stress (STS) is alive and
kicking among substance
says Victoria Hancock
ecent research into employees at a national substance
misuse charity showed that frontline staff who were
regularly exposed to their victims’ traumas often suffered
symptoms similar to post-traumatic stress disorder (PTSD).
These included intrusion (involuntary thoughts and images),
flashbacks and hyperarousal, and were a result of indirect
trauma ie through the retelling of the client’s own trauma.
The intensity of symptoms was such that half of substance misuse
professionals who took part in our Birmingham City University study were
found to be suffering from ‘high’ or ‘severe’ secondary traumatic stress (STS).
As author of An exploratory study on secondary traumatic stress amongst
substance misuse professionals, I’d noted there was a lack of research into
the issue of frontline staff working with individuals presenting with trauma
and going on to experience STS. This was especially the case when it came
to substance misuse professionals – in fact, this was the first time such a
study has been done in the UK, although previous research in the USA and
Australia has identified these issues. Of 225 substance misuse professionals
who took part in the American survey, 19 per cent showed symptoms of
PTSD – in other words they were suffering secondary trauma. In Australia
the figure was similar, at almost 20 per cent.
Our UK study findings highlighted that STS among substance misuse
practitioners warranted further investigation, especially in term of client,
14 • DRINK AND DRUGS NEWS • MAY 2020
staff and service-level outcomes. Organisations should be looking into
this area to help manage and promote both a healthy workforce and
Senior staff members should be trained to identify employees with STS
and organise support for them – whether that means allowing the affected
individual to take a leave of absence, receive counselling, or engage with
them on regular debriefing exercises.
Organisations should nurture a supportive culture for staff to achieve a
work-life balance, and one of the ways they can achieve this is by helping to
identify a range of coping mechanisms unique to individual staff members
when working with traumatised clients.
Clients’ needs are often complex and diverse, including comorbidity of
substance misuse and mental illness. As a consequence, staff can be
exposed to vivid descriptions of trauma, as well as accounts of neglect and
abuse. The result is direct emotional distress, now recognised as STS.
Workplace stress has been recognised within the health profession,
but this has usually centred around doctors and nurses. Other professions
where STS and its negative effects on individuals has been specifically
identified include social workers, mental health nurses, sexual assault
therapists, journalists and asylum evaluators/interpreters. The condition
can manifest through symptoms such as depression, despair and
cynicism, and it is common to experience alienation from friends, family
and colleagues, as well as a range of both physical and psychological
symptoms. From an organisational perspective, individuals with STS are
much more likely to be less efficient team members than their ‘healthier’
colleagues, due mainly to tiredness.
However, it’s not all bad news. A previous study on social workers looking
after children said exposure to trauma actually made them better at their
job, because they were able to empathise more. There was also ‘personal
growth’ for the individual in that it made them value relationships more,
develop wisdom and be grateful for what they had. For some it even altered