The views expressed herein have not been approved by the House of Delegates or the Board of Governors of the American Bar Association, and accordingly, should not be construed as representing the policy of the American Bar Association.
Hearing testimony and evidence of trauma in court
Listening to clients’ heart-wrenching trauma stories
Preparing cases and reading about trauma
Working daily with juvenile court clients who struggle with trauma can take an emotional toll. Let it build and it causes secondary traumatic stress (STS) --the emotional and behavioral response to increased exposure to trauma. STS is a recognized response in professionals who work with trauma victims. Its signs and symptoms in attorneys are becoming better known and strategies are emerging to address it.
“Emotional distress resulting from this work is understandable,” said Carly Baetz, JD, PhD, Mount Sinai Health System, Center for Child Trauma and Resilience in New York City. “We are not super heroes. We can only do our best,” she said.
Baetz, also an attorney, represented children in child protection and juvenile justice cases at the New York City Legal Aid Society, Juvenile Rights Practice before becoming a psychologist providing mental health services to children with trauma histories. Her experience as a juvenile court lawyer and mental health professional serving trauma victims have shaped her view on STS for attorneys.
Presenting the ABA webinar “Understanding the Impact of Secondary Trauma on Lawyers Working with Children and Families,”1 Baetz shared information on:
- trauma and its impact on child victims,
- the extent of trauma among juvenile court clients,
- how clients’ trauma impacts attorneys, and
- strategies attorneys can use to address STS.
Trauma and its Impact on Clients
Understanding how exposure to clients’ trauma affects attorneys begins with understanding trauma and its impact on victims. Baetz shared common ways victims experience trauma:
- Actual or threatened death, serious injury, or sexual violence
- Physical abuse, sexual abuse, community violence, or loss of a loved one
- Significant impact on the brain and body
- Changed view and response to stress and others in the world
Exposure to trauma triggers an alarm system in the brain, said Baetz. This alarm system can become hypersensitive and easily reminded of the trauma. “When the alarm is activated, it hijacks the body and causes a reaction. Normal stressors to most people can provoke extreme reactions in people who have experienced trauma,” she said. There is no time to consider options, as the brain’s focus is keeping the victim safe. Typical reactions to trauma by victims include:
- Reliving the experience
- Avoidance of thoughts, feelings, and reminders of the trauma
- Guarded behavior
- Viewing the world and people as unsafe
- Numbing behaviors (drug or alcohol use)
- Intrusive images
- Post-traumatic stress disorder (PTSD)
Trauma and Juvenile Court
Children and families involved in the juvenile court system frequently experience trauma. Baetz cited research showing:
- 70-90% of youth in the juvenile justice system have histories of trauma. Among these youth, the average number of traumas experienced is more than six, and 30-50% develop PTSD (compared to 3-6% in the general population.
- 90% of caregivers in child protection cases have trauma histories.
Trauma histories make it hard to navigate the legal system because the victims’ alarm response is easily triggered, said Baetz. Triggers are everywhere—intrusive questions, perceptions of not being safe or heard, and loss of control.
How Trauma Exposure Affects Attorneys
Empirical research on STS and attorneys is small but growing, said Baetz. She cited existing research on STS among family/criminal court attorneys and public defenders showing high rates of STS:
- A 2003 study of STS for family and criminal court attorneys found STS was higher than for mental health professionals
- A 2011 study of public defenders found 34% met criteria for STS and 75% met criteria for functional impairment (disruption in personal life, family life, work life, etc.)
The impact of STS can take many forms:
Emotional impact. Working extensively with clients who are struggling with their own histories of trauma and trauma-related symptoms can have an emotional impact on attorneys, said Baetz. Secondary traumatic stress can result from any aspect of an attorney’s job involving indirect exposure to trauma (hearing or reading a client’s trauma stories, hearing testimony and evidence in court). STS can also result from direct exposure to trauma, such as experiencing the death of a client, witnessing an assault, or receiving a threat.
Workplace impact. The impact of trauma exposure can be felt at work. Baetz shared the following workplace symptoms:
- Avoidance is a common coping strategy. Avoiding certain clients, not returning phone calls, avoiding certain questions in client interviews, arriving late to work, missing meetings, and calling in sick are typical avoidance behaviors.
- Decreased empathy toward clients may also occur, making it hard for attorneys to feel for their clients.
- Hypervigilance may cause attorneys to feel on edge, maintain an intense focus or worry about the safety and welfare of all clients, and become easily startled or upset.
- Irritability can cause attorneys to become more easily agitated, argumentative, or impatient with clients, coworkers, supervisors, judges and court staff.
- Difficulty concentrating can affect attorneys’ ability to focus and remember things.
- Lost sense of purpose causes attorneys to lose sight of the meaning of working with victims and can cause feelings of hopelessness or dread.
Personal impact. STS symptoms can also affect attorneys’ home lives. Common physiological symptoms attorneys may experience include trouble sleeping, nightmares, headaches, and extreme fatigue. Interpersonal effects may involve strained relationships with friends and family members, compromised parenting, and withdrawal from social interactions. Friends and family may find it hard to understand what the attorney is experiencing, making it hard for them to be a source of support.
Baetz stressed that the impact of STS looks different for everyone. In some it can lead to irritability and aggressive behavior and extreme physical reactions. Others may tune out through numbing or withdrawal behaviors, which can involve alcohol/drug use or shutting down. Some may begin to view the world and others differently—the world becomes unsafe and no one can be trusted.
How Attorneys Can Manage STS
With growing understanding of the impact of trauma exposure on attorneys and their ability to advocate for clients, strategies are emerging to help identify and address STS. Baetz shared individual and organizational strategies that are proving effective.
Find healthy outlets outside work. Beatz urged attorneys to incorporate strategies that buffer exposure to trauma and create healthy outlets that get the mind off work and clients’ stories. For example:
- Regular vacations (work free!)
- Exercise, healthy eating, and enough sleep
- Breaks during the day
- Clear work boundaries
- Activities/hobbies outside work
- Connections with family and friends
- Reduced caseloads
- Diversified practice – ensuring client base is diverse, not only trauma victims
Talk about it. Seek friends, family, supervisors, and colleagues who understand and are willing to listen and offer advice. Lacking social support is known to increase a person’s vulnerability to STS. Sometimes just having someone who will listen can make a difference.
Seek counseling. Many workplaces offer counseling through Employee Assistance Programs (EAP). Outside therapy may be another option. The ideal therapist is experienced treating individuals with trauma. Attorneys may find it hard to acknowledge STS and seek support, thinking it shows weakness or may have unwanted repercussions. Baetz stressed “it is ok to acknowledge you are not doing ok and need support. You don’t have to go it alone.”
Relax. Finding ways to de-stress and relax can be calming and help put the challenges at hand in perspective. Mindfulness practice (focusing on the present moment without judgment), yoga, meditation, and music can be helpful. Finding what works and making it a regular practice can help.
Find meaning. It can be easy to lose sight of the reason or underlying meaning of working with trauma victims. Reconnecting with what is meaningful about the work and what drew the attorney to the field can help. Writing it down can be useful for attorneys to serve as a reminder when things are difficult. Similarly, posting an image or the names of clients can help remind attorneys why they entered the field.
An organization’s culture is key to supporting attorneys and helping them address STS. Baetz finds that more organizations are embracing efforts to recognize and address STS. Yet there are wide variations, with some organizations offering a very supportive office culture and others doing nothing at all. According to Baetz, qualities of supportive organizations include:
Foster a safe and supportive environment by:
- Addressing employees’ physical and psychological safety
- Discussing STS in staff meetings, meetings with supervisors, and case discussions
- Having wellness or STS committees
- Encouraging staff get-togethers
- Encouraging access to EAP or other supports
Value work-life balance by encouraging breaks, leaving work on time, taking vacations, and providing support for overwhelmed staff.
Create manageable caseloads. Unwieldy caseloads that keep attorneys juggling case after case with no end is a recipe for STS. Implementing strategies to help staff with high caseloads can help.
Implement a debriefing protocol for responding to workplace trauma. Consider routine, anonymous staff surveys to gauge STS and well-being.
Provide training to staff on understanding trauma, its impact on clients and staff, skills for working with trauma victims, and managing STS.
Support colleagues. Colleagues can watch out for one another and create a support system by watching for STS symptoms, checking in with colleagues, creating peer support groups, normalizing STS by talking about it, and sharing supportive resources.
Attorneys working with trauma victims are vulnerable to STS. Incorporating strategies to manage STS on a personal and organizational level can ensure attorneys stay motivated and committed to the field so they can represent clients zealously and ethically. Helping others should not hurt the helpers.
Claire Chiamulera, legal editor, ABA Center on Children and the Law, is CLP’s editor.
1The webinar, Understanding the Impact of Secondary Trauma on Lawyers Working with Children and Families,” was presented by Carly Baetz, JD, PhD, Mt. Sinai Health System, NY, NY. Eva J. Klain, JD, director, Trauma-Informed Legal Advocacy Project, ABA Center on Children and the Law, moderated the webinar. It was supported by the following ABA groups: Center on Children and the Law Permanency Project, Standing Committee on Legal Aid and Indigent Defendants, Division for Public Services, Commission on Disability Rights, Health Law Section, Commission on Youth at Risk, and the Center for Professional Development.
Listen to the free webinar
Are You Vulnerable to Secondary Traumatic Stress?
All professionals who work with trauma victims are vulnerable to STS. It is a normal response to the work. Factors that can increase the risk of STS include:
- Having a prior history of trauma (research is mixed on this).
- Lacking a support system, especially social and organizational support.
- Having high caseloads.
Two tools are available to assess STS:
ProQOL - The most commonly used measure of the negative and positive effects of helping others who experience suffering and trauma. The ProQOL has sub-scales for compassion satisfaction, burnout, and compassion fatigue.
Rainville, Christina. “Understanding Secondary Trauma: A Guide for Lawyers Working with Child Victims.” ABA Child Law Practice 34(9), September 2015. www.childlawpractice.org
Institute for Redress & Recovery, Santa Clara Law. (n.d.) Secondary Trauma and the Legal Process: A Primer & Literature Review. Santa Clara, CA: Author. Available from
van Dernoot Lipsky, L., & Burk, C. (2009). Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others. San Francisco, CA: Berrett-Koehler Publishers.