Psychometric Properties of the Secondary Traumatic Stress–Informed
Organizational Assessment
Ginny Sprang
University of Kentucky
Leslie Ross
Children’s Institute, Inc., Los Angeles, California
Brian C. Miller
Primary Children’s Hospital, Salt Lake City, Utah
Kimberly Blackshear
Duke University
Sarah Ascienzo
University of Kentucky
This article describes the development and psychometric properties of the Secondary Traumatic Stress
Informed Organizational Assessment (STSI-OA), a 40-item instrument designed to evaluate the degree
to which an organization is STS-informed and able to respond to the impact of secondary traumatic stress
in the workplace. A sample of 629 respondents representing multiple systems of care, job roles, and
functions completed the STSI-OA. Analyses revealed a 5 factor structure that explained a large
proportion of variance, excellent internal consistency, good test–retest reliability, and concurrent criterion
validity with the Trauma System Readiness Tool Vicarious Trauma domain. Quartile scores and means
were calculated to allow for comparisons. Based on the results of this analysis, it appears the STSI-OA
total and domain scores can be used to create a blueprint for organizational learning, and to reliably track
progress toward desired change over time.
Keywords: organizational assessment, secondary traumatic stress, secondary traumatic stress–informed
organizational assessment, STSI-OA
Organizations as varied as hospitals, child welfare agencies,
community mental health centers, domestic violence shelters, or
refugee centers ask their clinical providers to work with persons
who have experienced trauma. For many workers employed by
these organizations it is a routine part of their daily duties to bear
witness to recounted stories of tragedy, abuse, and even torture
(Lambert, Engh, Hasbun, & Holzer, 2012). There is ample empir-
ical evidence that employees who provide services to traumatized
populations are at increased risk of experiencing symptoms of
secondary trauma stress (Brady, Guy, Poelstra, & Brokaw, 1999;
Bride, 2007; Cieslak et al., 2014; Follette, Polusny, & Milbeck,
1994; Ghahramanlou & Brodbeck, 2000).
Secondary Traumatic Stress includes symptoms that are similar to
posttraumatic stress symptoms (intrusive symptoms, avoidance, reex-
periencing, alternations in cognitions and mood), and is caused by
indirect (vs. direct) exposure to the traumatic experiences of another
person (Figley, 1995). The prevalence of secondary traumatic stress in
clinicians ranges from 15% to over 50%, depending on setting,
amount of trauma exposure, and a variety of personal and occupa-
tional factors (Adams & Riggs, 2008; Bride, 2007; Bride, Hatcher, &
Humble, 2009; Bride, Jones, & MacMaster, 2007; Dominguez-
Gomez & Rutledge, 2009; Quinal, Harford, & Rutledge, 2009; Smith
Hatcher, Bride, OH, Moultrie King, & Franklin Catrett, 2011). At the
very heart of secondary traumatic stress is psychological distress,
which can range from a reduced sense of well-being to Posttraumatic
Stress Disorder (American Psychiatric Association, 2013).
It is proposed that the effects of secondary traumatic stress can
be mediated (Miller & Sprang, 2016), although the best approach
to reduce these effects has yet to be demonstrated. Self-care
approaches (e.g., healthy eating, work-life balance, meditation)
have typically been promoted as possible remedies to the impact of
indirect trauma exposure (Stamm, 1995). Yet self-care approaches
have yet to be validated as effective in reducing secondary trau-
matic stress (Bober & Regehr, 2006). Additionally, there is a
growing recognition that the emphasis on self-care places all of the
responsibility upon the professional, and not upon the organization
or work that placed them in “harm’s way.”
Ginny Sprang, College of Medicine, Department of Psychiatry, and Center
on Trauma and Children, University of Kentucky; Leslie Ross, Children’s
Institute, Inc., Los Angeles, California; Brian C. Miller, Primary Children’s
Hospital, Salt Lake City, Utah; Kimberly Blackshear, National Center for
Child Traumatic Stress, Duke University; Sarah Ascienzo, Center on Trauma
and Children, University of Kentucky.
Special thanks to all the members of the initial STSI-OA workgroup:
Ginny Sprang, Leslie Ross, Kimberly Blackshear, Brian Miller, Cynthia
Vrabel, Jacob Ham, Jim Henry, and James Caringi, the members of the
NCTSN’s STS Collaborative Group, and expert reviewers for their assis-
tance with the development and field testing of the STSI-OA.
Correspondence concerning this article should be addressed to Ginny
Sprang, Center on Trauma and Children, University of Kentucky, 3470
Blazer Parkway, Suite 100, Lexington, KY 40506-0027. E-mail: sprang@
uky.edu
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Traumatology © 2016 American Psychological Association
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