Factors associated with Type II trauma in occupational groups working with traumatised children: a systematic review

Abstract

Background: There is evidence that “Type II trauma” (TTT) - repeated exposure to traumatic events - can lead to the development of post-traumatic stress disorder (PTSD). TTT frequently occurs in occupational groups working with children who are themselves victims of trauma.

Aim: To conduct a systematic review identifying risk factors for/protective factors against TTT-associated mental ill-health in employees working with traumatised children and explore how this type of work impacts upon social functioning.

Method: Databases were searched for relevant studies and supplemented by hand searches.

Results: 836 papers were found and 13 were included in the review. The key themes identified were coping mechanisms; social support; personality; demographics; occupational support; work-related stressors; traumatic exposure; organisational satisfaction; training/experience and impact on life.

Conclusion: Unhelpful coping strategies (e.g. denial) appeared to increase the risk of TTT. Training and strong support may be protective and work-related stressors (e.g. excessive workload) appeared detrimental. Despite some positive impacts of the work (e.g. becoming more appreciative of life) many negative impacts were identified, demonstrating the importance of minimising risk factors and maximising protective factors for staff at risk of TTT.

Keywords:

• Child welfare workers
• complex trauma
• secondary trauma
• trauma
• type II trauma

Acknowledgements

The research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King’s College London in partnership with Public Health England (PHE). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health or Public Health England. The funding body did not play a role in the design, collection, analysis or interpretation of data; the writing of the manuscript; or the decision to submit the manuscript for publication.

Declaration of interest

NG runs a psychological health consultancy which provides among other services TRiM training.