Understanding Secondary Trauma & Burnout: A Guide to Self-Care
Discover evidence-based strategies for coping with secondary trauma, vicarious trauma, and burnout. This resource offers practical tools for carers, clinicians, teachers, and support workers to maintain wellbeing while helping others.
What is Secondary Trauma?
Definition
Secondary trauma is emotional duress that results from indirect exposure to the traumatic experiences of others. It develops when we absorb the emotional weight of others' suffering.
Prevalence
Approximately 30% of healthcare and human service workers experience significant symptoms of secondary trauma during their careers.
Most Affected
Therapists, first responders, social workers, and others who regularly engage with traumatised individuals are particularly vulnerable to developing secondary trauma.
Understanding Vicarious Trauma

Cognitive Changes
Fundamental shifts in thinking and perception
Safety Concerns
Increased perception of threat and danger
Trust Issues
Difficulty maintaining trust in relationships
Vicarious trauma involves long-term cognitive changes resulting from exposure to others' trauma. A 2022 UK survey found that 62% of child welfare professionals reported symptoms of vicarious trauma.
Defining Burnout
Exhaustion
Feeling depleted of energy and emotionally drained
Cynicism
Detachment and negative attitudes toward work
Reduced Efficacy
Diminished sense of accomplishment and productivity
Burnout impacts 40-60% of UK health and social care workers. While not classified as a medical condition, the WHO recognises it as an occupational syndrome in the ICD-11.
Symptoms and Warning Signs
Emotional Signs
  • Emotional numbness
  • Irritability and mood swings
  • Loss of empathy
  • Helplessness
Cognitive Signs
  • Difficulty concentrating
  • Intrusive thoughts
  • Decreased self-efficacy
  • Negative worldview
Physical Signs
  • Persistent fatigue
  • Sleep disturbances
  • Headaches
  • Gastrointestinal problems
Causes and Risk Factors
Excessive Workload
High caseloads and overexposure to trauma narratives
Organisational Factors
Lack of support, resources, recognition and appropriate supervision
Personal History
Previous trauma and lack of self-care strategies
Impact on Mental Health and Life
£1.7B
Annual NHS Cost
Economic impact of burnout (King's Fund, 2020)
67%
Increased Risk
Higher likelihood of depression and anxiety (BMJ Open, 2019)
42%
Staff Turnover
Percentage considering leaving their profession (Royal College of Nursing, 2021)
Secondary trauma and burnout not only affect professional performance but can spill over into personal relationships, leading to social withdrawal and difficulty maintaining work-life balance (Journal of Occupational Health Psychology, 2018; World Health Organization, 2022).
Emotional Toll: Stories from the Field
Sarah, A&E Nurse during COVID-19
I found myself waking up with nightmares about patients I couldn't save. The constant exposure to suffering and death during the pandemic left me feeling hollow. I didn't recognise myself anymore – I was snapping at my children and withdrawing from friends.
James, Social Worker in Child Protection
After years of hearing horrific stories of child abuse, I began to see danger everywhere. I became hypervigilant with my own children and struggled to trust anyone with their care. The world started to feel like an unsafe place.
Priya, Refugee Support Counsellor
The stories of war and persecution began to haunt me. I found myself feeling guilty about my comfortable life and became overwhelmed by helplessness. It took me months to recognise I was experiencing vicarious trauma.
Difference Between Burnout and Trauma Responses
The Science of Trauma: Brain and Body
Neurological Impact
Studies from 2021-2023 show chronic cortisol elevation from vicarious trauma can lead to hippocampal shrinkage, affecting memory and emotional regulation.
Physical Manifestations
The body stores trauma responses through autonomic nervous system dysregulation, leading to fight-flight-freeze and fawn reactions and physical symptoms.
Cognitive Effects
British Psychological Society research confirms "brain fog," attention problems, and decision-making difficulties result from constant exposure to others' trauma.
Mindfulness Explained
Present-Moment Awareness
Mindfulness involves deliberately paying attention to present experiences without judgment. It creates space between stimuli and response, allowing for more measured reactions.
Evidence-Based Benefits
Mindfulness-based Interventions (MbI) have been shown to lower anxiety and stress by up to 58% among healthcare workers. NICE guidelines now recommend it for frontline NHS staff.
Neurological Changes
Regular mindfulness practice creates measurable changes in brain regions associated with attention, emotional regulation, and resilience against stress.
Meditation Practices for Daily Life
Breath Meditation
Simple 5-minute focus on breathing patterns
Body Scan
Systematic attention to physical sensations
Walking Meditation
Mindful movement for active professionals
Loving-Kindness
Cultivating compassion for self and others
JAMA 2022 research shows just 12 minutes of daily meditation reduces perceived stress by 25%. Popular apps like Headspace and Calm offer guided sessions for beginners.
Practical Self-Care Strategies
Prioritise Sleep
Aim for 7-9 hours with consistent bedtime routines. Avoid screens before sleep and create a restful environment.
Nourish Your Body
Focus on balanced nutrition with regular meals. Limit caffeine and alcohol which can exacerbate anxiety and sleep disturbances.
Maintain Connections
Schedule regular time with supportive friends and family. Share experiences but set boundaries around work discussions.
Move Regularly
Physical activity reduces stress hormones and improves mood. Even short walks during breaks can make a difference.
Trauma-Informed Workplaces

Organisational Recognition
Acknowledging the reality of secondary trauma
Policy Implementation
Creating structures that support wellbeing
Regular Supervision
Providing space for reflection and processing
Culture of Self-Compassion
Normalising self-care as professional responsibility
70% of NHS trusts have adopted trauma-informed care guidelines, recognising that supporting staff wellbeing directly impacts quality of care and service sustainability.
Early Intervention and Prevention
Self-Assessment
Use validated tools like the Professional Quality of Life Scale (ProQOL) or Maslach Burnout Inventory to monitor your wellbeing regularly.
Supervision
Engage in regular clinical supervision to process challenging cases and identify early warning signs of distress.
Boundaries
Establish clear work-life boundaries including email-free evenings and protected time for recovery between intense cases.
Help-Seeking
Normalise reaching out for support as a sign of professional strength rather than weakness or incompetence.
Peer Support and Professional Networks
Peer support programmes show remarkable effectiveness, with research indicating a 30% lower risk of severe burnout among professionals who participate in regular peer debriefing. Support lines like Mind, Samaritans, and Professionals' Aid Trust offer specialised assistance.
Online Resources and Mobile Apps
Headspace
Offers guided meditations specifically designed for healthcare professionals and teachers, with programmes for sleep, stress, and focus.
NHS Every Mind Matters
Provides free tools, personalised action plans, and resources specifically designed for those in caring roles.
MindEd e-Learning
Offers specialised modules on recognising and addressing secondary trauma and burnout in professional contexts.
When to Seek Professional Help
Red Flag Symptoms
  • Persistent depression or anxiety
  • PTSD symptoms (nightmares, flashbacks)
  • Suicidal thoughts or hopelessness
  • Substance misuse to cope
NHS Pathways
  • GP referral to counselling
  • Self-referral to IAPT services
  • Occupational health support
  • NHS Staff Mental Health Hotline
Other Options
  • Private therapy (BACP/UKCP registered)
  • Charity services (Mind, Samaritans)
  • Professional body support programmes
  • Crisis text line: text SHOUT to 85258
Moving Forward: Building Personal and Collective Resilience
Self-Compassion
Celebrate small wins and practice kindness toward yourself
Continuous Learning
Develop knowledge about trauma and self-care strategies
Community Building
Create networks of mutual support with colleagues
Advocacy
Promote systemic changes in workplace practices
Your wellbeing matters. By prioritising self-care and connecting with others, you not only protect yourself but strengthen your capacity to help others. We invite you to share your own healing stories and strategies as we build resilience together.