Secondary Trauma and Its Impact On Young People

The impact of experiencing traumatic events like natural disasters, sexual assault, accidents, or loss isn’t easy to quantify. This is in large part because trauma, the emotional response to traumatic events, is extremely complex. But it’s also because the effects of trauma don’t stop with the person who’s gone through it.

For some people, particularly young people and behavioral health professionals like therapists and social workers, indirect trauma can also have a significant impact. When trauma is passed on to someone else through family or community exposure, experts call this “secondary trauma.”

Although secondary trauma is a relatively new concept in the fields of psychology and traumatology (the study, diagnosis, and treatment of trauma), and one without a formal clinical diagnosis, we can learn a lot about it through the existing research and what we know about trauma overall.

What is secondary trauma?

Secondary trauma is the secondhand experience of negative psychological and behavioral outcomes because of secondhand exposure to a traumatic event.

Secondary trauma is often written about in research as a natural outcome of professions where people provide support to trauma survivors. This is sometimes referred to as “secondary traumatic stress disorder,” “vicarious trauma” or “compassion fatigue.” Secondary trauma can also, however, be experienced by children or adolescents with close bonds to an adult or relative who has been abused, experienced intimate partner violence, served in the military with combat exposure, or otherwise has a history of trauma or post traumatic stress disorder (PTSD). 

Research has also demonstrated that children and adolescents who witness traumatic events in the media can be vicariously traumatized by the experience.

What are the symptoms of secondary trauma?

After experiencing second exposure to trauma, people may have the following symptoms:

• Anger
• Anxiety
• Depression
• Low self-esteem
• Emotional exhaustion
• Difficulty concentrating
• Body aches
• Sleep problems
• Changes in eating habits
• Startle responses
• Addictive behaviors
• Withdrawal from others

According to psychologist Dr. Robert Motta, secondary trauma parallels PTSD symptoms and acute stress disorder. However, experts draw a distinction between these clinical diagnoses and the experience of secondary trauma, which does not currently have a related diagnosis in the Diagnostic and Statistical Manual of Mental Disorders-5th edition (the manual behavioral health professionals use to diagnose mental disorders).

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How common is secondary trauma in young people?

One study published in 2021 in the Journal of Child & Adolescent Trauma sought to determine the prevalence of vicarious trauma exposure during a young person’s lifetime. In the study, they defined the term as “indirectly learning about the violent victimization of others” through vicarious family trauma and vicarious community trauma—and they didn’t incorporate the knowledge of a loved one’s traumatic experiences, which can also be significantly impactful. Still, 29% of the 4,549-person sample population, including young people ages 0-17, reported experiencing some form of vicarious trauma exposure during their lifetimes. 

According to the study, vicarious exposure to community trauma was more likely to lead to traumatic symptoms than family trauma exposure (although the researchers noted this may have been because community trauma was more commonly reported in the data set they examined). 

White young people were also more likely to experience trauma symptoms in response to vicarious trauma than other race/ethnicity groups, but they were less likely to be vicariously exposed to trauma overall. In contrast, Black young people were shown to demonstrate stronger emotional and psychological resilience in the face of vicarious trauma.

What are the causes of secondary traumatic stress?

In the 1998 book “Burnout in Families: The Systemic Costs of Caring,” psychologist Dr. Arlene Steinberg wrote that children may experience secondary trauma in one of two main ways:

Directly witnessing a loved one’s trauma

The children of parents who experience intimate partner violence or sexual assault, for example, may be exposed to that trauma (on purpose or by accident) if they witness the event as it happens.

Knowledge of a loved one’s trauma

In some cases, a child may hear about a parent’s trauma secondhand. For example, if a parent is managing PTSD from an adverse childhood experience or military deployment, the traumatic event or events would have taken place before the child was born. Even so, the child may be aware of the trauma through conversation with the parents or through the negative outcomes of that trauma in the present day. 

Knowledge is one way that trauma can be passed down through different generations.

Is there anything that can prevent secondary trauma in youth?

Trauma is complex, so there’s no way to completely prevent it from happening. However, some factors have been associated with a reduced impact.

The Children’s Bureau, a U.S. federal agency, has  identified protective factors that can improve outcomes overall, especially in relation to traumatic events, for children:

• Nurturing and attachment
• Knowledge of parenting’s role in development
• Parental resilience 
• Social connections
• Concrete parental supports
• Children’s social and emotional competence

When considering exposure to another person’s trauma more specifically, according to a 2015 paper published in Psychology, possible protective factors in instances of exposure to maternal trauma include:

• A second parent’s mental health
• The stability of a spousal relationship
• A positive mother-child relationship
• A secure, non-threatening environment
• A community with social support

It’s important to acknowledge, however, that these protective factors aren’t always within our control. However, parenting practices like routine family activities, parental monitoring and awareness of a child’s feelings and behaviors, regular support and affirmation, and a moderate level of strictness (granting autonomy when appropriate) can help support healthy parent-child relationships.

Supporting young people with secondary trauma

Secondary trauma has only been somewhat recently explored in research, so there aren’t clear standards about what therapeutic modalities best support those who experience it. That said, several treatments have been hypothesized as possible options treatments for secondary trauma:

Cognitive behavioral interventions

In a 2011 issue of the Journal of Contemporary Psychotherapy, researchers suggested that cognitive behavioral interventions, which have proven very effective in a variety of psychological challenges among young people, may be helpful for children whose parents are in active military duty.

The most well-known cognitive behavioral intervention is cognitive behavioral therapy (CBT). In CBT, clients are supported through a deeper understanding of their thought processes and patterns of feelings and behavior so they can challenge what’s no longer serving them. A form of CBT called trauma-focused CBT can be especially helpful for young people managing the effects of trauma.

Support groups

In Dr. Steinberg’s writing on secondary trauma in children, the psychologist uplifted support groups as a way for older children and adolescents in particular to feel understood, seek validation, and process challenging feelings around people with similar experiences.

Support groups may involve facilitated conversations among peers or be more comparable to group therapy because a therapist is leading the group in developing evidence-based strategies for coping with mental health challenges.

Other forms of trauma-informed care

Any kind of psychotherapy can be trauma-informed as long as the provider aims to incorporate “the four R’s”:

• Realize trauma’s potential impact and treatment paths.
• Recognize trauma’s signs and symptoms.
• Respond by fully integrating trauma knowledge into practice.
• Resist re-traumatization of people receiving care.

For young people managing the effects of direct trauma, trauma-focused CBT and eye movement desensitization and reprocessing (EMDR) therapy have been recommended as the most effective therapeutic modalities by the World Health Organization.

Lessons from secondary trauma in healthcare professionals

We can also look at the recommendations of treatment for secondary trauma identified by specialists supporting healthcare professionals who experience it (e.g., social work professionals, child welfare professionals, therapists, nurses).

The Administration for Children & Families advises that professionals in human services agencies explore self-care, including positive lifestyle choices like regular exercise and good sleep habits, and journaling to process emotional experiences among the treatment strategies worth considering.

How Charlie Health can help young people with secondary trauma

Charlie Health’s comprehensive suite of therapeutic modalities brings clients ages 11-30 a broad range of support for whatever they’re managing. Whether you or your child is navigating secondary trauma or recovering from trauma firsthand, our clinicians will customize a virtual Intensive Outpatient Program (IOP) to begin and guide the healing process. Our clinicians are trained in CBT, dialectical behavior therapy (DBT) skills, attachment-based family therapy, and more trauma informed modalities that can be focused on combined to support young people experiencing more challenging mental health issues.

Each week, people who enroll with Charlie Health will receive individualized therapy, meet with a supported group they’ve been matched with for connection and community, and have dedicated therapy sessions that involve family members in care.

If you or a loved one between the ages of 12 and 28 are struggling with secondary trauma or a history of direct trauma exposure, reach out to our Admissions team (available 24/7) to see if our IOP is the right fit. Get in touch today.