Wellbeing for workers supporting children and families after a disaster

What is this practice paper about?

In Australia, disasters are becoming more frequent and severe and impacting more families and communities than ever before. This is putting unprecedented pressure on practitioners, frontline workers and volunteers who respond during and after disasters. As we become more aware of the needs of infants, children and families who experience disasters, we are also recognising the additional strain on the workers striving to keep them safe and help them recover.

If you require immediate support, please call Lifeline Australia on 13 11 14 or text 0477 13 11 14.

Who is this resource for?

This practice paper is for anyone who is currently supporting, or could support, infants, children, parents and/or families after a disaster. This includes employed practitioners, workers, organisation leaders and volunteers in:

• health services
• social and community services
• education
• first response and emergency services
• government (policymaking and agencies)
• non-government organisations
• community-led initiatives.

Definitions

For the purposes of easy reading, the terms ‘children’, ‘parents’ and ‘workers’ or ‘practitioners’ are used throughout this resource and we define them in the following ways:

Children: includes newborn infants, babies and children up to 12 years old.

Parents: the biological, adoptive, foster and kinship carers of a child, as well as individuals who have chosen to take up primary or shared responsibility in raising that child.

Workers/practitioners: all individuals with a role that involves or might involve supporting infants, children, parents and/or families in the context of a disaster of any kind.

Key messages

• ‘Worker wellbeing’ refers to the physical, mental, emotional and social health of workers and how they cope with the demands and challenges of their day-to-day role.
• Worker wellbeing is important because it has the potential to impact three key groups: the workers themselves; the workers’ families; and the people they are working to support.
• Assisting families and children in disaster settings can be extremely rewarding, but it can also be demanding and emotionally taxing. Research shows that working with infants and children at risk of harm increases practitioners’ risk of psychological harm.
• Working in disaster situations differs significantly from other types of work due to the chaotic environment, complexities and likely exposure to multiple potentially traumatic impacts on families, children, animals and livelihoods. Workers are exposed to high levels of distress, grief, fear and anger, and may be asked to assist in response or recovery activities without previous experience or training.
• A child-centred and family-focused approach to worker wellbeing emphasises the importance of workers looking after their own health so they are better able to assist children and families. This approach relies on the organisation and the individual sharing responsibility for managing and promoting worker wellbeing.
• A strong organisational commitment to worker wellbeing is fundamental, but individuals and families also have a crucial role to play.
• A shared approach strengthens workers’ ability to effectively support children and families who have experienced potentially traumatic events by fostering workers’ resilience, enhancing their capacity to adaptively cope with work-related stressors, and reducing the adverse impacts of work.
• Essential organisational practices include:
  • establishing clear role definitions to minimise ambiguity and stress
  • implementing connection through regular discussions about experiences, reactions and support networks
  • maintaining a trauma-informed environment.
• It is important for organisations to cultivate a culture of care and compassion by offering both emotional and practical support, providing constructive feedback and promoting a healthy work-life balance.
• Before an individual can focus on their own wellbeing, they need to know what to look for and where to seek support. This requires psychoeducation and reducing stigma around prioritising personal psychological and emotional wellbeing.
• Key strategies for individual workers include building a strong support network, actively taking care of physical and mental health, and seeking professional advice if challenges persist. This involves getting good quality sleep, regularly exercising, eating nutritious foods, fostering social connections and maintaining trusted support networks.
• Honest self-reflection is also crucial; workers must check-in with themselves to see if they are experiencing emotional difficulties, burnout or compassion fatigue. The sooner they prioritise their own health, the quicker their wellbeing can get back on track.

As the frequency and impacts of disasters have increased, so too has research around how to provide optimal care to children and families in affected communities. We now know that disasters (of all types) have unequal impacts, and that certain population groups, including infants, children and young people, are at greater risk of experiencing mental health difficulties related to a disaster (Newnham et al., 2022; Chen et al., 2020).

There is a growing body of research about the psychosocial impacts – both positive and negative – on practitioners and volunteers working in the disaster context. However, there has been limited attention to the wellbeing of workers specifically assisting children and families during and after disasters. Practitioners and volunteers report that it can be highly rewarding work, but also emotionally demanding. Working in a context where infants and children are at risk of harm increases practitioners’ own risk of psychological harm (Ireland & Huxley, 2018).

The wellbeing of practitioners and workers is fundamental not just for the individuals themselves, but also their loved ones, and the children and families they are supporting. Worker wellbeing is a shared responsibility between organisations, individuals and families, and this paper offers practical strategies for prioritising worker wellbeing at every level.

Child-centred practice in disaster contexts prioritises the unique needs, vulnerabilities and voices of children to support their safety, wellbeing and resilience throughout all phases of a disaster. It acknowledges that children of all ages, from infants to adolescents, can be adversely affected by disasters. A child-centred approach recognises that children have different developmental journeys, capacities and coping skills that must be understood and addressed by the workers who are supporting them and their families.

In the context of disasters, a family-focused approach involves a collaborative and supportive partnership between workers and families. The aim is to empower families to identify their needs, co-create solutions and participate in decision-making.

It is important a child-centred and family-focused approach is extended to worker wellbeing. That means acknowledging that workers must nurture their own physical, mental, emotional and social wellbeing in order to provide effective and sustainable support to others. This includes support for both children and families who have experienced a potentially traumatic event and (if relevant) to members of the worker’s own family, who may also have been exposed to the disaster.

Commonly, workers will focus solely on supporting adults in disaster situations, because parents care for the immediate needs of their children. Some practitioners avoid working with children as they don’t feel confident in their skills to support infants and young children experiencing extreme stress.

The key difference in working directly with children in disaster situations is that children, particularly infants, are reliant on adults for their physical and psychological wellbeing. Infants and children’s earlier stage of physical, cognitive and emotional development makes them less equipped to deal with the stresses of a disaster independently, and more reliant on the support of caring, trustworthy adults. If you are a first responder, practitioner or volunteer working in a disaster context, this includes you. Workers supporting children and families through disasters are often also parents. With the added challenge of being deeply motivated to help others – often driven by a strong sense of commitment to their role – workers may struggle to prioritise their own wellbeing amid competing demands and the distress of those they are supporting. Balancing the responsibility of caring for others with self-care requires a concerted effort by workers to ensure their own physical and mental health does not suffer.

In this video (5 minutes, 37 seconds) practitioners discuss the importance of workers reflecting on the potential impacts of their involvement in disaster response and recovery on themselves and their family members.

Research shows working in disaster situations can foster resilience and psychological growth, and that shared experiences strengthen social bonds and increase solidarity, enhancing motivation and job satisfaction (Masten & Osofsky, 2010). However, the chaotic environment, fieldwork and outreach efforts also place workers at higher risk of physical and psychological harms.

Disaster workers are exposed to high levels of distress, grief, fear and anger – directly through activities such as rescue and indirectly through witnessing traumatic events. They may also hear individuals recount their traumatic experiences or read case files involving children who have suffered during the disaster. This exposure, combined with the challenge of assisting in response or recovery activities without enough previous experience or training, can amplify the difficulties workers face and impact their ability to effectively support children and families affected by the disaster.

Practitioners and volunteers working in disaster contexts are at increased risk of:

• Vicarious trauma: This occurs when workers are exposed to the traumatic stories or experiences of others and it affects their own sense of safety, trust and meaning. Vicarious trauma can change workers’ beliefs, values and emotions. It may cause them to feel disconnected, numb or hopeless and experience anxiety, irritability or intrusive thoughts.
• Secondary traumatic stress (STS): STS is the emotional distress that a worker may experience in response to hearing about the firsthand trauma experiences of children or families they are assisting. Symptoms are similar to those of post-traumatic stress disorder and may include intrusive thoughts, sleep problems, hypervigilance or hyperarousal, apathy, depression or physical exhaustion (Cocker & Joss, 2016).
• Burnout: This is a state of physical, emotional and mental exhaustion caused by prolonged or excessive stress. Burnout can result from unrealistic expectations, heavy workloads, lack of resources or lack of recognition. Workers who suffer from burnout may feel overwhelmed, cynical, detached or ineffective in their work (Salvagioni et al., 2017).
• Compassion fatigue: This is a condition that affects workers who care for people who are suffering or in distress. Compassion fatigue can cause workers to lose their empathy, compassion and enthusiasm for their work. Workers may also experience symptoms of anxiety, depression, anger, guilt or isolation (Patole, Pawale, & Rath, 2024).
• Anger: This may become problematic when anger increases in intensity, frequency and duration and is difficult to regulate. It has been associated with chronic exposure to traumatic events (Forbes et al., 2008).
• Moral injury: This occurs when individuals experience distress after witnessing or participating in events that contradict their deeply held moral beliefs. This can happen through acts of commission (doing something against one’s values), omission (failing to act in line with one’s values), or betrayal by others in positions of power. The resulting feelings of guilt, shame, disgust and anger, alongside difficulty with self-forgiveness, can lead to profound psychological and behavioural challenges (Knobloch & Owens, 2024; Norman & Maguen, 2024).

Worker wellbeing will vary significantly in these extreme situations, based on roles and exposure levels (including previous exposure to disasters) as well as personal qualities and skills. Individual practitioners will face unique challenges, including differing risks of physical and psychological harm, secondary traumatic stress and vicarious traumatisation. For example:

• First responders face increased risks of physical and psychological harm due to their involvement in the immediate aftermath of disasters. First responders frequently experience symptoms of PTSD, anxiety and depression as a result of their exposure to potentially traumatic events (Substance Abuse and Mental Health Services Administration [SAMHSA], 2018). The high-pressure environment and the need to make quick, life-saving decisions contribute to their elevated stress levels. For more on this, and a series of strategies, check out Beyond Blue’s Good practice framework for mental health and wellbeing in police and emergency services organisations.
• Educators are often the first point of contact for families after a disaster, sharing the responsibility of addressing children’s emotional and educational needs. They may also be directly involved as first responders if they have children in their care during the disaster or if their educational facilities are used as evacuation or relief centres for the community. Consequently, educators can experience secondary traumatic stress and burnout as they provide continuous support to affected children, while simultaneously managing their professional responsibilities and their own emotional responses to the disaster. Acknowledging these roles and the associated strains on people’s wellbeing is crucial.
• Mental health practitioners may provide support to children and families experiencing significant difficulties during, immediately after and in the longer term following a disaster. The cumulative effect of working with distressed children and families over extended periods can lead to vicarious traumatisation and compassion fatigue. Despite their training, the emotional toll of witnessing the long-term consequences of disasters on families can impact practitioners’ mental health and professional efficacy (Naushad et al., 2019).

It is important to acknowledge that workers supporting children and families through disasters may also be personally affected by the situation, as they manage their professional responsibilities but also their personal lives. These workers often juggle multiple roles – such as being a school principal, a coach at local sporting events, a volunteer firefighter and a family member – each with its own set of responsibilities and demands. Balancing these diverse roles requires significant effort and resilience, as they navigate various needs and challenges beyond their primary work responsibilities.

These impacts underscore the importance of shared responsibility when it comes to worker wellbeing. A strong organisational culture of worker wellbeing that includes comprehensive planning, as well as targeted resources and support, is fundamental.

Mental ill health accounts for 13.3% of Australia’s total burden of disease and injury and costs the economy $20 billion annually in lost productivity and labour participation (Productivity Commission, 2020). In addition to the financial costs, and potential legal obligations, there is a moral imperative for organisations and services to prioritise the wellbeing of employees who are supporting children, families and communities impacted by disasters.

In the following video (6 minutes, 10 seconds) practitioners discuss organisational responsibilities and strategies for fostering the wellbeing of workers supporting children and families after a disaster.

The following are strategies to prompt discussion and action to improve your organisation’s focus on worker wellbeing.

Support workers to support infants and children

Supporting children and families during disasters involves navigating complex and emotional situations. Workers may encounter significant difficulties and distress, similar to those seen by youth justice or child protection workers, which can be both challenging and profoundly rewarding. The ability to provide critical support to children and families during times of need highlights the importance of this work.

Organisations should offer a range of support options to address workers’ varying levels of need, employing a stepped or matched care approach. This includes low-intensity options such as psychoeducation on the staff intranet, general wellbeing promotions, peer support and management training for handling sensitive conversations. More specialised support should be available from the organisation’s wellbeing staff or Employee Assistance Program (EAP).

To effectively support their workforce, organisations must provide targeted training and resources that address the unique aspects of working with at-risk populations in disaster contexts. This training should equip workers with strategies to self-manage the emotional and psychological toll of their roles while including access to experienced mentors and supervisors who understand these specific challenges. Creating a supportive environment where workers can openly discuss their experiences and seek advice about their practice is crucial for maintaining personal wellbeing.

Additionally, organisations should continuously monitor and evaluate the effectiveness of their wellbeing initiatives to ensure ongoing improvement. Providing ongoing professional development and mental health resources tailored to supporting the needs of children and families in disaster contexts will enhance workers’ ability to deliver effective assistance while protecting their own mental health. This balanced approach helps sustain their impactful work and acknowledges both the difficulties and rewards of their vital contributions.

For a great place to start, take a look at the practices described in Wellbeing for workers supporting children and families after a disaster and Emerging Minds’ Community Trauma Toolkit. The Australian Institute for Disaster Resilience (AIDR) knowledge hub also provides a range of helpful workforce support resources.

Foster a culture of care

Essential organisational practices for supporting worker wellbeing include:

• establishing clear role definitions to minimise ambiguity and stress
• implementing clear and regular communication and support networks
• maintaining a trauma-informed environment.

Organisations that implement such practices prioritise safety, offer workers the autonomy and flexibility to make decisions about how they perform their duties and manage their work responsibilities, foster collaboration, and build trust. These factors are all crucial for supporting worker resilience and enabling an effective disaster response (West, 2020).

Organisations can foster a culture of care and compassion for workers by offering both emotional and practical support, providing constructive feedback and promoting the healthy integration of work into their life.

Regular check-ins between workers and their managers/supervisors can ensure work progress is monitored to identify challenges or gaps, provide support and guidance, and acknowledge achievements and successes. Check-ins can also foster a sense of belonging and trust among workers and enhance their wellbeing and performance.

Organisations should also strive to avoid or reduce the effects of prolonged or repeated exposure to disaster-related stressors that can adversely affect workers’ physical and mental health. Adequate breaks and rest periods are essential during and after shifts, and across the duration of the disaster response and recovery efforts. Workers should be encouraged to engage in healthy and relaxing activities to restore their energy and resilience.

Enhance psychological safety

Psychological safety is not just about reducing exposure to psychosocial hazards; it also encompasses an individual’s perception of the consequences of taking an interpersonal risk (Edmondson & Lei, 2014). In an organisation or workplace psychological safety means feeling safe to take risks with other team members and with the organisational hierarchy. It means trusting that it is OK to speak up, to disagree and to offer negative feedback without risk of ridicule or reproach.

Organisations can enhance the psychological safety of their workers and volunteers by creating supportive environments that foster interpersonal trust, mutual respect and open communication, with the ability to express vulnerability and clarity of expectations. These components are particularly important in disaster settings.

The following are some effective strategies to enhance psychological safety.

Maintain strong values and high ethical standards

Workers are more likely to feel motivated, engaged and supported when their personal values align with the organisation’s mission and vision. Organisations can engage workers by involving them in the development of mission statements and values and clearly communicating goals, expectations and ethical standards. Workers should be provided with opportunities to contribute to decision-making and feedback processes.

A term you might come across is ‘moral injury’, which Phoenix Australia defines as ‘witnessing or experiencing acts that conflict with your own deeply held moral beliefs, values, and expectations’ (Phoenix Australia, n.d.). Organisations striving for best practice in disaster contexts should create psychologically-safe work environments that promote transparent communication, safety in speaking up and regular discussions with supervisors and among teams. They also address moral injury and fulfill their duty of care to workers, volunteers and their families.

Comprehensive training, resources and support are essential to help employees cope with the stresses and exposure to potentially traumatic events inherent in disaster-related work. Organisations must establish, and actively uphold, a commitment to moral integrity and high ethical standards. This means not just having policies in place but ensuring they are effectively implemented and regularly evaluated for their impact. Organisations must highlight the support structures in place to address moral injury and demonstrate a commitment to responsiveness and continuous improvement based on feedback and evidence.

Support employees’ families

Organisations should foster a culture of compassion and understanding that addresses both general family needs and the specific challenges faced by parent-workers who are assisting others during and after disasters. To safeguard worker and family wellbeing, organisations should adopt a proactive and holistic approach to disaster preparedness. This involves:

• providing support systems to help workers manage their responsibilities to both their families and their professional roles
• equipping workers with the skills and knowledge needed to handle work challenges
• addressing the unique impacts on parent-workers and their dependent children.

A worker’s wellbeing in the context of a disaster is influenced by their individual experiences and stressors, as well as the ways in which the disaster affects their loved ones. While being able to support their family can provide parent-workers with comfort and strength, having to do so while also undertaking disaster response duties within the community can introduce additional stressors in the form of competing demands. As such, organisations should facilitate opportunities for workers to communicate with their families during disaster response. When workers are in hazardous situations or may have difficulty maintaining communications – such as first responders performing rescues – organisations can support families by offering a point of contact and also reaching out to update and check in with workers’ family members.

It is also important for organisations to encourage and enable workers to seek assistance as needed and find a healthy work-life balance. It is essential that all employers promote positive mental and physical health practices, facilitate opportunities for reflection and encourage self-care with workers.

If you are a practitioner engaged in disaster work, this section will offer strategies you can use to reflect on, and protect or nourish, your own wellbeing. However, if you are a leader, you may use these strategies to inform organisational programs, resources and employee support policies.

In the immediate aftermath of a disaster you might find yourself putting aside your own emotions and concerns in order to get on with the critical task of supporting those in need. This is called ‘compartmentalising’ and it allows you to assist in the disaster response despite the stress and physically and/or emotionally demanding work that’s required.

This separation may be necessary (and useful) in the short term, but over time it can prove unsustainable and counterproductive unless you take care of your own wellbeing. As the community moves from disaster response to recovery, you will need to shift focus too. It is essential to prioritise your own wellbeing and take steps to look after yourself.

Following are six key strategies for maintaining and enhancing your wellbeing.

Whether you work in disaster response and recovery as part of your day-to-day work, or as part of the surge/volunteer workforce, your family responsibilities and concerns become intertwined with your professional responsibilities. Your loved ones, especially dependent children, will worry about your safety and may be affected by the uncertainty and stress of the situation.

For younger children, who may not fully understand the nature of your work, this could mean increased anxiety or clinginess. Older children, on the other hand, might struggle with their own fears and concerns about your safety, leading to stress or emotional strain. Without clear and understandable information, children might rely on their imagination or what they have heard to fill in the gaps.

If you are worried about your children or other family members, it can impact your wellbeing and your effectiveness in your role. The following strategies can help workers and their families cope with the stress of disaster work and potential impacts on family members or the family as a unit:

• Provide your partner and children with information about how you stay safe at work. This might include explaining (and showing them) any personal protective equipment you wear, safety protocols and contingency plans that are in place to protect you from harm. Depending on your role, this might mean reassuring children that you have trained for this, that you keep fit for this or that you work in a team and others support you.
• Develop your own household plan well ahead of any impending disaster, clarifying the roles of each family member. Explain how you will manage your family’s needs and care during a disaster. If possible, provide predictability around when you will need to leave and when they can expect to see you again. Try to stick to any agreed schedule and communicate any changes as best you can. Read more about additional strategies in Disaster preparedness with a focus on infants, children and families and other disaster preparedness resources for families.
• Listen to your partner and tackle any challenges as a team. Your partner will likely be the first to notice if your wellbeing is being impacted by your work and will be worried about you. They may be solely managing the family unit while you are absent and notice the impacts on your children. Acknowledge the impacts of your work and remember to express gratitude and appreciation for their support and understanding.
• Ask open-ended questions to get a clearer picture of what your child understands about your work. Share age-appropriate information about your role and its impact, and listen to your children’s concerns and feelings. This can help them feel more secure and involved while reducing their anxiety and confusion. The Emergency Services Foundation’s Families guide offers advice for recognising mental health concerns, initiating honest and supportive conversations, and talking to your children about what your role entails.
• Clarify expectations about your work and help your family to understand the purpose and value of what you do. This can help your partner and children to develop a positive and realistic view of your role while fostering a sense of pride and respect. Another good discussion is around the boundaries and limits of your work, and the importance of maintaining a balance between work and family life.
• Show your children positive and realistic portrayals of disaster workers and their contributions. This will teach them about the nature and challenges of the work, and the ways that workers cope and care for themselves and others. Reading stories can also inspire children and families to identify with the values and strengths of workers, and to recognise their own resilience and coping skills. ABC Kids’ Helping Hands disaster resilience toolkit offers age-appropriate stories about disasters and disaster workers. Children’s Health Queensland’s Birdie’s Tree online storybooks are also designed to help young children make sense of various disaster scenarios and the workers who play a pivotal role.

The better you can explain what you do and how you stay safe, the less your family will worry when you are away at work. This will benefit your own wellbeing, the wellbeing of your loved ones, and your capacity to support children and families affected by a disaster.

Helpful resources and organisations

The following resources and organisations offer evidence-based advice and practical strategies to safeguard and enhance the wellbeing of workers involved in disaster response and recovery.

Resources

• Emergency Services Foundation (ESF) – Families guide
  The ESF Families guide recognises the vital role that families play in the wellbeing of emergency service volunteers. It offers simple, practical tips for detecting signs of mental distress and how to be supportive. There is advice on talking to your children about emergency services work, and where to go for help if you or a family member needs support.
• Professional Quality of Life (ProQOL) measure
  The ProQOL measure is a valuable, free tool for measuring your wellbeing. Developed by Dr Beth Hudnall Stamm PhD, the scale can help you to confirm if you are happy and satisfied in your role or suffering compassion fatigue. The website also includes fact sheets on topics including worker burnout, explaining signs and symptoms, vulnerability factors, prevention and recovery strategies, as well as information on how organisations can better protect their workers.
• National Disaster Mental Health and Wellbeing Framework
  The Australian Government’s National Disaster Mental Health and Wellbeing Framework includes information and recommendation that is useful for organisations working towards best practice in the wellbeing of workers.
• Disaster mental health hub
  Phoenix Australia’s disaster mental health hub links to a wealth of professional resources developed by key mental health organisations across Australia. The resources are designed especially for health practitioners and emergency workers supporting disaster-affected communities, and include everything from bilingual resources and teacher tipsheets to making your organisation more trauma-informed and accessible.
• Impacts of multiple disasters on communities: Tips for practitioners and recovery workers
  Impacts of multiple disasters on communities, a resource from Phoenix Australia, focuses on meeting the needs of communities and families affected by multiple disasters, and includes advice for workers on how to prioritise your own wellbeing, including maintaining healthy boundaries in small communities.
• Emotional wellbeing following a disaster
  The Queensland Mental Health Commission’s Emotional wellbeing following disaster is a four-page, A4 flyer that explains how mental wellbeing can be impacted by disasters and the steps that can be taken if things don’t improve over time.
• Work and mental health resources from Beyond Blue
  • Work and mental health advice is a resource that explains what a healthy workplace looks like, as well as offering advice on protecting your own wellbeing, supporting others and understanding your rights and obligations.
  • The Good practice framework for mental health and wellbeing in police and emergency services organisations is an evidence-based guide that specifically provides police and emergency services organisations with guidance to protect the mental health of their workforces, promote wellbeing and prevent suicide.
  • Beyond Blue’s wellbeing action tool is a simple, printable template that will help you to identify things that spark joy in your life, before reflecting on why they work and building other positives around them.

Organisations

• The Benefolk Foundation – Community Well
  The Benefolk Foundation’s social sector wellbeing and resilience hub, the Community Well, aims to address stress, anxiety and burnout among social sector leaders, staff and volunteers with workplace resources such as an organisational heath check and a workplace wellbeing strategy template.
• Black Dog Institute
  The Black Dog Institute has information, resources and programs to help organisational leaders and managers to provide a psychosocially safe workplace, identify and mitigate risks to workers’ mental health and promote good mental health and wellbeing in the workplace. Read more on the workplace mental health and wellbeing page on their website.Black Dog’s national emergency worker support service offers free, confidential mental health support to emergency service workers and volunteers and evidence-based strategies for coping with stress and support options.
• The IFRC Reference Centre for Psychosocial Support
  Created by the International Federation of Red Cross and Red Crescent Societies (IFRC) and based in the US, the IFRC Reference Centre for Psychosocial Support addresses the challenges volunteers face while working long hours in demanding emergency environments, often dealing with both their own emotional struggles and those of the communities they support. It offers practical tools to prepare and support volunteers during and after disasters, conflicts and other crises, with a focus on wellbeing, communication, peer support and evaluation. The centre also emphasises the importance of emotional preparedness, the toolkit goes beyond basic first aid and disaster response training.

Beyond Blue. (2020). Good practice framework for mental health and wellbeing in police and emergency services organisations.

Cocker, F., & Joss, N. (2016). Compassion fatigue among healthcare, emergency and community service workers: A systematic review. International Journal of Environmental Research and Public Health, 13(6), 618. DOI: 10.3390/ijerph13060618.

Cowlishaw, S., O’Dwyer, C., Bowd, C., Sadler, N., O’Donnell, M., Forbes, D., & Howard, A. (2024). Pandemic impacts and experiences after disaster in Australia: Qualitative study of compound impacts following the Black Summer bushfires. BJPsych Open, 10(2), e43. DOI: 10.1192/bjo.2023.648.

Ireland, C. A., & Huxley, S. (2018). Psychological trauma in professionals working with traumatized children. The Journal of Forensic Practice, 20(3), 141–151. DOI: 10.1108/JFP-10-2017-0045.

Masten, A. S., & Osofsky, J. D. (2010). Disasters and their impact on child development: Introduction to the special section. Child Development, 81(4), 1029–1039. DOI: 10.1111/j.1467-8624.2010.01452.x.

Nagoski, E., &Nagoski, A. (2019). Burnout: The secret to solving the stress cycle. Ballantine Books.

Newnham, E. A., Mergelsberg, E. L. P., Chen, Y., Kim, Y., Gibbs, L., Dzidic, P. L., Ishida DaSilva, M., Chan, E. Y. Y., Shimomura, K., Narita, Z., Huang, Z., & Leaning, J. (2022). Long-term mental health trajectories after disasters and pandemics: A multilingual systematic review of prevalence, risk, and protective factors. Clinical Psychology Review, 97, 102203. DOI: 10.1016/j.cpr.2022.102203.

Phoenix Australia. (n.d.). Moral Injury Outcome Scale research project [Web page]. Accessed 30 October 2024.

Productivity Commission. (2020). Mental health: Productivity Commission inquiry report. Australian Government.

Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & de Andrade, S. M. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLOS ONE, 12(10), e0185781. DOI: 10.1371/journal.pone.0185781.

Substance Abuse and Mental Health Services Administration. (2018). First responders: Behavioral health concerns, emergency response, and trauma. US Government.

Patole, S., Pawale, D., & Rath, C. (2024). Interventions for compassion fatigue in healthcare providers – A systematic review of randomised controlled trials. Healthcare, 12(2), Article 171. DOI: 10.3390/healthcare12020171.

Naushad, V. A., Bierens, J. J. L. M., Nishan, K. P., Firjeeth, C. P., & Moham, O. H. (2019). A systematic review of the impact of disaster on the mental health of medical responders. Prehospital and Disaster Medicine, 34(6), 632–643. DOI: 10.1017/S1049023X19004874.

Norman, S. B., & Maguen, S. (2024). PTSD: National Center for PTSD: Moral injury. US Department of Veterans Affairs.

Knobloch, L. K., & Owens, J. L. (2024). Moral injury among first responders: Experience, effects, and advice in their own words. Psychological Services, 21(3), 500–508. DOI: 10.1037/ser0000838.

Forbes, D., Parslow, R., Creamer, M., Allen, N,, McHugh, T, & Hopwood, M. (2008). Mechanisms of anger and treatment outcome in combat veterans with posttraumatic stress disorder. Journal of Trauma and Stress 21(2), 142–149.DOI: 10.1002/jts.20315.

West, M. A. (2020). Compassionate and collective leadership for cultures of high-quality care. In A. Montgomery, M. van der Doef, E. Panagopoulou, E., & M. P. Leiter (Eds.), Connecting healthcare worker well-being, patient safety and organisational change (pp. 207–225). Springer.