Secondary Traumatic Stress Scale (STSS)
Also known as: STSS, Bride STSS
The STSS is a 17-item self-report scale measuring secondary traumatic stress (STS)—trauma-related symptoms experienced by professionals exposed to others' trauma through their work. Developed by Bride and colleagues in 2004, the STSS operationalizes the concept of secondary traumatic stress disorder, a recognized occupational health concern affecting mental health professionals, physicians, first responders, and others in trauma-exposed occupations. The scale is used for occupational health screening, research on clinician burnout, and organizational assessment of workplace trauma exposure.
Key highlights
- Occupational specificity—directly measures trauma exposure through work rather than general burnout, capturing the distinct phenomenon of secondary traumatic stress
- Brevity and efficiency—17 items requiring 3–5 minutes to complete, facilitating organizational screening and repeated measurement
- Strong psychometric properties—Cronbach's α 0.80–0.85 for total scale; good test-retest reliability; demonstrated validity in diverse professional populations
- Dimension-specific measurement—three subscales (intrusion, avoidance, arousal) enable identification of specific symptom patterns and targeted intervention (e.g., exposure work for avoidance)
- Organizational utility—facilitates screening of entire teams or organizations, informing staffing decisions, workload distribution, and support resource allocation
Intuition
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How it works
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When to use it
The STSS is appropriate for occupational health screening of trauma-exposed professionals, research examining clinician burnout and occupational stress, and organizational assessment of workplace mental health. It is particularly valuable in mental health agencies, trauma centers, emergency departments, and first responder organizations to identify clinicians at risk and inform support interventions (peer support, clinical supervision, time off, workload adjustment). The scale is less suitable for diagnostic confirmation alone (clinical interview and functional assessment should supplement it) and should not replace organizational policies supporting clinician wellbeing.
Strengths & limitations
- Occupational specificity—directly measures trauma exposure through work rather than general burnout, capturing the distinct phenomenon of secondary traumatic stress
- Brevity and efficiency—17 items requiring 3–5 minutes to complete, facilitating organizational screening and repeated measurement
- Strong psychometric properties—Cronbach's α 0.80–0.85 for total scale; good test-retest reliability; demonstrated validity in diverse professional populations
- Dimension-specific measurement—three subscales (intrusion, avoidance, arousal) enable identification of specific symptom patterns and targeted intervention (e.g., exposure work for avoidance)
- Organizational utility—facilitates screening of entire teams or organizations, informing staffing decisions, workload distribution, and support resource allocation
- Does not measure burnout per se—the STSS addresses secondary traumatic stress (PTSD-like symptoms) but not general burnout (emotional exhaustion, depersonalization); complementary burnout measures may be needed
- Occupational focus only—applicable only to professionals with direct client/patient contact involving trauma; not suitable for non-trauma occupations or clients
- Self-report vulnerability—scores may reflect social desirability (underreporting symptoms to appear coping) or catastrophizing (overreporting to justify workload concerns)
- Does not address preventive factors—the STSS measures risk but not protective factors (clinical supervision quality, organizational support, self-care practices) that moderate STS impact
- Organizational context variation—the same STSS score may indicate different clinical significance depending on workplace context (understaffed crisis units vs. well-resourced trauma clinics)
Common pitfalls
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Frequently asked
What is the difference between secondary traumatic stress and burnout?
Secondary traumatic stress (STS) comprises PTSD-like symptoms (intrusion, avoidance, arousal) arising from empathic exposure to others' trauma. Burnout reflects emotional exhaustion, depersonalization, and reduced personal accomplishment from job demands generally. An individual can have STS without burnout (recent trauma case causing acute symptoms in a well-supported clinician) or burnout without STS (exhaustion from administrative work with minimal trauma exposure). Assess both using separate instruments; some clinicians experience both simultaneously.
Does having secondary traumatic stress mean I should leave my job?
Not necessarily. High STSS scores indicate you need support and potentially workload adjustment, not career change. Many clinicians experience secondary traumatic stress and continue working effectively with proper support (supervision, peer consultation, personal therapy, time boundaries). Work with your supervisor, organization, and mental health provider to identify modifications that reduce distress while maintaining meaningful work.
Can organizational changes reduce secondary traumatic stress?
Yes. Organizational factors significantly impact STS: strong clinical supervision, manageable caseloads, trauma-informed workplace policies, peer support, and access to clinician mental health services all reduce STS. Organizations should use STSS data not to blame individual clinicians but to assess workplace factors and implement systemic changes. Shared workload, team debriefing, and institutional support reduce occupational trauma exposure.
How do I distinguish secondary traumatic stress from my own trauma history?
Secondary traumatic stress arises from current work with clients' trauma; unresolved personal trauma may be reactivated or exacerbated by client material. In assessment, clarify the timing and specific triggers: STS symptoms directly relate to client cases, whereas personal trauma symptoms may be triggered more broadly. Clinical supervision can help distinguish and address both; personal therapy is often warranted if personal trauma is impacting clinical work.
Sources
- 1.Bride, B. E., Robinson, M. M., Edwards, B., & Lochner, B. (2004). Development and validation of the Secondary Traumatic Stress Scale. Journal of Traumatic Stress, 17(3), 231-239.
- 2.Figley, C. R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner/Mazel.
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Cite this page
ScholarGate. (2026, June 3). Secondary Traumatic Stress Scale. ScholarGate. https://scholargate.app/trauma-psychology/secondary-traumatic-stress-scale