Symptomatology and Mediating Caseload Variables of Community Mental Health Clinicians’ Vicarious Traumatization: A Causal-Comparative Investigation
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Authors
Edwards, Brittany
Issue Date
2026-02
Type
Dissertation
Language
en
Keywords
vicarious trauma , community mental health , caseload , Healthcare Innovation & Delivery
Alternative Title
Abstract
This study addressed a research problem on community mental health therapists’ risk of vicarious trauma, a condition associated with post-traumatic stress symptoms and reduced clinical effectiveness. Because community mental health clinicians frequently treat highly trauma-exposed clients and often manage larger, more complex caseloads, understanding factors contributing to their vicarious trauma risk is critical for supporting therapist well-being and maintaining quality care for vulnerable populations. However, limited prior research has examined the relationship between occupational setting and vicarious trauma. Via a constructivist self-development theory lens, this quantitative, causal-comparative study investigated whether community mental health clinicians report greater vicarious trauma than therapists in other settings and whether caseload size or diagnostic composition mediate this relationship. Trauma therapists in the United States were recruited through social media platforms to complete an online survey on their occupational setting, caseload size and diagnostic composition, and vicarious trauma symptoms using the validated Vicarious Trauma Scale. Although an initial independent samples t-test found no statistically significant difference in vicarious trauma between community mental health clinicians and therapists in other settings, a post-hoc t-test revealed significantly higher vicarious trauma among community mental health clinicians compared to private practice therapists. Mediation analyses using multiple linear regression indicated neither caseload size nor diagnostic composition significantly mediated the relationship between occupational setting and vicarious trauma, though caseload data inconsistencies limit interpretation. These findings suggest occupational setting may influence vicarious trauma risk but is unlikely to act alone, underscoring the need for organizational supports and continued research on additional contributing factors to better protect clinicians’ welfare and treatment quality.