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Secondary Trauma in Forensic Interviewers
Secondary trauma in forensic interviewers is a symptom cluster comparable to PTSD that occurs in professionals that conduct interviews with children to determine if abuse or neglect has occurred. Secondary trauma results from repeated exposure to trauma through repeated contact with others who have been traumatized.

History and Definitions
Secondary trauma in forensic interviewers was first discussed in the 1980’s by Dr. C.R. Figley in his book series on compassion fatigue. Figley defined secondary trauma as analogous to PTSD under the DSM-IV, with an emphasis on how people can be traumatized without experiencing the events themselves. Figley also noted that “compassion fatigue” or “secondary victimization” are other names for secondary trauma. Figley’s original work on secondary trauma also introduced two disorders related to secondary trauma, “secondary traumatic stress (STS)” and “secondary traumatic stress disorder (STSD)”.

Figley noted that the study of secondary traumatic stress occurred due to rising awareness of the “number and variety of traumatic events” and renewed interest within the field of psychology. Figley’s 1995 definition of secondary trauma as aligned with DSM-IV PTSD included “re-experiencing”, “avoiding”, and “persistent arousal”. As understanding of the field evolved, so did the definition of secondary trauma. However, there has been a push within the field to better define secondary trauma and further differentiate it from PTSD. More current definitions began to include the specific PTSD symptoms that are reflected into secondary traumatic stress, including negative affect and dysfunctional cognitive states. Further research began to also incorporate emotional reactions including grief, terror, and rage.

Secondary trauma has also been differentiated from burnout. Burnout is defined as a condition that emerges through chronic interpersonal workplace stress and has been shown to be related to both self-efficacy and occupational stress. Where burnout and secondary traumatic stress both involve repeated exposure to stressors, secondary trauma has been recognized as having an acute onset. Secondary trauma was also viewed as conceptual in nature until 2004 when Bride et al. created their measure of secondary traumatic stress. However, a 2014 meta-analysis showed overlap between burnout and secondary traumatic stress, reporting that in professionals exposed to secondary trauma they were likely to report similar levels of job burnout and secondary trauma.

Measures of Secondary Traumatic Stress
In 2004, Bride et al. developed and published the Secondary Traumatic Stress Scale (STSS). The STSS is a 17-item measure developed to measure secondary trauma as operationalized as intrusion, avoidance, and arousal symptoms. The original validation sample for the STSS was master’s level social workers and the STSS was found to be reliable (alpha = 0.93) and valid, making it one of the first psychometric measures of secondary trauma.

Due to the overlap between PTSD and secondary traumatic stress symptoms, measures of PTSD have also been used to measure secondary traumatic stress. However, it is important to note these measures are applied to proximal experiences of trauma to help differentiate between PTSD and secondary trauma. These include the Trauma Symptom Inventory (TSI), the Compassion Satisfaction and Fatigue Test Questionnaires (CSFT), and the Trauma Stress Institute Belief Scale (TSIBS-R-L) among others.

Forensic Interviewing: Definitions
Forensic interviewing is related to social work, psychology, and law enforcement but is its own unique field of work. Forensic interviewers are specialized interviewer who work with children who may have been victims of crimes such as abuse or having witnessed a criminal act. Forensic interviewers are typically part of a multidisciplinary team consisting of law enforcement, social services, and medical workers. However, these interviewers are often the first to speak to the victim to determine if abuse has occurred and if it meets legal criteria.

Forensic interviewers undergo specialized training in developmentally sensitive and noncoercive techniques. The interview process is typically structured or semi-structured, objective, and time limited. It is important to note that interviewers are not allowed to voice empathy during their interviews to avoid bias. Forensic interviewers also experience unique stressors due to the nature of their position as they must interview the victim, debrief with colleagues, and if needed testify in court.

Forensic Interviewing and Secondary Trauma Risk
Forensic interviewers are at an increased risk due to prolonged exposure to indirect trauma through victims stories. Due to the unique nature of their position, forensic interviewers are also at an increased risk for exposure to trauma and secondary traumatic stress through organizational demands. Yet, forensic interviewers are an understudied population with regard to secondary trauma and its impact on their work.

Studies on secondary trauma and burnout have found association between certain factors and likelihood of developing secondary trauma. Some relevant factors included white identity, frequently feeling overwhelmed at work, low compassion satisfaction, inadequate organization support, and frequent direct exposure to graphic materials. In another study, non-white identity was found to be more significantly associated with experiences of secondary trauma. Other variables associated with secondary trauma in forensic interviewers were age and experiences of loss, with older workers reporting less STS and those with a recent loss reporting higher levels of STS.

Research on organizational demands on forensic interviewers have identified isolation, flexibility, and norms of self-sacrifice as being associated with secondary trauma. Research has also shown an effect of caseload on secondary traumatic stress, and additional research found that professionals who were on-call showed higher burnout. Finally, an association between job support (operationalized as internal job support, external social support, and external job support) and experiences of secondary trauma has also been demonstrated.

Implications for Practice
As we have research support for the existence of secondary trauma in forensic interviewers, we need ways to reduce this risk. One proposed way of doing so if utilizing the Secondary Trauma-Stress Organizational Assessment Tool (STS-OA). This tool helps create a secondary trauma-informed workplace, based upon current secondary trauma literature.

Organizational satisfaction was found to influence experiences of burnout. Job support from co-workers and supervisor was a protective factor against STS and something that can easily be fostered within an organization and something that should take place at all levels within an organization. Other organizational ways to reduce STS include additional supervision and time to debrief with colleagues. However, reducing caseloads was not found to be effective on reducing secondary trauma. However, high caseloads with low organizational support may be a factor contributing to secondary traumatic stress.

In addition, social support from external sources were found to be effective at reducing secondary trauma and helpful coping mechanisms included outside hobbies and activities unrelated to work. A sense of humor was also found to be a helpful way to cope with stressors. More research is needed within this area to find the best ways to support forensic interviewers and other professionals who may experience secondary trauma.