An estimated 100,000 people work today as commercial content moderators. These moderators are often exposed to disturbing content, which can lead to lasting psychological and emotional distress. This literature review investigates moderators’ psychological symptomatology, drawing on other occupations involving trauma exposure to further guide understanding of both symptoms and support mechanisms. We then introduce wellness interventions and review both programmatic and technological approaches to improving wellness. Additionally, we review methods for evaluating intervention efficacy. Finally, we recommend best practices and important directions for future research. Content Warning: we discuss the intense labor and psychological effects of CCM, including graphic descriptions of mental distress and illness.