Meta-Analysis of Risk Factors for Secondary Traumatic Stress in Therapeutic Work With Trauma Victims

Jennifer M. Hensel, Carlos Ruiz, Caitlin Finney, Carolyn S Dewa

Research output: Contribution to journalArticlepeer-review

99 Scopus citations


Revisions to the posttraumatic stress disorder (PTSD) diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) clarify that secondary exposure can lead to the development of impairing symptoms requiring treatment. Historically known as secondary traumatic stress (STS), this reaction occurs through repeatedly hearing the details of traumatic events experienced by others. Professionals who work therapeutically with trauma victims may be at particular risk for this exposure. This meta-analysis of 38 published studies examines 17 risk factors for STS among professionals indirectly exposed to trauma through their therapeutic work with trauma victims. Small significant effect sizes were found for trauma caseload volume (r = .16), caseload frequency (r = .12), caseload ratio (r = .19), and having a personal trauma history (r = .19). Small negative effect sizes were found for work support (r = -.17) and social support (r = -.26). Demographic variables appear to be less implicated although more work is needed that examines the role of gender in the context of particular personal traumas. Caseload frequency and personal trauma effect sizes were moderated by year of publication. Future work should examine the measurement of STS and associated impairment, understudied risk factors, and effective interventions. Copyright

Original languageEnglish (US)
Pages (from-to)83-91
Number of pages9
JournalJournal of Traumatic Stress
Issue number2
StatePublished - Apr 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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