The culture of organizations dealing with trauma: Sources of work-related stress and conflict

In a comparative qualitative study of 13 organizations worldwide working with survivors of extreme trauma, the relationship between work-related stress and conflict and the structure of the organization is examined. Seventy-two caregivers, supervisors, and experts are interviewed and external organizational analyses and capacity assessments analyzed. The results show that organizations with high stress and conflict levels exhibit considerable structural deficiencies and an atmosphere shaped by a reenactment of the traumatic world of clients. This chaotic, unstructured, unpredictable environment parallels the total absence of structure that exists when a victim is at a perpetrator’s disposal. Organizations with low stress and conflict levels, however, prove to have fairly clear organizational structures. The results of this study show that structural shortcomings are an important source of work-related stress and conflict in organizations dealing with extreme trauma. Furthermore, the study raises the question whether the stress symptoms experienced by caregivers amount to a diagnosis of “secondary” or “vicarious traumatization.” Caregivers in organizations with structural deficiencies show symptoms described by others as secondary traumatization. However, these symptoms subside after organizational transformation and structural improvement. It is found that caregivers in well-structured organizations exhibit almost no such symptoms.