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Secondary Trauma & Compassion Fatigue Check-In

For therapists, social workers, first responders, nurses, and other helping professionals regularly exposed to other people's trauma. Measures exposure levels, secondary traumatic stress symptoms, coping habits, and organizational support gaps, with an AI follow-up interview that reconstructs the specific case or incident behind a respondent's most acute symptom rather than relying on abstract self-ratings.

Sample questions

A preview of what’s in the template. Every question is editable before you launch.

14 questions · ~7 min
Q01
Message

Thanks for taking a few minutes for this check-in. It's about the emotional toll of hearing or witnessing other people's traumatic experiences through your work — sometimes called secondary or vicarious trauma. Your answers are confidential and there are no right answers; honest ones help us support staff better. About 6 minutes. If anything here brings up distress, please reach out to your supervisor or EAP resources afterward.

Q02
Multiple ChoiceRequired

In the last 30 days, how often has your work required you to directly hear or witness detailed accounts of someone else's traumatic experience (e.g., abuse, violence, disaster, medical trauma)?

  • Never
  • A few times
  • Weekly
  • A few times a week
  • Daily or almost daily
Q03
Slider MatrixRequired

In the last 30 days, how often have you noticed each of the following?

5 rows, one slider each
  • Unwanted, intrusive thoughts or images related to a case or incident you weren't directly part of
  • Avoiding people, places, or media that remind you of work-related trauma
  • Feeling constantly on edge, jumpy, or hypervigilant
  • Emotional numbness or feeling detached from people you care about
  • Trouble falling or staying asleep because of work-related thoughts
Slider 010Min:NeverMax:Constantly
Q04
Opinion ScaleRequired

Overall, how much has hearing or witnessing others' traumatic experiences affected your own emotional wellbeing in the last 30 days?

Scale: 17
Min:Not at allMax:A great deal
Q05
Multiple Choice

Which of the following do you currently use to cope with the emotional impact of your work? Select all that apply.

  • Talking with colleagues informally
  • Formal supervision or case debriefing
  • Exercise or physical activity
  • Therapy or counseling for myself
  • Limiting exposure to trauma-related content outside work
  • Spiritual or faith-based practice
  • Alcohol or substances to relax
  • Journaling or creative outlets
Q06
MatrixRequired

How much do you agree with each statement about support at your current workplace?

5 rows × 5 columns
  • My supervisor checks in on how I'm coping, not just my caseload or productivity
  • My workload allows enough time to process difficult cases
  • I have access to trained peer support or debriefing after critical incidents
  • My organization provides training on managing secondary trauma
  • I would feel comfortable telling my supervisor I'm struggling with a case
Columns: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q07
Best–Worst Trade-off (MaxDiff)Required

If your organization could add or improve one support at a time, which would help most and which would help least?

  • Mandatory debriefing after difficult cases
  • Caseload or exposure limits
  • More frequent clinical supervision
  • Access to confidential counseling
  • Structured peer support groups
  • Paid mental health days
  • Training on secondary trauma resilience
  • Flexible scheduling after critical incidents
Pick best & worst per setBest:Would help mostWorst:Would help least
Q08
AI Interview

Identify the specific case, client, or incident (without needing identifying details) that has affected this respondent most in the last 30 days, and reconstruct what happened afterward: did they talk to anyone, take time to process it, or push through without support. If they flagged a support gap in the workplace statements, probe concretely what would have made the biggest difference in that moment. If they report minimal impact, ask what specific habits or boundaries they use that seem to be working, so they can be shared as protective practices.

Q09
Long Text

Is there anything about how secondary trauma shows up in your work that we haven't asked about?

Q10
Message

Almost done — just a few background questions to help us understand patterns across roles. All optional.

Q11
Multiple Choice

Which best describes your role? (Template note: replace with your organization's actual role categories before launching.)

  • (Replace with Role A, e.g., Case Manager)
  • (Replace with Role B, e.g., Therapist/Counselor)
  • (Replace with Role C, e.g., First Responder)
  • (Replace with Role D, e.g., Nurse/Medical Staff)
  • Prefer not to say
Q12
Multiple Choice

How long have you worked in a role that involves regular exposure to others' trauma?

  • Less than 1 year
  • 1-3 years
  • 4-7 years
  • 8-15 years
  • More than 15 years
  • Prefer not to say
Q13
Multiple Choice

What best describes your primary work setting?

  • In-person direct service
  • Remote or telehealth
  • Hybrid
  • Administrative or supervisory
  • Prefer not to say
Q14
Message

Thank you for being honest about something that's hard to talk about. Responses are aggregated and never tied to individuals, and the findings will directly inform staffing, supervision, and support planning. If you need support now, please reach out to your supervisor or your organization's employee assistance program.

What’s included

  • AI follow-ups

    Adaptive probes on open-ended answers that pull out detail a static form would miss.

  • Attention checks

    Built-in safeguards against rushed answers and low-quality respondents.

  • AI-drafted copy

    Wording, ordering, and branching written by the AI — tuned to your research goal.

  • Auto report

    Themes, quotes, and a plain-English summary write themselves once responses come in.

How it compares

We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.

Why this template

  • Includes an AI follow-up interview that reconstructs the specific case or incident behind a respondent's most acute symptom, rather than stopping at abstract self-ratings
  • Combines quantitative measures (slider matrix on symptom frequency, opinion scale on overall impact, matrix on workplace support) with qualitative depth so patterns and root causes both surface
  • Uses a max-diff exercise to prioritize which organizational support to add next, giving programs actionable direction rather than just a diagnostic score
  • Closes with a long-text reflection and a de-identified background section, so responses can be compared across roles, tenure, and work settings without compromising anonymity

QuestionPro

Secondary Trauma Survey Questions + Sample Questionnaire Template

This is a sample questionnaire and question bank for secondary trauma rather than an interactive fielding tool with adaptive logic. It covers similar ground (exposure, symptoms, coping) but presents standard survey question types for researchers to copy or adapt. Useful as a reference library more than a ready-to-run respondent experience.

What it does well

  • Directly targeted at secondary trauma, matching the topic closely
  • Provides sample questions researchers can copy into their own survey tool
  • Backed by a large established survey platform with broad question-type support

Where it falls short

  • No adaptive AI follow-up to probe the specific incident behind a symptom — respondents only self-rate
  • No mention of voice AI interviews or screen-share guided tasks
  • No published methodology for how quality or depth of response is scored

Jotform

Psychological Trauma Questionnaire Form Template

This template is built for general psychological trauma intake (e.g., clinical or patient-facing use) rather than the workplace secondary-trauma/compassion-fatigue focus for helping professionals — the audience and intent differ from ours. It's a static, drag-and-drop form, easy to customize and deploy quickly, but not designed to explore an incident behind a rated symptom. Best treated as a general-purpose form builder template rather than a specialized secondary trauma instrument.

What it does well

  • Fast to set up and customize using Jotform's drag-and-drop form builder
  • Familiar, broadly accessible form format for respondents
  • Part of a large template library with easy integrations (payments, notifications, etc.)

Where it falls short

  • Not specific to secondary trauma or helping-professional exposure — targeted at general psychological trauma intake
  • Static question set with no adaptive AI follow-up interview or case reconstruction
  • No automated per-response quality scoring or auto-generated analytical report

Ready to launch?

Open this template in the editor. Every part is yours to change before the first respondent sees it.