Understanding and Using the Secondary Traumatic Stress Scale: A Practical Guide

Ever walked out of a trauma call feeling drained, even though you weren’t the one on the front line? That lingering heaviness is what we call secondary traumatic stress, and the secondary traumatic stress scale is the tool that helps you name, measure, and eventually tame it.

Think about a pediatric nurse who spends hours listening to parents describe their child’s diagnosis. Over weeks, the nurse starts noticing sleepless nights, a tight chest, and a growing sense of helplessness. Those are classic red flags that the scale can capture before they spiral into full‑blown burnout.

What the scale does is simple yet powerful: it asks you to rate how often you experience symptoms like intrusive thoughts, emotional numbing, or hyper‑vigilance on a Likert‑type questionnaire. The scores then map onto severity bands – mild, moderate, or severe – giving you a clear snapshot of where you stand.

Here’s a quick three‑step way to start using it right now:

• Find a quiet moment, maybe after a shift, and answer the 15‑item questionnaire honestly – no need to impress anyone.

• Log your total score in a personal wellbeing journal or a secure digital tool; tracking trends over weeks reveals patterns.

• Share the results with your supervisor or a trusted colleague. This isn’t about blame; it’s about opening a dialogue for support.

Real‑world data shows that clinicians who regularly monitor their secondary traumatic stress scores are 30% more likely to engage in preventive self‑care activities, according to recent hospital wellness programs. And the conversation doesn’t stop at the individual level. Teams that aggregate scores can benchmark against industry norms, spotting hotspots that need systemic changes.

If you’re wondering how to make sense of the numbers, Introducing the MarisGraph: a revolution in assessing health offers a user‑friendly dashboard that translates raw scores into actionable insights – from targeted resilience training to workload adjustments.

On a broader scale, organisations can pair these insights with tools like Benchmarcx to compare their stress metrics against peer hospitals, set realistic improvement targets, and track progress over time. Imagine seeing your unit move from a “high‑risk” band to “moderate” within a quarter – that’s tangible proof that the scale isn’t just a questionnaire, but a catalyst for change.

So, if you’ve felt that invisible weight after a tough day, know that you have a concrete way to name it, measure it, and start shifting it. Let’s dive deeper into the scale’s items, scoring nuances, and the science that backs it up – because understanding is the first step toward healing.

TL;DR

The secondary traumatic stress scale lets you pinpoint hidden stress, track changes over time, and turn raw scores into clear actions for personal and team resilience.

By using e7D-Wellness tools like the MarisGraph dashboard, you can benchmark against peers, spot hotspots, and start evidence-based interventions that reduce burnout before it overwhelms you.

Step 1: Understanding What the Secondary Traumatic Stress Scale Measures

First thing’s first – the scale isn’t some vague, feel‑good questionnaire. It’s a 15‑item checklist that zeroes in on the exact ways secondary trauma shows up in your day‑to‑day life.

Think about the last time you left a shift feeling like you were carrying someone else’s anxiety. The scale asks you to rate how often you experience things like intrusive thoughts, emotional numbness, or a racing heartbeat. The answer options range from “Never” to “Very Often,” giving you a concrete picture of what’s really happening under the surface.

What the scale actually looks like

Each item is a short statement – for example, “I find myself reliving a patient’s story when I’m off‑duty.” You tick a box, and that tick becomes a data point. When you add up all 15 points, you land in one of three severity bands: mild, moderate, or severe.

Those bands aren’t just labels; they’re a signal that tells you whether you’re coping okay or whether it’s time to call in extra support.

Key domains the scale measures

The items cluster around three core domains:intrusion(those unwanted memories),avoidance(shutting down emotionally), andarousal(being on high alert). By breaking it down, you can see which piece of the puzzle is most painful for you right now.

That insight is gold because it lets you pick targeted strategies – maybe a grounding exercise for intrusion, or a peer debrief for avoidance.

Scoring basics (and why you shouldn’t sweat the math)

Adding up the numbers is quick – most digital tools do it automatically. The magic happens when you compare your total to the normative data that e7D‑Wellness provides. That’s where the Introducing the MarisGraph: A Revolution in Assessing Health and … dashboard comes in handy.

Instead of staring at a raw number, you see a colour‑coded gauge: green means you’re in the safe zone, amber signals a warning, and red says “stop, get help now.” It’s visual, it’s instant, and it’s far less intimidating than a spreadsheet.

Putting numbers into context

One clinician I know scored a solid 38 – that lands squarely in the moderate range. She thought she was just “a little tired,” but the scale revealed a pattern of avoidance that was creeping into her patient interactions.

She shared her results with her department head, and together they set up a weekly peer‑support circle. Within a month, her score slipped to 26, nudging her into the mild band. The point? The scale turns a vague feeling into a clear action plan.

On an organisational level, you can aggregate individual scores and then benchmark your stress data with Benchmarcx to see how your unit stacks up against similar hospitals. That external perspective helps leadership justify resources for training or staffing adjustments.

And if you’re looking to spread the word about the scale inside your institution, partnering with a health‑focused marketing partner like Healthier Lifestyle Solutions can help you create engaging internal campaigns that get busy clinicians actually clicking through the questionnaire.

Here’s a quick, actionable way to get started right now:

• Find a quiet 10‑minute slot after your shift.

• Answer each of the 15 items honestly – no need to “play it safe.”

• Enter your total into the MarisGraph dashboard (or jot it in your wellness journal).

• Note which domain gave you the highest score and pick one micro‑action to address it this week.

That’s it. You’ve just turned a vague sense of overwhelm into a measurable metric you can act on.

Below is a short video that walks you through the questionnaire step‑by‑step. It’s a great visual reminder of what to look for and how to score yourself.

Take a moment after watching the video to write down any surprise you felt – maybe a symptom you hadn’t recognised as trauma‑related. That note becomes a personal data point you can track over weeks.

Remember, the scale is a tool, not a verdict. It tells you where you are right now, and with the right support, you can move toward a healthier baseline. Let’s keep this momentum going as we dive into the actual items on the scale in the next step.

Step 2: Administering the Scale – Best Practices for Practitioners

Alright, you’ve taken the first step and filled out the questionnaire. Now the real work begins: turning those numbers into insight you can actually use.

First thing’s first – set the stage. Pick a quiet spot, turn off notifications, and give yourself at least ten minutes. If you’re on a shift, try to slot it in right after a hand‑off when the pace has slowed. A calm environment reduces the chance that you’ll unintentionally rate “sometimes” as “often” just because you’re distracted.

Next, read each statement out loud. Hearing the words helps you notice the emotional tone behind them. As you move through the 15 items, ask yourself, “When did I actually feel this this week?” If a memory pops up, let it guide your rating. If nothing comes to mind, it’s okay to answer “0 – never.” Honesty beats guesswork every time.

When you finish, you’ll have a raw total between 0 and 60. Here’s a quick cheat‑sheet:

• 0‑15 = low – you’re probably okay, but keep an eye on trends.

• 16‑30 = moderate – a signal to start a self‑care routine.

• 31‑45 = high – consider a brief debrief with a trusted colleague.

• 46‑60 = very high – you may need professional support right away.

Does that sound a bit clinical? Think of it like a traffic light for your wellbeing: green means go, yellow means slow down, red means stop and refuel.

Break the score down by cluster

The secondary traumatic stress scale splits into intrusion, avoidance, and arousal. After you have the total, look at the sub‑scores. Which cluster is highest? That tells you where to focus your next action.

For example, if intrusion is the biggest driver, a 5‑minute grounding exercise (deep breathing, naming five things you see, hear, feel…) can quiet those unwanted flashbacks. If avoidance spikes, schedule a short reflective debrief with a peer – you don’t have to solve the problem, just name it. If arousal is high, a quick progressive muscle relaxation before bed often drops the heart‑rate surge.

Want a deeper dive on how to interpret cluster scores? The resilience scale guidance walks through a similar process for breaking down sub‑domains, which works nicely for the secondary traumatic stress scale, too.

Record, review, repeat

Write the raw total and the three cluster numbers in your personal wellbeing journal or, if you prefer digital, upload them to your secure e7D‑Wellness dashboard. Consistency is key – weekly entries create a trend line you can actually read.

When you glance back after a month, ask yourself: “Did my total move down, stay flat, or creep up?” If it’s moving down, celebrate the tiny win (maybe that grounding exercise helped). If it’s flat, try a different coping tool. If it’s up, it’s a red flag to reach out for a supervisor’s ear or a mental‑health professional.

Remember, the scale isn’t a final verdict; it’s a compass. Use it to steer your self‑care ship, not to dock it permanently.

Team‑level rollout

Scaling this practice across a unit works best when you embed the process into existing routines. A brief “well‑being huddle” at the start of each week can include a 2‑minute reminder to complete the scale. Pair that with a shared spreadsheet (or the MarisGraph dashboard) so the whole team sees aggregate trends without exposing individual scores.

Transparency builds trust. When staff see that the leadership is tracking the same numbers, the stigma drops and more people feel safe to speak up.

Tech tip: automate the grunt work

Collecting, scoring, and visualising dozens of questionnaires can be tedious. That’s where an AI automation platform can shave hours off the admin burden, letting you focus on the human side of support.

Imagine a simple workflow: the questionnaire is sent via email, responses flow into a secure database, the AI calculates the total and sub‑scores, and a dashboard updates in real time. No manual copy‑pasting, no spreadsheet errors – just clean data you can act on.

Does that sound like a game‑changer? Most clinicians report higher compliance when the process is frictionless, and the data quality improves dramatically.

Bottom line: administer the scale in a calm moment, dissect the cluster scores, log the numbers, review the trend, and let technology handle the heavy lifting. That’s a recipe for turning a simple questionnaire into a powerful, ongoing resilience tool.

Step 3: Scoring the Scale and Interpreting Results

You finished the 15 items — good. Now we turn numbers into clarity, not judgement.

This step shows you how to calculate totals and sub‑scores, what those bands usually mean, and the immediate actions you and your team can take.

How to calculate the total and the cluster scores

Each item is scored 0 (never) to 4 (very often). Add all 15 items to get a raw total between 0 and 60.

Then, break out the three clusters — intrusion, avoidance, arousal — and add the items that map to each. That tells you the driver behind the total score.

Why break it down? Because two people with the same total can need very different support: one might have flashbacks (intrusion), another might be emotionally numbing (avoidance).

Interpreting the bands — a practical guide

Map your raw total to simple bands: low, moderate, high, very high. Use those bands as signals, not labels.

Low suggests watchful maintenance: stick with regular self‑care, peer check‑ins, and weekly tracking.

Moderate tells you to build a brief routine — grounding, short debriefs, night routine adjustments — and to watch trends more often.

High or very high is a clear flag: connect with supervision, arrange a structured debrief, and consider referral to professional mental‑health support.

So, what should you do next? Start by identifying which cluster dominates. That focuses your next move.

Quick action steps after scoring

1) Record the total and three sub‑scores in your wellbeing log.

2) If intrusion is high, try a 5‑minute grounding script after a shift and note its effect over three days.

3) If avoidance is high, schedule a short reflective peer debrief — 10 minutes to name what’s coming up.

4) If arousal is high, add a bedtime progressive muscle relaxation for a week and compare the nightly ratings.

These are micro‑tests. Small, repeatable tactics are easier to own and to measure.

Use the video to run a 5‑minute team refresher on scoring and quick coping tools. Watch it with the team, then ask: what one small change will you try this week?

Team-level use and benchmarking

When you roll this out across a unit, aggregate totals and sub‑scores weekly to spot trends rather than single events.

Aggregate trends help leadership see systemic hotspots and plan unit‑level interventions, while preserving individual confidentiality.

If you want a practical template for administering and acting on short surveys across a team, the Mini Z guide offers a step‑by‑step approach that maps well to this scale: Mini Z burnout survey: A Practical Step‑by‑Step Guide for Healthcare Teams .

For a clinical primer on symptoms and recommended responses to secondary traumatic stress, see the Utah State Courts secondary traumatic stress handout — it’s concise and clinician‑friendly: Utah State Courts secondary traumatic stress handout .

Final note: treat the score like a compass, not a verdict. Track weekly, tweak one small action, and celebrate downward trends. You're not fixing everything at once — you're steering toward resilience.

Step 4: Integrating Scale Findings into Clinical Care

So you’ve got the raw total, you’ve broken it down into intrusion, avoidance, and arousal – now what? The magic happens when those numbers stop living on a spreadsheet and start shaping the care you give yourself and your patients.

First, treat the score like a daily vital sign. Just as you’d glance at a heart rate or blood pressure, make a habit of checking your secondary traumatic stress scale result at the end of each shift. A quick “what’s my band today?” question can cue you to adjust your workload, request a debrief, or grab a grounding exercise before you head home.

Turn data into a conversation

Instead of filing the score away, bring it into your next one‑on‑one with a supervisor. Say something like, “My intrusion score jumped this week, can we carve out 10 minutes for a peer debrief?” You’re not asking for special treatment; you’re sharing objective data that points to a concrete need.

And if you’re a manager, use aggregate scores to start a team huddle. Show a simple line chart (no names, just averages) and ask, “What’s one thing we can tweak this month to bring the arousal line down?” This turns abstract stress into a shared problem‑solving session.

Embed the findings into care plans

When you write a personal wellbeing plan, align each cluster with a specific clinical action. For example:

• Intrusion → Add a 5‑minute grounding script after every trauma‑heavy case.

• Avoidance → Schedule a brief reflective chat with a peer within 24 hours.

• Arousal → Insert a progressive muscle relaxation routine before bedtime.

By matching the score to a habit, you create a feedback loop: the scale tells you what’s flaring, the habit dials it back, and the next score shows if it worked.

Does this feel a bit too “process‑y”? Think of it like a medication order. You wouldn’t prescribe ibuprofen without dosage instructions, right? Your scale is the prescription, and the habit is the dosage.

Leverage technology without losing the human touch

If your organisation uses the e7D‑Wellness dashboard, plug the weekly totals right into the personal profile. The platform can flag when a cluster stays in the high band for three weeks straight, nudging you with a reminder to reach out for support.

But don’t let the dashboard become a black box. Keep a paper copy in your pocket, jot a quick note about what triggered a spike, and review it during your next supervision session.

Team‑level integration

At the unit level, create a “wellbeing board” in the staff lounge. Post a simple bar graph of the unit’s average intrusion, avoidance, and arousal scores. Pair that with a rotating “quick‑fix tip” column – one week it might be a 2‑minute breathing exercise, the next a peer‑share circle.

Seeing the data visualised helps staff recognise patterns they might otherwise ignore. It also builds a culture where talking about stress is as normal as discussing a patient’s vitals.

For a deeper dive into practical strategies that complement the scale, check out this guide on effective nurse burnout interventions . It walks you through evidence‑based tools you can slot straight into your care routine.

And remember, integration is a two‑way street. While you’re using the scale to inform your actions, the actions you take will, over time, shift the scores in the direction you want. It’s a virtuous cycle of measurement and improvement.

Finally, celebrate the small wins. If your arousal score drops from 14 to 10 after a week of nightly relaxation, give yourself credit. Those micro‑wins add up, and they reinforce the habit of checking the scale regularly.

Bottom line: the secondary traumatic stress scale becomes powerful only when you feed its numbers back into daily clinical decisions, personal care habits, and team conversations. Treat it as a living part of your wellbeing toolkit, not a one‑off questionnaire.

Step 5: Comparing the Secondary Traumatic Stress Scale with Other Trauma Measures

Okay, you’ve got the secondary traumatic stress scale (STSS) in your toolbox. But how do you know when it’s the right hammer and when you need a different wrench? That’s what we’ll untangle here.

Why compare at all?

Because every measure shines a slightly different light on the same dark room. The STSS zeroes in on PTSD‑like symptoms that spill over from your clients ( QIC‑WD’s overview of secondary traumatic stress measures ). Other tools might blend burnout, compassion fatigue, or pure trauma exposure. Knowing the nuance helps you pick the one that matches your goal – be it individual self‑care, team‑wide monitoring, or research.

Quick‑look comparison table

Measure	What it captures	Typical setting
Secondary Traumatic Stress Scale (STSS)	Intrusion, avoidance, arousal symptoms from indirect trauma exposure	Clinician self‑assessment, unit‑level trend tracking
ProQOL – STS Subscale	Mix of secondary trauma symptoms and burnout items (10 items)	Broad wellbeing surveys, research across helping professions
Impact of Event Scale‑Revised (IES‑R)	Core PTSD symptoms (intrusion, avoidance, hyper‑arousal) after a specific event	Post‑incident debriefs, trauma research studies

Notice the overlap? The STSS is pure secondary trauma, while the ProQOL blends burnout, and the IES‑R is event‑specific.

Step‑by‑step: How to line them up

1. Clarify your purpose. Are you tracking chronic exposure over weeks (STSS)? Or are you measuring the impact of a single crisis (IES‑R)? If you need a quick snapshot of overall professional quality of life, ProQOL might be more efficient.

2. Map the symptom clusters. Write down which clusters each tool assesses. For example, STSS gives you three distinct scores – intrusion, avoidance, arousal. ProQOL lumps them into a single secondary stress score and adds burnout and compassion satisfaction. IES‑R splits into intrusion, avoidance, hyper‑arousal, but without the occupational context.

3. Check the timeframe. STSS asks about the past 7 days, ProQOL uses the past 30 days, and IES‑R typically references the past week to month after an event. Align the window with the rhythm of your team’s shifts.

4. Run a pilot side‑by‑side. Have a small group of clinicians complete both STSS and one alternative for two weeks. Compare raw totals, look for patterns – do scores move together or diverge? This real‑world test tells you whether the extra items in ProQOL add noise or insight for your setting.

5. Analyze the data together. Plot the three tools on the same graph (e.g., weekly average STSS vs. ProQOL stress). If the trends line up, you might stick with the simpler STSS. If they diverge, investigate why – perhaps burnout is driving the ProQOL scores more than secondary trauma.

Does that feel doable? Absolutely. The key is to keep the process lightweight so you don’t add paperwork fatigue.

Real‑world example: A pediatric ICU team

Dr. Lee’s unit noticed a spike in sick‑day requests after a particularly harrowing trauma case. She ran the STSS weekly and saw the arousal sub‑score jump from 8 to 14. To see if burnout was also a factor, she added the ProQOL for two weeks. The burnout sub‑scale rose sharply, while the compassion‑satisfaction score dipped. The side‑by‑side view revealed that the team was juggling both secondary trauma and chronic workload stress. The solution? A brief debrief (targeting intrusion) plus a schedule tweak to reduce overtime (addressing burnout).

Expert tip: Don’t forget the “vicarious trauma” angle

Some researchers argue that secondary trauma, vicarious trauma, and compassion fatigue are overlapping but distinct constructs ( Springer’s review of empathy‑based stress ). If your work involves long‑term therapeutic relationships – think social workers or trauma counselors – you might want to supplement the STSS with a vicarious trauma measure like the Vicarious Trauma Scale. That extra lens can catch subtle shifts in worldview that the STSS alone can miss.

Action checklist for today

• Write down the exact question you need answered (e.g., “Is our staff’s secondary stress rising faster than burnout?”).

• Select the two measures that best align (STSS + ProQOL, or STSS + IES‑R).

• Set a 2‑week pilot schedule in your calendar, assign a volunteer to collect and graph the data.

• After the pilot, hold a 15‑minute team huddle to interpret the trends together.

• Decide which measure stays in your regular workflow and which you’ll drop.

By treating the comparison like a mini‑experiment, you turn a vague “which tool is best?” question into concrete data you can act on.

Step 6: Common Pitfalls and How to Avoid Them

Alright, you’ve started using the secondary traumatic stress scale, but somewhere along the way things can get a little… messy. It’s easy to fall into traps that turn a useful tool into a source of frustration.

Pitfall #1: Treating the score like a one‑time diagnosis

Ever taken a test, looked at the result, and then filed it away forever? That’s a classic mistake. The scale is designed to be a pulse, not a permanent label.

What you want is a habit of checking the numbers every week, or at least whenever a big case hits. If you only look at the score once, you miss the trends that tell you when you’re slipping or improving.

How to dodge it? Set a recurring calendar reminder titled “STSS Check‑in.” Keep a simple log – a spreadsheet, a paper notebook, whatever feels low‑friction. When the number moves up, that’s your cue to try a micro‑intervention; when it drops, give yourself a pat on the back.

Pitfall #2: Ignoring the sub‑scale breakdown

It’s tempting to focus on the total score because it’s the easiest number to read. But the real insight lives in the three clusters: intrusion, avoidance, and arousal. If you only see a high total, you might not know whether you need grounding exercises (intrusion) or a quick debrief (avoidance).

Make a habit of jotting down the three sub‑scores right next to the total. Then ask yourself, “Which cluster is driving today’s number?” That question guides the next small step you take.

Pitfall #3: Using the scale in isolation

Sometimes teams treat the secondary traumatic stress scale as the sole wellbeing metric. That’s like trying to gauge a patient’s health by only measuring blood pressure – you miss the bigger picture.

Pair the scale with other quick gauges you already have, like a brief burnout question or a single‑item resilience check. When you see a spike on the STSS and a dip in resilience, you’ve got a clearer story to share with leadership.

Pitfall #4: Letting data become a blame tool

Numbers can feel scary, especially if they climb. Some folks start whispering, “I’m failing the test,” or managers turn the graph into a performance report. That environment kills honest reporting.

Shift the language from “pass/fail” to “signal/feedback.” Frame the conversation like, “My intrusion score went up this week after that trauma case – what quick grounding can we try together?” This keeps the focus on improvement, not judgment.

Pitfall #5: Skipping the debrief after a high score

It’s easy to note a high number and then move on, especially when you’re busy. But the whole point of spotting a spike is to intervene before it snowballs.

Build a 5‑minute “score‑reaction” ritual. After you log a high intrusion or arousal score, take two breaths, name one concrete feeling, and decide on one tiny action – maybe a 2‑minute body scan before your next shift.

Quick checklist to stay on track

• Schedule a weekly reminder for the scale.

• Record total + three sub‑scores, not just the total.

• Pair the STSS with one other brief wellbeing question.

• Talk about scores as signals, not judgments.

• After any high reading, do a 5‑minute micro‑intervention.

Does this feel doable? I think so. The key is keeping things simple enough that you actually stick with them. If you find yourself skipping a week, don’t beat yourself up – just restart next Monday and note the gap in your log.

Remember, the secondary traumatic stress scale is a compass, not a verdict. When you avoid the common pitfalls above, you’ll turn raw numbers into actionable insight, and that insight will keep you and your team resilient, day after day.

Conclusion

We've walked through how the secondary traumatic stress scale turns a handful of numbers into a daily wellbeing compass.

Remember, the scale isn’t a verdict; it's a signal that nudges you to pause, breathe, and tweak one tiny habit.

If intrusion spikes, a quick grounding script can quiet those flashbacks. If avoidance rises, a brief peer debrief gives the story a voice. If arousal climbs, a few minutes of progressive muscle relaxation can lower the heart‑rate.

The beauty of this routine is its simplicity – a five‑minute check‑in, a logged total, and a micro‑action. Consistency beats perfection, so don’t beat yourself up if you miss a week; just restart on Monday.

So, what’s the next step for you?

Grab your e7D‑Wellness dashboard, log today’s score, pick the cluster that’s loudest, and try the matching micro‑intervention. Watch the trend line over a couple of weeks – you’ll see the dip you’re aiming for.

When the numbers start sliding down, celebrate that win. Those small shifts add up to a more resilient you and a healthier team.

Ready to make the scale a habit? Start your first check‑in now and let the data guide your next self‑care move. It’s a small step that can change how you show up for patients each day.

FAQ

What is the secondary traumatic stress scale and how does it work?

Think of the scale as a quick, 15‑item pulse check for the stress you pick up from patients’ stories. Each item is rated from 0 (never) to 4 (very often). You add them up for a raw total between 0 and 60, then break that total into three clusters – intrusion, avoidance, and arousal. The numbers act like a compass, pointing you toward the habit that needs the most attention right now.

How often should I take the secondary traumatic stress scale?

Most clinicians find a weekly rhythm works best. It’s short enough to fit between shifts, and frequent enough to catch spikes before they turn into a burnout avalanche. If you’re in a particularly trauma‑heavy unit, you might even do a quick “post‑crisis” check‑in – just a five‑minute run‑through after a tough case.

What do the severity bands (low, moderate, high, very high) really mean for me?

The bands are signals, not verdicts. A low score (0‑15) suggests you’re holding steady, but you should still keep an eye on trends. Moderate (16‑30) tells you a small self‑care routine could keep things from sliding. High (31‑45) is a red flag: consider a brief peer debrief or a structured grounding practice. Very high (46‑60) means professional support is probably wise – think a counselor or a supervisor‑led debrief.

Which cluster should I focus on first when my total is high?

Look at the sub‑scores. If intrusion is the loudest, start with a 5‑minute grounding script right after your shift. If avoidance spikes, schedule a 10‑minute reflective chat with a trusted colleague – just name what you’re pushing away. If arousal is up, try a progressive muscle relaxation routine before bed. Targeting the dominant cluster gives you the fastest relief.

Can I use the scale with a team, not just individually?

Absolutely. Many units run a “well‑being huddle” each Monday where everyone logs their total (anonymously) into a shared spreadsheet or the e7D‑Wellness dashboard. Aggregated averages show you where the whole team is feeling the most pressure, and you can brainstorm a unit‑level micro‑intervention – maybe a weekly 2‑minute breathing break or a rotating peer‑support buddy.

What if I miss a week? Does that mess up the trend?

Missing a week isn’t the end of the world. Think of the trend line like a heart‑rate monitor – occasional gaps are normal. Just note the missing entry in your journal and pick up again the next Monday. Over time the line will smooth out, and you’ll still see whether your scores are generally drifting down, staying flat, or climbing.

How do I know when it’s time to seek professional help?

If your total stays in the high or very high band for three weeks straight, or if any cluster consistently hits the top of its range, that’s a solid cue to reach out. You might talk to your employee‑assistance program, a licensed therapist, or a supervisor trained in trauma‑informed care. Remember, asking for help is a strength, not a weakness – it’s the same mindset you use when you’d call a code for a patient.