Summary PDF: What works to reduce burnout and vicarious trauma among refugee service providers?

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What works to reduce burnout and vicarious trauma among refugee service providers?

There is strong evidence for a variety of strategies to reduce vicarious trauma, secondary traumatic stress, compassion fatigue, and burnout among helping professionals.

  • A strong body of evidence has developed in the past twenty years on reducing stress reactions among a variety of professional helpers in a wide range of settings and professions.
  • Strategies to reduce stress reactions share common features across all the types of staff stress reactions: vicarious trauma, secondary traumatic stress, compassion fatigue, and burnout.


Effective strategies encompass both organizational and self-care interventions.

  • The evidence suggests that self-care contributes to reduced stress, but that self-care alone is insufficient to mitigate staff stress and that organizational interventions to foster lower-stress work environments are vital.


Suggestive findings for resettlement staff mirror those for helping professionals generally.

  •  Three studies on resettlement staff suggest that their stressors and strategies for addressing them are similar to those of helping professionals in other settings. Furthermore, the evidence from studies of refugee service providers suggests that organizational transformation plays a vital role in staff well-being.


Refugee service providers should develop, implement, and evaluate policies and practices to mitigate staff stress reactions.

  • Evidence suggests that agencies should implement broad-based staff stress reduction strategies that:
    • Educate and engage senior leadership on the need to address staff stress reactions
    • Decrease staff workloads
    • Create comfortable, confidential workspaces and retreat spaces
    • Practice proactive, trauma-informed supervision
    • Enhance peer support opportunities
    • Individualize stress reduction approaches for each staff member
  • Refugee-serving organizations should encourage self-care among their staff, and provide opportunities for staff to use personal activities to reduce stress, but should recognize that self-care is not enough.
  • Because the evidence suggests that organizational factors are vital to the well-being of refugee service providers, organizations should examine steps they can take to lower their employees’ stress, such as those listed above. These steps should be based on the work-related risk factors identified in the literature, such as unreasonable workload expectations, lack of management support, and poor communication.

Post TitleStrength of EvidenceType of StudyDirection of Evidence
The Association between Energy Balance-Related Behavior and Burn-Out in Adults: A Systematic ReviewStrongSystematic reviewPositive impact
Addressing Secondary Traumatic Stress: Models and Promising PracticesStrongSystematic reviewPositive impact
The culture of organizations dealing with trauma: Sources of work-related stress and conflictSuggestiveSuggestive evidencePositive impact
Early Post-trauma Interventions in Organizations: A Scoping ReviewStrongSystematic reviewPositive impact
Mindfulness therapies on health professionalsStrongMeta-analysisPositive impact
Factors associated with Type II trauma in occupational groups working with traumatised children: a systematic reviewStrongSystematic reviewPositive impact
The impact of mindfulness-based interventions on doctors’ well-being and performance: A systematic reviewStrongSystematic reviewPositive impact
A Systematic Review of Job Demands and Resources Associated with Compassion Fatigue in Mental Health ProfessionalsStrongSystematic reviewPositive impact
The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysisStrongSystematic reviewPositive impact
The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: a systematic reviewStrongSystematic reviewPositive impact
Insomnia Interventions in the Workplace: A Systematic Review and Meta-AnalysisStrongSystematic reviewPositive impact
Impact of social support in preventing burnout syndrome in nurses: A systematic reviewStrongSystematic reviewPositive impact
The Impact of Nurse Leadership Styles on Nurse Burnout: A Systematic Literature ReviewStrongSystematic reviewPositive impact
Effectiveness of interventions to reduce emergency department staff occupational stress and/or burnout: a systematic reviewStrongSystematic reviewPositive impact
Causes and consequences of burnout among mental health professionals: A practice-oriented review of recent empirical literatureStrongSystematic reviewPositive impact
Factors Associated With Burnout and Stress in Trainee Physicians: A Systematic Review and Meta-analysisStrongMeta-analysisPositive impact
Meta-analysis of risk factors for secondary traumatic stress in therapeutic work with trauma victims.StrongSystematic reviewPositive impact
The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic ReviewStrongSystematic reviewPositive impact
The perceived and experienced role of the nurse unit manager in supporting the wellbeing of intensive care unit nurses: An integrative literature reviewStrongSystematic reviewPositive impact
Secondary traumatic stress and burnout among refugee resettlement workers: The role of coping and emotional intelligenceSuggestiveSuggestive evidencePositive impact
Responding to secondary traumatic stress: A pilot study of torture treatment programs in the United StatesSuggestiveSuggestive evidencePositive impact
Interventions for secondary traumatic stress with mental health workers: A systematic reviewStrongSystematic reviewNo evidence about impact
Training future psychologists to be competent in self-care: A systematic reviewStrongSystematic reviewPositive impact
Optimising strategies to address mental ill-health in doctors and medical students: ‘Care Under Pressure’ realist review and implementation guidance.StrongSystematic reviewPositive impact
Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review.StrongSystematic reviewPositive impact
Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What’s New? A Systematic ReviewStrongSystematic reviewPositive impact
Organizational strategies to reduce physician burnout: a systematic review and meta-analysisStrongMeta-analysisPositive impact
Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systematic ReviewStrongSystematic reviewPositive impact
Mindfulness-based stress reduction for psychological distress among nurses: A systematic reviewStrongSystematic reviewPositive impact
Strategies to promote coping and resilience in oncology and palliative care nurses caring for adult patients with malignancy: a comprehensive systematic reviewStrongSystematic reviewPositive impact
Burnout among music therapists: An integrative reviewStrongSystematic reviewPositive impact
A Systematic Review of Interventions to Improve Humanism in Surgical PracticeStrongSystematic reviewPositive impact
The benefits of mindfulness-based interventions on burnout among health professionals: A systematic reviewStrongSystematic reviewNo evidence about impact
Relationship between environmental factors and burnout of psychotherapists: Meta-analytic approachStrongSystematic reviewPositive impact
Systematic Review: Expressive arts interventions to address psychosocial stress in healthcare workersStrongSystematic reviewPositive impact
Combined Interventions to Reduce Burnout Complaints and Promote Return to Work: A Systematic Review of Effectiveness and Mediators of ChangeStrongSystematic reviewPositive impact

Studies included in the database focused on high-income or upper middle-income countries, including but not limited to the United States. Studies included must have been published since 2000. To identify evidence, we searched the following websites and databases using the following population, methodology, and target intervention terms:

Websites and Databases Methodology Terms Target Intervention Terms
Campbell Collaboration
Cochrane Collaboration
Evidence Aid
Grantmakers Concerned with Immigrants and Refugees
Social Services Abstracts
Social Work Abstracts
“compassion fatigue”
“secondary trauma”
“vicarious trauma”

For databases or websites that permitted only basic searches, free-text terms and limited term combinations were selected out of the lists above, and all resultant studies were reviewed for relevance. Conversely, for databases or websites with advanced search capability, we made use of relevant filters available. All search terms were searched in the title and abstract fields only in order to exclude studies that made only passing mention of the topic under consideration.

After initial screening, Switchboard evidence mapping is prioritized as follows: First priority is given to meta-analyses and systematic reviews, followed by individual impact evaluations when no meta-analyses or systematic reviews are available. Evaluations that are rated as impact evidence are considered before those rated as suggestive, with the latter only being included for outcomes where no evidence is available from the former.