Brian E. Bride

Development and Validation of the Secondary Traumatic Stress Scale

Objective: To describe the development and validation of the Secondary Traumatic Stress Scale (STSS), a 17-item instrument designed to measure intrusion, avoidance, and arousal symptoms associated with indirect exposure to traumatic events via one’s professional relationships with traumatized clients. Method: A sample of 287 licensed social workers completed a mailed survey containing the STSS and other relevant survey items. Results: Evidence was found for reliability, convergent and discriminant validity, and factorial validity. Conclusions: The STSS fills a need for reliable and valid instruments specifically designed to measure the negative effects of social work practice with traumatized populations. The instrument may be used to undertake empirical investigation into the prevention and amelioration of secondary traumatic stress among social work practitioners.

Correlates of Secondary Traumatic Stress in Child Protective Services Workers

SUMMARY The purpose of this study was to add to the limited research on secondary traumatic stress in child welfare by investigating correlates of secondary traumatic stress (STS) in child protective services workers. Specifically, we examined the relationship between levels of STS in CPS professionals and personal history of trauma, peer and administrative support, intent to remain employed in child welfare, professional experience, and size of caseload. This study documents the existence of secondary traumatic stress in the population and the relationship between levels of secondary traumatic stress in CPS professionals and the group of potential correlates: personal history of trauma in the past year and lifetime, peer support, administrative support, intent to remain employed in child welfare, professional experience, and size of caseload.

The Secondary Traumatic Stress Scale (STSS): Confirmatory Factor Analyses with a National Sample of Mental Health Social Workers

SUMMARY The Secondary Traumatic Stress Scale (STSS; Bride, Robinson, Yegidis, & Figley, 2004) is an easy to administer 17-itemself-report measure of secondary trauma. Bride et al. (2004) reported a measure of three domains of traumatic stress specifically associated with secondary exposure to trauma: intrusion, avoidance, and arousal. The STSS was reported to have high levels of internal consistency reliability and indicated evidence of convergent, discriminant, and factorial validity. The purpose of this paper is to examine the reliability and validity of the STSS with a national, random sample of mental health social workers. To assess the fit of the data to the three-factor structure proposed by Bride et al., a confirmatory factor analysis was performed on data from 275 social workers who indicated exposure to client trauma. The model fit the data adequately although high factor intercorrelations strongly suggest a unidimensional scale. Subsequent confirmatory factor analysis of a unidimensional scale and a second order factor analysis yielded similar results. Findings indicate the need for further scale validation. Challenges remain for measuring and distinctly differentiating between secondary trauma symptoms of arousal, avoidance, and intrusion. Implications and suggestions for future research are discussed.

Secondary Trauma and Military Veteran Caregivers

The article focuses on the secondary trauma stressors experienced by those who care for members of the military with special attention to the caregivers of war fighters seeking help from combat stress. Consistent with the theme of the special issue of understanding and preparing for the challenges of combat stress, the authors suggest that military caregiver stress and resilience require attention. The article calls for more attention to this area by researchers, practitioners, and policy makers given the growing combat stress injuries due, in large part, to recent multiple and lengthy deployments. The first section of the article describes secondary traumatic stress (STS) conceptually by identifying and defining STS and related constructs and the relevant theories and the prevalence estimates. The middle section of the article discusses the risk and protective factors for STS. The latter section provides an overview of very underdeveloped literature on military veteran caregivers by first describing this population, the most promising approaches to mitigating and preventing STS, and several model programs that may be useful for units of military caregivers.

Organizational factors associated with the use of contingency management in publicly funded substance abuse treatment centers

A promising area within technology transfer studies is the identification of organizational factors that influence the adoption of treatment innovations. Although studies have identified organizational factors associated with the adoption of pharmacological innovations, few studies have examined organizational factors in the adoption of psychosocial innovations, among which contingency management (CM) is a significant practice. Using data from a sample (N = 318) drawn from the population of publicly funded treatment centers in the United States, this study modeled organizational factors falling in the domains of structural characteristics, workforce variables, values and norms, and patient characteristics associated with the use of CM. Organizations were more likely to use CM if they embrace a supportive therapeutic approach, are research friendly, offer only outpatient levels of care, or serve drug-court patients. Implications for studying the diffusion and implementation of evidence-based psychosocial interventions are discussed.

Secondary traumatic stress, job satisfaction, and occupational commitment in substance abuse counselors

It has been argued that secondary traumatic stress (STS) may adversely affect the retention of counselors and other helping professionals. However, there has been little research regarding the rela...

An Assessment of Secondary Traumatic Stress in Juvenile Justice Education Workers

Given the frequency and violent character of the traumas encountered by juvenile offenders, staff members who regularly interact with juveniles in custody are at risk of developing secondary traumatic stress. Juvenile justice teachers and staff (N = 118) were administered a cross-sectional survey, including the Secondary Traumatic Stress Scale. Respondents said the students were moderately traumatized (47%), severely traumatized (27%), and very severely traumatized (7%). Regarding STS, the most frequently reported symptom was intrusive thoughts related to work with the students, mentioned by 61% of respondents. Additionally, 81% met at least one, 55% met two, and 39% met all three core diagnostic criteria for posttraumatic stress disorder. Recommendations for juvenile justice staff members and for the organization are provided to address practice and policy implications.

HIV/AIDS services in private substance abuse treatment programs

BACKGROUND HIV infection among substance abusers is a growing concern in the United States. Little research, however, has examined the provision of HIV/AIDS services in substance abuse treatment programs. METHODS This study examines the provision of onsite HIV/AIDS services in a nationally representative sample of 345 privately funded substance abuse treatment programs. Data were collected via face-to-face interviews with administrators and/or clinical directors of treatment programs in 2007-2008. RESULTS Results show that larger programs and programs with a higher percentage of both African American and injection drug using (IDU) patients were more likely to offer onsite HIV/AIDS support groups and a dedicated HIV/AIDS treatment track. Multinomial logistic regression reveals that the odds of offering onsite HIV testing services were higher for hospital based programs, programs providing medical services onsite, and programs with higher percentages of African American patients, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. The odds of providing onsite testing were lower for outpatient-only treatment programs, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. CONCLUSIONS Our findings highlight critical barriers to the adoption of onsite HIV/AIDS services and suggest treatment programs are missing the opportunity to significantly impact HIV-related health outcomes.

The use of art and music therapy in substance abuse treatment programs.

AbstractAlthough the implementation of evidence-based practices in the treatment of substance use disorders has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs’ use of Motivational Enhancement Therapy was positively related to offering art therapy, whereas use of contingency management was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents.

Secondary Traumatic Stress in Military Primary and Mental Health Care Providers

The purpose of this study was to explore rates of secondary traumatic stress (STS) in a sample of 70 military primary and mental health care providers. The sample included working professionals within two military hospitals. Participants completed surveys containing a demographic questionnaire and the Secondary Traumatic Stress Scale. Results of data analysis found military participants in the sample to be experiencing relatively low rates of STS. Over half of the sample reported endorsing at least one symptom of STS occurring within the last week, whereas 8% of participants indicated moderate to high symptomatology. The most frequently reported symptoms were feeling emotionally numb and trouble sleeping followed by the intrusive thoughts about clients. The least frequently reported symptom was feeling jumpy. Implications of study findings and recommendations for future research are outlined.