Address Vicarious Trauma Using These Strategies, Resources

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, DBH(s), of EFS Supervision Strategies, LLC., discusses key vicarious trauma concepts, how to assess it in the workplace, and strategies and available resources to manage it.

As the COVID-19 pandemic continues to stretch the country's healthcare system to its limits, frontline healthcare professionals are at greater risk of experiencing vicarious trauma. Beyond normal stress, vicarious trauma results from repeated exposure to traumatic events that lead to escalated feelings of powerlessness and guilt similar to post-traumatic stress disorder. In turn, healthcare professionals who experience vicarious trauma are susceptible to increased stress, anxiety, substance abuse, depression, and unfortunately, suicide.

"We are just seeing the start of a mental health crisis from the pandemic. Probably not a day goes by in which we don't see at least 10­–15 headlines on various new terminology about mental health as a crisis," says Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, DBH(s), of EFS Supervision Strategies, LLC. "While this was still going on, we felt that it was essential to just acknowledge and think what we need to do to best prepare our workforce for what is coming and what to expect moving forward."

In a recent HealthLeaders webinar, Fink-Samnick discussed key vicarious trauma concepts, how to assess it in the workplace, and strategies and available resources to manage it.

After her presentation, Fink-Samnick answered questions from the audience. The following transcript of that question-and-answer session from the webinar has been edited for brevity and clarity.

Q: Do you have a self-assessment or inventory worksheet you can recommend?

Fink-Samnick: There are so many! The Coronavirus Anxiety Workbook is a great resource for self-assessment. I've had colleagues use it themselves. I've had colleagues use it with patients with severe mental illness. It really speaks to a whole boatload of symptoms to normalize the realities that we're facing right now because everyone's anxious. Anxiety before COVID-19 was probably the top behavioral health symptom. And we know the challenges with anxiety when it totally interferes with our occupational and our life functioning, which many people are feeling right now. The workbook is awesome.

PsychHub and the Mental Health Playbook have a lot of health assessment sheets. Another site is called Therapist Aid. Anybody that does behavioral health knows that this is one of the prime sites that treatment professionals use. It is full of self-assessments on anxiety, stress, and depression.

One of my favorite tools is called a DASS-21. It is 21 very simple questions that you score and it will give you the level of anxiety, depression, and stress. It is a beautiful worksheet that can really help you level set where you’re at. It is also one of my favorite ones to use with clients. I’m not ashamed to admit that I even use it myself to do a check-in. So, hopefully those are helpful.

Q: I noticed my staff are getting very testy with each other. Do you have suggestions for diffusing this before it gets out of control? They have been a cohesive team and now they are complaining about each other.

Fink-Samnick: This is common in any environment where there's stress. It's a dynamic that is common in workplaces that are facing budget cuts. I often talk about it even in the context of workplace bullying where staff get crispy around the edges; they're scared, they worry, and they can't talk about it. You want to try to pull them together for a "kumbaya" moment, but they don't want to.

The best way that I have found to deal with that with colleagues is to just approach them. Go up to them and say, "Hey, what gives today?" Don't try to explain it or try to rationalize it. Some people have asked if they can go up to a colleague and give them a hug. Well, I suppose yes, if you have that kind of relationship.

You can try to tell folks, "You can feel this way but don't take it out on each other. It's only going to make it rougher. The first thing people do when they get frustrated is take it out on each other. That's the most normal thing in the world but that's not going to cut it. That makes your work workplace and work experience even tougher.

I'm a firm believer—as a New Yorker—in getting out of the corner and saying, "I know you are testy. I know you're crispy. Stop! Let's figure out together how to work through it." That's a thing that folks have done. They get together and they [say], "All right, everybody's feeling it. Let's figure out how to get rid of it right now." And tomorrow they may need something else and that's OK.

Q: How do we best cope with the reality of colleagues and friends who are not following Centers for Disease Control and Prevention (CDC) protocols (e.g., wearing masks, social distancing)?

Fink-Samnick: I want to be respectful because there may be some listening to this webinar that have their own views and maybe cringe when I mention the CDC. I often say you can't be accountable for everybody else. You can only be accountable for your own practice, your own patterns, and what you do. So, what do we do? You try to educate. You try to guide. You be mindful of your distance from those people, try to inform them, and then let it go. You've got to save the energy and use it where you can. But you've got to protect yourself; you absolutely must protect yourself.

Q: Have you heard of Code Lavender? Any successes with that type of program?

Fink-Samnick: Code Lavenders are interesting. I think every organization is trying to do something special for the workforce with positive acknowledgments and really trying to reframe. There are different types of programs, so I'm going to talk broadly. For example, there are things like at a hospital that has a higher percentage of COVID patients, [so] music plays every time there's a discharge.

The interesting thing about Code Lavenders is that they were not designed for the workforce but more for patients, family members, or other visitors to achieve emotional equilibrium. To that end, there is an opportunity for the industry and its organizations to develop unique initiatives to address workforce stress and its behavioral manifestations.