Sustaining the Practitioner: The role of trauma-informed supervision and wellbeing

Working in trauma-related environments can be meaningful, purposeful and deeply relational. We have the privilege of witnessing courage, change, connection and recovery. At the same time being present with experiences of trauma, distress, loss and injustice which can ask a great deal of us. The impact of this work does not mean we are not resilient enough, rather it reflects something very human: we can be affected by what we hear, witness and hold in our work.

Research increasingly reinforces the importance of recognising both the individual and organisational factors that influence how people experience trauma-related work. A systematic review by Sutton et al. (2022) examining organisational contributors to vicarious trauma found that factors within the workplace, including workload, support and organisational conditions can influence practitioner wellbeing. Wellbeing in trauma work is not simply an individual responsibility. Personal strategies are important, but they occur within a much broader environment of quality supervision, supportive relationships, thoughtful leadership and organisational environments that recognise the impact of the work and create space to respond to it. When these supports are embedded into practice, they can help us remain connected to ourselves, one another and to the meaning we find in the work.

Understanding the impacts of trauma-related work

Terms such as vicarious trauma, secondary traumatic stress, compassion fatigue and burnout are often used together and there can be some overlap between them. They can, however, help us understand the different ways in which the work may affect us.

• Vicarious trauma describes the changes that can develop through repeated empathetic engagement with trauma. Over time, this may influence our thoughts, emotions, assumptions and ways of understanding ourselves, other people and the world. Research distinguishes this cumulative process from secondary traumatic stress, which may occur more acutely following indirect exposure to trauma.
• Secondary traumatic stress can involve trauma-related stress responses arising through exposure to another person’s traumatic experiences.
• Compassion fatigue is commonly associated with the emotional strain that may occur through sustained caring and empathetic engagement.
• Burnout is associated with ongoing workplace demands and conditions and not specific to working with trauma.

Understanding these experiences gives us language for noticing what may be happening, without making the impact of the work a personal failing.

What is trauma-informed supervision?

Trauma-informed supervision offers a supportive professional space to explore both the work and its potential impact on us. It brings a trauma-informed lens to supervision by recognising how trauma can shape experiences, relationships, and systems, while also paying attention to the cumulative effects of working in trauma-related environments.

Within trauma-informed supervision we can to explore:

• Stress responses and the impacts of ongoing trauma-related work such as vicarious trauma, compassion fatigue and burnout.
• Practical strategies to support regulation, boundaries and wellbeing
• Relational and organisational influences on how we experience the work
• Strengths, meaning and connection that can emerge through the work.

More recent research specifically examining trauma-informed supervision identified three interconnected areas: developing a supportive supervisory relationship, facilitating trauma-informed learning and building resilience.

What is Vicarious Resilience?

Trauma-informed supervision is not only about identifying what is difficult, it also creates space to recognise vicarious resilience, the ways we can be strengthened, inspired and changed through witnessing courage, recovery, connection and growth. By holding both challenges and the strengths of trauma-related work, supervision can help us build awareness, maintain perspective and make intentional choices about what we need to sustain ourselves over time.

Vicarious resilience describes positive changes that can emerge through our engagement with the strength, resourcefulness, adaptation and recovery we witness through our work. It can include shifts in perspective, a greater appreciation of relationships, increased hope, a stronger sense of meaning or an expanded understanding of human capacity. This matters because trauma-related work can hold more than one experience at the same time. We can find something difficult and still find it meaningful.

Research completed with 373 social workers provides an interesting example. Mendez-Fernandez et al (2022) found that recovery experiences and organisational support were associated with less vicarious trauma and greater vicarious resilience while high trauma caseloads were identified as a risk factor. This shifts the conversation to asking ‘What are the conditions that enable people to remain well and experience resilience in this work?

Trauma-informed supervision therefore gives us an opportunity to pause before the stress becomes something we simply learn to push through. It can create space to identify what may need to change but also to notice what is sustaining us. So rather than viewing wellbeing and supervision as something we turn to when things become difficult, we can see them as an important part of how we practice well and sustain ourselves in the work. The aim is not to remain untouched by what we do. It is to understand the potential impact, have spaces where it can be acknowledged, strengthen the individual and organisational supports around us, and remain open to the meaning, connection and vicarious resilience that can also emerge through the work.

To engage in your own supervision practice with Blue Knot find more information on what support we can provide Trauma-informed Supervision

References

Cook, R. M., Krell, M. M., Hayden, L. A., Gracia, R. & Denitzio, K. (2023). Trauma-informed supervision and related predictors of burnout and secondary traumatic stress among pre-licensed counsellors. International Journal for the Advancement of Counselling, 45, 107–123.

Henderson, A., et al. (2025). Personal trauma history and secondary traumatic stress in mental health professionals: A systematic review. Journal of Psychiatric and Mental Health Nursing.

Méndez-Fernández, A. B., et al. (2022). Vicariously resilient or traumatised social workers: Exploring some risk and protective factors. British Journal of Social Work, 52(2), 1089–1109.

Sutton, L., Rowe, S., Hammerton, G. & Billings, J. (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).

Zacharias, B. S. & Upendra, S. (2024). A systematic review on the burden of secondary traumatic stress among healthcare providers. Journal of Education and Health Promotion, 13.