Secondary Trauma Research Articles

Indirect Exposure to Atrocities and Post-Traumatic Stress Disorder Symptoms among Aid Workers: Hemispheric Lateralization Matters.

Background: Humanitarian aid workers (HAWs) are indirectly exposed to atrocities relating to people of concern (POC). This may result in a risk of secondary traumatization demonstrated by post-traumatic stress symptoms (PTSSs). Previous studies have demonstrated that hemispheric lateralization (HL) moderates the relationship between threat exposure and post-traumatic stress symptoms (PTSSs). Aims: We hypothesized that indirect exposure to atrocities (IETA) would be positively correlated with PTSSs among HAWs with right and not left HL. Method: Fifty-four HAWs from several countries that provided humanitarian support in Greece and Colombia participated in this correlational and cross-sectional observation study. They completed scales relating to IETA, PTSSs were assessed using a brief, valid scale, and HL was measured. Results: IETA was positively and significantly related to PTSSs (r = 0.39, p < 0.005). Considering HL, IETA was unrelated to PTSSs among people with right HL (r = 0.29, p = 0.14), while IETA was related to PTSSs among people with left HL (r = 0.52, p = 0.008). Right HL emerged as a protective factor in the relationship between IETA and PTSS. Conclusions: An assessment of dominant HL can serve as one consideration among others when deploying HAWs in specific locations and roles, vis à vis IETA. Moreover, those found to have a higher risk for PTSSs based on their HL could be monitored more closely to prevent adverse reactions to IETA.

The Costs of Caring: Quantifying Compassion Fatigue and Compassion Satisfaction in Burn Therapists.

Recovery from a severe burn injury requires early and aggressive therapy, which is often painful and distressing to the patient. Burn therapists who guide these interventions may be prone to experiencing secondary trauma and compassion fatigue through repeated exposure to difficult situations. At the same time, therapists may gain a sense of purpose and altruism from their work, fostering compassion satisfaction. Despite being well documented in other health professions, compassion fatigue and compassion satisfaction have not been sufficiently explored among burn therapists. This study aimed to quantify and characterize burn therapists' compassion fatigue and satisfaction using the Professional Quality of Life scale and to answer the question of what job-related factors may impact these outcomes. A total of 143 burn therapists participated in this study. Results revealed compassion fatigue subsale scores of burnout and secondary traumatic stress in the low or moderate range and compassion satisfaction scores in the moderate or high ranges for all participants. This study presents new knowledge for the field of burn care in its quantification of professional quality of life in burn therapists. While burn therapists experienced moderate-to-high levels of compassion satisfaction in their work, burnout and stress also approached moderate levels. Years of practice was a significant predictor of compassion. Although the reasons for this are not clear, it may be related to increased competence or confidence in practice and may suggest a need for different support strategies for practitioners at each stage of their burn therapy career.

A Viscous-Biofluid Self-Pumping Organohydrogel Dressing to Accelerate Diabetic Wound Healing.

Viscous biofluids on wounds challenge conventional "water-absorbing" wound dressings in efficient drainage due to their poor fluidity, generally causing prolonged inflammation, anti-angiogenesis, and delayed wound closure. Herein, it is reported that a self-pumping organohydrogel dressing (SPD) with aligned hydrated hydrogel channels, prepared by a three-dimensional-templated wetting-enabled-transfer (3D-WET) polymerization process, can efficiently drain viscous fluids and accelerate diabetic wound healing. The asymmetric wettability of the hydrophobic-hydrophilic layers and aligned hydrated hydrogel channels enable unidirectional and efficient drainage of viscous fluids away from the wounds, preventing their overhydration and inflammatory stimulation. The organogel layer can adhere onto the skin around the wounds but can be easily detached from the wet wound area, avoiding secondary trauma to the newly formed tissues. Taking a diabetic rat model as an example, the SPD can significantly downregulate the inflammation response by ≈70.8%, enhance the dermal remodeling by ≈14.3%, and shorten wound closure time by about 1/3 compared with the commercial dressing (3M, Tegaderm hydrocolloid thin dressing). This study sheds light on the development of the next generation of functional dressings for chronic wounds involving viscous biofluids.

Exploring the Impact of Rehabilitation and Custody Orientations on Workplace Experiences of Juvenile Probation and Detention Officers

Prior research has suggested that juvenile justice staff’s support for rehabilitation is important for the success of their juvenile clients. The purpose of this article was to assess how rehabilitation and punishment orientations impacted burnout, secondary trauma, job stress, and job satisfaction among juvenile probation and detention officers. Results indicated that having more of a rehabilitation orientation did not demonstrate direct effects on the workplace outcomes included in this study. However, staff who indicated more of a punishment orientation were less likely to report emotional exhaustion and personal accomplishment, as well as less job stress, but were more likely to report feelings of depersonalization.

Correctional Officer Responses to Workplace Trauma: Refining the Vicarious Trauma Toolkit

The Vicarious Trauma Toolkit (VTT) was created as a mental health resource for first-responders such as police officers and fire fighters who are routinely exposed to vicarious workplace trauma. While VTT services are appropriate for these occupational groups, they seem less so for correctional officers who are also exposed to secondary trauma at work. To widen the VTT’s reach to a correctional context, open-ended questionnaire data gathered from correctional officers ( N = 193) working in a Southeastern state prison system were analyzed inductively to understand the different types of trauma they encounter in their job, and their responses to trauma. Respondents cited both direct and vicarious trauma sources, including assaults, self-injury, and suicide. Their responses were categorized as either negative (alcohol use), neutral (professional detachment), or positive (gratefulness). Additional VTT resources that can reach an international audience of frontline workers are proposed in light of these findings.

Determinants of Negative and Positive Consequences of Indirect Exposure to Trauma in Polish Nuns Caring for Disabled People: The Role of Spirituality and Optimistic Life Attitude.

Professionals working with people after traumatic experiences are indirectly exposed to the consequences of trauma. The aim of the study was to establish the role of spirituality and optimism in the occurrence of secondary traumatic stress and growth among 104 Polish Catholic nuns caring for peoplewith adisability. The study used 4 standard measurement tools. A multidimensional analysis identified four types of consequences. Nuns caring for people with disabilities are as vulnerable to secondary traumatization as other professionals working with traumatized people, but they are more likely to experience positive consequences of care, and this is thanks to theirspirituality.

A longitudinal study of child and adolescent psychopathology in conditions of the war in Ukraine

IntroductionAccording to UNICEF, 2 million children have left the country since the beginning of the war. 2.5 million Ukrainian children are internally displaced persons. Minors often become victims or witnesses of violence.The events of 2022-2023 are the largest military conflict in the world since World War II. The impact on the mental health of the population is characterized by the variety and mass of traumatizing factors.Mental trauma causes PTSD, depressive disorders (DD), anxiety disorders (AD), behavioral disorders (CD), attention deficit hyperactivity disorder (ADHD).ObjectivesThe aim of the study was to determine the prevalence of PTSD and its comorbidities at different stages of experiencing a traumatic experience.Methods785 teen`s displaced from the zone of military operations, occupied territories were surveyed. Examinations included: K-SADS-PL, PSC-17, SCARED, CATS. 260 teen`s were examined during - 6, 400 – 6–12 months after traumatization.ResultsAfter 6 months of trauma, PTSD was diagnosed in 9.8%, ADHD – 10.2%, DD-22.3%, AD-30.8%, CD – 15.4%, 28.8%; examined 6 to 12 months after the injury, respectively: 21.9%, 12.6, 33.3%, 11.5%, 18.0%.ConclusionsIn war-affected children, PTSD is a risk factor for the subsequent development of comorbid depression, anxiety, conduct disorders, and ADHD. Female sex, secondary traumatization after displacement increase the risk of developing depression, signs of pervasive development and ADHD - the risk of destructive and self-injurious behavior. The prevalence of PTSD, DD, ADHD increases within 6-12 months after the trauma, the sensitivity of children with PTSD to secondary traumatic events increases.Disclosure of InterestNone Declared

Secondary Trauma by Internet Content Moderation: a Case Report

Introduction In recent years, a global debate has emerged regarding the protection of Internet users from exposure to harmful content. Content moderation is defined as the organized practice of filtering user-generated content posted on internet, social networks, and media to determine the appropriateness of the content for a site, locality, or jurisdiction. The growing volume of this content along with the psychological impact of this activity have promoted the application of automated approaches based on artificial intelligence and machine-learning. However, the changing characteristics of content, as well as the cultural differences that influence its appropriateness, mean that human moderation of Internet content currently continues to exist. Psychological effects of this activity such as symptoms of post-traumatic stress disorder (PTSD) could represent an example of secondary trauma.Objectives Our aim is to describe a clinical case of post-traumatic stress disorder presenting with specific traumatic exposure idiosyncrasy that could lead to a better consequence characterization of a recent social phenomena such as internet content moderation.MethodsWe expose the clinical case of a woman with emotional distress who was reffered to our outpatient psychiatric unit in Barcelona in 2022 after five years working as an internet content moderator.ResultsWe describe the case of a 35-year-old woman without relevant medical, toxicologic or psychiatric record that presents to our out-patient psychiatric clinic with post-traumatic stress disorder after five years of working as an internet content moderator and being exposed to visual traumatic content such as sexual assault and paedophilia. The clinical presentation consisted with one year of recurrent daily panic attacks, intrusive images about the traumatic exposure, intrusive thoughts, insomnia, vivid nightmares, avoidance of exposure to her son, distrust of the environment and intense fear for her son security. The disorder interfered in her capacity to work. The patient received psychological treatment and ISRS (Sertraline) was prescribed, however only partial response was reached with persistence of the majority of symptoms.ConclusionsThe presented case suggests a temporal and symptom content relationship between the described work exposure and the appearance of emotional distress in a patient without PTSD history. Although previous evidence of secondary trauma in people exposed to indirect traumatic experiences has been reported, for example in healthcare professionals, the exposure to alien trauma through digital exposure as a workactivity is yet to be specifically examined. It is necessary to expand knowledge on the clinical expression of this phenomenon due to the observed recurrence of anxious and depressive symptomatology related to repeated exposure to traumatic content.Disclosure of InterestNone Declared

Association of prosocial personality traits with symptoms of depression, anxiety and stress in psychiatric nurses; Single-centre cross-sectional study in Croatia

IntroductionSymptoms of depression, anxiety and stress are more common in the population of nurses working in psychiatric hospitals than in many other segments of the health care system. These three elements of psychological distress (depression, anxiety, stress) may reduce the nurse’s ability to establish quality therapeutic relationships with patients, which are very important in the treatment of mental disorders. Some studies suggest that prosocial personality traits may have a protective role. Other research suggests that high levels of empathy, for example, may increase secondary traumatisation and lead to more pronounced symptoms of distress.ObjectivesThe main objective of the study was to examine the association of prosocial personality traits with symptoms of depression, anxiety and stress in nurses employed in a psychiatric clinic. The hypothesis was that more pronounced prosocial personality traits are associated with a lower expression of symptoms of depression, anxiety and stress.MethodsThe target population were nurses employed in a psychiatric hospital working directly with patients. No sample was selected, but the whole available population was invited to participate. The independent variable was prosocial personality traits measured by the Prosocial Personality Battery (PSB). The outcome was symptoms of distress (depression, anxiety and stress) measured using the Depression, Anxiety, Stress Scale-21 (DASS-21). The hypothesis was tested using three linear regression analyses.ResultsTotal of 63 MST were included with a median (interquartile range) age of 34 (24-42) years. Prosocial personality traits were statistically significantly associated with scores on the DASS-21 subscale measuring depression: personal distress (PD) (r = 0.32; P = 0.01) and self-reported altruism (r = 0.30; P = 0.02). Only the subscale measuring the specific personality trait of personal distress (PD) was statistically significantly correlated with the scores of the other two DASS-21 subscales, anxiety and stress (anxiety: r = 0.54; P &lt; 0.001; stress: 0.46; P &lt; 0.001). Helpfulness was negatively related to anxiety (b = -0.29; P = 0.03).ConclusionsThis research partially confirmed the hypothesis that stronger prosocial personality traits are associated with a lower prevalence of symptoms of depression, anxiety and stress in the MST of employees in a psychiatric clinic.Disclosure of InterestNone Declared

Experimental research based on robot-assisted surgery: Lower limb fracture reduction surgery planning navigation system.

Lower extremity fracture reduction surgery is a key step in the treatment of lower extremity fractures. How to ensure high precision of fracture reduction while reducing secondary trauma during reduction is a difficult problem in current surgery. First, segmentation and three-dimensional reconstruction are performed based on fracture computed tomography images. A cross-sectional point cloud extraction algorithm based on the normal filtering of the long axis of the bone is designed to obtain the cross-sectional point clouds of the distal bone and the proximal bone, and the optimal reset target pose of the broken bone is obtained by using the iterative closest point algorithm. Then, the optimal reset sequence of reset parameters was determined, combined with the broken bone collision detection algorithm, a surgical planning algorithm for lower limb fracture reset was proposed, which can effectively reduce the reset force while ensuring the accuracy of the reset process without collision. The average error of the reduction of the model bone was within 1.0 mm. The reduction operation using the planning and navigation system of lower extremity fracture reduction surgery can effectively reduce the reduction force. At the same time, it can better ensure the smooth change of the reduction force. Planning and navigation system of lower extremity fracture reduction surgery is feasible and effective.

Is a Personal Trauma History a Risk Factor for the Development of Secondary Traumatization in EMDR Therapists?

Symptoms severe enough to constitute a secondary traumatization (ST) can arise from providing eye movement desensitization and reprocessing (EMDR) treatment. However, little is known about specific risk factors such as a personal trauma history. EMDR therapists (n= 115) filled out a questionnaire battery to test whether the personal trauma history predicts symptom levels over and beyond vicarious exposure and whether vicarious exposure mediates the relationship between primary trauma history and current ST severity. Current exposure predicts ST symptom severity, while lifetime exposure is negatively associated. The number of primary traumata and the total severity of primary traumata do not explain additional variance in ST symptom severity. The mediation model suggests that primary trauma exposure instead is associated with treating more traumatized clients. The current results suggest that ST is a relevant topic to address in EMDR training, but the personal trauma history does not seem to constitute a relevant risk factor per se. It might, however, be associated with preferences for clientele composition, which in turn might act as a risk factor.

Spouses of First Responders: Support for Living With Posttraumatic Stress

Emergency first responders (police, fire, paramedic, dispatch) engage in work that includes multiple traumas, sometimes leading to posttraumatic stress. Due to work spillover at home, spouses are susceptible to vicarious and secondary trauma. While there are debriefings for traumatic calls for first responders, no such thing exists for the spouses who are the first to provide support at home. There is a lack of availability of resources supporting first responder spouses, particularly those whose first responders are diagnosed with posttraumatic stress disorder. Stepping into this gap is a unique 6-day residential treatment program provided in a secluded location in Northern California, where a small number of clients engage in a program directed by peers who have been through the program themselves, culturally competent clinicians, and chaplains. The therapeutic milieu is supported by psychoeducation, group processing, nutritious meals, daily activity, and an optional daily chapel program. Based on a dissertation, and using Gass’ wheel of change as a framework, this article shares the results of a qualitative study of eight participants' experiences of the program gleaned from in-depth interviews, a review of program agendas, and self-assessment scores pre- and postprogram. Inductive analysis resulted in common themes including a reduction in isolation, anxiety, and depression symptoms, normalization of experiences, and community. Like the insider-researcher author, individuals finding that they have “lost themselves” in the role of first responder spouse identify this residential treatment experience as a “back to myself” program. Further research on program effectiveness via program evaluation is recommended.

That’s Gonna Leave a Mark: Positionality and Secondary Trauma in Researching Mass Killing and Genocide

In this article, I describe two fieldwork experiences dealing with traumatic subject matter: a three-month trip to the Russian Federation, researching the crimes of Stalin against the Soviet population, and a two-week odyssey across Poland, researching memorialization of the Holocaust as it occurred there. I had a much more difficult time on the Polish trip. These trips took place at different times, and my positionality had changed dramatically between the two experiences. The other relevant factor in each case was the nature of the material itself and the extent to which I was exposed to it. The Stalinist Terror is much more submerged in Russian society, for example, and it was often challenging to find evidence that it had occurred, as this involved travel to often far-flung Gulag and mass execution sites. In the Polish case, however, the Holocaust narrative and evidence of its occurrence was front and center in my experiences there, to the extent that the ubiquity of sites where terrible events occurred became overwhelming. The interaction of my positionality and the extent to which I was exposed to different types of traumatic experience, led to widely differing emotional tolls on my psyche in each case. I hope an analysis of this interaction, and the differing effects it produced provides information about planning and executing research on traumatic subjects that is valuable to others preparing to undertake it. (Or perhaps it will provide a cautionary tale about what to avoid). This article adds to the literature on personal negative outcomes experienced by those researching traumatic subject matter, particularly in the social sciences.

Suicide among psychiatrists: From healers to seekers of mental health care

Addressing suicide and mental health issues among psychiatrists, particularly during a crisis such as the COVID-19 pandemic is important. several factors contribute to this risk, such as long duty hours, burnout, emotional exhaustion, exposure to secondary trauma, and the impact of the pandemic on the mental health of healthcare workers. This paper emphasizes the urgent need for interventions at individual and organizational levels to address burnout and mental health issues among psychiatrists. Supporting the mental resilience of mental health professionals will improve the mental health of the community.

Tension band high-strength suture combined with absorbable cannulated screws for treating transverse patellar fractures: finite element analysis and clinical study.

Objective: Few reports exist on the treatment of transverse patellar fractures (TPFs) using absorbable cannulated screws and high-strength sutures, and most screws and sutures lack good biomechanics and clinical trials. Therefore, this study aimed to demonstrate the biomechanical stability and clinical efficacy of tension-band high-strength sutures combined with absorbable cannulated screws (TBSAS) in treating TPFs (AO/OTA 34 C1). Methods: Finite element models of five internal fixation schemes were established: tension-band wire with K-wire (TBW), TBW with cerclage wire (TBWC), TBW with headless pressure screws (TBWHS), TBW with full-thread screws (TBWFS), and TBSAS. We comprehensively compared the biomechanical characteristics of the TBSAS treatment scheme during knee flexion and extension. Forty-one patients with TPFs in our hospital between January 2020 and August 2022 were retrospectively enrolled and divided into the TBSAS (n = 22) and TBWC (n = 19) groups. Clinical and follow-up outcomes, including operative time, visual analog scale (VAS) pain score, postoperative complications, Bostman score, and final knee range of motion, were compared between both groups. Results: Finite element analysis (FEA) showed that TBWHS and TBWFS achieved the minimum mean fracture interface relative displacement during knee flexion (45°, 0-500N bending load) and full extension (0°, 0-500N axial load). There was no significant difference between TBSAS (0.136mm) and TBWC (0.146mm) during knee flexion (500N); however, TBSAS displacement was smaller (0.075mm) during full extension (500N). Furthermore, the stress results for the internal fixation and the patella were generally lower when using TBSAS. Retrospective clinical studies showed that the TBSAS group had a shorter operative time, lower VAS pain score at 1 and 2months postoperatively, better Bostman knee function score at 3 and 9months postoperatively, and better final knee joint motion than the TBWC group (all p < 0.05). There were five cases (26.3%) of internal fixation stimulation complications in the TBWC group. Conclusion: TBSAS demonstrated excellent safety and effectiveness in treating TPFs. It is sufficient to meet the needs of TPF fixation and early functional exercise and effectively reduces metal internal fixation-induced complications and secondary surgery-induced trauma.

More Than Surviving: Secondary Trauma in English Language Arts

Using methods of storytelling to share and make sense of their experience with trauma in English language arts classrooms, the authors imagine healthier ways of coming into relationship with the traumatic conditions produced in schools.

Occupational Health Services in policing: identifying the psychological burden to OHS team members.

Occupational Health Services (OHS) workers in the police are exposed to stressful and pressurized environments where they try to help employees deal with serious physical and mental health conditions. This study used psychological surveillance to identify the level of mental health conditions within each of the police OHS (POHS) roles and to identify whether it was possible to identify the main hazards and resilience factors related to these conditions. Data on mental health conditions (anxiety, depression, post-traumatic stress disorder [PTSD] and secondary trauma) were gathered with questionnaires measuring lifestyle, coping skills, workability and illness behaviour. Personal information and average symptoms, hazards, and resilience factors were measured and compared between the POHS groups. Stepwise linear regression was used to identify the variable that explained the symptoms' level. Data were gathered from 251 POHS team members working in multidisciplinary services, including OH physicians, psychologists, advisors, nurses, technicians, well-being and administrators. The results showed that POHS teams are experiencing levels of symptoms significantly higher than those found in the general population and that OH counsellors had lower levels of symptoms and sickness absence than their colleagues. The stepwise regression identified managing workloads to be associated with lower symptom levels. The findings illustrated the importance of a manageable workload, a stable, resilient personality and a positive attitude towards work. Using coping skills, including physical fitness, social support, involvement and getting enough sleep is associated with lower anxiety, depression, PTSD and secondary trauma symptoms.

MHealth Gratitude Exercise Mindfulness App for Resiliency Among Neonatal Intensive Care Unit Staff: Three-Arm Pretest-Posttest Interventional Study.

Health care is highly complex and can be both emotionally and physically challenging. This can lead health care workers to develop compassion fatigue and burnout (BO), which can negatively affect their well-being and patient care. Higher levels of resilience can potentially prevent compassion fatigue and BO. Strategies that enhance resilience include gratitude, exercise, and mindfulness. The purpose of this study was to determine if a 3-week daily resiliency practice, prompted via a gratitude, exercise, and mindfulness smartphone app, impacted the professional quality of life, physical activity, and happiness level of health care workers in a newborn intensive care unit setting. In total, 65 participants from a level III newborn intensive care unit at a regional hospital in the western United States completed this study. The Professional Quality of Life Scale, Physical Activity Vital Sign, and Subjective Happiness Score instruments were used to evaluate the effects of the mobile health (mHealth) intervention. Further, 2-tailed dependent paired t tests were used to evaluate participant pre- and postintervention instrument scores. Multiple imputation was used to predict scores of participants who practiced an intervention but did not complete the 3 instruments post intervention. Dependent t tests using the original data showed that participants, as a whole, significantly improved in BO (t35=2.30, P=.03), secondary trauma stress (STS; t35=2.11, P=.04), and happiness (t35=-3.72, P<.001) scores. Compassion satisfaction (CS; t35=-1.94, P=.06) and exercise (t35=-1.71, P=.10) were trending toward, but did not reach, significance. Using the original data, only the gratitude intervention group experienced significant improvements (CS, BO, and happiness), likely due to the higher number of participants in this group. Analysis using imputed data showed that participants, as a whole, had significant improvements in all areas: CS (t64=-4.08, P<.001), BO (t64=3.39, P=.001), STS (t64=4.08, P<.001), exercise (t64=-3.19, P=.002), and happiness (t64=-3.99, P<.001). Looking at the intervention groups separately using imputed data, the gratitude group had significant improvements in CS, BO, STS, and happiness; the exercise group had significant improvements in STS and exercise; and the mindfulness group had significant improvements in CS and happiness. Phone app delivery of resilience-enhancing interventions is a potentially effective intervention model for health care workers. Potential barriers to mHealth strategies are the technical issues that can occur with this type of intervention. Additional longitudinal and experimental studies with larger sample sizes need to be completed to better evaluate this modality.

Biomimetic short fiber reinforced 3-dimensional scaffold for bone tissue regeneration

Bone defects caused by diseases and trauma are considered serious clinical challenges. Autologous and allogeneic transplantations are the most widely used methods to mitigate bone defects. However, transplantation poses risks such as secondary trauma, immune rejection, and disease transmission to patients. Preparing a biologically active bone tissue engineering scaffold as a bone substitute can overcome this problem. In the current study, a PLGA/gelatin (Gel) short fiber-reinforced composite three-dimensional (3D) scaffold was fabricated by electrospinning for bone tissue defect repair. A hybrid scaffold adding inorganic materials hydrotalcite (CaAl-LDH) and osteogenic factors deferoxamine (DFO) based on PLGA and Gel composite filaments was prepared. The structure, swelling, drug release, and compressive resilience performance of the 3D scaffolds in a wet state were characterized and the osteogenic effect of the crosslinked scaffold (C-DLPG) was also investigated. The scaffold has shown the optimum physicochemical attributes which still has 380 kPa stress after a 60% compression cycle and sustainedly released the drug for about twenty days. Moreover, a promising In vivo osteogenic performance was noted with better tissue organization. At 8 weeks after implantation, the C-DLPG scaffold could fill the bone defect site, and the new bone area reached 19 mm2. The 3D microfiber scaffold, in this study, is expected to be a promising candidate for the treatment of bone defects in the future.

Child Health Needs and the Child Abuse Pediatrics Workforce: 2020-2040.

Child abuse pediatrics (CAP) subspecialists evaluate, diagnose, and treat children when abuse or neglect is suspected. Despite the high rates of child maltreatment across the United States, CAP remains the smallest pediatric subspecialty. The CAP workforce faces numerous challenges, including few fellows entering the field, decreased financial compensation compared with other fields of medicine, and threats to workforce retention, including secondary trauma and harmful exposure in the media. A microsimulation model that estimates the future of the US CAP workforce over the next 20 years shows that, although the number of child abuse pediatricians in the field is expected to increase, the growth is smaller than that of every other pediatric subspecialty. In addition to the low overall CAP workforce in the United States, other workforce issues include the need to increase CAP subspecialists who are underrepresented in medicine and unequal geographic distribution across the country. To meet the medical needs of suspected victims of maltreatment, especially in CAP-underserved areas, many children are evaluated by providers who are not board-certified in CAP, such as general pediatricians, family medicine physicians, emergency medicine physicians, and advanced practice providers, whose CAP experience and training may vary. Current child abuse pediatricians should continue introducing the field to medical students and residents, especially those who identify as underrepresented in medicine or are from CAP-underserved areas, and offer mentorship, continuing education, and oversight to non-CAP physicians meeting this population's medical needs.