The terms secondary traumatic stress (STS), vicarious traumatization (VT), and compassion fatigue (CF) have all been used, sometimes interchangeably, to refer to the observation that those who provide clinical services to trauma survivors may themselves experience considerable emotional disruption, becoming indirect victims of the trauma. Consequently, such reactions are becoming viewed as an occupational hazard of providing clinical services to traumatized populations. The purpose of this paper is to provide an overview of the conceptual and empirical literature on secondary traumatic stress, as well as recommendations for its prevention. It is hoped that this article will serve to increase the awareness of this potential occupational hazard of counseling traumatized substance abusers among substance abuse treatment counselors, administrators, and educators. (Contains 1 figure.)