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What is secondary traumatic stress?

 Let’s reduce the stigma and relieve the burden

July 15, 2022

At Children’s Cove, we work with child survivors of sexual abuse, assault, violence, and exploitation. We listen as children tell their story, and our multidisciplinary team gathers the information needed for an investigation. Coordinated care is provided to each child and their non-offending family members who may be affected by the trauma.

For every child who is a victim of crime, there’s a team of professionals from law enforcement, child protection, mental health and medical services working to support them. The trauma the survivor and their family experience is often palpable.  What is also important to note is that the effect of that trauma does not stop with the families – professionals who work in this field also experience something called vicarious trauma or secondary traumatic stress.

Vicarious trauma is when an individual, because of their work, experiences a profound shift in their worldview. This secondary traumatic stress is the emotional toll absorbed at each instance of hearing about someone else’s trauma, or talking with someone about their trauma, or witnessing someone else’s trauma after the fact. This participation in the experience of another’s trauma, even to support them, has consequences that mirrors post-traumatic stress disorder, or PTSD.

One misunderstanding about secondary trauma, and the stress felt from it, is the belief that each incident is addressed and moved past. Unfortunately, this is not the case. Secondary traumatic stress is cumulative, as each incident, each memory and each sense is touched from the experience of what you heard, how you heard, where and what you saw. It becomes a permanent impression in your mind,

Often professionals who work at child advocacy centers, law enforcement agencies, as well as those who provide emergency medical, mental health, or child protective services, recognize these experiences as an occupational hazard.  Even when this occupational hazard is identified, there is an expectation that due to the job they hold, they are a professional and should be able to process their vicarious trauma.  This very unfair expectation has created a stigma around asking for help, which creates an emotional burden with no outlet.

With no outlet, imagine each vicarious traumatic experience as a drop of water into a glass a person must carry with them everywhere. At first the weight of that glass isn’t much. But with time, more drops are collected in the glass, the weight builds, the strain grows and the burden of carrying all that water becomes too much. This is usually when the water spills over and the result can be an emotional breakdown, impulsive decision-making like quitting a job, or struggles with substance misuse, or worse.

At Children’s Cove, we believe it’s imperative that our team members are well taken care of – that we address and discuss openly vicarious trauma and secondary traumatic stress. We incorporate conversations about trauma in our interviews, staff meetings and regular supervision. Our staff regularly attends trainings on managing secondary traumatic stress and we’ve partnered with Calmer Choice to learn mindfulness skills to aid in our own self-care.

For those of you who need help decompressing to relieve secondary traumatic stress, here are a few suggestions we’d like to offer.

The first is the most important: empty your glass before it gets too heavy.

As a larger culture in our country, we have a terrible habit of going and going until we have nothing left. that doesn’t happen to work very well in these circumstances. You must find a way to empty the glass. This is typically something that you do, it’s not something that you take. It’s finding, and setting regular time for, an activity that you enjoy which makes you active, mentally, or physically. It’s taking the time to talk with a friend, and if you feel brave, talk about what you have been feeling lately.  It’s volunteering or engaging in an activity to support others you don’t see regularly. It’s reconnecting with your spirituality or faith. It’s allowing yourself permission to see a therapist.

To address the impact of secondary traumatic stress, it is vital to acknowledge that there is an emotional burden and that it is imperative to take time to heal. Making conscious choices and decisions to set time for ourselves by doing something we know replenishes our strength – either mentally, physically, or spiritually will allow us to empty that glass a little bit, to continue to carry it forward.

Remember, you matter. We matter. The roles that we all play in each other’s lives matter.

Please take care of yourselves.

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A message to our children: “Let’s talk now, not later.”

June 20th, 2022

As the summer arrives, many of us welcome the season by purchasing beach stickers, pulling out the beach towels, bathing suits, floats, boogie boards and coolers for weekends at our favorite seashore spot. We are busy planning summer camp for the kids, family vacations and time off for fun.

At Children’s Cove, we are preparing for summer by provide training and education to camp counselors across the Cape and Islands to recognize and respond to abuse for children in their care. We have turned on the air conditioning to make sure our building is comfortable and welcoming for the families we serve. Summer is also a strategic planning time with our advisory council. Admittedly, at times, it can be quiet over the summer at the Cove, as there is typically a drop in cases referred to us by our community partners. It’s a time for us to catch up, organize, and prepare for the unfortunately busy Fall.

Once kids and teens return to school in the Fall, we get more referrals as school is a place where students make a connection to adults they trust and feel comfortable talking about what happened over the summer. They might reveal their experience with a family member who visited and did something inappropriate, the person at camp who touched them when no one else was around, or the party at the local beach where someone didn’t listen to the word “NO” or used alcohol to get their way.

Once kids and teens return to school in the Fall, we get more referrals as school is a place where students make a connection to adults they trust and feel comfortable talking about what happened over the summer. They might reveal their experience with a family member who visited and did something inappropriate, the person at camp who touched them when no one else was around, or the party at the local beach where someone didn’t listen to the word “NO” or used alcohol to get their way.

When a person is victimized, they often tell no one. Because of the stigma of sexual assault and abuse, coupled with the accompanying feelings of mistrust and fear, approximately 90% of assaults and abuse go completely unreported. Many don’t know who to tell or ask for help. It can take a long time for someone to find their voice. It may take days, weeks, months or longer for a victim to recognize that what they experienced was an assault or at the very least, something which was not consented to. This delay can cause challenges for the victim’s mental and physical health, evidence preservation for an investigation, and unfortunately the degradation of the believability of a survivor by the general public.

We can do something about this.

We need to have open and honest conversations with our kids and teens. Our children need to know it’s okay to speak up and tell us if something happens to them anytime, not just summer. It is important to sit down, talk about sexual abuse and sexual assault, and tell kids and teens that if something happens, it’s not their fault – that they will receive help and support. Let’s talk about consent, what it means to them and what their expectations are if something starts to happen. These are difficult, but necessary conversations to have. When we don’t talk about these issues and let our kids and teens know that it’s ok to talk about them, it only furthers the stigma. Silence says these subjects are taboo and off limits, even if it impacts them.

We want our children to make good decisions, to always act responsibly and safely. However, kids and teens make mistakes. We need them to know they are not responsible for being a victim of child abuse – only the perpetrator of that abuse is at fault. Parents need to let their children know they will not get in trouble for telling them they were assaulted at a party, no matter what they were doing or wearing. Children of all ages should know they can ask for help.

As parents, as caregivers, we need to practice what we preach. When children make mistakes and come to us, we cannot fly off the handle (as much as we’d like to). We need to thank them for being honest. If a child reports something has happened, no matter who it was – believe them, support them, and tell them, “Thank you for being so brave to tell me, or anyone, about this.” The ability to say “thank you for telling me, you are so brave” can make an impact in lessening the stigma of child sexual abuse and assault.

For a simple and fun video which may help start a conversation about consent, follow this link. To learn more about ways to create safe environments for children over the summer, please read this article and resources from our partners at Safe Kids Thrive.

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Mental Health Awareness and our Critical Needs

May 24th, 2022

May is when flowers are blooming at full speed, bees are buzzing, and birds are singing. The longer sunny days bring a lightness to people’s steps as they stroll around our beautiful community. May is also National Mental Health Awareness Month, which allows us to shine a light on the fact that in the United States between 17-20% of people will receive a mental health diagnosis.

According to the National Alliance on Mental Illness, it is important to raise awareness about what a mental illness is. A mental illness is a condition that affects a person’s thinking, feeling or mood. These diagnoses or conditions could impact someone’s ability to relate to others or function in their activities of daily living. Each person, regardless of the diagnosis, will have different experiences. While primary care physicians can prescribe some medications to provide support to certain conditions, it is the work of behavioral health providers to truly support those who have received such diagnoses.

Beyond long-term diagnoses or conditions, every day people have experiences where they would benefit from the support of a behavioral health professional. Trauma, loss, stress from work, fears, phobias, and substance misuse; there is no shortage of reasons why someone would benefit from a provider. However, there is a fear associated with seeking professional health due to the stigma surrounding why someone may seek out a provider. At Children’s Cove we depend on our trauma informed providers to support children who have been victims of crime, as well as support their non-offending family members. And yet, even with this critical reason for support, we have a serious challenge on our hands.

Across Cape Cod and the Islands, parents experience immense difficulty when seeking accessible services for their children. Whether searching for support groups, outpatient therapists, mentors, in-home therapists, or other wrap-around services, we are tremendously under capacity to serve our children. Depending on the services, health insurance, and location a family lives, there could be a 3-6 month wait time (or more) for a child to begin receiving services. While this is not a situation unique to the Cape and Islands, it is certainly an exacerbated one.

A primary issue in each town or region is a lack of child-focused providers and organizations. And in those organizations which do provide services for children the capacity is already at its limit. The challenges of living in our region (high cost of living, lack of attainable housing, barriers to transportation) have impacted the behavioral health and human services field making it difficult for agencies to hire professionals who work with children. In response to this crisis of children’s behavioral health services and support network, the Children’s Behavioral Health Working Group (CBHWG) was formed to serve the Cape and Islands.

The CBHWG started as a grassroots movement in 2019 by a local foster parent who discovered how difficult it was to get services for children in her care. Through conversations with other foster parents and young families, she realized how large-scale the problem was and decided she wanted to sound the alarm to the community. Since 2019, the group has grown to include dozens of individuals and organizations and has hired a coordinator for the initiative.

Barbara Dominic, LICSW, works as a consultant for Barnstable County, and is the manager of the Children’s Behavioral Health Working Group. Barbara, a licensed social worker, and counselor in a local school district, was drawn to the group and its mission because she knew how hard it was for children to gain access to services.

With her coordination, the CBHWG has become a collaboration of 25-30 human service agencies, where behavioral health providers and community stakeholders work together to increase access to, and maximize the efficacy of, the Cape and Islands behavioral health system of care for children, adolescents, and young adults ages 0-18. This is accomplished through collaboration, advocacy, education, and training. This group meets monthly to focus on training and education for behavioral health providers in the community, allowing time and the opportunity to work together to solve the challenges around service shortages for children. The participants also gather information about current needs, trends and pending legislation which impact behavioral health services for children and families in our community.

The CBHWG has gained traction at the state house with regular attendance of a representative from Senator Julian Cyr’s office who keeps the group apprised of any legislation which may impact services in our region. The group also seeks to strengthen and build a collaboration of providers to reduce the practice of organizations working in silos, which aims to maximize the efficacy of each organization’s service to the community. The CBHWG also discusses how to effectively advocate for increased reimbursement rates, workforce salaries, barriers to employment such as housing and processional licensing.

When speaking with Barbara about the work of the group, one of the key points she made was that there needs to be a greater awareness to the community at large about behavioral health care. She also believes that when it comes to the need for services in our community, we need to speak in a unified voice that says, “we are here and we have needs on Cape Cod and the Islands,” to state agencies and elected officials. By talking about this issue, rather than keeping it in the shadows, the stigma of mental health can be addressed and the barriers to access can begin to come down. Barbara also stated that, as a community, we need to prioritize our children and young people. For their health, for the health of our community, we need to place an emphasis on the importance of mental health and needed services for children both now and in the future.

As a community it can be hard to prioritize mental health services and support. We know as a community we have so many issues: wastewater, climate change, healthcare, traffic, the economy, and a large senior population who have very specific needs. This is where the CBHWG can also provide support. The working group, and Barnstable County government, will be working in the near future to perform a thorough needs assessment of children’s behavioral health services in our community. This study will provide supportive data to understand the gaps in services that our communities need for effective advocacy and awareness to support our children’s mental health.

Studies and assessments take time, and many of our children need services now. When community members ask Barbara, “what can we do about this now?” she says it can be hard to answer with just one thing. So, she simply recommends that people “…be aware of the services for children which are available in your community and see if they are accessible. Learn more about what supports children in your community, or if there is a lack of services. And listen to what discussions take place at town meeting regarding children, or regarding supportive services for children and young families in your community. If you don’t hear any, perhaps there is an opportunity for one.”

Please email Barbara to learn more about the Children’s Behavioral Health Working Group, or ways you can support children’s behavioral health in our community.

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We Can Prevent Child Abuse Together

April 18th, 2022

In the United States, National Child Abuse Prevention Month is annually observed throughout the month of April. It is a critical time to raise awareness of our nation’s child abuse crisis. The statistics remain overwhelmingly alarming that one in four girls — and one in six boys — will be sexually abused before their 18th birthday. Most victims suffer in silence as it is estimated that more than 90 percent of abuse victims never report what happened to them. Even more disturbing is that more than 90 percent of perpetrators are someone an abused child knows and trusts – a coach, camp counselor, teacher, someone in their faith community, or a family member.

This month child safety advocates across the state and nation are urging communities to come together to make a difference. We ask that parents and caregivers “Have the Conversation” with their children, their family, and friends about sexual abuse, and begin to talk with young children about body safety. This includes which parts of their bodies are private, not to be touched by anyone, and reminding them they need to immediately tell an adult they trust if someone has touched them inappropriately. As children get older, these conversations can evolve into discussions about personal privacy, online safety, and consent. By starting these discussions when children are young, and having them often, parents and caregivers can open the gateway to communication about all types of “difficult” topics across the span of a child’s development into an adult.

If child victims disclose their sexual abuse, most often it is to a safe adult who is obligated by law to report it, and that adult is known as a mandated reporter. Mandated reporters in Massachusetts include a wide range of professionals, most notably, teachers, coaches, therapists, and guidance counselors. As the child advocacy center for Cape Cod and the Islands, we work with our multidisciplinary partners to respond to these disclosures and provide compassionate, comprehensive, and collaborative response services at no cost to survivors of child abuse. Collectively we utilize our evidence-based programs, network of community partnerships, educational outreach, and awareness efforts to empower survivors, promote healthy outcomes, and help mitigate the stigma of child abuse.

We can make a strong impact in the prevention, early recognition, and coordinated response to child sexual abuse on Cape Cod, Nantucket, and Martha’s Vineyard. We can do this by working together to help parents learn how to break the stigma of talking about child sexual abuse. Let’s teach children about body safety and foster healthy communication between children and their parents about difficult subjects.  Our community should offer regular and ongoing training for professionals who work with children to help them effectively recognize and respond to someone who may have been abused. And we can ask organizations who serve children to institute effective policies and procedures mandating such training and instituting rigorous hiring practices.

As a community, we need to provide a safe environment for all children in our public spaces, in schools and in organizations that serve children.  Our first step in achieving this level of safety is for everyone to make preventing sexual abuse a priority. For too long, sexual abuse has been a taboo subject hidden in the shadows, increasing the likelihood of the victimization of children.  It is not easy to identify a predator in the community, at work, or even in one’s home, as they are most often people we know and trust. However, we can work together to reduce the instances where that predator is able to take advantage of a child.

The more we bring these discussions to light, the closer we will be to a community where children are free of abuse, have a voice that is heard, and where they enjoy healthy, safe, and empowered lives.

If you have a concern that a child isn’t safe, or may need help, please click here to find the next steps to get someone support.

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