Posttraumatic stress disorder, secondary traumatic stress, and burnout in frontline workers in homelessness services: risk and protective factors

Abstract

ABSTRACT People experiencing homelessness (PEH) frequently have multiple and complex needs that may contribute to interpersonal difficulties that affect their relationships with services. As a result, professionals working in frontline homelessness services are frequently exposed to primary trauma (e.g. workplace aggression, crisis situations) and secondary trauma (e.g. hearing about service users’ traumatic experiences). This cross-sectional study explored organizational and individual factors in relation to three related but distinct facets of work-related distress: posttraumatic stress disorder (PTSD), secondary traumatic stress (STS), and burnout. A sample of 139 frontline workers in UK homelessness services completed an inventory of 15 possible distressing workplace experiences and four psychometric questionnaires. Results clearly evidence that frontline workers are exposed to high levels of potentially traumatic incidents at work and that this is associated with significant distress, with 23% of the sample meeting the threshold for PTSD diagnosis. Hierarchical multiple regression analyses identified trauma exposure and the use of “maladaptive” cognitive coping strategies as strong predictors of PTSD and STS, while organizational culture and compassion satisfaction were protective against burnout. These findings have important service implications, and recommendations are made regarding trauma- and psychologically informed approaches that organizations can implement to effectively support their employees.