Secondary trauma, burnout, and teacher self‐care during COVID19: A mixed‐methods case study

2.1. Guiding theoretical model

Professional well‐being among those who work in the “helping professions,” such as teachers and counselors, has received growing attention over the past decades (Stamm, 2010), including the “costs of caring” (Figley, 1999) and responses to direct or indirect exposure to trauma (Stamm, 2010). Stamm (2002) developed a data‐informed model distinguishing perceived positive aspects of helping, or compassion satisfaction, from the negative aspects, referred to as compassion fatigue. Compassion satisfaction is characterized by positive appraisals about work, which may include the impact of one's work, abilities and/or colleagues. In contrast, compassion fatigue encompasses negative symptoms associated with working with others, namely, burnout and secondary trauma. According to Stamm's, 2002 model, a complex interplay of perceptions regarding three “environments” contribute to the degree to which people may simultaneously experience compassion satisfaction and fatigue: work conditions and tasks, the individual(s) being helped, and the caregiver/helper individual characteristics that lend to resiliency or vulnerability in response to stressors, including trauma.

2.2. Burnout and secondary trauma: vulnerability and impact

Burnout is a psychological syndrome characterized by feeling ineffective at work, emotionally depleted, and/or cynical about clients or students (Maslach et al., 1997; Stamm, 2002). Professions requiring interactions with people pose a risk for burnout, and thus, teachers who are engaging with students and staff on a daily basis are at risk. However, teacher burnout severity may fluctuate depending on individual factors, such as personality (Kim et al., 2019), organization factors such as work conditions (Skaalvik & Skaalvik, 2009), and transactional factors, that is, teachers' perceptions of both the work conditions and resources with which to navigate them (Chang, 2009). For example, transactional factors such as perceived low social support, especially from administrators (Maslach et al., 2001; Pressley, 2021), and perceptions of student misbehavior (Aldrup et al., 2018; Aloe et al., 2014) contribute to teacher burnout.

The negative impact of burnout on teachers is wide ranging. For example, teacher burnout has been found to be associated with mental health problems such as depression (Capone et al., 2019), absenteeism, job performance, and retention (Swider & Zimmerman, 2010). Among students, satisfaction with school, achievement and perceptions of teacher support have been found to be negatively correlated with teacher burnout (Arens & Morin, 2016). Similarly, in their systematic review, Madigan and Kim (2021) found evidence that teacher burnout was associated with lowered student achievement and motivation (Kim & Burić, 2020). More specifically, teacher burnout has been associated with student cynicism (Tikkanen et al., 2021) and disruptive behaviors were greater in classrooms with teachers whose stress and coping were correlated with burnout than those who were not (Herman et al., 2020). Taken together, these findings suggest that burnout is a component of compassion fatigue which can affect both school personnel and students.

Another component of compassion fatigue is secondary traumatic stress (Stamm, 2002). Secondary traumatic stress, also referred to as vicarious trauma (Pearlman, 1995), is characterized by fear, intrusive thoughts, and/or avoidance in response to direct or indirect exposure to traumatic events (Hydon et al., 2015; Stamm, 2002). There is the risk of secondary traumatic stress for anyone who works with children who have been traumatized, as others may be exposed to students' stories of violence, abuse, or crises. Additionally, those who have experienced trauma may be at increased risk for secondary traumatic stress (National Child Traumatic Stress Network, 2011). Unlike burnout, secondary trauma symptom onset can be abrupt (Stamm, 2010). However, the relationship between secondary traumatic stress job satisfaction and burnout among teachers is not clear. One study investigating public school teachers found high secondary traumatic stress, but there was average job satisfaction and burnout (Borntrager et al., 2012). In related findings, Christian‐Brandt et al. (2020) reported that while lower compassion satisfaction and higher burnout were associated with plans to leave the profession, secondary traumatic stress was not.

2.3. Compassion satisfaction, self‐efficacy, and self‐care

Where compassion fatigue encompasses the negative aspects of working in a caring profession, compassion satisfaction encompasses positive views about the work of helping. Compassion satisfaction includes positive views about the impact of the work, colleagues, and clients, as well as self‐efficacy, a positive appraisal of one's ability to do the work (Stamm, 2002, 2010). There are few studies on compassion satisfaction in education. Caringi et al. (2015) concluded that compassion satisfaction may shield teachers from burnout.

In contrast to compassion satisfaction research in education, there is extensive research on the conceptualization, measurement, and practice implications of self‐efficacy. According to Bandura (1986), teacher self‐efficacy involves educators' belief in their capability to perform particular tasks and face challenges (Bandura, 1986). Self‐efficacy has been found to be positively related to job satisfaction (Avanzi et al., 2013; Federici & Skaalvik, 2012), and negatively associated with burnout (Avanzi et al., 2013) and emotional exhaustion (Federici & Skaalvik, 2012). More recently, Soncini et al. (2021) investigated teachers' experiences with remote learning during COVID‐19 and concluded that self‐efficacy was a buffer against teacher burnout. Taken together, these findings suggest that self‐efficacy may play a role in contributing to compassion satisfaction and perhaps, mitigating burnout.

The World Health Organization (WHO) defines self‐care as “the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider” (WHO, 2018, What do we mean by self‐care?). Self‐care is a wide‐ranging concept, encompassing many aspects of health including hygiene, nutrition, exercise and leisure, living conditions, income, culture, self‐medication (WHO), faith, support, and sense of control (Everly & Lating, 2013).

Although self‐care practices within stressful working conditions have been found to mitigate compassion fatigue among mental health professionals (Coleman et al., 2016) and teachers (Schussler et al., 2018), self‐care is often promoted through a Western, medical model lens. This model emphasizes the individual rather than the community (Michaeli, 2017), which critics note does not address the organizational structures that are contributing to stress and exhaustion (Lewis et al., 2022; Pyles, 2020).

2.4. Trauma‐informed schools

A considerate number of students have been exposed to trauma, which evidence suggests can affect their ability to attend to the demands of schooling and learning. In addition, at times, schools can be a site of recreating trauma (Olson, 2009; Venet, 2021). Due to the evidence that trauma affects students' learning and that school practices can augment trauma or, conversely, support a student exposed to trauma, many schools have adopted a “trauma‐informed” or “trauma‐sensitive” approach. Venet (2021) suggests that adopting these approaches is a matter of educational equity. These approaches do not look the same in every school but often have some consistent themes, such as asking a child what happened to them rather than “what did you do” when a child is showing behavioral symptoms. This takes the blame off the child and creates a supportive environment rather than a punitive atmosphere (Ballin, in press; Cole et al., 2013). Cole provides a definition of a trauma‐informed school, where “all students feel safe, welcomed, and supported and where addressing trauma's impact on learning on a school‐wide basis is at the center of its educational mission” (p. 11) An important tenet of trauma is that it is school‐wide.

In her book Equity‐Centered Trauma‐Informed Education, Venet (2021) noted that many of the commonly used definitions of trauma‐informed approaches refer to trauma that has already happened to the child. Venet argues for the need to also consider what goes on in schools that can contribute to trauma, so she defines an equity‐centered, trauma‐informed education that includes equity and social justice as key drivers to a trauma‐informed school and community. Adopting a trauma‐informed approach supports the students' emotional well‐being allowing them to have more mental capacity to focus on academics and learning (Cole et al., 2013). Venet (2021) notes that for students to be successful in school, teachers also need to feel cared for to avoid burnout. She describes an “ethic of care” (p. 129) suggesting that all people in the school need to feel cared for. In her description of the trauma‐informed approach, she includes the need to provide support and care for teachers as part of the caring culture suggesting that self‐care should not be the sole responsibility of each individual teacher but instead should be part of the entire school culture.

3.2. Research questions

We framed our research around the following research questions:

• 1.
  To what degree do teachers experience symptoms of secondary trauma and burnout?
• 2.
  To what degree do teachers report signs of compassion satisfaction and efficacy in their teaching?
• 3.
  What is the teachers' knowledge about secondary trauma, and what is their experience with self‐care?

3.3. Research site

This case study involved one K–5 elementary school in the northeastern United States (referred to in this study by the pseudonym “Wellington School”). There are 215 students at the school, along with a total of 33 teachers and support staff. Over the past 6 years, Wellington School has adopted the school‐wide trauma‐informed approach that includes a strong network of support faculty, a common mission to create a safe school environment for all children, and an established understanding that the child's behavior is a message that often needs decoding and compassion (Ballin, 2022). Based on research conducted by Ballin (in press), Wellington school has implemented a trauma approach through: (1) training the teachers and staff; (2) establishing a network of supportive staff including a behaviorist, a therapeutic classroom teacher, a full‐time school counselor, and nurse; (3) supporting a co‐teaching model with general education and special education teacher in every classroom; (4) creating common areas to support students' emotional needs. Overall, there appears to be a strong sense of community as reported by the teachers, students, and parents.

While it can be difficult to identify students affected by trauma, compared to others in the district, Wellington School has the highest percentage of students considered “economically disadvantaged” and a higher percentage than average when compared to the state. Sixty‐eight percent of students at Wellington are identified as low income and 79.2% are identified as “high needs,” according to Massachusetts Department of Education statistics. These numbers can be compared to the overall state, which reports 43.8% low‐income students and 55.6% high needs (Massachusetts Department of Elementary & Secondary Education, 2022). Additionally, the principal, based on experience at the school, identifies the student population as one that has a high number of students living with trauma. Trauma stressors in this community identified by the principal include drug addiction, domestic violence, and poverty. This study site was chosen for the faculty's commitment to embracing the trauma‐informed approach, as well as the interest shown by the principal and adjustment counselor in exploring issues of secondary trauma and burnout for the teachers.

3.4. Participants

A total of 19 Wellington educators out of a possible 33 participated in either fall 2020 or spring 2021 data collection, or both fall and spring. There was one male participant and 18 females. Participants reflected a broad of roles within a typical elementary school, including eight classroom teachers, an administrator, a nurse, a paraprofessional, and eight specialists (e.g., physical education teacher, special educator, reading, behavioral, etc.). Among the classroom teachers, almost all grades, one through five, were represented. While our goal was for all 19 educators to participate in both fall and spring surveys as well as the spring interview, 17 participated in the fall survey, 13 participated in the spring survey and interview, while 9 of 19 total participated in both the fall and spring survey along with the interview (see Tables 1 and 2). In the fall survey, we recruited participants during a remote school meeting. The researchers presented a PowerPoint about the research. Participants that agreed to be part of the research were given time during the meeting to take the survey. In spring, recruitment was limited to email as there was no time available during faculty and staff meetings. As a result, we had fewer participants in spring for the interview that followed the survey.

Data collection began in the fall of 2020 when school buildings reopened and the majority of participants reported teaching in the building in fall, with one teacher and one specialist reporting a hybrid model, while all participants reported teaching in the school building in spring. Overall, the 19 participants reported longstanding careers in the field of education, $\bar{x}$ = 17.63 (SD = 9.7) years of experience, while the reported years at Wellington School, $\bar{x}$ = 10.39 (SD = 7.56), were lower and varied. In sum, participants represented a group that was experienced and familiar with Wellington School. In the demographics survey, our focus was on the teachers' years of experience in education and at Wellington, the research site. We did not gather data on age of teachers, race, and ethnicity.

We invited teachers and staff to participate in a remote faculty meeting in the fall. After describing the study, we provided a link to the survey which, following informed consent, they could complete online through Qualtrics survey software. A follow‐up email with an invitation to participate was sent to faculty and staff approximately 1 week after the fall 2020 faculty. In spring 2021, we recruited participants through two email announcements as there was no time available during a spring faculty meeting. In the spring, participants were also invited to participate in a semistructured interview upon completion of the online survey and following the spring survey, they were invited to participate in an interview via Zoom.

At the end of the spring survey, participants indicated if they were willing to participate in a 30‐min interview and then scheduled a time to meet remotely on Zoom with one of the researchers. Researchers reviewed informed consent procedures verbally at the beginning of the interview and the interviews were recorded with participant permission. After each interview, the Zoom transcript was assigned a number to keep the interviews anonymous for confidentiality and coding purposes. All participants were offered a 50.00 gift card for their participation in the study. The study received Internal Review Board approval from Simmons University.

3.5. Measures

4.1. Burnout and secondary trauma symptoms

We examined burnout and secondary trauma with survey and interview questions. Table 1 outlines all Professional Quality of Life (ProQOL) 5 raw subscale scores; corresponding scaled score levels of burnout and secondary traumatic stress are discussed here. Burnout summary scaled scores suggest participants fell within the low average levels of reported burnout in both fall 2020 and spring 2021 (see Table 1). Secondary traumatic stress levels also fell within the low end of the average range in both fall 2020 and spring 2021. Among participants who took part in both fall and spring surveys, secondary traumatic stress remained in the low average range (see Table 1).

From our qualitative data, we learned that teachers knew the definition of secondary trauma but did not seem to connect to it. In interviews, most participants provided a definition but did not articulate how they were affected by the students' trauma, while some responded by talking about students' trauma rather than their own responses. One teacher noted that she was relatively new to the school and perhaps that was a reason she did not feel so deeply affected. She described seeing another teacher crying about a child's situation at home: “She was crying and she seemed very upset about it. She's worked here a lot longer than I have, and she knows a lot of the students really well and what they've gone through.” Other teachers said that they were exhausted but did not link their exhaustion to secondary trauma. All the interviewees seemed to have a rudimentary understanding of secondary trauma, but none seemed to have reflected on it before our conversations.

4.2. Compassion satisfaction and self‐efficacy

Scaled compassion satisfaction scores fell within the high range for all fall 2020 groups and the high average range for spring 2021 groups (see Table 1). Mean self‐efficacy scores ranging from 12 to 120 were 90.43 (SD = 7.22) and 85.42 (SD = 9.06) for total fall and spring participant groups, respectively, while a slight downward trend was also present for participants who took part in fall and spring; the sample size does not allow for examination of statistical differences.

Interview data also reflected compassion satisfaction and efficacy in that participants described examples of how their work had value and they were making a difference in the lives of the students, despite the behavioral challenges they sometimes witnessed. Notably, they attributed behavioral challenges to the effects of the child's exposure to trauma. Self‐efficacy appeared in qualitative data as shared knowledge of how trauma affects students. For example, several teachers noted, and the one administrator explained, that outside of the school, most people did not understand what it was like to work every day with students who were exposed to trauma. And yet, within the school community, there appeared to be a sense of shared understanding of the students' trauma and how to best respond. One teacher explained,

Someone else is having a freak out, so I guess I'm able to … start at a place where I'm calm, then when someone else is having a difficult time, then I can kind of understand where that's coming from better and, like, figure out ways to help in a more productive way.

4.3. Relational and adaptive self‐care

One of the highest reported types of self‐care was relationship support; mean self‐care support scores ranging from a possible 4–20 were 17.33 (SD = 2.19) in the fall group and 16.58 (SD = 3.34) among faculty that participated in the spring. Participants also reported relatively high on the self‐care awareness and structure subscales, which include a manageable schedule, as well as physical and relationships that support a healthy work‐life balance. Mindful Self‐Care means and standard deviations are shown in Table 2. Participants described a sense of support from colleagues and the administration during the interviews as well as self‐care adaptations in response to COVID‐19 in their responses to open‐ended survey questions.

Self‐care subscale survey results are consistent with the qualitative data theme of a supportive work environment and relational self‐care. Interview data indicated numerous forms of relational and structural support such as teachers and specialists giving each other breaks, noting that “people watch out for each other” and describing generally positive talk in the faculty and staff room. From the open‐ended questions in the survey, we know that teachers felt more demands, fatigue, and overwhelm during the COVID‐19 year. Yet, based on the interviews, we noted a theme of teachers feeling supported by other teachers and for some, also by the administration. The principal noted, “I try to take care of staff by checking in with them often, showing that I am concerned about difficulties they may be having and providing support either through the school adjustment counselor, nurse or behavioral staff.” One teacher described this support: “There's staff, they're also not just administration, but other staff that can kind of help you out in a better way, and that's like accepted and encouraged by administration, which is a really great thing.” Another interviewee noted the support among the teachers. “It seems like a really good network … the teachers help support each other.” Finally, a teacher described a positive feeling in the whole school. “The whole school in general there's a very positive vibe in our school, which is nice. I don't feel like you see that very often in the workplace.”

How teachers practiced self‐care differed, but they all described its meanings in similar ways. Teachers described their self‐care as prayer, walks, exercise, getting tasks done that they didn't want to do, reading, spending time alone, and putting themselves first.

It means taking care of it, means setting boundaries, and it means taking care of myself and being kind to myself, and when I say taking care of myself, I mean basically mentally, spiritually, and emotionally, professionally. Just give myself grace and let things go when I need to let them go.

Participants also viewed self‐care as integral to supporting students. One teacher noted,

I definitely think when I have time to do certain things like exercise and things like that, I can come in with, a much more calm like reasoning skills and then I can, like, meet people with more understanding and more compassion.

During the COVID‐19 year, teachers expressed a loss of self‐care routines as well as the need to adapt, and many noted that they had less time due to increased demands. One teacher explained:

In light of COVID, I've lost people, places, and activities that anchored my life—my mom died, a local farmstand where I often (happily) shopped is closed; I no longer go the Y for exercise classes I had participated in for 20 years; friends I used to gather with I no longer see… I hadn't realized how important my weekly routines were to my self‐care.

Participants referred to individual self‐care practices primarily happening outside of the school day. Teachers did not have expectations that the administration would support their self‐care. Teachers described the offer from the administration of after‐school yoga classes as an example of administrative support for self‐care. Some appreciated the yoga class and others did not. Some teachers observed that since they were “older” (as they defined themselves), they had gotten more committed to making sure they did some kind of self‐care every day. “I'm older than I used to be and I think I'm wiser than I used to be, I think I'm better at setting boundaries and better at self‐care, and I protect my self‐care routines.” One self‐described younger teacher suggested she did not understand the need for self‐care.

5.1. Limitations of the study

As a case study, our findings reflect data from one school and, therefore, we cannot extrapolate to all schools. The small sample size limited quantitative data analysis; statistical differences between groups could not be examined and descriptive statistics are from relatively small groups. Additionally, only about half of the school community participated in this study. For the quantitative data, we needed to address the “response bias” as noted by Creswell (2014). Creswell explains bias as “the effect of nonresponses on survey estimates” (p. 162). For our study, this means we need to understand how the people who did not respond may have responded, which might have influenced our results. It is possible that the people who did not respond felt too overwhelmed to take the time to participate in a survey and an interview. They might have been the population that experienced more burnout or reported secondary traumatic stress. Additionally, it is possible that people experiencing secondary trauma may not have wanted to share with us or complete a survey, lending to underreporting of their symptoms.