The Social Psychology of Compassion

This article places social work clinicians’ compassion fatigue, burnout, and other negative consequences in a broader context of positive social work. We argue for a paradigm shift towards identifying the factors that lead clinical social workers toward human flourishing in their field. We introduce a model for creating “compassion satisfaction” or feelings of fulfillment with clients, rooted in positive psychology and expanded to incorporate the social work perspective. The model suggests that affect, work resources, and self-care influence clinicians’ positivity–negativity ratio, which in turn can result in compassion satisfaction. To maximize compassion satisfaction, research, education, and training should consider how classroom instruction and workplace policies can promote the most success among clinical social workers.     

Rethinking professional quality of life for social workers: Inclusion of ecological self-care barriers

ABSTRACT

This study conducted a survey among social workers in a mid-Atlantic state in the U.S. and examined the relationship between self-care behaviors, self-care barriers and compassion satisfaction, burnout, and secondary traumatic stress (STS) from an ecological perspective. The study found that social workers had a moderate level of compassion satisfaction, low risk of burnout, and low risk of STS. Bachelor-degree social workers had higher levels of burnout and lower levels of compassion satisfaction than others. Multiple regression results showed that self-care behaviors and self-care barriers did not predict compassion satisfaction. Self-care behaviors and self-care barriers were significantly associated with the level of burnout. Self-care barriers significantly contributed to STS, while self-care behaviors did not significantly decrease STS. This study implies that promoting self-care behaviors and decreasing self-care barriers can promote higher levels of professional quality of life. In addition to social workers’ individual-level self-care activities that are often stressed in prior research on STS and burnout, employers, supervisors, family members, and community members play a critical role in promoting a manageable work-life balance for social workers, thereby allowing them to use more self-care behaviors, while reducing barriers to self-care and ultimately reducing risk of burnout and STS.     

Associations Among Attachment Style,Burnout, and Compassion Fatigue in Health and Human Service Workers: A Systematic Review

Health and human service workers are at risk for developing burnout or compassion fatigue due to the demanding nature of their work. Attachment theory makes specific predictions that may help explain why some workers experience burnout or compassion fatigue and others do not. The purpose of this systematic review is to identify and attempt to explain patterns and inconsistencies in results across studies that have examined the association between adult attachment style and burnout or compassion fatigue. Ten studies representing a diverse range of disciplines within the health and human service sectors were included in the research synthesis. The findings demonstrated consistent results for secure and anxious attachment, suggesting that attachment security is associated with lower levels of burnout, whereas attachment anxiety is associated with higher levels of burnout. Some studies found an association between avoidant attachment and burnout, whereas others did not. The results are discussed in terms of their implications for the selection, training, and supervision of health and human service workers.     

Professional quality of life of adult protective service workers

Adult Protective Services (APS) workers are exposed to substantial occupational hazards and job stress, but these stressors are underdocumented. Therefore, we sought to describe APS workers’ work environments and responses to occupational hazards and stressors, including compassion fatigue, burnout, and secondary traumatic stress. Survey data were gathered with closed-ended questionnaires administered to APS workers in an urban setting. Virtually all workers (97%) reported exposure to one or more environmental hazards in their work, and 80% reported hazard exposure in the past month. Workers also reported mixed responses to their work environment and to experiences with supervision. A sizable minority (22.7%) was at high risk for burnout, 24.6% were at risk for secondary traumatic stress, and 19.9% reported low compassion satisfaction. The results document multiple stressors in APS work. The APS partner is committed to ongoing efforts to better support its staff, and these findings can inform future efforts to enhance supervisor support and worker self-care, to minimize burnout and secondary traumatic stress.     

Sociological conceptualizations of compassion fatigue: Expanding our understanding

Compassion fatigue has been primarily studied at the micro level and framed as a psychological “personal trouble” that results from one's personality traits, demographic characteristics, or life and work stressors. In addition, compassion fatigue is used to predict other psychological outcomes such as burnout, depersonalization, and stress. This literature on compassion fatigue has been reviewed, in order to illustrate areas where sociologists can contribute to a more nuanced understanding of the phenomenon. In this article we conceptualize compassion fatigue as a sociological concept and overview the potential ways that sociological approaches can enhance our understanding. We draw on the literatures of emotion work, social exchange theory, and macrolevel sociological theories to facilitate the use of compassion fatigue from a sociological perspective. For example, we use concepts such as social integration and anomie to stimulate thinking about rates of compassion fatigue.     

Effect of Seminar on Compassion on student self-compassion,mindfulness and well-being: A randomized controlled trial

ABSTRACT

Objective: Mindfulness-based interventions have been shown to have psychological benefits in college students. We explored the effects of an academic Seminar on Compassion on student psychological health. Participants: Forty-one participants (14 male, 27 female, mean age 19.8 ± 1.4 years) were assessed pre- and post- spring semesters 2013 and 2014. Methods: Students were randomized to the Seminar on Compassion or a wait-list control group. Participants completed self-report measures on anxiety, depression, perceived stress, self-compassion, compassion and mindfulness. Salivary alpha-amylase was also assessed. Results: At baseline, self-compassion and mindfulness were negatively correlated with depression, anxiety, and perceived stress. There were significant changes between the intervention and control group from Time 1 to Time 2 in mindfulness, self-compassion, compassion, and salivary alpha-amylase; however, there were no significant changes in depression, anxiety, and perceived stress. Conclusions: The course was effective in increasing mindfulness, self-compassion and compassion, and decreasing a salivary marker of stress.     

The role of self-care on compassion satisfaction,burnout and secondary trauma among child welfare workers

Child welfare workers are routinely exposed to multiple traumatic events when working with children and families, and are at an increased risk of experiencing burnout and secondary trauma. Self-care is often recommended as a restorative or protective activity against the negative effects of working with traumatized individuals, although few studies have examined the benefit of self-care empirically. Trauma-informed self-care (TISC) includes being aware of one's own emotional experience in response to exposure to traumatized clients and planning/engaging in positive coping strategies, such as seeking supervision, attending trainings on secondary trauma, working within a team, balancing caseloads, and work–life balance. Compared with generic personal care activities, TISC is likely to be especially relevant for child welfare workers. This study examined the role of TISC on compassion satisfaction, burnout and secondary trauma which was assessed by administering surveys to a sample of 104 child welfare case managers and supervisors. Almost one third of the sample reported high levels of burnout (29.8%) and secondary trauma (28.8%), and low levels of compassion satisfaction (31.7%). Results suggested that workers who engaged in higher levels of TISC experienced higher levels of compassion satisfaction and lower levels of burnout, although there was no relationship with secondary trauma. Findings provide preliminary evidence that TISC may be a beneficial practice to reduce risk of burnout and preserve workers' positive experience of their job, however workers experiencing secondary trauma are likely to need additional specialized intervention to assist them with their recovery.     

Health,wellness, and workplace experiences of lesbian,gay, and bisexual social workers

Abstract

Using data from an online survey of 6,112 licensed social workers in 13?U.S. states, rates of reported behavioral health problems and service utilization, physical health problems, adverse childhood experiences, workplace stress, and compassion satisfaction were compared between heterosexual male, heterosexual female, gay/bisexual male, and lesbian/bisexual female respondents. Sexual minority workers reported far higher rates of mental health problems and service utilization, higher rates of physical problems, more frequent reporting of adverse childhood experiences, with no differences found between groups regarding workplace stress and compassion satisfaction. Minority stress theory and historical trauma are used as frameworks to conceptualize the findings.     

Secondary traumatic stress and burnout in child welfare workers: a comparative analysis of occupational distress across professional groups

This study describes predictors of secondary traumatic stress and burnout in a national sample of helping professionals, with a specific focus on the unique responses of child welfare (CW) workers. Specific worker and exposure characteristics are examined as possible predictors of these forms of occupational distress in a sample of 669 professionals from across the country who responded to mailed (e-mail and post) invitations to participate in an online survey. E-mail and home mailing addresses were secured from licensure boards and professional membership organizations in six states from across the country that had high rates of child related deaths in 2009. Respondents completed the Professional Quality of Life IV (Stamm, 2005) to ascertain compassion fatigue (CF) and burnout symptoms. Being male, young, Hispanic, holding rural residence, and endorsing a lack of religious participation were significant predictors of secondary traumatic stress. Similarly, being male and young predicted high burnout rates, while actively participating in religious services predicted lower burnout. CW worker job status as a professional was significantly more likely to predict CF and burnout compared to all other types of behavioral healthcare professionals. Based on the findings from this study, this paper proposes strategies for enhancing self-care for CW workers, and describes the essential elements of a trauma-informed CW agency that addresses secondary traumatic stress and burnout.     

Teaching self-care: The utilization of self-care in social work practicum to prevent compassion fatigue,burnout, and vicarious trauma

ABSTRACT

Field practicum is paramount to social work pedagogy in the preparation of emerging direct practice professionals. Field students integrate foundational knowledge as they implement practice skills learned in the classroom during the social work practicum experience. Working with clients who are suffering is inevitable in direct social work practice and field practicum students can be exposed to a broad range of intense emotional experiences as they assist clients in need. Integrating self-care skills, techniques and strategies into daily social work practice becomes essential to prevent compassion fatigue, burnout, and vicarious trauma. Incorporating self-care skills into the field practicum enhances opportunities for transformative student learning and helps to strengthen professional socialization during this critical educational experience. This article highlights the implementation of professional self-care instruction, use of activities and written student critical reflection assignments designed to enhance the practice experience through incorporating self-care education and strategies among undergraduate students within the field practicum seminar.     

Workplace stress among psychiatric nurses. Prevalence,distribution, correlates, & predictors

Vicarious trauma and burnout are serious manifestations of workplace stress. Both can have substantial consequences for health care professionals, health services, and consumers. This article reports results of a study examining the prevalence, distribution, correlates, and predictors of vicarious trauma and burnout among registered psychiatric nurses (RPNs). A survey was distributed to all practicing RPNs in Manitoba, Canada (N = 1,015). The survey contained the Maslach Burnout Inventory, the Traumatic Stress Institute Belief Scale (i.e., a measure of vicarious trauma), and a section on symptoms of posttraumatic stress disorder (PTSD). The RPNs were found to be experiencing high levels of emotional exhaustion (i.e., high burnout) and even higher levels of personal accomplishment (i.e., low burnout). No significant differences were found between respondents' total scores on the Traumatic Stress Institute Belief Scale and instrument norms for mental health care professionals. Predictors of burnout and vicarious trauma also are presented in this article. Stress experienced by RPNs, as well as strengths on which to build, clearly are evident in the study results. Strategies for reduction in workplace stress may benefit psychiatric nurses, clients, and health services.     

Finding the sweet spot: Developing,implementing and evaluating a burn out and compassion fatigue intervention for third year medical trainees

Medical trainees are at high risk for developing burnout. Introducing trainees to the risks of burnout and supporting identification and proactive responses to their ‘warning’ signs of compassion fatigue (CF) is critical in building resiliency. The authors developed and evaluated a burnout and CF program for third year trainees at a Canadian Medical School. Of 165 medical trainees who participated in the burnout and CF program, 59 (36%) provided evaluation and feedback of the program and its impact throughout their year. Participation included self-utilization of a validated CF and burnout tool (ProQOL) across three time-points, workshop feedback, and focus group participation. Results highlighted the importance of 1) Recognizing Individual Signs & Symptoms of Stress, CF and Burnout; 2) Normalizing Stress, CF and Burnout for Students and Physicians; 3) Learning to Manage One’s Own Stress. A decrease in compassion satisfaction and increase in burnout between beginning and end of third year were found. Further outcomes highlighted the importance of learning, living and surviving CF and burnout in clerkship. Emergent theory reveals the important responsibility educators have to integrate CF and burnout programs into ‘the sweet spot’ that third year offers, as trainees shift from theoretical to experiential practice as future clinicians.     

Counselor happiness: Effects of therapy work with similar trauma

ABSTRACT

Many studies have researched burnout, compassion fatigue, secondary trauma, vicarious trauma, and shared trauma of practicing mental health professionals. Few have focused directly on the impact of personal trauma history on mental health professionals’ happiness. This exploratory study used an online survey to investigate the relationships among mental health professionals’ personal trauma history, happiness, and the effects of seeing clients with similar trauma. Personal trauma history was determined through a demographic survey and Posttraumatic Stress Disorder Checklist, and happiness was analyzed using the Oxford Happiness Questionnaire. The study examined several demographic variables to predict happiness. The study found that posttraumatic stress and number of client sessions were the most significant predictors of happiness.     

Compassion Fatigue in the Treatment of Combat-Related Trauma During Wartime

This article utilizes relevant data on the troops serving in Iraq and Afghanistan, and a composite case of a clinician working with combat survivors, in order to illustrate the potential for compassion fatigue in clinicians treating this cohort. Review of the literature on the effects of compassion fatigue related to combat trauma and the impact of collective shared trauma is presented. This is done in order to emphasize the complexity of the provision of war trauma treatment post 9/11 in the context of the ongoing wars. There is an urgent need for the mental health field to continue to develop interventions and educational programs that will help mitigate the deleterious effects of compassion fatigue in clinicians working with this population.     

Exhausted,Stressed, and Disengaged: Does Employment Create Burnout for Social Work Students?

Although burnout is a known risk for practitioners, some social work students may experience burnout in the classroom as a result of role conflict from balancing academics with employment. Higher rates of burnout occur in other disciplines in employed students, even higher than in professionals, because of the stress of shifting priorities between workplace and collegiate responsibilities. Employment can decrease collegiate engagement and academic competence and deter persistence to degree, all of which lead to the reduced competency associated with burnout. Additionally, physical and mental health factors are associated with role conflict, leading to a higher risk of burnout for employed students and resulting in burnout for social work students in the classroom even prior to becoming a practitioner.     

Predictors of Job Satisfaction and Burnout in Child Abuse Professionals: Coping,Cognition, and Victimization History

ABSTRACT

This study investigated coping style, work-related cognition, and victimization history as predictors of job satisfaction and burnout in child abuse professionals. Subjects were 215 participants in a conference on sexual abuse victim treatment. We developed a questionnaire assessing a variety of cognitions related to work with human services clients. One of the findings was that job satisfaction showed no relation to items portraying simple optimism or pessimism about helping clients, but satisfaction was related to a number of cognitions that combined realism and hope in a distinctive fashion. The coping strategies of Planful Problem Solving, Positive Reappraisal, and Seeking Social Support were associated with positive work experience, and the coping mechanisms of Confrontive Coping, Escape/Avoidance, and Accepting Responsibility were associated with negative work experience. Job satisfaction was higher in subjects reporting a childhood history of sexual abuse or neglect.     

Charting the attitudes of county child protection staff in a post-crisis environment

Three children died while in the Erie County Child Protective Services (CPS) system between 2012 and 2014. The purpose of this mixed-methods study is to understand the impact on CPS workers in the post-crisis environment. The results of the ProQOL Ver. 5.0 survey we administered to Erie County CPS workers revealed low levels of compassion satisfaction, but surprisingly low levels of burnout and compassion fatigue as well. The qualitative phase of this study, consisting of 10 focus groups, revealed dissatisfaction with continued high caseloads, bureaucratic and punitive agency practices, work-life imbalance, inconsistent and inadequate supervision, unsafe work environments, unappealing office conditions and lack of workplace amenities, weak organizational support, inconsistent procedures and policies, limited opportunities for peer support, and shuffling of work teams with little to no input from CPS workers. We conclude that Erie County's CPS Division adheres to an antiquated machine bureaucracy (top-down) organizational structure which is out of step with efficient and effective management of the contemporary workforce in a field where child abuse and maltreatment is a persistent if not growing problem.     

Building Resilience in Social Workers: An Exploratory Study on the Impacts of a Mindfulness-based Intervention

Burnout is a frequent and well-documented consequence of social work practice. The literature suggests that mindfulness-based interventions might help develop the mental states and emotional skills that are indicators of resilience. This mixed-methods, non-randomised controlled, exploratory study with 14 social workers in Canada investigated differences in social workers’ levels of stress, resilience, and burnout after a mindfulness-based intervention, compared to a waitlist group. The intervention group was also interviewed about changes in their relationships within the workplace, their perceived sense of mental health, and wellbeing. Results suggested that the mindfulness-based intervention significantly decreased the treatment group’s perceived stress compared to those on the waitlist and continued to decline for 26 weeks post-intervention. Intervention participants reported positive changes in attitudes, perspectives, behaviours, and energy in relation to their workplace relationships with peers and supervisors. Mindfulness-based interventions for reducing stress and building resilience to burnout in social workers and other helping professionals hold promise, and invite further research.     

Risk and protective factors for secondary traumatic stress and burnout among home visitors

ABSTRACT

The overarching goal of this study was to understand the context of home visitor secondary traumatic stress and burnout, and how this might affect intention to quit among home visitors, particularly focusing on potential risk factors and supportive strategies identified by the home visitors. All home visitors providing services in the state in which the research was conducted (N = 27) completed a structured interview and a quantitative survey at two time points, 6 months apart. Results indicated that more than two-thirds of the home visitors experienced either medium or high levels of secondary traumatic stress and burnout over the course of the study. Approximately one quarter of home visitors indicated thinking of leaving their present positio. Qualitative data indicated that risk factors associated with burnout included those related to both direct and non-direct services. Risk factors associated with secondary traumatic stress included traumatic stress of families, inability to recognize one’s own experiences of secondary traumatic stress, and unhealthy work culture. In terms of protective factors, home visitors strongly emphasized the importance of having a supportive supervisor who they could trust and communicate with openly.