Organizational Factors Impacting Secondary Traumatic Stress, Burnout, and Compassion Satisfaction Among Behavioral Health Providers: A Mixed-Methods Exploration

Background: Clinical social work is a demanding field given the complexity of client needs, exposure to suffering, and high workload. These challenges place providers at increased risk of burnout, secondary traumatic stress (STS), and moral injury, which can negatively affect their health and wellbeing (Armes et al., 2022) as well as reduce the effectiveness of client services (Sprang et al., 2021). These challenges also restrict the positive benefits providers experience in their work, such as compassion satisfaction (CS) (Alonazi et al., 2025). Provider-level factors, such as self-care practices, are often targeted in intervention efforts (Molnar et al., 2017). Less attention has focused on organizational factors, despite evidence suggesting organizational factors can greatly impact experiences of STS, burnout, and CS (Bride et al., 2023; Sprang et al., 2021). Methods: To address this gap, we used a convergent mixed-methods design to explore (1) the unique contribution of provider and organizational factors to STS, burnout, and CS and (2) BHPs’ perspectives concerning how organizations could better support their professional wellbeing. BHPs (N=604) completed an online survey questionnaire that included open- and closed-ended items. Hierarchical linear regression examined provider (self-care, self-compassion, years’ experience, client contact hours, resilient coping) and organizational factors (training and supervision, culture, workload, resources, support) associated with STS, burnout, and CS, while content analysis was used to analyze open-ended responses. Data integration occurred during analysis. Results: Participants worked in a range of settings, including community-based (38.5%), inpatient (24.8%), and IOP (11.8%). Thirty-seven percent of participants identified as White and 34.8% as Black. Participants reported moderate levels of CS (M=37.31; SD=6.7), high levels of STS (M=53.56; SD=15.73) and moderate levels of burnout (M=25.65; SD=5.37). For STS, the regression model was significant, F(5, 565)=47.48, p>.001, and accounted for 44.7% of variance in STS scores. Years experience, client contact hours, self-care, and self-compassion practices were significant provider-level factors, and resilient coping approached significance (p=.058). Supervision and training, organizational culture, and organizational workload emerged as significant organizational factors. For burnout, the model was significant, F(5, 565)=59.058, p>.001, and accounted for 50.2% of variance in scores. Resilient coping and self-compassion practices were significant provider-level factors, while supervision and training and organizational culture were significant organizational factors. For CS, the model was significant, F(5, 565)=46.41, p>.001, and accounted for 44.1% of variance. Years of experience, self-care, resilient coping, and self-compassion practices were significant provider-level factors, while supervision and training, organizational culture, and organizational support were significant organizational factors. Content analysis of open-ended responses (N=188) yielded five themes: (1) strengthen workplace culture, (2) promote wellbeing through supportive structures and practices, (3) improve benefits and compensation, (4) address high workloads and resource deficits, and (5) improve supervision and training. Implications: BHPs in the sample reported concerning levels of burnout and STS, highlighting the crucial need to address these occupational hazards. Findings suggest efforts focused on improving supervision and addressing organizational culture may be particularly beneficial in mitigating STS and burnout and enhancing CS. Policy and practice recommendations for providers and organizations are provided.