  PTSD in non-Western settings (Hinton & Lewis-
Fernandez, 2011). Conversely, both Palinkas, Petterson, 
Russell, and Downs (2004) and Hinton, Hinton, Pich, 
Loeum, and Pollack (2009) determined that manifesta-
tion of  PTSD in the form of  frightening nightmares 
occurs far more frequently in non-Western settings. 
Somatic symptomology also appears to be consider-
ably more common in certain cultural groups than in 
others (Hinton & Lewis-Fernandez, 2011). Although 
study of  cultural variation in symptomology has not yet 
been extended explicitly from PTSD to STS, given the 
marked parallels between the two conditions there is 

every reason to believe that manifestation of  STS varies 
by cultural background as well (Baird & Kracen, 2006; 
Bell, 2003). Accordingly, graduate training programs in 
psychology would be wise to include information on 
these cultural variations as part of  their teaching on STS 
so as to ensure that trainees of  divergent cultural back-
grounds are informed regarding how STS may influence 
them differentially due to their distinctive heritage.

A second curricular implication of  STS for gradu-
ate training programs in applied forms of  psychology 
concerns the inclusion of  at least some specialized 
trauma training as a standard element of  the curriculum. 
As mentioned previously, the rates of  trauma exposure 
and trauma-related disorders among those who seek 
mental health treatment are high (Craine et al., 1988; 
Hanson et al., 2002; Mauritz et al., 2013). Subsequently, 
it is safe to assume that the preponderance of  mental 
health professionals will be exposed to client trauma 
at some point in their careers. Therefore, given the 
evidence that suggests specialized trauma training 
protects mental health professionals against STS devel-
opment when faced with client trauma (Eidelson et al., 
2003; Ortlepp & Friedman, 2002), it seems that inclu-
sion of  this training into graduate training programs as 
a fixed curricular element would prove beneficial for 
the vast majority of  students.

Environment Implications
The existence of  STS as a work-related hazard for 

mental health professionals also has compelling impli-
cations for the departmental environment cultivated by 
graduate training programs in psychology. For many 
students, departmental practicum experiences consti-
tute their first real and sustained exposure as clinicians 
to the world of  direct service provision. Consequently, 
it is probable that for a sizable portion of  students, 
this experience is largely responsible for shaping their 
perception of  the features that comprise an appropri-
ate work environment for mental health professionals. 
While this is a heavy responsibility for training programs, 
it can also be regarded as a prime opportunity to model 
for students the type of  work environment research 
has shown functions as a protective factor against STS 
(Boscarino et al., 2004; Orltepp & Friedman, 2002). For 
example, Morrison (2007) determined that a support-
ive, open workplace environment in which workers 
are encouraged to dialogue with their colleagues about 



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SECONDARY TRAUMATIC STRESS

the feelings and fears that arise in response to work 
with traumatized clients protects against STS. Likewise, 
Coster and Schwebel (1997) highlighted the importance 
of  workplace environments that purposefully endeavor 
to normalize, and thus to destigmatize, STS. Similarly, 
Moran (2002) emphasized the value of  workplace envi-
ronments in which humor is embraced. Consistent, 
widespread efforts by graduate training programs in 
psychology to cultivate a workplace environment in 
their own training clinics that exudes these protective 
factors would undoubtedly produce great dividends, as 
it would equip students with first-hand awareness of  
what a healthy workplace looks like. This, in turn, would 
enhance students’ ability following graduation to iden-
tify and avoid STS facilitative workplace environments.

A starting point for programs aiming to institute 
the aforementioned environmental changes might be to 
execute a confidential survey of  students for purposes 
of  ascertaining student perceptions of  the department 
climate. That is, do students perceive that open discus-
sion of  the feelings and fears they experience in response 
to their work with traumatized clients is welcomed and 
will not reflect poorly on their clinical evaluations? 
Likewise, do students report that appropriate humor is 
embraced and cultivated by clinical faculty or do they 
regard stoicism as the norm? Programs could then use 
the information gleaned from these surveys to structure 
their approach to instituting necessary environmental 
changes. The specific form these changes take will 
depend on the distinctive environmental weaknesses 
that are identified, as well as on the available resources 
and skill set possessed by department personnel.

Departmental Direct Service Implications
The final category of  implications of  STS for 

graduate training programs in psychology concerns 
the direct service experience students accrue through 
required participation in departmental training clinics 
(APA, 2013). There is no reason to assume that students 
working with clients in such clinics are immune to STS. 
Rather, quite to the contrary, it is probable that students 
working in these settings are actually more susceptible 
to STS than is the average licensed professional working 
in the field. Research has repeatedly demonstrated that 
lack of  experience working with traumatized individuals 
is a risk factor for STS development (Abu-Bader, 2000; 
Cunningham, 2003; Pearlman & Mac Ian, 1995), and 

graduate students—as a consequence of  their status 
as students in training—inherently possess minimal 
hands-on experience providing mental health services 
to all types of  clients, traumatized clients included.

The fact that students working in departmental 
training clinics may be at heightened risk of  develop-
ing STS due to their limited clinical experience implies 
that the graduate programs that house these clinics need 
to make special efforts to operate the clinics in such a 
way that risk of  student development of  STS is mini-
mized. Fortunately, there are a number of  steps graduate 
programs can take to decrease the likelihood that their 
students will develop STS as a consequence of  provid-
ing services in the departmental clinic. For example, 
both Boscarino and colleagues (2004) and Ortlepp and 
Friedman (2002) established that quality supervision 
is a major STS preventative factor. This indicates that 
graduate training programs should ensure all students 
engaged in departmental clinic work are provided with 
regular, quality supervision in which discussion of  the 
personal effects of  exposure to client trauma is encour-
aged. Correspondingly, careful client screening is crucial 
in order to prevent students from being assigned clients 
whose trauma level warrants treatment by a professional 
with more experience than is possessed by most begin-
ning clinicians. Lastly, in light of  the strong relationship 
between high caseloads and STS (Kadambi & Truscott, 
2004), it seems prudent for training clinic leadership to 
carefully monitor student caseloads in an attempt to 
protect students from becoming so overwhelmed that 
STS ensues.

A related concern involves whether graduate train-
ing programs should routinely assess students for STS 
during their tenure in departmental training clinics. On 
one hand, such assessment seems warranted. After all, 
the licensed professionals who administrate depart-
mental training clinics have a responsibility to protect 
the clients served within those clinics from harm (APA, 
2010) and, as has previously been established, STS has 
great potential to impair the quality of  the services that 
a mental health professional provides (Collins & Long, 
2003; Figley, 1995, 2002). On the other hand, institution 
of  department-wide screening procedures for STS—
particularly if  certain screening results are associated 
with student remediation—could cultivate a depart-
ment climate in which students conceal their symptoms, 
thereby diminishing the likelihood that those students 



74

KEY, RIDER

suffering from STS will receive the assistance of  which 
they are in need. Therefore, due to the ethical complexi-
ties involved, graduate training programs in psychology 
should approach the implementation of  routine STS 
screening in departmental clinics with much foresight 
and deliberation, taking special pains to consider and 
balance the needs of  both clients and trainees.

Conclusion

In closing, the experience of  STS and its very 
troubling symptoms, is a distinct possibility for all 
individuals who devote their professional efforts to 
providing mental health services to hurting people 
(Cieslak et al., 2014). Accordingly, it only makes sense 
that education about and prevention of  STS should 
become a standard element of  every psychology grad-
uate program responsible for training mental health 
professionals. As detailed above, three types of  changes 
training programs could begin to make immediately to 
better equip students concerning STS involve curricular 
changes, department environment changes, and direct 
service experience changes.

Given that these proposed forms of  change have 
received limited attention in the research literature, 
future research efforts should be aimed at evaluating 
their effectiveness and practicality from an empirical 
standpoint. Additionally, if  and when training programs 
adopt the proposed changes described herein, objective 
and quantitative evaluation of  the impact of  the changes 
on the clinical efficacy of  the students enrolled in these 
training programs should follow. Moreover, research 
aimed at ascertaining rates of  STS among graduate 
psychology students is called for to provide a clearer 
picture of  the extent of  the impact of  STS on the grad-
uate trainee population, as is research that explores what 
distinguishes graduate training programs with high rates 
of  STS among students from those with low rates.

Ultimately, the hope is that STS education and 
prevention will become a widespread focus of  all gradu-
ate training programs in applied forms of  psychology. 
The more students who are sent into the field of  mental 
health work are adequately equipped to identify and 
successfully manage the STS, the more traumatized 
clients will be able to receive the services of  which they 
are desperately in need.

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