Trauma-informed approach: Addressing secondary trauma through organizational transformation
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Published
2025-12-30
Xiomara Hernández González
Alexandra Rivera González
Loggina S. Báez Ávila
Betzaida Santiago Rodríguez
Melanie Negrón-Marín
https://orcid.org/0009-0001-8213-148X
Abstract
Secondary trauma is a common occupational risk for professionals who provide support to trauma survivors. It refers to the symptoms an individual experiences after witnessing or hearing about another person's trauma or suffering. The impact can be significant, both physically and emotionally, and potentially affecting personal and professional performance. It is essential for organizations to assess their practices and procedures to identify how they influence staff’s ability to cope with and/or recover from secondary trauma. The trauma-informed approach (TIA) provides a “lens” to promote the safety of both the individuals served and the professionals providing services. TIA is particularly relevant in high-risk work environments, where organizations must take responsibility for preventing and adequately addressing secondary trauma. This article aims to explore potential gaps between literature and organizational practices related to secondary trauma through the lens of TIA. Additionally, we share lessons learned from organizational transformation processes in Puerto Rico, tools for organizations seeking to restructure using a trauma-informed approach, and recommendations for expanding knowledge on this topic at the local level.
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Keywords
secondary trauma, trauma-informed approach, organizational transformation, organizational responsibility
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Lemieux-Cumberlege, A. H., Griffiths, H., Pathe, E., & Burley, A. (2023). Posttraumatic stress disorder, secondary traumatic stress, and burnout in frontline workers in homelessness services: Risk and protective factors. Journal of Social Distress and Homelessness, 33(2), 329–340. https://doi.org/10.1080/10530789.2023.2191405
Leung, T., Schmidt, F., & Mushquash, C. (2023). A personal history of trauma and experience of secondary traumatic stress, vicarious trauma, and burnout in mental health workers: A systematic literature review. Psychological Trauma: Theory, Research, Practice, and Policy, 15(2), 213–221.
https://doi.org/10.1037/tra0001277
Mahon, D. (2022). Implementing trauma informed care in human services: An ecological scoping review. Behavioral Sciences, 12(11), 431.
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McCausland, T. (2023). Creating psychological safety in the workplace. Research-Technology Management, 66(2), 56–58.
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Miller, J. J., Lianekhammy, J., & Grise-Owens, E. (2018). Examining self-care among individuals employed in social work capacities: Implications for the profession. Advances in Social Work, 18(4), 1250–1266.
https://doi.org/10.18060/22320
Moscoso Álvarez, M. R., Colón Jordán, H. M., Reyes Pulliza, J. C., & Rodríguez Figueroa, L. (2023). El uso de substancias en los escolares puertorriqueños: Consulta juvenil 2020-2022. Administración de Servicios de Salud Mental y Contra la Adicción. https://docs.pr.gov/files/ASSMCA/Consultas/Informe_CJ_2020-22_ISLA_18%20abr%2023_FINAL.pdf
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https://doi.org/10.1016/j.ajog.2021.08.012
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https://doi.org/10.1037/trm0000228
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https://doi.org/10.1080/1045988X.2021.1972920
Sánchez-Cardona, I., Sardiñas, L. M., Rivera-Colón, E. A., Vélez Álamo, C., Moore, B. A., & Sánchez-Cesáreo, M. (2024). The effects of mindfulness and psychological capital on reducing worker stress and promoting health. Journal of Workplace Behavioral Health, 40(4), 522-541. https://doi.org/10.1080/15555240.2024.2425431
Scottish Government. (2023). Evidence review: Enablers and barriers to trauma-informed systems, organisations and workforces. APS Group Scotland. https://shorturl.at/cCbCh
Strolin-Goltzman, J., Breslend, N., Hemenway Deaver, A., Wood, V., Woodside-Jiron, H., & Krompf, A. (2024). Moving beyond self-care: Exploring the protective influence of interprofessional collabora-tion, leadership, and competency on secondary traumatic stress. Traumatology, 30(1), 69–76. https://doi.org/10.1037/trm0000244
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Sutton, L., Rowe, S., Hammerton, G., & Billings, J. (2022). The contribution of organisational factors to vicarious trauma in mental health professionals: A systematic review and narrative synthesis. European Journal of Psychotraumatology, 13(1), Article 2022278. https://doi.org/10.1080/20008198.2021.2022278
Trauma Informed Oregon (TIO). (2016). Roadmap to trauma informed care.
https://traumainformedoregon.org/wp-content/uploads/2018/12/Original-Roadmap-to-Trauma-Informed-Care-with-Considerations-12-12-18.pdf
Tullberg, E., & Boothe, G. (2019). Taking an organizational approach to addressing secondary trauma in child welfare settings. Journal of Public Child Welfare, 13(3), 345–367. https://doi.org/10.1080/15548732.2019.1612498
Unick, G. J., Bassuk, E. L., Richard, M. K., & Paquette, K. (2019). Organizational trauma-informed care: Associations with individual and agency factors. Psychological Services, 16(1), 134–142. https://doi.org/10.1037/ser0000299
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https://d7a3216312da6f8c5faa-a6c4a22c6d23d8694e5e3f94c3d57dde.ssl.cf2.rackcdn.com/a0e85665e0234198afb5f8be3ad06601_Self-Care-FINAL-R.pdf
Armes, S. E., Lee, J. J., Bride, B. E., & Seponski, D. M. (2020). Secondary trauma and impairment in clinical social workers. Child Abuse & Neglect, 110(3), 104540. https://doi.org/10.1016/j.chiabu.2020.104540
Berger, R., & Quiros, L. (2014). Supervision for trauma-informed practice. Traumatology, 20(4), 296–301.
https://doi.org/10.1037/h0099835
Berger, R., & Quiros, L. (2016). Best practices for training trauma-informed practitioners: Supervisors’ voice. Traumatology, 22(2), 145-154.
http://dx.doi.org/10.1037/trm0000076
Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59(1), 20–28. https://doi.org/10.1037/0003-066X.59.1.20
Bride, B. E., Sprang, G., Hendricks, A., Walsh, C. R., Mathieu, F., Hangartner, K., Ross, L. A., Fisher, P., & Miller, B. C. (2024). Principles for secondary traumatic stress-responsive practice: An expert consensus approach. Psychological Trauma: Theory, Research, Practice, and Policy, 16(8), 1301–1308. https://doi.org/10.1037/tra0001575
Bunting, L., Montgomery, L., Mooney, S., MacDonald, M., Coulter, S., Hayes, D., & Davidson, G. (2019). Trauma informed child welfare systems—A rapid evidence review. International Journal of Environmental Research and Public Health, 16(13), 2365.
https://doi.org/10.3390/ijerph16132365
Collins-Camargo, C., & Antle, B. (2017). Child welfare supervision: Special issues related to trauma-informed care in a unique environment. The Clinical Supervisor, 37(1), 64-82.
https://doi.org/10.1080/07325223.2017.1382412
Dombo, E. A., & Blome, W. W. (2016). Vicarious trauma in child welfare workers: A study of organizational responses. Journal of Public Child Welfare, 10(5), 505–523.
https://doi.org/10.1080/15548732.2016.1206506
Edmondson, A. C. (2019). The fearless organization: Creating psychological safety in the workplace for learning, innovation, and growth. John Wiley & Sons.
Fernández, V., Gausereide-Corral, M., Valiente, C., & Sánchez-Iglesias, I. (2023). Effectiveness of trauma-informed care interventions at the organizational level: A systematic review. Psychological Services, 20(4), 849–862.
https://doi.org/10.1037/ser0000737
Fisk, G. M., & Daoust, L. E. (2025). Advancing a trauma-informed approach to leadership in the workplace: A conceptual review and theoretical extension. Psychology of Leaders and Leadership, 28(2), 131-156.
https://doi.org/10.1037/mgr0000172
Figley, C. R. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. En C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 1–20). Brunner/Mazel.
Goldstein, E., Chokshi, B., Melendez-Torres, G. J., Rios, A., Jelley, M., & Lewis-O'Connor, A. (2024). Effectiveness of trauma-informed care implementation in health care settings: Systematic review of reviews and realist synthesis. The Permanente Journal, 28(1), 135–150. https://doi.org/10.7812/TPP/23.127
Grise-Owens, E., & Miller, J. J. (2021). The role and responsibility of social work education in promoting practitioner self-care. Journal of Social Work Education, 57(4), 636–648.
https://doi.org/10.1080/10437797.2021.1951414
Grupo Nexos. (2024). Vídeo: Estudio de caso sobre desarrollo de capacidades [Video]. Grupo Nexos Inc.
Health Outreach Partners. (2021). Organizational self-care: Addressing the collective responsibility for your employees’ wellbeing.
https://outreach-partners.org/wp-content/uploads/2021/07/HOP-Organizational-Self-care-Resource.pdf
Heffernan, K., & Viggiani, P. (2015). Going beyond trauma-informed care (TIC) training for child welfare supervisors and frontline workers: The need for system-wide policy changes implementing TIC practices in all child welfare agencies. The Advanced Generalist: Social Work Research Journal, 1(3–4), 37–58.
Huertas, X., Sánchez-Cesáreo, M., Morales Boscio, A., Rivera, E., De Pedro, Z., Adames, C., Delgado, J., Corrada, R., Montalvo, J., Ortiz, M., Santiago, B., Saez, Y., Rodríguez, G., Medina, E., del Toro, E., Arroyo, Y., Rivera, C., Rivera, S., López, D., ... Gerena, G. (2021). Families first Puerto Rico Title IV-E prevention plan 2022-2026. Grupo Nexos, Inc.
Junta de Prácticas Basadas en Evidencia para Puerto Rico (JPBE-PR). (2020a). Definición trauma [Documento no publicado].
Junta de Prácticas Basadas en Evidencia para Puerto Rico (JPBE-PR). (2020b). Definición conceptual de acercamiento informado en trauma (adaptado de SAMHSA, 2014; y Modi, 2019) [Documento no publicado].
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., Benjet, C., Bromet, E. J., Cardoso, G., Degenhardt, L., de Girolamo, G., Dinolova, R. V., Ferry, F., Florescu, S., Gureje, O., Haro, J. M., Huang, Y., Karam, E. G., Kawakami, N., Lee, S., Lepine, J. P., Levinson, D., … & Koenen, K. C. (2017). Trauma and PTSD in the WHO World Mental Health Surveys. European Journal of Psychotraumatology, 8(5), 1353383.
https://doi.org/10.1080/20008198.2017.1353383
Koury, S. P., Green, S. A., & Way, I. (2022). Trauma-informed organizational change manual. The Institute on Trauma and Trauma-Informed Care.
Lemieux-Cumberlege, A. H., Griffiths, H., Pathe, E., & Burley, A. (2023). Posttraumatic stress disorder, secondary traumatic stress, and burnout in frontline workers in homelessness services: Risk and protective factors. Journal of Social Distress and Homelessness, 33(2), 329–340. https://doi.org/10.1080/10530789.2023.2191405
Leung, T., Schmidt, F., & Mushquash, C. (2023). A personal history of trauma and experience of secondary traumatic stress, vicarious trauma, and burnout in mental health workers: A systematic literature review. Psychological Trauma: Theory, Research, Practice, and Policy, 15(2), 213–221.
https://doi.org/10.1037/tra0001277
Mahon, D. (2022). Implementing trauma informed care in human services: An ecological scoping review. Behavioral Sciences, 12(11), 431.
https://doi.org/10.3390/bs12110431
McCausland, T. (2023). Creating psychological safety in the workplace. Research-Technology Management, 66(2), 56–58.
https://doi.org/10.1080/08956308.2023.2164439
Miller, J. J., Lianekhammy, J., & Grise-Owens, E. (2018). Examining self-care among individuals employed in social work capacities: Implications for the profession. Advances in Social Work, 18(4), 1250–1266.
https://doi.org/10.18060/22320
Moscoso Álvarez, M. R., Colón Jordán, H. M., Reyes Pulliza, J. C., & Rodríguez Figueroa, L. (2023). El uso de substancias en los escolares puertorriqueños: Consulta juvenil 2020-2022. Administración de Servicios de Salud Mental y Contra la Adicción. https://docs.pr.gov/files/ASSMCA/Consultas/Informe_CJ_2020-22_ISLA_18%20abr%2023_FINAL.pdf
Owens, L., Terrell, S., Kane Low, L., Loder, C., Rhizal, D., Scheiman, L., & Seng, J. (2022). Universal precautions: The case for consistently trauma-informed reproductive healthcare. American Journal of Obstetrics and Gynecology, 226(5), 671-677.
https://doi.org/10.1016/j.ajog.2021.08.012
Pérez Pedrogo, C., Sánchez Cesáreo, M., Martínez Taboas, G., Colón Jordán, H., & Morales Boscio, A. (2016). Violencia comunitaria: Programas basados en evidencia como alternativas para su mitigación. Revista Puertorriqueña de Psicología, 27(1), 26-42.
Powell, T. M., Yuma, P. J., Scott, J., Suarez, A., Morales, I., Vinton, M., Marrero, M., & Li, S.-J. (2020). In the aftermath: The effects of hurricanes Harvey and Maria on the well-being of health-care and social service providers. Traumatology, 26(3), 298-307.
https://doi.org/10.1037/trm0000228
Rivera-Colón, E., Sánchez-Cardona, I., De Pedro-Serbiá, Z., Torres-Dávila, P., & Gleason-López, M. (2020). Radiografía organizacional: Evaluación organiza-cional de la Administración de Familia y Niños del Departamento de la Familia de Puerto Rico. Instituto Tercera Misión, Universidad Carlos Albizu. https://familiesfirst.pr.gov/uploads/archivos/13kqzm6ghylcc40kkg.pdf
Rodriguez, A., Fei, Z., Barrera, W. A., Tsao, E. H., Waterman, J., Franke, T. M., Mogil, C. E., Bonilla, B., Cugley, G. M., Gillams, T., & Langley, A. (2023). Leveraging leadership in child welfare systems: Large-scale trauma- and resilience-informed training initiative. The Journal of Behavioral Health Services & Research, 50, 18–35. https://doi.org/10.1007/s11414-022-09815-2
Sánchez-Cardona, I., Pérez Pedrogo, C., Lopez-Torres, S., & Sánchez-Cesáreo, M. (2022). Vulnerabilities and academic outcomes among students in Puerto Rico. Preventing School Failure: Alternative Education for Children and Youth, 66(1), 77–88.
https://doi.org/10.1080/1045988X.2021.1972920
Sánchez-Cardona, I., Sardiñas, L. M., Rivera-Colón, E. A., Vélez Álamo, C., Moore, B. A., & Sánchez-Cesáreo, M. (2024). The effects of mindfulness and psychological capital on reducing worker stress and promoting health. Journal of Workplace Behavioral Health, 40(4), 522-541. https://doi.org/10.1080/15555240.2024.2425431
Scottish Government. (2023). Evidence review: Enablers and barriers to trauma-informed systems, organisations and workforces. APS Group Scotland. https://shorturl.at/cCbCh
Strolin-Goltzman, J., Breslend, N., Hemenway Deaver, A., Wood, V., Woodside-Jiron, H., & Krompf, A. (2024). Moving beyond self-care: Exploring the protective influence of interprofessional collabora-tion, leadership, and competency on secondary traumatic stress. Traumatology, 30(1), 69–76. https://doi.org/10.1037/trm0000244
Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). A treatment improvement protocol. Trauma-informed care in behavioral health services (TIP Series 57, HHS Publication No. SMA 13-4801). U.S. Department of Health and Human Services. https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4816.pdf
Sutton, L., Rowe, S., Hammerton, G., & Billings, J. (2022). The contribution of organisational factors to vicarious trauma in mental health professionals: A systematic review and narrative synthesis. European Journal of Psychotraumatology, 13(1), Article 2022278. https://doi.org/10.1080/20008198.2021.2022278
Trauma Informed Oregon (TIO). (2016). Roadmap to trauma informed care.
https://traumainformedoregon.org/wp-content/uploads/2018/12/Original-Roadmap-to-Trauma-Informed-Care-with-Considerations-12-12-18.pdf
Tullberg, E., & Boothe, G. (2019). Taking an organizational approach to addressing secondary trauma in child welfare settings. Journal of Public Child Welfare, 13(3), 345–367. https://doi.org/10.1080/15548732.2019.1612498
Unick, G. J., Bassuk, E. L., Richard, M. K., & Paquette, K. (2019). Organizational trauma-informed care: Associations with individual and agency factors. Psychological Services, 16(1), 134–142. https://doi.org/10.1037/ser0000299
U.S. Census Bureau. (2023). Poverty status in the past 12 months. American Community Survey.
https://data.census.gov/table/ACSST1Y2023.S1701?g=040XX00US72
How to Cite
Trauma-informed approach: Addressing secondary trauma through organizational transformation. (2025). Puerto Rican Journal of Psychology, 36(2), 286-300. https://doi.org/10.55611/reps.3602.11
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Si se acepta un trabajo para su publicación, los derechos de impresión y de reproducción por cualquier forma y medio son de la Asociación de Psicología de Puerto Rico (APPR), que no rechazará cualquier petición razonable por parte de los autores para obtener el permiso de reproducción de sus contribuciones. Debe adjuntarse una carta tipo de cesión de derechos. Se entiende que las opiniones expresadas en los artículos son de responsabilidad exclusiva de los autores y no comprometen la opinión y política científica de la Revista ni de la APPR. Igualmente, las actividades descritas en los trabajos publicados estarán de acuerdo con los criterios de ética, tanto por lo que se refiere a los trabajos con humanos como a la experimentación animal, así como en todo lo relativo a la ética profesional.
How to Cite
Trauma-informed approach: Addressing secondary trauma through organizational transformation. (2025). Puerto Rican Journal of Psychology, 36(2), 286-300. https://doi.org/10.55611/reps.3602.11