Vicarious trauma has been a focus of scholars for many years and demonstrates that vicarious trauma effects professional behaviorally, personally, and physiologically. This quantitative cross-sectional study explored the relationship between vicarious trauma and occupational exposure (caseload size) disrupting the cognitive structures of empathy, control, and esteem. The theoretical framework for this study was the constructivist self-development theory, which described how helping professionals develop vicarious trauma after exposure to traumatic stories. The social cognitive theory was also used for this study, explaining how elementary school counselors can increase their capacity for empathizing through modeling and experiencing empathy from others. The study explored predictive relationships through a regression analysis to determine if vicarious trauma and occupational exposure disrupted the three cognitive structures of empathy, control, and esteem. The study comprised 79 participants, females aged 35 to 44. Only 44 participants completed the entire survey, which can be attributed to survey fatigue. Thus, the study was forced to be run under power. The results indicated that none of the participants experienced a disruption in the cognitive structures of empathy, control, or esteem due to experiencing vicarious trauma and occupational exposure (caseload size). It is recommended that future researchers examine this phenomenon and population in the form of qualitative interviews, focus groups, or case studies to further explore vicarious trauma development within the field of elementary school counselors. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]