Blue Knot Review - Summer 2022

This quarterly journal focuses on the practical application of key concepts, developments and perspectives about complex trauma and the continuum of trauma-informed practice.

In this edition, we are reflecting on the topics of vicarious trauma, compassion and empathy in the workplace and some foundational concepts around organisational change and the impact on change of culture.  We hope you find something of interest to reflect upon or to support your practice.

Contents of this edition are:

Research Highlight

The contribution of organisational factors to vicarious trauma in mental health professionals: a systematic review and narrative synthesis Lucy Sutton, Sarah Rowe, George Hammerton & Jo Billings (2022)

Training for Professionals

New Training Calendar January to June 2023

New Leadership Program: Trauma-Responsive Leadership – Self within Organisation

Toolbox: Readiness for Change Checklist


Podcast: Empathy and Compassion Work: Part 2 with Taryn Hughes

Toolbox: Trauma-informed Low Impact Discussions



Blue Knot Updates

Join Our Team – Blue Knot Contractor roles





Research Highlight - The contribution of organisational factors to vicarious trauma in mental health professionals: a systematic review and narrative synthesis

Lucy Sutton, Sarah Rowe, George Hammerton & Jo Billings (2022) The contribution of organisational factors to vicarious trauma in mental health professionals: a systematic review and narrative synthesis, European Journal of Psychotraumatology, 13:1, 2022278, DOI: 10.1080/20008198.2021.2022278

The highlighted research this quarter is focused on the impacts of vicarious trauma and other stress outcomes in the human services realm and what  organisations might find helpful to consider in supporting their workforce.

The authors use the umbrella term of Secondary Traumatic Stress throughout the article, to refer to both the wider concepts of Compassion Fatigue and Vicarious Trauma. These terms are often used interchangeably alongside burnout which can become confusing, so it is important to note that:

While the constructs of CF and STS focus on outward symptoms, VT centres around the changes to cognitive schema and core beliefs as a result of exposure to and engagement with the traumatic material presented by clients (McCann & Pearlman, 1990). VT is associated with cognitive disruptions in the areas of trust, safety, dependency, power, esteem, and intimacy (Pearlman & Saakvitne, 1995).

Although conceptually different, it is increasingly understood that there is convergence between these three constructs (Jenkins & Baird, 2002).”

The authors highlight the impacts on personal and professional capacity of experiencing these stress outcomes. The flow-on effect to organisational productivity is real. Lack of awareness of these impacts and poor structural support and workforce planning can be detrimental for both individuals and organisations.

The article notes research to date currently is focused on the individual and factors that can make a person more vulnerable to these stress outcomes.

The article identifies six organisational factors from the literature. These areas identified were key to providing a framework of support to the workforce.

“Priority areas should include ensuring access to regular and relational orientated supervision, strong peer support networks, and a balanced and diverse caseload. The qualitative literature also suggested that trauma specific training which includes training in STS may be beneficial to mental health professionals. In addition, adopting a culture that recognizes and legitimizes the existence and expression of STS can play a key role in promoting greater staff wellbeing. Awareness of the definition and symptoms of STS can help to validate feelings that many believed were unique to them and allow them to process these feelings as normative components of their work – without fear of being branded as weak or unfit for the job. “

The importance of deep consideration around the purpose, quality and time around how to do this is highlighted as critical to the implementation of all key areas and the impact.

Utilising a trauma lens and applying the trauma informed principles means understanding in context how these six areas can be embedded. This fosters a felt sense of safety for individuals, teams and the wider culture, through building trustworthiness, providing consistency and reliability and prioritising these key supports. Empowering people to contribute to process and share what works in this regard and what does not, through choice and collaboration. It is also key for organisations to integrate intersectionality and accessibility into all structures.

The article is found at the link above and gives opportunity to reflect on and/or build awareness of the importance of understanding the impacts and costs of secondary trauma.

Image of six key elements from research as discussed in text

Education and Training

2023 Training Calendar

Blue Knot has launched our new bi-yearly calendar continuing to offer a variety of training formats from January to June 2023. Virtual classrooms and webinars offer the flexibility as well as face-to-face training offering a different way to connect.

This calendar offers a blended version of foundational information and safety and stabilisation practices – Trauma Sensitive Practice: Working with Complex Trauma. This alternate offering to the foundational training for those who have some awareness but provides an opportunity to refresh and build on their understanding of the importance of relationship and regulation.

Those wishing to start their journey on building awareness should attend our Foundations in Building Trauma Awareness training which then leads on to Trauma Awareness in Practice in which the trauma-informed principles are explored more practically.

Our Redress two-day intensive develops and deepens the understanding of institutional trauma and the process of redress including direct personal response.

People at desk talking

The Leadership stream now offers two days of diving into self as Leader and Leader within the Organisation, and how we can manage change and support the path towards being trauma-informed and safe as both an individual and within the wider context of the organisation.

There is training for every level whether starting or building on your learning to provide best practice when working with complex trauma. See our calendar here:

Trauma Responsive Leadership - Leader within the Organisation

It is important to recognise the systemic barriers that can prevent individual staff and teams from engaging fully in trauma-informed relationships and practices. It is also important to identify that despite the systemic barriers many staff are also engaging in trauma-informed practices without naming them as such. Organisational change starts with individuals, a commitment to becoming trauma aware and then adopting practices across the organisation that are trauma-sensitive, and trauma-responsive so a more trauma-informed organisation is operating.

In a leadership position it can be difficult to focus on consciously embedding organisational cultural change when faced to the often default position, the pressures of management responsibilities. Sandra Bloom (2011) in her chapter ‘Trauma-organised systems and parallel process’ in Managing Trauma in the Workplace: Supporting Workers and Organisations’, makes an important point when she states that ‘it is useful to think about parallel processes of recovery because in reality, we cannot stop the systems from functioning in order to fix what is broken.

The flow of clients who need services has not and will not stop in any world that we can realistically anticipate today. So, we have to mend our broken systems at the same time that we are providing services to the people who need them.

Trauma-informed culture, systems and their principles and practices support:

  • reflection in place of reaction,

  • curiosity in lieu of numbing,

  • self-care instead of self-sacrifice

  • and collective impact rather than siloed structures

Epstein, K, Speziale, K, Gerber &Loomis, b (2014) SF DPH TIS (Trauma-informed systems initiative)




Understanding the ecology is key, as in your role you operate at a personal, practice and organisational level.  Influence and opportunity to effect change is possible at all levels within the organisation. As reflected in Gray & Tracey (2016) Implementing a Trauma-informed framework in a disability non-government organisation: Research Report, Western Sydney University, understanding how to implement trauma-informed principles at each level can provide clarity for the steps moving forward.

Personal level – engagement and linking the trauma lens though self-awareness and self-compassion, an understanding of vicarious trauma, compassion fatigue and burnout. Attending training and group supervision that develop psychological flexibility skills to support staff’s ability to self-regulate and manage stress.

Practice level – trauma awareness, supporting language and practice that normalises a person’s response and reframes them from a strength-based perspective. This can be achieved through practices such as mentoring staff to use a trauma-informed approach in developing support and safety planning documents, engaging in reflective practice sessions.

Organisational level – supporting a governance framework that promotes organisational congruence across all levels of service and management. This begins through the development of a shared understanding of responsibility and linkages to the organisation’s existing benchmarks and strategic plans.

Therefore, it is important as leaders to reflect on parallel processes at every level and with the clients you serve, understand the current position you have adopted and find ways to acknowledge the work already being done. Every interaction is an intervention and opportunity to connect and to understand one another. In the wider scheme of an organisation where there are systemic barriers, we need to focus on the opportunity for change in the moment that however small it may feel, is an opportunity to model values, actions and responses.

To explore this topic more you can find the following in our training calendar at Exploring the Path to Trauma-informed Organisational Change or read more on our website Trauma-informed Organisational Change

Toolbox: Readiness for Change Checklist

When starting to consider an organisational change process, it is important to begin with an understanding of how your organisation is currently functioning. An organisational review and/or walkthrough can be helpful before embarking on an organisation-wide project.

First understand where the need for a change process has originated from. Has it been driven by the senior leadership team or is it a small group of enablers within the organisation? Is it one particular area of the business? What has been the catalyst for this conversation and why?

Developing a shared understanding of the parameters and objectives for change in regard to function, roles and activities allows for the ideal scope to be created whether on a micro or macro level. It begins to shape the answer to the question – Where do we start?

Key questions are:

  • How does the organisation/team currently operate?  What have we observed at all levels?
  • What is the organisation/area/team’s current understanding of trauma-informed principles?  How do we know?
  • What is the vision for success? What changes are required? Urgently? In the medium to longer term? What tells us this?

These questions allow for exploration of current practices, culture and strategic objectives of the organisation.


group discussion

Using the following questions as prompts, assess organisational readiness for change. Answer each question with a rating of 1 (not at all/not at all ready) to 10 (yes/ready)


Is the organisational structure able to assist and support change? If not, what changes are necessary?

Does the structure of the organisation enable a two-way flow of decision-making and skills required for change? If not, where are the barriers?


Are there adequate organisational resources (time/financial/personnel) to adopt change?

Where, how and who makes decisions about the release of time/finances and personnel to support the changes needed? Is there a shared organisational understanding of where and how these decisions are made?


How and where does intra-agency (i.e. between people, activities, settings within the organisation) communication occur?

What are the barriers to open effective communication? Do strategies exist to address them?

Dependent on the ratings you can identify the areas for further exploration and work prior to embarking on a change process. Further information on these processes can be found in our Organisational Guidelines Organisational guidelines for trauma-informed service delivery

Resources: Podcast - Empathy and Compassion Work: Part 2 with Taryn Hughes

This podcast considers the impacts of compassion fatigue and the cost of caring.

That self-care is not enough, we must use the power of relationship to connect with others and seek support when needed. Understanding the signs of all stress outcomes is important, and learning how to utilise clear boundaries to create space.

As an organisation, and as a leader, Simon Sinek shares his view “It is important to care for your employees’ experience. I believe that a world in which the vast majority wake up inspired, feel safe at work and return home fulfilled at the end of the day is possible.”

Woman on a couch speaking

It is also important to note that not everyone suffers from or is impacted by vicarious trauma and/or compassion fatigue. People have varying degrees of emotional resiliency and capacity.

When creating spaces for teams or individuals to debrief, it is important to be clear on the type of process being utilised and within and to set up structures which allow for safety in debriefing.

This podcast gives several different viewpoints and experiences on working with teams and organisations, and how, as individuals to be empowered in your own work/life experience.

You can find it at this link:

Toolbox: Trauma-informed low impact discussions

Colleagues can often re-traumatise each other when helping professionals hear and see difficult things, a normal reaction is to want to debrief with someone.

Therefore, it is helpful to observe when we need to share whether we are defusing or debriefing and who the best person to do that with should be. Defusing is expressing our emotional needs and reactions to a situation/content. (focused on you). Debriefing examines the information surrounding the event/situation/client and managing risk (focusing on other)

Applying a trauma-informed lens creates an awareness of who we are approaching and why, what our intent of the conversation is, giving choice to the other person in engaging in the content and then utilising the space as needed.

Developing a language around this whether as a leader, or with your supervisor and team can support environmental wellbeing.

Join Our Team

Blue Knot has experienced growth in our training and supervision arm and is seeking suitably qualified practitioners who have a trauma lens and a knowledge base in complex trauma.

questions see descriptor

The Blue Knot Foundation is seeking trainers experienced in the field of complex trauma to deliver training programs from our suite of trauma- informed and therapeutic clinical packages.

The Role

This is a contract position based on bookings for individual training events and could complement the work of professionals in private practice or who work part time in a trauma service. Blue Knot’s span across Australia requires trainers with a range of backgrounds, working not only in clinical roles but in practice roles with adults, children, youth and families.

Blue Knot trainers deliver the organisation’s material in a variety of settings, face to face training, virtual classrooms, webinars and speaking engagements. Training runs in one or two-day formats publicly and within organisational settings.

Questions see descriptor

Blue Knot Foundation is seeking supervisors experienced in the field of complex trauma to deliver trauma-informed supervision to a wide range of organisations across different sectors.

The Role

This is a contract position for group supervision facilitation and could complement the work of professionals in private practice or who work part time in a trauma service.

Blue Knot trauma-informed supervision focuses on applying the principles of trauma-informed practice to the supervision space.  The aim of the sessions is to provide supervisees with an opportunity to debrief, recognise and respond to vicarious trauma, and explore tips and strategies which support optimal communication practices and interpersonal connections with people they support.

For more information about both of these roles please see our website page for the application process at Join Our Team . Please contact our team if you are unsure and would like to talk the positions through further. We are looking for a diversity of practitioners to join us, so we encourage you to apply!

From all of us at Blue Knot we wish you a safe and restful holiday period. Our offices are closed from the 23 December until the 9th January 2023. The professional services arm will begin delivery after the 16 January 2023.

Our website is available for resources for you and your families across the office closure.

Our Helplines will also be open across the break if you need additional assistance.

Christmas bauble