Mitigating Psychological Distress Among Humanitarian Staff Working With Migrants and Refugees: A Case Example

  • Kristen L. Guskovict Humanitarian Empathy and Refugee Trauma (HEART) of Aid Work, KLG Consulting Services
  • Miriam Potocky School of Social WorkFlorida International University
Keywords: Humanitarian workers, refugee, migrant, self-care, stress management, Greece


Ongoing acute stress in humanitarian work leads to psychological distress among humanitarian workers. Stress management within humanitarian agencies requires responses at both the individual staff member and agency levels. Stress management is often conceptualized in four categories: stress that can be accepted; stress that can be altered; stress to which individuals can adapt; and stress that can be avoided. Humanitarian workers accept the stress created by the environment in which they choose to work. They can manage stress by altering their own behaviors through improved communication skills and the implementation of self-care plans. They can adapt, with the help of staff care plans such as counseling and peer support, to the stress created by their own histories of trauma or mental illness. The stress created by the workplace can be avoided. However, without a comprehensive support plan for mitigating psychological distress, both the individual humanitarian worker and the agency overall suffer. This article reviews current literature regarding the impact of avoidable stress and the impact of adaptation programs such as staff care and stress management plans on humanitarian work, and illustrates these impacts with a case example from the Danish Refugee Council, an international non-governmental organization with approximately 300 employees working in Greece.


Ager, A., Pasha, E., Gary, Y., Duke, G., Eriksson, C., & Cardozo, B. (2012). Stress, mental

health, and burnout in national humanitarian aid workers in Gulu, Northern Uganda. Journal of Traumatic Stress, 25, 713-720.

Bell, H., Kulkarni, S., & Dalton, L. (2003). Organizational prevention of vicarious trauma.

Families in Society, 84, 463-471.

Bennett, M., & Eberts, S. (2015). The experiences of short-term humanitarian aid workers in

Haiti. Mental Health, Religion & Culture, 18, 319-329.

Bilal, M., Rana, M., Rahim, S., & Ali, S. (2007). Psychological trauma in a relief worker: A case

report from earthquake-struck areas of Northern Pakistan. Prehospital and Disaster

Medicine, 22, 458-462.

Blanchet, C., & Michinov, E. (2014). Relationships between stress, social support and

transactive memory among humanitarian aid workers. International Journal of Emergency Management, 10, 259–275.

Brooks, S., Dunn, R., Sage, C., Amlot, R., Greenberg, N., & Rubin, G. (2015). Risk and

resilience factors affecting the psychological wellbeing of individuals deployed in humanitarian relief roles after a disaster. Journal of Mental Health, 24, 385-413.

Cardozo, B., Crawford, C., Eriksson, C., Zhu, J., Sabin, M., Ager, A., Foy, D., Snyder, L.,

Scholte, W., Kaiser, R., Olff, M., Rijnen, B., & Simon, W. (2012). Psychological distress, depression, anxiety, and burnout among international aid workers: A longitudinal study. PloS One, 7, e44948.

Cardozo, B., Holtz, T., Reinhard, K., Gotway, C., Ghitis, F., Toomey, E., & Salama, P. (2005).

The mental health of expatriate and Kosovar Albanian humanitarian aid workers. Disasters, 29, 152-170.

Cardozo, B., Silvilli, T., Crawford, C., Scholte, W., Petit, P., Ghitis, F., & Ager, A. (2013).

Factors affecting mental health of local staff working in the Vanni region, Sri Lanka. Psychological Trauma: Theory, Research, Practice and Policy, 5, 581-590.

Connorton, E., Perry, M., Hemenway, D., Miller, M. (2011) Humanitarian relief workers and

trauma-related mental illness. Epidemiologic Reviews, 34, 145-155.

Curling, P., & Simmons, K. (2010). Stress and staff support strategies for international aid work.

Intervention, 8, 93-105.

Dahlgren, A., DeRoo, L., Avril, J., Bise, G., & Loutan, L. (2009). Health risks and risk-taking

behaviors among International Committee of the Red Cross (ICRC) expatriates returning from humanitarian missions. Journal of Travel Medicine, 16, 382-390.

Ehrenreich, J., & Elliot, T. (2004). Managing stress in humanitarian workers: A survey of

humanitarian aid agencies’ psychosocial training and staff support. Peace and Conflict: Journal of Peace Psychology, 10, 53-66.

Eriksson, C., Bjork, J., Larson, L., Walling, S., Trice, G., Fawcett, J., Abernethy, A., & Foy, D.

(2009). Social support, organizational support and religious support in relation to burnout

in expatriate humanitarian aid workers. Mental Health, Religion & Culture, 12, 671-686.

Eriksson, C., Kemp, H. V., Gorsuch, R., Hoke, S., & Foy D. (2001). Trauma exposure and PTSD

symptoms in international relief and development personnel. Journal of Traumatic Stress, 14, 205-212.

Eriksson, C., Lopes Cardozo, B., Ghitis, F., Sabin, M., Gotway Crawford, C., Zhu, J., Rijnen, B.,

Kaiser, R. (2013). Factors associated with adverse mental health outcomes in locally recruited aid workers assisting refugees in Jordan. Journal of Aggression, Maltreatment & Trauma, 22, 660-680.

European Civil Protection and Humanitarian Aid Operations (July 27, 2017). Greece.

Retrieved from

Francis, F., Galappatti, A., & van der Veer, G. (2012). Developing a responsive model to staff

care beyond individual stress management: A case study. Intervention, 10, 74-78.

Goncalves, P. (2011). Balancing provision of relief and recovery with capacity building in

humanitarian operations. Operations Management Research, 4, 39-50.

Halbesleben, J., & Buckley, M. (2004). Burnout in organizational life. Journal of Management,

, 859-879.

Harr, C. (2013). Promoting workplace health by diminishing compassion fatigue and increasing

compassion satisfaction. Social Work and Christianity, 40, 71-88.

Jokovic, D., Krstic, D., Stoyanovas, Z., & Spiric, Z. (2016). Experience of the air medical

evacuation team of Serbian armed forces in the United Nations mission in the Democratic Republic of the Congo: Deployment stress and psychological adaptation. Vojnosanitetski Pregled, 73, 188-191.

Jones, B., Muller, J., & Maercker, A. (2006). Trauma and posttraumatic reactions in German

development aid workers: Prevalence and relationship to social acknowledgement. International Journal of Social Psychiatry, 52, 91-100.

Maslach, C., Schaufeli, W., & Leiter, M (2001). Job burnout. Annual Review of Psychology, 52,


Mayo Clinic (2016). Need stress relief? Try the 4 A’s. Retrieved from

McCormack, L., & Joseph, S. (2012). Psychological growth in humanitarian aid personnel:

Reintegrating with family and community following exposure to war and genocide. Community, Work, and Family, 16, 147-163.

Musa, S., & Hamid, A. (2008). Psychological problems among aid workers operating in Darfur.

Social Behavior and Personality, 36, 407-416.

Nilsson, S., Sjöberg, M., Kallenberg, K., & Larsson, G. (2011). Moral stress in international

humanitarian aid and rescue operations: A grounded theory study. Ethics & Behavior, 21, 49-68.

Pearlman, L.A., & Saakvitne, K. W. (1995). Treating therapists with vicarious traumatization

and secondary stress disorders. In C. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress in those who treat the traumatized (pp. 150-177). London, UK: Brunner-Routledge.

Pigni, A. (2014). Building resilience and preventing burnout among aid workers in Palestine: A

personal account of mindfulness based staff care. Intervention, 12, 231-239.

Porter, B., & Emmens, B. (2009). Approaches to staff care in international NGOs. Retrieved


Pross, C., & Schweitzer, S. (2010). The culture of organizations dealing with trauma: Sources of

work-related stress and trauma. Traumatology, 16, 97-108.

Putman, K., Lantz, J., Townsend, C.C., Gallegos, A., Potts, A., Roberts, R., Cree, E., Villagran,

M., Eriksson, C., & Foy, D. (2009). Exposure to violence, support needs, adjustment, and motivators among Guatemalan humanitarian aid workers. American Journal of Community Psychology, 44, 109-115.

Rahman, A., Riaz, N., Dawson, K. S., Usman Hamdani, S., Chiumento, A., Sijbrandij, M.,

Minhas, F., Bryant, R. A., Saeed, K., van Ommeren, M. and Farooq, S. (2016). Problem Management Plus (PM+): Pilot trial of a WHO transdiagnostic psychological intervention in conflict-affected Pakistan. World Psychiatry, 15, 182–183.

Robinson, L., Smith, M., & Segal, R. (2017). Stress management: Using self-help techniques for dealing with stress. Retrieved from

Salloum, A., Kondrat, D., Johnco, C., & Olson, K. (2015) The role of self-care on compassion satisfaction, burnout and secondary trauma among child welfare workers. Child and Youth Services Review, 49, 54-61

Slewa-Younan, S., Uribe Guajardo, M. G., Heriseanu, A., & Hasan, T. (2015). A systematic

review of post-traumatic stress disorder and depression amongst Iraqi refugees located in western countries. Journal of Immigrant and Minority Health, 17, 1231-1239.

Sommers-Flanagan, R. (2007). Ethical considerations in crisis and humanitarian interventions.

Ethics & Behavior, 17, 187-202.

Strohmeier, H., & Scholte, W. F. (2015). Trauma-related

mental health problems among national

humanitarian staff: A systematic review of the literature. European Journal of Psychotraumatology, 6, 28541.

United Nations High Commissioner for Refugees (2001). Managing the stress of humanitarian

emergencies. Retrieved from

United Nations High Commissioner for Refugees (Aug. 6, 2017a). Syrian regional refugee

response. Retrieved from

United Nations High Commissioner for Refugees (Aug 10, 2017b). Greece.

Retrieved from