This study examined the relationship between three variables, compassion fatigue (CF), compassion satisfaction (CS), and burnout, and provider and setting characteristics in a sample of 1,121 mental health providers in a rural southern state. Respondents completed the Professional Quality of Life Scale as part of a larger survey of provider practice patterns. Female gender was associated with higher levels of CF, and therapists with specialized training in trauma work reported higher levels of CS than nonspecialists. Provider discipline proved to be an important factor, with psychiatrists reporting higher levels of CF than their non-medical counterparts. When providers were compared using rural, urban, and rural with urban influence classifications, the most rural providers reported increased levels of burnout but could not be distinguished from their colleagues on the CF and CS subscales. Important practice, education, and policy implications are noted for a multidisciplinary audience. American author James Baldwin (1963) wrote, ''One can give nothing whatever without giving oneself, that is to say risking oneself'' (p. 100). Risking exposure to vicarious trauma is an inherent part of the process when working with traumatized persons. The empirical literature has documented mental health consequences of professionals' exposure to trauma patients, responses that differ depending upon individual and contextual characteristics specific to the provider and the practice setting. This study explores variables that might influence such responses to vicarious exposure to traumatic stress by examining compassion fatigue (CF), compassion

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Based on these findings, recommendations are made about how to tailor a trauma-informed approach to the needs of custodial grandparents.

The current study examines trauma narratives from 28 survivors of interpersonal violence. A mixed-method approach assessed coherence and explored narrative characteristics among differentially exposed groups. The quantitative analysis revealed: (1) exposure to repetitive interpersonal violence was described with greater perception of severity and emotional tone than single interpersonal violence episodes, and (2) exposure to interpersonal violence in childhood was described with greater emotional tone than exposure to interpersonal violence in adulthood. The qualitative analysis revealed: (1) traumatic events were connected to proceeding adverse experiences, (2) attempted avoidance of memories of the violence, (3) an altered view of the self, and (4) lacked recognition that the violence was abnormal. The study supports the "dose-response relationship" of trauma exposure, and the life-altering, transformative nature of trauma exposure.

Background Research is needed to facilitate better understanding of how different groups have been impacted by COVID-19, especially those in already strained service systems such as foster care. These inquiries will support further response, recovery and preparedness efforts. Objective This qualitative study addressed how professionals and caregivers in foster care described being affected by COVID-19 in order to support future research and planning for foster care systems in this pandemic context. Participants and setting A sample of foster parents and foster care professionals (N = 357) from a mostly rural, southeastern state in the U.S. participated in the study. Methods Qualitative analysis was conducted of 357 open-ended responses regarding the impact of COVID-19 from a survey distributed in August 2020. Results The coding process resulted in the identification of 15 distinct themes: Isolation & Loss of Social Support, Work Changes/Stressors, School Issues, Childcare Issues, No Impact/Positive Changes, Financial Problems, Fear of Contagion, Negative Child Welfare Impacts, Mental Health Problems/Stress, Loss of Faith/Trust & Societal Frustrations, Health & Mental Healthcare Access Issues, PPE & Testing Issues, Grief & Loss, and Marital Problems. Secondary impacts rather than direct physiologic effects of the virus were primarily reported. Conclusions This study underscores the various challenges facing foster care systems, and how the pandemic context is exacerbating many of these issues. Further research is needed to ensure the implementation of adequately complex and nuanced responses that target needs and avoid creating further problems for foster care.

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These findings shed light on the endurance of insufficient behavioural health infrastructures despite therapists' access to scientifically validated treatments for trauma spectrum and co-morbid mental disorders suffered by children and adults. Such insights have implications for the success of global dissemination of validated behavioural health interventions.

Objective: Current tools available to assess secondary traumatic stress (STS) do not account for whether the symptoms are functionally related to indirect trauma, determine functional impairment caused by the STS symptoms, and/or consider the duration of the disturbance. This prevents delineation of various expressions of traumatic stress related to indirect trauma that may constitute the phenomenon of STS. The STS Clinical Algorithm (STS-CA) was developed to make these distinctions, so that interventions can be tailored to need. This study investigates the following: (1) the diagnostic concordance between the STS-CA findings and scores on the Secondary Traumatic Stress Scale (STSS); (2) reasons for diagnostic discrepancies between the STS-CA and the STSS assessments. Method: Three trained interviewers used the STS-CA to guide the determination of clinical outcome ( N = 181) in a diverse group of helping professionals. Results: There was 100% agreement between the CAPS and the STS-CA, and fair agreement (κ =.426, p = .000) between the STS-CA and the STSS. The STS-CA demonstrated more sensitivity in classifying positive cases, and specificity in delineating those with atypical cluster presentations or little to no functional impairment that prohibited a post-traumatic stress disorder diagnosis than the STSS. Implications: Effective treatment of STS requires proper identification and the delivery of protocols that are tailored to the unique ways that STS manifests. This study provides some insights into the utility of the STS-CA in guiding this process and creates STS categories to organize and classify intervention strategies.