The presented thesis includes a systematic literature review, an empirical research paper, and a critical appraisal providing a reflective overview of the research process.

In Chapter One, 21 studies exploring predictors of Secondary Traumatic Stress (STS) in mental health professionals are subject to narrative synthesis. Factors increasing risk of STS included personal trauma history, higher levels of empathy, larger caseloads, longer working hours and higher rates of exposure to traumatised clients. Factors reducing risk of STS included use of active coping strategies, frequent and effective supervision processes, perceived psychosocial support from colleagues and family/friends, and positive psychological affect. Findings are discussed in relation to the work-related stress literature, with clinical implications relevant for professionals and their employers provided.

Chapter Two details a study adopting a grounded theory methodology to explore the experiences of leaders across health, social care and education settings. Specifically, leaders are interviewed surrounding their experiences moving organisations towards trauma- informed culture change. The model constructed outlines three processes of leader-driven change, including “starting from within”, a process of leader self-exploration, “working with the threat response”, an approach to recognising and meeting the needs of stakeholders during change, and “rewriting historical cultural norms”, a commitment to dismantling hierarchical, power-led approaches used previously, in order to bring teams and services together towards shared goals. The model is discussed in relation to psychological theory before clinical implications and future research directions are considered.

Chapter Three provides a reflective overview of the research process as a whole, including the reasons for selecting this topic area, further consideration of epistemology and reflexivity, recognition of challenges and further detail surrounding key decisions made.