University of Northern Colorado Scholarship & Creative Works @ Digital UNC Dissertations Student Research 7-2020 Protective Factors for Secondary Traumatic Stress in Residential Treatment Staff Stacey Gagliano Follow this and additional works at: https://digscholarship.unco.edu/dissertations © 2020 STACEY GAGLIANO ALL RIGHTS RESERVED UNIVERSITY OF NORTHERN COLORADO Greeley, Colorado The Graduate School PROTECTIVE FACTORS FOR SECONDARY TRAUMATIC STRESS IN RESIDENTIAL TREATMENT STAFF A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Stacey Gagliano College of Education and Behavioral Sciences Department of School Psychology August 2020 This Dissertation by: Stacey Gagliano Entitled: Protective Factors for Secondary Traumatic Stress in Residential Treatment Staff has been approved as meeting the requirement for the Degree of Doctor of Philosophy in College of Education and Behavioral Science in the Department of School Psychology Accepted by the Doctoral Committee _______________________________________________________ David Hulac, PhD, Research Advisor _______________________________________________________ Robyn S. Hess, PhD, Committee Member _______________________________________________________ Basilia Softas-Nall, PhD, Committee Member _______________________________________________________ Thom Dunn, PhD, Faculty Representative Date of Dissertation Defense _________________________________________ Accepted by the Graduate School _____________________________________________ Cindy Wesley Interim Associate Provost and Dean The Graduate School and International Admissions ABSTRACT Gagliano, Stacey. Protective factors for secondary traumatic stress in residential treatment staff. Unpublished Doctor of Philosophy Dissertation, University of Northern Colorado, 2020. This cross-sectional study examined the relationship between empathy, a problem- focused coping style, compassion satisfaction (CS), staff cohesion, and symptoms of secondary traumatic stress (STS) in residential treatment center (RTC) staff, while controlling for previous direct trauma exposure. A total of 44 participants were recruited from RTCs in a western state and included mental health care providers (clinical staff), direct-care staff, and educational staff. Participants completed a 62-question electronic survey that included several self-report measures evaluating each of the aforementioned variables, in addition to demographics. A hierarchical multiple regression analysis was performed to determine the degree to which these variables explain STS symptoms in RTC staff. A one-factor ANOVA was utilized to compare rates of STS between across occupational groups. Findings of correlational analyses indicated that higher levels of problem-focused coping skills were significantly associated with a greater sense of empathy. Moreover, the experience of direct trauma, empathy, problem-focused coping, CS, and staff cohesion significantly explained STS symptoms in RTC staff. These results suggest that particular individual and/or organizational factors may serve a protective function against STS and further research is warranted as this knowledge may benefit training programs and staff development opportunities across systems that serve traumatized youth. iii ACKNOWLEDGEMENTS First and foremost, I would like to thank my incredibly supportive and loving husband, John. John definitively stated, early on in this process, “we will get you through this program.” He reiterated this to me many times throughout this journey and he truly meant it. The endless weekends he spent alone, without complaint, while I sat in our living room and worked for countless hours, is a testament to his dedication. The many days that he packed both lunch and dinner for me to take to campus for yet another 16- hour day, always showed me how much he cared. I am so grateful to have him in my life. I would not be where I am today, or who I am today, without his enduring love, support, and encouragement. I love you John. I would like to thank my parents, who struggled at first with idea that I would be moving across the country from them, but who each took a week off of work to make that four-day drive with us when the day finally came. They taught me to be the person that I am, and I am now able to go forward and help those in need because they instilled in me the value of hard work, kindness, compassion, and love. Thank you to my mother and father-in-law, who I feel so lucky to have in my life. They have been unwavering in their support for me and my goals and they never fail to tell me how proud they are of me. In addition, to my siblings, for taking the time to come visit me when I was unable to visit them, for always being a source of support and comfort. iv To my friends, who were understanding when I struggled to find time to talk and rarely visited. For always making me laugh and keeping my spirits high. This includes the new friends I made in Denver, who kept me sane and celebrated my wins every time. Also, the new friends I made in my program at UNCO, who studied with me, laughed with me, occasionally cried with me, and always encouraged me forward. Thank you to my dissertation committee, Dr. Robyn Hess, Dr. Thomas Dunn, Dr. Basilia Softas-Nall, and my dissertation chair, Dr. David Hulac. I appreciate your support and expertise throughout my years in the program. Thank you for lending your time and energy to my dissertation and helping me achieve my goals. Lastly, thank you to the residential treatment centers who partnered with me and generously allowed me to collect information from their staff. This project would not have been possible without them. More specifically, I would like to thank the clinical directors, who not only provided me with participants, but who have supported me, mentored me, and without whom I would not be the clinician I am today. v TABLE OF CONTENTS CHAPTER I. INTRODUCTION ........................................................................................................... 1 Significance of the Problem .................................................................................... 2 Statement of the Problem ...................................................................................... 11 Purpose Statement ................................................................................................. 12 Research Questions ............................................................................................... 13 Definition of Terms............................................................................................... 13 Summary of Introduction ...................................................................................... 15 II. LITERATURE REVIEW ............................................................................................. 17 Placements and Systems: Residential Care........................................................... 17 Youth in Residential Care ..................................................................................... 23 The Effects of Complex Trauma........................................................................... 25 The Important Role of Staff .................................................................................. 31 Trauma Loop ......................................................................................................... 34 Secondary Traumatic Stress .................................................................................. 37 Risk and Protective Factors .................................................................................. 41 History of Adversity and/or Trauma ......................................................... 41 Gender ....................................................................................................... 44 Coping Styles ............................................................................................ 45 Empathy .................................................................................................... 48 Compassion Satisfaction ........................................................................... 51 Work Environment.................................................................................... 53 Current Study ........................................................................................................ 54 III. METHODOLOGY ..................................................................................................... 56 Participants and Setting......................................................................................... 56 Instrumentation ..................................................................................................... 59 The Empathy Assessment Index ............................................................... 60 The Professional Quality of Life Scale ..................................................... 61 Coping with Stress .................................................................................... 62 Staff Cohesion ........................................................................................... 65 vi Demographic Characteristics .................................................................... 66 Research Design.................................................................................................... 67 Procedures ............................................................................................................. 68 Data Analysis