Community Mental Health Journal

, Volume 55, Issue 3, pp 454–462 | Cite as

PTSD Symptoms, Vicarious Traumatization, and Burnout in Front Line Workers in the Homeless Sector

  • Jeannette Waegemakers SchiffEmail author
  • Annette M. Lane
Original Paper


Work with clients who have trauma-related problems is reported to lead to a constellation of reactions including vicarious traumatization, compassion fatigue, and burnout. Traumatic experiences are ubiquitous in the lives of homeless people, stemming from multiple life events prior to, and as a result of, experiencing homelessness. While most studies examine either burnout and vicarious traumatization or potential PTSD in people who work with those who are traumatized, they generally do not look at the possible co-existence of all three factors. They also do not explore if these factors indicate the extent to which burnout or vicarious traumatization may lead to PTSD symptoms or that the existence of PTSD symptoms may precipitate greater rates of burnout. In addition, there are no existing studies that provide a quantitative view of the characteristics of frontline workers in homeless services. In this study, we surveyed 472 individuals who work in frontline positions in homeless shelters in 23 different organizations. We found rates of burnout, vicarious traumatization and compassion satisfaction, comparable to workers in other social services organizations but found rates of PTSD symptoms to be at 33% of the total population. This higher incidence of PTSD symptoms suggests that workers under-report traumatic stress when it is described as vicarious traumatization, that they specifically attribute this to client contact, and that vicarious traumatization is traumatic stress specifically attributed to job-related events.


Homelessness services Burnout PTSD Traumatic stress Frontline staff 



Funding was provided by Calgary Homeless Foundation and Edmonton Homeward Trust.


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC.: American Psychiatric Association.Google Scholar
  2. Baird, K., & Kracen, A. C. (2006). Vicarious traumatization and secondary traumatic stress: A research synthesis∗. Counselling Psychology Quarterly, 19(2), 181–188.Google Scholar
  3. Baum, N. (2015). Secondary traumatization in mental health professionals a systematic review of gender findings. Trauma, Violence, & Abuse, 17(2), 221–235.Google Scholar
  4. Beck, C. T. (2011). Secondary traumatic stress in nurses: A systematic review. Archives of psychiatric nursing, 25(1), 1–10.PubMedGoogle Scholar
  5. Bell, H., Kulkarni, S., & Dalton, L. (2003). Organizational prevention of vicarious trauma. Families in Society: The Journal of Contemporary Social Services, 84(4), 463–470.Google Scholar
  6. Berger, W., Coutinho, E. S. F., Figueira, I., Marques-Portella, C., Luz, M. P., Neylan, T. C., et al. (2012). Rescuers at risk: A systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Social Psychiatry and Psychiatric Epidemiology, 47(6), 1001–1011.PubMedGoogle Scholar
  7. Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748.PubMedGoogle Scholar
  8. Bride, B. E., Radey, M., & Figley, C. R. (2007). Measuring compassion fatigue. Clinical Social Work Journal, 35(3), 155–163.Google Scholar
  9. Burgess, L., Irvine, F., & Wallymahmed, A. (2010). Personality, stress and coping in intensive care nurses: A descriptive exploratory study. Nursing in critical care, 15(3), 129–140.PubMedGoogle Scholar
  10. Carleton, R. N., Afifi, T. O., Turner, S., Taillieu, T., Duranceau, S., LeBouthillier, D. M., et al. (2018). Mental disorder symptoms among public safety personnel in Canada. The Canadian Journal of Psychiatry, 63(1), 54–64.PubMedGoogle Scholar
  11. Cieslak, R., Shoji, K., Douglas, A., Melville, E., Luszczynska, A., & Benight, C. C. (2014). A meta-analysis of the relationship between job burnout and secondary traumatic stress among workers with indirect exposure to trauma. Psychological Services, 11(1), 75.PubMedGoogle Scholar
  12. Cloitre, M., Stolbach, B., Herman, J., van der Kolk, B., Pynoos, R., Wang, J., & Petkova, E. (2009). A Developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity. Journal of Traumatic Stress., 79(1), 1–10.Google Scholar
  13. Council on Accreditation.(2018).
  14. Cunningham, M. (2003). Impact of trauma work on social work clinicians: Empirical findings. Social work, 48(4), 451–459.PubMedGoogle Scholar
  15. Figley, C. R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Abingdon: Routledge.Google Scholar
  16. Figley, C. R. (2013). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized: Abingdon: Routledge.Google Scholar
  17. Finklestein, M., Stein, E., Greene, T., Bronstein, I., & Solomon, Z. (2015). Posttraumatic stress disorder and vicarious trauma in mental health professionals. Health & social work, 40(2), e25–e31.Google Scholar
  18. Hopper, E. K., Bassuk, E. L., & Olivet, J. (2009). Shelter from the storm: Trauma-informed care in homelessness services settings. The Open Health Services and Policy Journal., 2, 131–151.Google Scholar
  19. Kalliath, T. J., & Beck, A. (2001). Is the path to burnout and turnover paved by a lack of supervisory support? A structural equations test. New Zealand Journal of Psychology, 30(2), 72.Google Scholar
  20. Kulkarni, S., Bell, H., Hartman, J. L., & Herman-Smith, R. L. (2013). Exploring individual and organizational factors contributing to compassion satisfaction, secondary traumatic stress, and burnout in domestic violence service providers. Journal of the Society for Social Work & Research, 4(2), 114–130.Google Scholar
  21. Lang, A. J., Wilkins, K., Roy-Byrne, P. P., Golinelli, D., Chavira, D., Sherbourne, C., et al. (2012). Abbreviated PTSD Checklist (PCL) as a guide to clinical response. General Hospital Psychiatry, 34(4), 332–338.Google Scholar
  22. Lavoie, S., Talbot, L., & Mathieu, L. (2011). Post-traumatic stress disorder symptoms among emergency room nurses: Their perspective and a ‘tailor-made’ solution. Journal of Advanced Nursing, 67(7), 1514–1222. Scholar
  23. Lee, J., Daffern, M., Ogloff, J. R., & Martin, T. (2015). Towards a model for understanding the development of post-traumatic stress and general distress in mental health nurses. International journal of mental health nursing, 24(1), 49–58.PubMedGoogle Scholar
  24. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52, 379–422.Google Scholar
  25. McFadden, P., Campbell, A., & Taylor, B. (2014). Resilience and burnout in child protection social work: Individual and organisational themes from a systematic literature review. British Journal of Social Work, bct210.Google Scholar
  26. McLaughlin, K. A., Koenen, K. C., Hill, E. D., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 52(8), 815–830. e814.Google Scholar
  27. Mealer, M., Conrad, D., Evans, J., Jooste, K., Solyntjes, J., Rothbaum, B., & Moss, M. (2014). Feasibility and acceptability of a resilience training program for intensive care unit nurses. American Journal of Critical Care, 23(6), e97–e105.PubMedGoogle Scholar
  28. Melvin, C. S. (2015). Historical review in understanding burnout, professional compassion fatigue, and secondary traumatic stress disorder from a hospice and palliative nursing perspective. Journal of Hospice & Palliative Nursing, 17(1), 66–72.Google Scholar
  29. Morse, G., Salyers, M. P., Rollins, A. L., Monroe-DeVita, M., & Pfahler, C. (2012). Burnout in mental health services: A review of the problem and its remediation. Administration and Policy in Mental Health and Mental Health Services Research, 39(5), 341–352.Google Scholar
  30. Mullen, J., & Leginski, W. (2010). Building the capacity of the homeless service workforce. Open Health Services and Policy Journal, 3, 101–110.Google Scholar
  31. Nishith, P., Mechanic, M. B., & Resick, P. A. (2000). Prior interpersonal trauma: the contribution to current PTSD symptoms in female rape victims. Journal of abnormal psychology, 109(1), 20.PubMedPubMedCentralGoogle Scholar
  32. Nonprofit, H. R. (2017). 2016 Nonprofit Emplyment Praqctices Survey.
  33. Olivet, J., McGraw, S., Grandin, M., & Bassuk, E. (2010). Staffing challenges and strategies for organizations serving individuals who have experienced chronic homelessness. The Journal of Behavioral Health Services and Research, 37(2), 226–238.PubMedGoogle Scholar
  34. Pinto, R. J., Henriques, S. P., Jongenelen, I., Carvalho, C., Maia, ÂC., Jongenelen, I., et al. (2015). The Strongest correlates of PTSD for firefighters: Number, recency, frequency, or perceived threat of traumatic events? Journal of traumatic stress, 28(5), 434–440. Scholar
  35. Regehr, C. (2018). Stress, trauma, and decision-making for social workers. New York: Columbia University Press.Google Scholar
  36. Regehr, C., Hemsworth, D., Leslie, B., Howe, P., & Chau, S. (2004). Predictors of post-traumatic distress in child welfare workers: A linear structural equation model. Children and Youth Services Review, 26(4), 331–346.Google Scholar
  37. Regehr, C., LeBlanc, V. R., Bogo, M., Paterson, J., & Birze, A. (2015). Suicide risk assessments: Examining influences on clinicians’ professional judgment. American Journal of Orthopsychiatry, 85(4), 295.PubMedGoogle Scholar
  38. Solomon, Z., Benbenishty, R., Neria, Y., Abramowitz, M., Ginzburg, K., & Ohry, A. (1993). Assessment of PTSD: Validation of the revised PTSD Inventory. Israel Journal of Psychiatry and Related Sciences, 30, 110–110.PubMedGoogle Scholar
  39. Sprang, G., Craig, C., & Clark, J. (2011). Secondary traumatic stress and burnout in child welfare workers: A comparative analysis of occupational distress across professional groups. Child Welfare, 90(6), 149–168.PubMedGoogle Scholar
  40. Stamm, B. H. (2009). Professional quality of life: Compassion satisfaction and fatigue version 5 (ProQOL).Google Scholar
  41. Stamm, B. H. (2010). The ProQOL manual: The professional quality of life scale compassion satisfaction (2 edn.). Pocatello: B Compassion Fatigue/Secondary Trauma Scales.Google Scholar
  42. Stevens, M., & Higgins, D. J. (2002). The influence of risk and protective factors on burnout experienced by those who work with maltreated children. Child Abuse Review, 11(5), 313–331. Scholar
  43. Substance Abuse and Mental Health Service Administration. (2014). TIP 54 Trauma-Informed Care in Behavioral Health Services Washington, DC: US Government.
  44. Van Hook, M. P., & Rothenberg, M. (2009). Quality of life and compassion satisfaction/fatigue and burnout in child welfare workers: A study of the child welfare workers in community based care organizations in central Florida. Social Work and Christianity, 36(1), 36.Google Scholar
  45. Whitbeck, L. B., Armenta, B. E., & Gentzler, K. C. (2015). Homelessness-related traumatic events and PTSD among women experiencing episodes of homelessness in three U.S. Cities. Journal of traumatic stress, 28(4), 355–360. Scholar
  46. Wilkins, K. C., Lang, A. J., & Norman, S. B. (2011). Synthesis of the psychometric properties of the PTSD checklist (PCL) military, civilian, and specific versions. Depression and anxiety, 28(7), 596–606.PubMedPubMedCentralGoogle Scholar
  47. Wood, M. D., Foran, H. M., Britt, T. W., & Wright, K. M. (2012). The impact of benefit finding and leadership on combat-related PTSD symptoms. Military Psychology, 24(6), 529.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculty of Social WorkUniversity of CalgaryCalgaryCanada
  2. 2.Faculty of Health DisciplinesAthabasca UniversityAthabascaCanada

Personalised recommendations