Program Goals

The goals of Stress-Less Initiative (SLI ) are:

• Early identification of secondary traumatic stress (STS) and burnout
• Increasing awareness of thoughts, feelings, behaviors, and physical manifestations of stress
• Increasing trust and safety among team members
• Increasing of encouraging proactive organizational support
• Normalizing and validate STS symptoms and removing stigma of disclosure
• Instilling approaches to decrease staff turnover and reduce stress associated with providing trauma-focused services
• Identifying opportunities for individual growth

Logic Model

View the Logic Model for Stress-Less Initiative (SLI).

Essential Components

The essential components of Stress-Less Initiative (SLI ) include:

• Training is provided by the SLI Team prior to beginning the initiative:
• This training will ensure all team members:
• Begin the intervention with common background knowledge
• Have the necessary buy-in to make the intervention useful
• An additional training session will be held for team facilitators. SLI is internally led, and facilitators will be provided with materials (e.g., PPT, manual) for each session. Facilitators will lead the Assessment, Learning Collaborative, and Processing portions of each SLI session, and the skill share will rotate between team members. Facilitators will receive consultation and support from the Stress-Less team monthly.
• While the intervention is ongoing:
• The Stress-Less team will support implementation.
• Facilitators will meet regularly with the Stress-Less team over the course of the intervention period on consultation calls to:
• Discuss intervention fidelity
• Provide implementation strategies
• Help to troubleshoot any barriers to challenges
• Calls should occur approximately monthly.
• Facilitators:
• Ideally the facilitator(s) is in a supervisory or managerial position or holds a clinical position that affords them regular and consistent contact with the participating team.
• The facilitator should be easily accessible in case of a potential crisis.
• Sessions:
• Each session follows an “ALPS” framework: Assessment, Learning Collaborative (topic changes each session), Processing, and Skill.
• Each session begins with an assessment exercise in which participants reflect on their thoughts, feelings, behaviors, and body reactions and rate their stress level using a stress scale. Assessment fosters awareness of stress symptoms and provides a tool for measuring improvement over time.
• The learning collaborative component introduces concepts and practice strategies on how to engage in helping work while increasing resilience.
• The processing component is an opportunity to discuss the material presented, and how it relates to individual participants and to the work of the program/organization.
• The skills component is designed for team members to share, with the group, new self-care skills and strategies for coping with STS and to encourage one another in regular practice.
• Strongly encouraged for all frontline and clinical staff who have direct contact with clients/patients
• Other staff may also benefit from the Stress-Less Initiative and the decision to include other staff will be at the discretion of the administrative leaders and facilitator.
• Group size is recommended to be limited to 8-12 participants in order to maintain psychological safety.
• Multiple cohorts may be necessary in order to serve an entire agency.
• The Stress-Less Initiative PowerPoint Presentations contain specific content for each session. Intended to guide each session, the presentations can be displayed during facilitation. These presentations provide audiovisual content for participants as well as talking points for facilitators.
• Administrative Buy-in and Support:
• There are times when participants may express concerns regarding organizational factors or work strain that contribute to this stress.
• Agency leadership must be:
• Educated to the effects of STS on their workforce
• Provided with tools to effectively address STS
• Allocated external and internal resources to address it
• Administrative support for the model is critical as the intervention may require some flexibility in agency policy and procedures.
• Fidelity with Flexibility:
• While it is important to ensure fidelity to the model, some flexibility is permitted.
• As with any group intervention, there should be some adaptability to fit different community and group contexts.
• In addition, facilitators should allow flexibility in sessions to optimize the adult learning structure.
• A fidelity checklist will be provided to facilitators to ensure that key elements of the Stress-Less Initiative© are integrated into each session.
• Evaluation:
• While SLI has not yet been subject to rigorous empirical validation, efforts to evaluate its effectiveness are currently underway. Present evaluation aims include assessing the impact of the Stress-Less Initiative© on:
• Reducing STS
• Decreasing burnout and increasing compassion satisfaction and workplace resilience
• Increasing perception of supervisor, peer, and organizational support
• Increasing team resilience
• Increasing productivity and job satisfaction
• Mastery of intervention-targeted knowledge and concepts such as STS, mindfulness, personal stress reactions, and coping
• It is recommended that group participants and facilitators complete measure batteries at baseline, midintervention, and postintervention in order to evaluate the potential impact of the Stress-Less Intervention on these salient outcomes.
• Materials to Support Implementation
• The Stress-Less Initiative© Intervention Manual (Vega, 2020) provides a learning and reference guide for administrative leaders and facilitators as they implement the intervention. This how-to guide is organized into three sections:
• The first section provides an introduction for facilitators which includes:
• Goals of the model
• Guidelines for implementation which include:
• Recommendations regarding facilitation
• Eligibility
• Schedule of session
• Confidentiality
• Session components
• The second part of the manual details the protocol for all 12 standard sessions.
• Appendices to the manual include:
• The Stress-Less Initiative© Stress Scale
• Session handouts
• A fidelity tool
• Sample preintervention/postintervention measures for evaluation

Program Delivery

Recommended Intensity:

Initial training followed by monthly 90-minute sessions for 12 months

Recommended Duration:

Monthly for 12 months; can be continued as agency desires

Delivery Settings

This program is typically conducted in a(n):

• Outpatient Clinic
• Community-based Agency / Organization / Provider
• School Setting (Including: Day Care, Day Treatment Programs, etc.)

Homework

This program does not include a homework component.

Resources Needed to Run Program

The typical resources for implementing the program are:

Ideally the staff participating in SLI will have access to computer/projector to see the materials.

Manuals and Training

Prerequisite/Minimum Provider Qualifications

SLI Facilitators are trusted frontline staff (potentially a supervisor or manager of group participants) or someone who holds a clinical position that provides regular and consistent contact with frontline workers. There are no specific educational requirements for facilitators, but they should:

• Be trusted by the team
• Have a genuine understanding of how STS can negatively affect workers and clients
• Be an enthusiastic advocate for workers wellness
• Have excellent interpersonal skills and an ability to mediate conflict
• Be trained in trauma-informed care
• Have extensive knowledge of trauma symptoms
• Understand the implications of trauma-informed care for clinical practice

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Manual details:

• Vega, L. (2020). Stress-Less Initiative©: A trauma-informed group model to reduce secondary traumatic stress (ver. 2). Children’s Hospital of Philadelphia.

Contact the training contact below for more information.

Training Information

There is training available for this program.

Training Contact:

• Stress-Less Initiative, Center for Violence Prevention, Children’
  stressless@chop.edu

Training Type/Location:

Training will be provided by members of the SLI team and can be virtual or in person.

• The Stress-Less team will lead a two-hour training for all staff and leadership. All levels of an organization can be impacted by STS, so it important for the entire organization to understand the impact of trauma, know the signs and symptoms of secondary traumatic stress (STS), and learn about the Stress-Less model. This training will ensure all team members are beginning the intervention with common background knowledge and have the necessary buy-in to make the intervention effective.

• The Stress-Less team will host a two-hour session for facilitators, which will include training on the following:
• Trauma-informed care
• STS as an organizational issue
• The session components of the Stress-Less model
• A demonstration of a Stress-Less session and introduction of the Stress-Less materials

Number of days/hours:

<1 day: 90 minutes-2 hours for kickoff training; 1-2 hours for facilitator training

Information on pre-implementation materials, implementation support, fidelity measures and other implementation materials are available through the training contact above.

Relevant Published, Peer-Reviewed Research

Currently, there are no published, peer-reviewed research studies for Stress-Less Initiative (SLI).

Additional References