The Role of Secondary Traumatic Stress and Implementation Strategies in Successful Adoption of Evidence-Based Approaches to Address Traumatic Stress

Sprang, Ginny
Gusler, Stephanie
Whitt, Adrienne
Eslinger, Jessica
Hood, Caitlyn O.

Department of Psychiatry, Center on Trauma and Children, University of Kentucky College of Medicine

Thanos Karatzias served as action editor.

No funding source was used in the preparation of this article. All ethical and legal approvals were obtained from the University of Kentucky Institutional Review Board prior to the start of the study and conform to the standards set forth in the Declarations of Helsinki. Bias-free language was used throughout the article, and no culturally sensitive materials are included. Institutional Review Board approved consent form was provided to all participants, who could indicate their consent by agreeing to the terms. No penalties were associated with lack of consent. The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ginny Sprang served as lead for conceptualization, data curation, methodology, and writing–original draft. Stephanie Gusler contributed equally to conceptualization. Adrienne Whitt served in a supporting role for methodology. Jessica Eslinger served in a supporting role for writing–original draft. Caitlyn O. Hood served in a supporting role for conceptualization and writing–original draft. Ginny Sprang and Stephanie Gusler contributed equally to formal analysis.

Ginny Sprang, Department of Psychiatry, Center on Trauma and Children, University of Kentucky College of Medicine, 3470 Blazer Parkway, Suite 100, Lexington, KY 40509, United States [email protected]

Received February 3, 2025

revised April 24, 2025

Accepted April 26, 2025

Traumatology Publish Ahead of Print, June 26, 2025. | DOI: 10.1037/trm0000588

There are numerous trauma-focused evidence-based treatments and practices (EBT/EBP) that are effective for the treatment of traumatic stress. Yet, implementation of EBT/EBPs is a challenge, especially in real-world settings. This study investigated factors impacting EBT/EBP implementation, including the role of occupational distress and the types of implementation strategies used. A survey (N = 603) of community-based providers provided the data for the study. Respondents identified an EBT/EBP that had been onboarded by their organization and rated the success with implementation, as well as specific implementation strategies that were used. The respondents’ level of secondary traumatic stress (STS) was also assessed. The most frequently endorsed implementation activities were in the Learning and Practice, and Planning and Preparation domains. A ridge regression identified higher STS was associated with poorer implementation outcomes, though interaction between STS and planning and preparation suggests this is an area that can be significant in attenuating these effects. This is the first known investigation of the impact of STS on the implementation of trauma-informed EBT/EBPs.