When Self-Care Isn’t Enough: How EMDR Can Help Therapists Deal with Vicarious Trauma

Guest Blog Post by Skye Ross, LCSW

High rates of secondary traumatic stress among social workers and other healthcare workers should not be surprising. Those working directly with people who have experienced acute and chronic traumatic stress are at greater risk of developing symptoms related to secondary trauma (van Dernoot Lipsky & Burk, 2009). As many as 50% of social workers experience at least one symptom of traumatic stress, with as many as 15% meeting PTSD criteria (Bride, 2007). Others have found similarly high rates among nurses and physicians (Deriglazov et al., 2025; Kotera, et al., 2024; Kotera et al., 2021; Rahim et al., 2022).  

Self-care is often discussed in clinical supervision and workplaces where staff interact with trauma. We tell each other to seek out appropriate therapy, yet it can be hard to find a therapist with deep knowledge and practice supporting other mental health therapists. App-based mindfulness strategies may not be sufficient for this population (Deriglazov et al., 2025). Other supportive options are needed to reduce burnout, compassion fatigue, and symptoms of vicarious trauma among social workers, therapists, and other health care professionals. Eye Movement Desensitization and Reprocessing (EMDR) therapists can provide recent-event EMDR protocols to address the high rates of vicarious trauma evident in social workers and other health care providers.  

Defining vicarious trauma, trauma stewardship, and compassion fatigue 

McCann and Pearlman (1990) coined the term “vicarious trauma” to describe the specific countertransference response that happens between therapists and clients who are expressing traumatic material. Sometimes, when clients express the depth of their trauma, the therapist’s nervous system responds with stress and strong emotion as if the therapist were living the event. Secondary traumatic stress can cause therapists to experience ongoing, negative impacts on their mood, thoughts, and connection to others (Gentry, 2021).  

Laura Van Dernoot Lipsky refers to “trauma stewardship” as the all-encompassing process of how clinicians come to their work, how they are impacted by the work, and the processes through which they move forward with their experiences (van Dernoot Lipsky, 2009).  

“Compassion fatigue” refers to the specific cluster of burnout-like symptoms experienced by caregivers and those providing care to traumatized populations (Figley, 2002). Compassion fatigue ultimately results in a reduced ability to connect and hold empathy with the people you serve and others in your life. 

All of these terms relate to the impacts of secondary traumatic stress on our nervous systems, thoughts, and beliefs. Some of the common experiences include: 

  • Feeling helpless or hopeless (may include negative cognitions around impact or not being able to affect change; not being enough) 
  • Hypervigilance  
  • Tendency towards black-and-white thinking 
  • Exhaustion/fatigue 
  • Becoming sick more often  
  • Avoiding certain tasks at work or home 
  • Reduced joy during previously joyful or engaging activities  
  • Dissociation  
  • Guilt  
  • Anger 
  • Reduced sense of empathy 
  • Increased substance use/other risk-taking behavior 
  • Grandiosity 

Next steps: EMDR treatment as community care for vicarious trauma

The standard response for health and mental health care professionals experiencing burnout and vicarious trauma has been “self-care.” Meaningful self-care involves reconnecting with your values, practicing with alignment, as well as taking care of basic needs (e.g., eating well, sleep hygiene, spiritual connection, etc.) (Lakshmin, 2023; van Dernoot Lipsky, 2009). We know from doing this work that caring for ourselves is integral to sustaining our ability to remain committed to the work we do.

One of the ways EMDR therapists can best support other therapists is by offering accessible therapy specifically to address the vicarious and secondary trauma among our peers. When we follow the standard protocol, we desensitize and reprocess information across 3 prongs of experience: Past, Present, and Future. Recent event protocols focus on desensitizing present-day traumas and stressors. Rather than opening up the memory network, these protocols are significantly more contained, which can be helpful for mental health therapists. Additional training and/or consultation is recommended when you first implement recent event protocols in your own practice.

Common recent event protocols include:

  • R-TEP (Recent-Traumatic Episode Protocol)
  • EMD (Eye Movement Desensitization/restricted protocol)
  • EMDr (limited processing EMDR)

More information about these and other recent event protocols can be found in the EMDRIA™ Library. Using recent event protocols can prevent PTSD and reduce vicarious trauma responses after healthcare professionals’ experiences of traumatic events.

Research suggests recent-event protocols have short-term and potential long-lasting efficacy in reducing the impact of an event on mental health (Jarero, et al., 2011; Tsouvelas, et al., 2019). Assessing burnout and compassion fatigue (Adams et al., 2009) and then integrating EMDR recent event protocols into crisis response teams can support mental health workers in high-stress roles (Tsouvelas et al., 2019; Jarero et al., 2011). 

Self-compassion can reduce shame

Attuning to the shame that interferes with accessing care can offer insight into potential longer-term work. While mental health treatment tends to be more normalized among mental health care workers, we still see shame impeding treatment among our own community (Kotera et al., 2024; Kotera et al., 2019). Shame can also be addressed by integrating compassion-focused therapy techniques to support positive cognitions (PCs) associated with self-compassion (Kennedy, 2014; Ross, 2026). According to Kotera, Green, & Sheffield (2019), self-criticism and self-compassion are significantly correlated with mental health symptoms among social work students. While data is still growing, there is evidence that self-compassion plays a role in mitigating burnout among social workers, therapists, and other health care professionals as well (Kotera et al., 2021; Deriglazov et al., 2025; Rahim et al., 2022; Kotera et al., 2024). 

The power of group work

In my experience, supporting other therapists using the Group Traumatic Episode Protocol (G-TEP) developed by Elan Shapiro to address vicarious trauma has been helpful (Tsouvelas et al., 2019). G-TEP is a group version of Shapiro’s Recent Event Traumatic Episode Protocol (R-TEP). Like R-TEP, the therapist contains processing to only associations that are related to the target. However, processing in G-TEP is completed privately, so G-TEP uses elements of EMD (e.g., returning to target after each set of BLS) to make sure all group participants are contained.  

Therapists, social workers, and nurse practitioners who have participated in G-TEP group work identify feeling lowered distress (measured by SUDs). I have also used G-TEP to target EMDR therapists’ anxiety, shame, and imposter syndrome that hinders their use of EMDR in sessions. Therapists, nurses, and physicians who have attended my G-TEP groups report reduced sense of distress and increased confidence in their ability to perform their jobs, as measured by SUDs and measurement of the validity of the positive cognition following G-TEP processing. 

With the high rates of vicarious trauma that take place in healthcare professional populations (van Dernoot Lipsky & Burk, 2009), it is worthwhile to explore the use of recent event protocols for individuals and groups in these caring professions. Using R-TEP or G-TEP or other recent event protocols can supplement ongoing therapy as part of a therapist self care routine. For EMDR therapists who see health and mental health professionals, using recent event protocols can be hugely impactful for reducing the impacts of vicarious trauma and workplace trauma, which in turns reduces compassion fatigue and supports keeping good professionals empowered in their caring roles.  

 

Skye Ross is an EMDRIA Certified Therapist™ and an EMDRIA Approved Consultant-in-Training™. Her experience spans practice with people experiencing addiction, chronic illness, perinatal mental health disorders, and complex PTSD in community mental health, criminal court, and private practice. 

 

References 

Adams, R. E., Boscarino, J. A., & Figley, C.R. (2006). Compassion fatigue and psychological distress among social workers: A validation study. American Journal of Orthopsychiatry, 76(1): 103 – 108. https://doi.org/10.1037/0002-9432.76.1.103  

Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1): 63-70. https://doi.org/10.1093/sw/52.1.63 

Deriglazov, D., Halamova, J., & Kernova, L. (2025). Burnout, compassion fatigue, and compassion satisfaction interventions via mobile applications: A systematic review and a meta-analysis. Worldviews on Evidence-Based Nursing, 22(3), e70033. https://doi.org/10.1111/wvn.70033  

Dolezal, L. (2022). Shame anxiety, stigma and clinical encounters. Journal of Evaluation in Clinical Practice, 28(5): 854-860. https://doi.org/10.1111/jep.13744  

Figley, C. R. (2002). Compassion fatigue: psychotherapists’ chronic lack of self care. Journal of Clinical Psychology, 58(11), 1433-1441. https://doi.org/10.1002/jclp.10090  

Gentry, J. E. (2021). Certified compassion fatigue professional manual. PESI, Inc.  

Jacob, K. M., & Lambert, N. (2021). Trauma exposure response: How secondary trauma affects personal and professional life. MedEd Portal, 17: 11192. https://doi.org/10.15766/mep_2374-8265.11192   

Jarero, I., Artigas, L., & Luber, M. (2011). The EMDR protocol for recent critical incidents: Application in a disaster mental health continuum of care context. Journal of EMDR Practice and Research, 5(3). https://doi.org/10.1891/1933-3196.5.3.82    

Kennedy, A. (2014). Compassion-focused EMDR. Journal of EMDR Practice and Research, 8(3): 135-146. https://doi.org/10.1891/1933-3196.8.3.135  

Kotera, Y., Green, P, & Sheffield, D. (2019). Mental health attitudes, self-criticism, compassion and role identity among UK social work students. The British Journal of Social Work, 49(2): 351-370. https://doi.org/10.1093/bjsw/bcy072 

Kotera, Y., Maxwell-Jones, R., Edwards, A. M., & Knutton, N. (2021). Burnout in professional psychotherapists: Relationships with self-compassion, work-life balance, and telepressure. International Journal of Environmental Research and Public Health, 18(10): 5308. https://doi.org/10.3390/ijerph18105308 

Kotera, Y., Jackson, J. E., Kirkman, A., Edwards, A. M., Colman, R., Underhill, A., Jackson, J. G., Baker, D., & Ozaki, A. (2024). Comparing the mental health of healthcare students: Mental health shame and self-compassion in counselling, occupational therapy, nursing, and social work students. International Journal of Mental Health and Addiction, 22: 2787-2804. https://doi.org/10.1007/s11469-023-01018-w  

Lakshmin, P. (2023). Real self-care: A transformative program for redefining wellness (crystals, cleanses, and bubble baths not included). Penguin Random House. 

McCann, I. L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3(1): 131–149. https://doi.org/10.1007/BF00975140 (Retrieved from: https://link.springer.com/article/10.1007/BF00975140)  

Rahim, H. F. A., Fendt-Newlin, M., Al-Harahsheh, S.T., & Campbell, J. (2022). Our duty of care: A global call to action to protect the mental health of health and care workers. Doha, Qatar: World Innovation Summit for Health. World Health Organization. https://www.who.int/publications/m/item/wish_report  

Ross, S. D. (2026). Treating shame with EMDR: Practical strategies for therapists. EMDRIA Focal Point Blog. https://www.emdria.org/blog/treating-shame-with-emdr/

Torres-Gimenez, A., Garcia-Gilbert, C., Gelabert, E., Mallorqui, A., Segu, X., Roca-Lecumberri, A., Martinez, A., Gimenez, Y., & Sureda, B. (2024). Efficacy of EMDR for early intervention after a traumatic event: A systematic review and meta-analysis. Journal of Psychiatric Research, 174, 73-83. https://doi.org/10.1016/j.jpsychires.2024.04.019  

Tsouvelas, G., Chondrokouki, M., Nikolaidis, G., & Shapiro, E. (2019). A vicarious trauma prevention approach. The group traumatic episode protocol EMDR and workplace affect in professionals who work with child abuse and neglect. Dialogues in Clinical Neuroscience & Mental Health, 2(3): 130-138.  https://doi.org/10.26386/OBRELA.V2I3.123 (Retrieved from: https://www.semanticscholar.org/paper/A-vicarious-trauma-preventive-approach.-The-Group-Tsouvelas-Chondrokouki/da1f11b30138df24236a5092da30a15533791ca3)

van Dernoot Lipsky, L. & Burk, C. (2009). Trauma stewardship: An everyday guide to caring for self while caring for others. Berrett-Koehler Publishers, Inc.  https://traumastewardship.com/trauma-stewardship-book/

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Date
October 16, 2026

Contributor(s)
Skye Ross

Topics
Workplace Trauma

Client Population
First Responders/Healthcare Workers

Practice & Methods
EMDR Early Intervention, Group, Self-Care, Your EMDR Practice

Audience
EMDR Therapists, General/Public

Language
English

Content Type
Blog/Blog Post

Access Type
Open Access

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