Tertiary victimization

Who cares for the caregivers? Tertiary victimization and emotional competencies

A silenced reality in the professional field

​ ​In the social, healthcare, and educational sectors, thousands of professionals face emotionally demanding situations every day. They support people in crisis, intervene in vulnerable contexts, and hold space for stories filled with pain.

But who prepares them emotionally to carry so much?

The answer is usually… no one.

​ ​Although the focus is often on the direct victim, there is a more silent form of harm that also needs visibility: tertiary victimization.

What is tertiary victimization?

​ ​In many emotionally demanding or caregiving workplaces, we often talk about the importance of care, self-care, and preventing burnout. However, there is a little-known but increasingly relevant concept: tertiary victimization. This phenomenon is fueled by silence, labels, cold protocols, and work environments that minimize the emotional impact of the job.

​ ​And it’s more present than we think…

​ ​It occurs when those who care for, accompany, or assist others (whether in health, education, social services, or leadership) become emotionally affected by supporting people going through difficult situations.

​ ​Similarly, tertiary prevention refers to interventions aimed at repairing already existing damage—when emotional exhaustion is evident and action is needed to support and restore those affected by the constant caregiving role.

​ ​To better understand the general framework of the three levels of prevention—primary, secondary, and tertiary—we share this video that explains each prevention level:

“At INEEW, we apply these same levels of prevention within our training programs: from individual courses to anticipate burnout, to group interventions aimed at repairing the emotional impact on teams already affected.”

Professionals under pressure: Who cares for the caregivers?

​ ​Studies show that between 30 % and 50 % of helping professionals experience compassion fatigue or emotional burnout (Ruiz-Fernández et al., 2020). Without institutional support programs, many end up leaving their vocation, developing psychological disorders, or even unintentionally re-victimizing the people they serve (González et al., 2021).

But why does this happen?

​ ​Professionals in fields such as healthcare, social work, or law can be indirectly affected by tertiary victimization due to:

• Institutional stigmatization for working with vulnerable populations.
  
  
• Emotional overload that is neither recognized nor supported.
  
  
• Lack of safe spaces to share their experiences or seek emotional help without fear.

Did you know…?

​ ​A recent study by Corral and Abásolo (2025), conducted with 258 professionals in the psychosocial and judicial fields, found alarming figures:

• Over 60 % experienced compassion fatigue.
  
  
• Many showed signs of burnout and secondary trauma (defined as a form of stress affecting individuals who, without having directly experienced a traumatic event, develop trauma symptoms from repeated exposure to stories, images, or testimonies of others’ traumatic experiences).
  
  
• However, the study also identified something hopeful: those who received institutional emotional support developed what they called vicarious resilience—the ability to strengthen themselves emotionally through guidance and accompaniment.
  
  

The environment can also harm (or heal)

​ ​Contemporary victimology no longer focuses solely on the direct victim. As explained by organizations such as the Organization for Security and Co-operation in Europe (OSCE, 2009) and the Canadian Ministry of Justice (2001), it is also crucial to examine how institutional and media environments perpetuate suffering.

​ ​In fact, recent studies (Vásquez et al., 2021) have shown that when institutions fail to provide real emotional support, professionals are more likely to:

• Abandon their vocation
  
  
• Develop anxiety or insomnia
  
  
• Even unintentionally re-victimize those they serve due to a lack of emotional tools

What do professionals say they need?

​ ​A systematic review (PMC, 2022) revealed something quite striking: what professionals value most is not more protocols, but humanity:

• Immediate emotional support
• Genuine recognition
• Active, nonjudgmental listening

​ ​However, many institutions opt for bureaucratic responses that, far from helping, increase emotional disconnection.

​ ​The way an institution manages the emotional needs of its workers and clients directly affects their mental health. Unexpressed emotions, cold or rigid environments, and the absence of active listening worsen the consequences of trauma, both for victims and for those who care for them (Figley, 1995; Maslach & Leiter, 2016).

“What if we invest in emotional education?”

When prevention is emotional: evidence in action

• In Granada (Spain), a public hospital implemented a program for “second victims”—professionals involved in traumatic clinical events. Thirty-five percent of the staff showed significant emotional symptoms. Thanks to the protocol, medical leave decreased and workplace climate improved (Martínez et al., 2023).
• In Germany, training staff in emotional regulation reduced institutional occupational health costs and improved professional retention (Neubert et al., 2024).
• At the University of Barcelona, emotional education programs for teachers and teams reduced stress and increased group cohesion (Bisquerra & Pérez Escoda, 2012).

Practical strategies for organizations

What can institutions do to prevent tertiary victimization?
 

• Train staff in basic and advanced emotional competencies.
  
  
• Implement emotional supervision and group care spaces.
  
  
• Appoint trained emotional health representatives within each team.
  
  

The first step toward real change…

​ ​Caring for caregivers is not just an ethical necessity; it is a smart, humane, and sustainable strategy. In contexts where emotional exhaustion becomes the norm rather than the exception, investing in emotional education is a concrete way to transform workplace cultures from within.

​ ​Tertiary victimization is not resolved with well-intentioned speeches, but with structural decisions, safe spaces, and real tools. Training in emotional competencies not only improves the mental health of teams but also directly impacts productivity, organizational climate, and talent retention.

​ ​At INEEW, we work to make this care a real practice, both at an individual and institutional level. If you feel it’s time to drive this change, we are here to support you.

You can start today:

Train individually through our virtual campus

Or also:

Learn about the projects we carry out within organizations

​ ​Caring for those who support others is more than a compassionate choice: it is a transformative action.

References:

• Bisquerra, R., & Pérez Escoda, N. (2012). Competencias emocionales para un cambio de paradigma en educación. Revista Educación XXI, 15(2), 61–82. https://doi.org/10.5944/educxx1.15.2.143
  
  
• Corral, S., & Abásolo, A. (2025). Impacto psicológico en profesionales que tratan con víctimas: fatiga, trauma vicario y resiliencia. Universidad de Deusto / Clínica Forense de Bilbao.
  
  
• Figley, C. R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner/Mazel.
  
  
• González, M., López, J. A., & Sanz, A. (2021). Burnout en profesionales de ayuda: Un análisis cualitativo. Revista Española de Psicología, 24(1), e53. https://doi.org/10.1017/S1138741621000090
  
  
• Justice Canada. (2001). Victims of crime research series: Secondary victimization. Department of Justice Canada. https://www.justice.gc.ca/eng/rp-pr/cj-jp/victim/rr01_9/rr01_9.pdf
  
  
• Martínez, F., Rodríguez, L., & Sierra, J. (2023). Implementación de protocolos de apoyo en hospitales públicos. Gaceta Sanitaria, 37(2), 144–152. https://doi.org/10.1016/j.gaceta.2022.08.004
  
  
• Maslach, C., & Leiter, M. P. (2016). Burnout: The cost of caring. Harvard University Press.
  
  
• Mdpi. (2022). Support needs among healthcare workers after adverse events. International Journal of Environmental Research and Public Health, 19(11), 6454. https://doi.org/10.3390/ijerph19116454
  
  
• Neubert, M., Schäfer, H., & Kunz, J. (2024). Emotional competence training in healthcare workers: A cost-benefit study. International Journal of Public Health, 69(3), 299–309. https://doi.org/10.3389/ijph.2024.03214
  
  
• OSCE. (2009). Secondary and tertiary victimization of victims of crime. Organization for Security and Co-operation in Europe. https://www.osce.org/files/f/documents/2/5/26723.pdf
  
  
• PMC. (2022). Second victims in healthcare: Systematic review of needs and institutional responses. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185930/
  
  
• Ruiz-Fernández, M. D., Pérez-García, E., & Ortega-Galán, Á. M. (2020). Fatigue, burnout, and compassion satisfaction among emergency nurses during COVID-19. Journal of Clinical Nursing, 29(21–22), 3901–3909. https://doi.org/10.1111/jocn.15469
  
  
• Santos, C. A., & Andreotti, Y. (2015). Victimización terciaria en procesos institucionales. Tesis de Maestría, Pontificia Universidad Católica de São Paulo. https://tede2.pucsp.br/handle/handle/17396