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.     

Home Visitor Relationship Security: Association With Perceptions of Work,Satisfaction, and Turnover

Home visiting is widely used to improve outcomes in families at risk for poor parenting. Impact is modest and variable, owing in part to poor fidelity. Attachment theory suggests that home visitors' relationship security influences fidelity because establishing a trusting relationship with parents is central to service delivery. This study describes paraprofessional home visitors' relationship security and relates it to demographics, psychological attributes, and work perceptions and intentions. Home visitors (n = 62) varied widely on the two major domains of relationship security: anxiety and avoidance. Relationship security was stable over time. Relationship anxiety and avoidance were associated with psychological and work constructs in theoretically predicted ways. Relationship anxiety was negatively associated with self-efficacy and positively associated with negative affect and indicators of burnout. Relationship avoidance was negatively associated with self-efficacy, job satisfaction, and tenure as a home visitor. Implications for research and practice are discussed.     

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.     

The Fatigue of Compassionate Social Workers: An Introduction to the Special Issue on Compassion Fatigue

The paper introduces the special issue by first discussing its purpose for the reader and the field of social work. Each article, in the order it appears, is discussed in terms of its contribution to the special issue and the field and linking conceptually each with others in the collection. These articles discuss the special challenges of social workers working with clients who live with the traumatic effects of disasters—both natural and human-caused or human-contributed, war combat, HIV/AIDS, and substance abuse. It is noted that far more research, education, and practice innovation should be devoted to compassion fatigue. The article ends with a final plea not only for such attention but also standards of self-care in addition to standards of professional practice.     

Utilizing Compassion Fatigue Education in Hurricanes Ivan and Katrina

Compassion Fatigue is a state that includes the symptoms of Post-Traumatic Stress Disorder. This text reviews events following the Hurricane Ivan and Katrina disasters and how Compassion Fatigue education helped to identify and ameliorate symptoms of the problem. I worked in a community center in the Pensacola area for one week following Ivan and in a shelter in my residential area of Houma, Louisiana for two months following Katrina. Examples of traumatic stories and coping with my own secondary stress are given. Implications include education regarding CF for all mental health professionals, especially during and following work in disasters or with populations of the traumatized.     

Using Critical Incident Stress Debriefing to Mediate Organizational Crisis,Change and Loss

This article provides an overview of the development of critical incident stress debriefing and suggests its utility for both traditional and nontraditional purposes, by employee assistance practitioners. Both crises and traumas are defined and a brief history of the development of CISD is offered. The critical incident stress debriefing process is explicated and examples of how CISD's has been used by EAPs is shared. Case studies are then offered of both traditional and nontraditional situations where a CISD process was used by an internal EM, including a homicide, an operating room fire, an organizational change and multiple losses of employees by a work unit.     

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.     

Long-Term Prediction of Relationship Satisfaction and Stability by Stress,Coping, Communication,and Well-Being

In this 10-year longitudinal study, long-term relationship satisfaction and stability were predicted from communication behavior, stress level, physical and psychological well-being, and individual and dyadic coping skills. The predictors were assessed at the beginning of the study. Significant predictors of relationship satisfaction (n = 103 couples) for both men and women were relationship satisfaction in the beginning, and for men additionally their dyadic coping competencies. Significant predictors of relationship stability (N = 162 couples) were relationship length, relationship satisfaction of both men and women, as well as women’s positive communication. The percentage of correct classifications (stable or unstable relationship) over a period of 10 years was 80.3%. Implications for research and prevention as well as the importance of coping skills for relationship outcome are discussed.     

Impact of client suicide on social workers and counselors

Recent studies on the impact of client suicide on mental health professionals focus on psychiatrists and psychologists, while,in the current mental health system in our country, most clients receive services from other clinicians. This research focuses on the impact of client suicide on social workers and counselors as well as organizational responses to client suicide/attempt. Data were collected via interviews and survey of 121 clinicians. Client suicide impacts clinicians adversely in many ways. Many participants felt their agency/practice could have done more to support them during post-suicide management. Data presented in this report have the potential to aid in the creation of needed workforce development initiatives.     

Dyadic Cross-Sectional Associations Between Depressive Mood,Relationship Satisfaction,and Common Dyadic Coping

The aim of this cross-sectional study was to investigate the mediational role of common dyadic coping in the links between depressive mood and relationship satisfaction. We estimated two competing Actor–Partner Mediator Models, in which the dyad is the highest unit of analysis. The first model specified dyadic coping as a mediator in the association between relationship satisfaction and depression, whereas the second model specified dyadic coping as a mediator between depression and relationship satisfaction. Analyzing data from 198 couples, our findings provided a plausible approximation of the second model, representing the interactional model of depression. They showed that common dyadic coping mediates the link between depression and relationship satisfaction for men only.     

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.     

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.     

Alcohol and Drug Use,and Sources of Stress

ABSTRACT

The purposes of this survey were to assess the prevalence of self-reported chemical use, concerns regarding coworker and family members' chemical use, and issues relating to life stress. A total of 2,567 faculty, staff, and administrators from a medium-sized, eastern, land-grant institution responded to a 20 item survey. Results indicated that tobacco was the most frequendy used chemical followed by alcohol. Participants were most concerned both about coworkers drinking and family member's drinking. Respondents also reported significant concerns regarding coworker's drug use. Applications for prevention, intervention and programming are discussed. Suggestions for future research are also provided.     

Sexual Satisfaction and Relationship Satisfaction in Dating Couples

Abstract

This study assessed the merits of an amended Interpersonal Exchange Model of Sexual Satisfaction (IEMSS; Lawrance & Byers, 1992, 1995) that includes a measure of relationship communality, a construct not adequately captured by existing exchange models of sexual/relationship satisfaction. A total of 189 undergraduates (102 female) in sexually active dating relationships completed measures of sexual satisfaction, relationship satisfaction, favorability of sexual exchanges, and the extent to which their romantic relationships were characterized by mutually communal behaviors (i.e., relationship communality). Analyses revealed that relationship communality made a small but unique contribution to sexual satisfaction and a large contribution to relationship satisfaction, even after controlling for sexual satisfaction and favorability of sexual exchanges. Implications for understanding the dynamics of sexually active dating relationships are discussed.     

Research on the Nature and Determinants of Marital Satisfaction: A Decade in Review

Scientific study of marital satisfaction attracted widespread attention in the 1990s from scholars representing diverse orientations and goals. This article highlights key conceptual and empirical advances that have emerged in the past decade, with particular emphasis on (a) interpersonal processes that operate within marriage, including cognition, affect, physiology, behavioral patterning, social support, and violence; (b) the milieus within which marriages operate, including microcontexts (e.g., the presence of children, life stressors and transitions) and macrocontexts (e.g., economic factors, perceived mate availability); and (c) the conceptualization and measurement of marital satisfaction, including 2‐dimensional, trajectory‐based, and social‐cognitive approaches. Notwithstanding the continued need for theoretical progress in understanding the nature and determinants of marital satisfaction, we conclude by calling for more large‐scale longitudinal research that links marital processes with sociocultural contexts, for more disconfirmatory than confirmatory research, and for research that directly guides preventive, clinical, and policy‐level interventions.     

Onward and Upward

No abstract available for this article.     

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.     

The Current State of Evaluation Practices in Employee Assistance Programs,San Francisco

This study assessed the current state of evaluation practices within Employee Assistance Programs (EAPs). Because of structural variation and previous design problems, an examination of EAPs was needed. The sample consisted of 34 EAPs, primarily drawn from the San Francisco ALMACA chapter. A Program Survey was sent to each EAP, which included a demographics and an evaluation section. This study found that 59% of the sample reported conducting program evaluation and another 20% planned future evaluations. The findings of this study suggest a trend toward an increasing awareness of the value of EAP evaluation; however, important issues still need to be addressed.     

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.