Secondary trauma for field workers
You were not under the rubble and you lost no one — yet you have not slept for weeks. Witnessing someone else's trauma affects the witness. This protocol covers the signs, post-shift decompression and support within the team.
Protocol 12 min read Usable in a team meeting CC BY-NC 4.0
Definitions
Four separate things, constantly confused
In field teams "I'm burnt out" becomes the name for everything. Underneath it sit four distinct conditions, each with a different remedy. Using the wrong name leads to the wrong response.
Secondary traumatic stress
Arises from repeated exposure to someone else's traumatic account or images. The symptoms resemble post-traumatic stress: intrusive images, nightmares, avoidance, hypervigilance. It starts quickly — sometimes after a single case.
Compassion fatigue
The erosion of the capacity for empathy. The person still works but is hollowed out; they grow distant from and numb towards the people they are helping. It accumulates slowly and is the hardest to notice.
Burnout
Comes not from trauma but from working conditions: endless shifts, vague roles, unsupported management, pointless bureaucracy. The remedy is a change to the system, not self-care. A breathing exercise does not repair a rota nobody will fix.
Moral injury
Appears when you cannot do what you know to be right: deciding who gets taken when resources run out, leaving before you could help. The dominant feelings are not fear but guilt and shame — which is also why it is the hardest to talk about.
Signs
What to look for in yourself and your colleagues
The most dangerous feature of secondary trauma is that the affected person is usually the last to notice. So the list runs both ways: while you watch yourself, watch your colleague too.
In the body
- Constant tiredness, waking unrested
- Headaches, stomach pain, muscle tension
- Getting ill more often
- Trouble sleeping, or sleeping too much
In feeling
- Quick anger, impatience
- Emotional numbness
- Hopelessness, cynicism
- Guilt: "I didn't do enough"
In thinking
- Scenes arriving uninvited
- Seeing the world as permanently dangerous
- Poor concentration, forgetfulness
- Excessive fear for your own family
In behaviour
- Withdrawing from the team and from family
- More alcohol, tobacco, medication
- Working constantly, refusing leave
- No boundaries, saying yes to every task
The earliest and most reliable sign is usually this: running out of patience with the people you are helping. It does not mean you have become a bad person. It means your capacity is full.
Protocol
Post-shift decompression — 20 minutes
This is not a psychological intervention; it is closing the day. The team leader runs it, attendance is voluntary and nobody is pushed to speak. It happens at the end of every shift, before people leave the site.
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1 · Five minutes
Bring the body down
Drink water, sit down, take your boots off. Long breaths: in for four, out for six. The pulse should drop before anyone speaks.
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2 · Five minutes
List the facts
What was done today, how many households were visited, what was completed. Facts before feelings: this gives the day a frame.
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3 · Five minutes
One sentence each
Everyone says one sentence: "What stayed with me most today was…" No comment, no advice, no fixing. Anyone can say "pass".
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4 · Five minutes
Close tomorrow
Tomorrow's time, the task list, who is off. Do not disperse with things left open; open ends are what people take home at night.
What not to do
- Do not have anyone narrate their trauma in detail. Compulsory, detailed retelling can do harm; that is why the round is one sentence long.
- Do not assess performance; this meeting is not where accounts are settled.
- Do not give advice or start a sentence with "if I were you".
- Do not let it run past half an hour.
Three duties for the team leader
- Speak first. A leader saying "today was hard for me" is the precondition for anyone else speaking.
- Impose the rest day. The colleague who refuses leave is the highest-risk member of the team.
- Protect the rotation. Do not put the same person on the heaviest task day after day.
Organisational
Care is not a solo task: it is a shared responsibility
Preventing secondary trauma is usually dumped on the individual — "look after yourself", and the subject is closed. In fact the decisive factor is working conditions. The following are the organisation's obligations, not the worker's good intentions.
Shifts and rotation
- No shift longer than 12 hours
- Rotation on high-exposure duties
- A mandatory rest day — not "if you want one"
- No lone working; pairs as a minimum
Supervision
- Regular case supervision
- An independent channel that produces no penalty
- An experienced person paired with each new volunteer
- Roles set out in writing
Exit and return
- A return conversation after a field deployment
- Free access to specialist support
- A closing conversation with volunteers who leave
- Shared practices of remembrance within the team
When to seek help
Signs that call for withdrawal from the field
If any of the following is present, the person should be stood down temporarily and referred for specialist assessment. This is not a sanction but a protective measure, and it must be presented as one.
- Intrusive images lasting more than a month and interrupting work
- Freezing, indecision or loss of attention in the field
- Anger or contempt towards the people being helped
- A marked increase in alcohol or substance use
- Persistently refusing leave, not wanting to go home
- Thoughts of self-harm — do not wait on this one
In that case, speak to a supervisor in your organisation or to a mental health professional. Supervision and self-care for field workers and volunteers is one of TAK-DER's areas of work.
Printable
Post-shift card
The 20-minute sequence
- Bring the body down — water, sit, long breaths (5 min)
- List the facts — what was done today (5 min)
- One sentence each — "what stayed with me…" (5 min)
- Close tomorrow — time, tasks, leave (5 min)
Attendance voluntary · "Pass" allowed · No advice · Never past 30 minutes
Weekly self-check
- I took at least one full day off this week
- I saw someone unconnected to the work
- I slept more than five hours on average
- I was able to switch the phone off when not on shift
- I was able to say no to a task
- There is no new pain in my body
Three or more left unticked: talk to your team leader.
References
Where the information on this page comes from
The distinctions between concepts, the symptom lists and the organisational obligations are adapted from the sources below. The post-shift sequence is TAK-DER's own team practice and is not offered as a clinical intervention.
- Caring for yourself and colleagues
- World Health Organization, War Trauma Foundation & World Vision International (2011). Psychological First Aid: Guide for Field Workers, "Caring for yourself and your colleagues". who.int
- Protecting aid workers
- Inter-Agency Standing Committee (2007). IASC Guidelines on MHPSS in Emergency Settings, Action Sheet 4.4 — the wellbeing of aid workers. interagencystandingcommittee.org
- Secondary traumatic stress
- Figley, C. R. (ed.) (1995). Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. New York: Brunner/Mazel.
- The risk of compulsory debriefing
- Rose, S., Bisson, J., Churchill, R. and Wessely, S. (2002). "Psychological debriefing for preventing post traumatic stress disorder (PTSD)", Cochrane Database of Systematic Reviews. cochranelibrary.com
- Humanitarian staff standards
- CHS Alliance (2014). Core Humanitarian Standard on Quality and Accountability, Commitment 8 — staff are supported. corehumanitarianstandard.org
Links go to the publisher; last accessed 11 September 2026. If you spot an error in a citation, tell us and we will correct it.