Vicarious Occupational Trauma Exposure (VOTE) Index
Many professionals who work with people who have trauma histories experience vicarious trauma. Vicarious trauma is “second hand” trauma that is passed on to workers when they interact with individuals who experienced trauma “firsthand” or encounter information about the trauma. A worker may not directly experience the trauma, but because they work with people or communities that have, the worker may experience these traumas indirectly. Vicarious trauma can negatively affect the mental and physical health of professionals through psychological and physiological stress-response pathways.
The Vicarious Occupational Trauma Exposure (VOTE) Index is a tool designed to identify:
- What parts of a worker’s job expose them to vicarious trauma
- How often they are exposed to vicarious trauma
- How strong the vicarious trauma exposure is
The VOTE Index assesses 16 common occupational sources of vicarious trauma across four domains: 1) clients/patients sharing about trauma; 2) receiving and reviewing evidence of trauma; 3) documenting and reporting trauma; and 4) other staff members sharing about trauma. This instrument was developed with interviews and focus groups of substance use disorder (SUD) providers; extensive review of the scientific literature on vicarious trauma in behavioral health, victim advocate, and housing/ homelessness workforces; and cognitive interviews of SUD providers to refine the instrument before being psychometrically tested.
The validity and reliability of the VOTE Index was assessed with two different approaches to scoring the instrument. The first approach is to sum an individual’s vicarious trauma exposure frequency scores (i.e. how often they experienced the exposure across all 16 items). This is a straight-forward approach that gauges how much an individual is exposed, but not how strong their exposure is. The second approach is to multiply each vicarious trauma exposure frequency score by the respective exposure impact score and then add all of these multiplied scores together. This score weights how much somebody is exposed to vicarious trauma by the strength of the exposure. Both approaches to scoring demonstrated excellent validity and reliability.
Uses of the Vicarious Occupational Trauma Exposure (VOTE) Index
The VOTE Index can be used in several ways, including to:
- Measure the total amount workers are exposed to vicarious trauma at work, which may vary by work setting or job role.
- Identifying the types of job tasks (such as writing notes or case consultation) that particularly expose workers to greater amounts of vicarious trauma. This information can be used to pinpoint what parts of a job may need to be changed or require greater supports.
The VOTE Index demonstrated very strong validity and reliability in a national sample of the substance use disorder workforce (N=1,415). The development and validation of the VOTE Index was funded by the National Institute on Drug Abuse (NIH-NIDA).
More information about the VOTE Index and FAQs can be found here.
The VOTE Index is available in two formats: one narrative and one in a table. Formatting was based on cognitive interviews.
How should I cite the VOTE Index?
While efforts are currently underway to publish the VOTE Index in a peer-reviewed journal, please use the following citation in the meantime:
Stelson, E., Sabbath, E.L., Chen, L., Sorensen, G., Berkman, L., Moallef, S., & Kubzansky, L.D. (2024). The Vicarious Occupational Trauma Exposure (VOTE) Index: Instrument development and validity and reliability assessment with the substance use disorder workforce.