“Who helps the helper?” In a new documentary, Portraits of Professional Caregivers: Their Passion and their Pain, this poignant question is posed by an early childhood educator. Over the last decade a plethora of research has emerged demonstrating that exposure to trauma and violence in early childhood can have devastating long-term effects on health and well-being. Even very young children can experience toxic levels of stress resulting in chronic health and mental health conditions, including diagnoses of post-traumatic stress disorder (PTSD) and depression. Science has also helped us understand that safe, stable and nurturing relationships with adults promote cognitive, social and emotional learning in young children and can prevent and mitigate the impact of trauma. Early Learning Programs are in an ideal position to create environments which foster and support this type of care– often referred to as trauma-informed care. Recognizing that trauma can seriously derail the learning process, there is a growing national movement to make educational settings for all children and youth trauma-informed.

We have also learned, however, that working with children and families affected by trauma and toxic stress takes its toll on professionals. Secondary Traumatic Stress is a verified condition that occurs “when an individual hears about the firsthand trauma experiences of another. Its symptoms mimic those of post-traumatic stress disorder (PTSD). Unfortunately, early childhood educators are vulnerable to secondary traumatic stress (also known as compassion fatigue or vicarious trauma). Secondary traumatic stress can lead to fatigue, intrusive negative thoughts, poor concentration, emotional detachment, interpersonal problems, absenteeism, depression and physical illness. Experiencing these symptoms can compromise early childhood educators’ ability to provide the high-quality, nurturing care that is critical for optimal development of their young students.

Compounding the problem of secondary traumatic stress, many staff working in early learning programs also struggle with their own trauma histories. At the Health Federation of Philadelphia, this has been our experience as we have provided training on trauma-informed practice to hundreds of staff in early learning settings. It has been especially true for staff we encounter in centers located in Philadelphia-area communities plagued by high rates of poverty, violence, crime, and inequity. Often, early learning staff lives, as well as works, in these neighborhoods and have levels of trauma exposure and associated poor health equaling those they serve.

As we support the growing movement for early learning environments that foster social and emotional learning and provide trauma-informed care, it is imperative that we strongly advocate that they include multi-level measures to prevent, identify and address secondary traumatic stress targeted at the individual, organizational and policy levels. Effective strategies include:

• Educating all staff about the signs and symptoms of secondary traumatic stress and self-care.

• Increasing providers feeling of overall competence and job satisfaction by providing opportunities for meaningful professional development.

• Providing opportunities for staff to safely explore their own trauma histories.

• Providing reflective supervision, a model which gives staff an opportunity to meet regularly and collaboratively with their supervisors to reflect on how their work affects them.

• Offering on-site opportunities for self-care activities such as physical activity, fun, yoga, meditation, etc.

• Making the creation of individual safety and self-care plans an organizational practice for all staff and students.

• Supporting staff in the forging of positive partnerships with parents/caregivers of children who have experienced trauma so that they can work together to assist the child.

• Ensuring that the physical environment staff works in is safe.

• Providing health and mental health care insurance and access to employee assistance programs.

• Providing paid sick leave.

• Advocating for higher wages for the early learning workforce.

Now, picture your last airplane ride. Remember waiting on the tarmac and listening as the flight attendant instructed you, that in the event of a loss of cabin pressure, to put on your own oxygen mask before assisting others. As we work together to ensure that all children have access to high quality early childhood education, we must insist that early learning providers not only get this message but that there is enough oxygen and masks for all.