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PTSD: National Center for PTSD

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Rural Provider Self-Care


Rural Provider PTSD Toolkit

Rural Provider Self-Care
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While working with trauma survivors can be very rewarding, you may experience a variety of stress reactions, which overlap.

Click each reaction to learn more.
Burnout Secondary Traumatic Stress Compassion Fatigue Vicarious Traumatization
Burnout comprises the emotional and physical exhaustion resulting from both occupational and personal stressors.51-53
Secondary Traumatic Stress
Secondary traumatic stress can occur in those who frequently listen to trauma histories,54,55 with reactions similar to posttraumatic stress disorder (PTSD) symptoms, such as re-experiencing, avoidance, and hyperarousal, anger, low mood, and social isolation.56
Compassion Fatigue
Compassion fatigue is broader than secondary stress and is characterized by the emotional strain experienced when working with individuals coping with traumatic stress.57 It also includes more general symptoms of burnout (e.g., emotional exhaustion).58
Vicarious Traumatization
Vicarious traumatization describes the cognitive, emotional, social, and behavioral changes that may occur while working with traumatized individuals. In particular, views of trust, safety, control, and esteem, may be called into question.59-61
The association between burnout and secondary traumatic stress is high, and they are likely to co-occur among those exposed indirectly to trauma through their work.62 As a rural provider, your self-care may be even more important because of the demands of working in small communities with fewer resources. This lack of resources has been shown to be associated with greater impairment and poorer quality of life in rural Veterans with mental health issues, which may contribute to more burden and greater sense of responsibility in your work.3

How can you be more successful at self-care?

As a provider you are most likely very well aware that there are many different ways to address stress; the key is to learn which strategies work best for you, and proactively put them into practice in a realistic, consistent, and disciplined way.63-73

Click an area to learn more.


Here are a few specific strategies that may be helpful in increasing self-awareness and well-being in relation to stress a work:
Monitor work demands to prevent being overwhelmed
Engage in regular self-reflection and adjustment
Make a list of those strategies that work for you, and keep it close at hand
Get a friend, family member, or colleague involved in checking on you
Make supervision, case conferences, or informal collegial support a priority in your work life
Determine your need for resources, as well as the availability of resources, and make efforts to use them effectively
Be proactive in time management68
Use active cognitive strategies to set appropriate boundaries85
Make efforts to construct a set of practices that enable you to transition out of your work day in a healthy way
Find ways to deal with the issues that may arise around mortality, suffering, loneliness and helplessness
Make time to honor the necessity of working actively to create and maintain a rewarding and meaningful personal life86
If you find that despite the self-care strategies you are actively engaging in, you are still experiencing reactions that interfere with your functioning or persist beyond a month, it may be helpful to seek treatment from a mental health provider. Cognitive behavioral therapy has resulted in positive effects on burnout, and produced greater effects than other types of workplace interventions, such as relaxation and meditation techniques.87

Click to learn more about the resources and support listed below.
Self-Care Resources

PTSD Information Voice Mail: (802) 296-6300
Also see: VA Mental Health