Compassion Fatigue,Compassion Satisfaction,and Burnout

Summary

Over the past several decades the mental health field has become increasingly concerned about potential negative effects in professionals of providing crisis intervention and traumatic stress services to individuals and groups. The employee assistance (EA) field has not received adequate attention with regard to the study of these negative effects, such as compassion fatigue. This paper highlights results from a national research study of members of the Employee Assistance Professionals Association (EAPA) who were assessed for risk for compassion fatigue and burnout, as well as potential for compassion satisfaction. Additionally, coping methods for dealing with work-related stress resulting from the provision of workplace crisis intervention services were measured. Findings indicate that EA professionals who provide clinical services and/or crisis intervention services in the workplace are at low risk for burnout, moderate risk for compassion fatigue, and have high potential for compassion satisfaction. Implications for the EA field, in terms of training and practice, are discussed.     

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.     

Sifting Through Trauma: Compassion Fatigue and HIV/AIDS

This article explores the compassion fatigue of the author and the graduate students he supervised while conducting psychotherapy with persons living with HIV/AIDS at a counseling center in Atlanta, Georgia. The metaphor of a sifter is suggested to represent the self-care strategies that providers employ to avoid and manage compassion fatigue. Several vignettes are presented and discussed from the perspective of the provider. The vignettes facilitate an examination of the contribution of trauma experienced by persons living with HIV/AIDS to the compassion fatigue of social service providers. The author recommends a renewal of research in the area of compassion fatigue among social service providers working with these clients.     

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.     

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.     

Childhood abuse history,secondary traumatic stress,and child welfare workers

Social workers are exposed to trauma vicariously through the trauma of their clients. This phenomenon, called secondary traumatic stress, vicarious traumatization, or compassion fatigue, presents a risk of negative personal psychological consequences. Based on a sample of 166 child welfare workers and using standardized measures, the study findings document the link between a personal history of primary trauma, childhood abuse or neglect, and the heightened risk for secondary traumatic stress in child welfare workers.     

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.     

Compassion fatigue in marriage and family therapy: implications for therapists and clients

Given that marriage and family therapists are exposed to a wide range of circumstances that leave them uniquely vulnerable to experiencing compassion fatigue, it is important to examine the stresses and hazards they face and what those consequences mean for both themselves and clients. It is essential that they identify how compassion fatigue negatively affects the therapeutic relationship and overall treatment outcome as well as that of the personal life of the family therapist. The marriage and family therapist is responsible and ethically obligated to identify and implement ways in which he or she can prevent and remedy compassion fatigue.     

Construction of a survey to assess workload and fatigue among AMT operators in Mexico

Operators of machinery classified as Advanced Manufacturing Technology (AMT) are exposed to high levels of workload and fatigue. However, only few studies have been conducted on this topic in Hispanic-American countries workers. Several instruments be used to assess workload and fatigue; however, only few of them have been adapted to Spanish language. This paper reports on the development and validity testing of a survey instrument in Spanish, aiming to subjectively assess workload and fatigue among AMT operators in Mexico. Method: After an exhaustive literature review in search of already available measurement instruments, they were adapted for content and later translated into Spanish; a pilot test was conducted to evaluate validity and reliability; afterwards appropriate modifications were made to the testing instruments. Final version of the instrument was applied to a group of 121 operators of CNC lathes. Reliability was analyzed using KMO and Cronbach alpha indices. Results: For the assessment of workload, both NASA-TLX and ISTAS 21 methods were incorporated to the survey instrument. As for fatigue assessment tools, these were SOFI-S, FAS and OFER questionnaires. Results show KMO value and Cronbach alpha above 0.6.Conclusions. The survey instrument as designed, allows the collection of reliable and valid data regarding workload and fatigue among AMT operators in Mexico.     

Trap of Conflicting Needs: Helping Professionals in the Wake of a Shared Traumatic Reality

Many professionals working in the wake of communal disasters are doubly exposed to the disaster, both as professionals and as members of the stricken community. Yet most studies of widely reported distress of these professionals examine manifestations like compassion fatigue, secondary traumatization, and vicarious traumatization, which do not take this double exposure into account. Moreover, these measures reflect the assumption that their distress is rooted in empathy with their clients or helpees. This paper argues that at least some of their distress derives from a self-perceived lapse of empathy. It contends that professionals living and working in a disaster stricken community are caught in a trap of conflicting inner needs stemming from the defenses they mobilize to cope with the heightened mortality salience aroused by communal disasters. Furthermore, it proposes an etiology of their distress.     

Compassion Fatigue and Countertransference: Two Different Concepts

There has been considerable conceptual confusion about the differences between compassion fatigue and countertransference. This often results in them being treated as the same phenomena, both in the literature and clinically. This paper maintains that these are, in fact, two different concepts that derive from different sources and serve different functions. Each of these two concepts requires different kinds of interventions as well.     

Therapists' Collusion with the Resistance of Rape Survivors

Based mostly upon a qualitative study of nine rape survivors, but also upon intensive review of the literature devoted to countertransference, vicarious traumatization, compassion fatigue, and burnout, this article examines collusive resistance, a process whereby therapists join clients to avoid confronting painful issues. It offers guidelines for the therapist to follow in the therapeutic dance to avert such collusion, and thereby to intervene more effectively especially with traumatized clients to facilitate their recovery actively, and, ultimately, to contribute to their true survivorship.     

The Use of Common Humanity Scenarios to Promote Compassion in Healthcare Workers

ABSTRACT

The importance of compassion in healthcare is universally acknowledged. However, the factors that enhance compassion are not well understood. The perception of common humanity has been proposed as a prosocial perspective that leads to unbiased universal compassion. There has been a lack of research into the relationship between common humanity and compassion. This study examined the use of common humanity scenarios to promote compassion in healthcare workers. Seventy-five healthcare workers were randomly assigned to two groups and shown a different common humanity scenario. The healthcare workers were asked what effect viewing the videos had on their perception of common humanity and compassion. Thematic analysis was used to identify themes. Four main themes emerged: (a) common bonds; (b) people have the same needs; (c) no one wants to suffer; (d) seeing strangers helping others is motivating. Healthcare workers reported feelings of care, concern, and compassion after viewing common humanity scenarios.

IMPLICATIONS

• Viewing common humanity scenarios appears to lead to enhanced feelings of connection to others and compassion in healthcare workers.

• Using common humanity scenarios may be a useful compassion training strategy in healthcare.

• Further research is necessary to gain a better understanding of how viewing common humanity material influences compassion.

     

Work-related factors associated with psychological distress among social workers

The current study assesses the association between several work-related factors and psychological distress among social workers (SWs) in Israel. The data were collected through structured questionnaires, administered to a sample of 494 SWs. The findings suggest that most of the examined work-related factors (namely, years of professional experience, personal work-related subjection to violence, burnout, compassion fatigue, and sense of coherence), with the exception of compassion satisfaction, significantly predicted psychological distress among SWs. The conclusion is that it is important to embed within the social work practice strategies for reducing sources of psychological distress (job demands) and increasing material, professional, and personal resources. Reducing the levels of psychological distress experienced by SWs will benefit not only themselves, but also their families and colleagues, as well as their clients. Moreover, this has potential benefits for the social work profession and for the general community.     

Predictors of Fatigue among Patients with Chronic Fatigue Syndrome

Activity logs involve patients writing down their activities over 1 or more days. Several studies have found these data collection instruments to accurately describe activities of patients with chronic fatigue syndrome (CFS). The purpose of this study was to utilize the repeated measures available on the National Institutes of Health Activity Record to evaluate predictors of fatigue at a given time point. A random intercept model was tested with the following variables predicting current fatigue: past fatigue (30 mins. prior), current category of activity (e.g., resting, work, recreation), past category of activity (30 mins. prior), the interaction of past fatigue and past activity, and TH2/TH1 immune shift. These findings and others suggest that activity logs can provide investigators and clinicians with valuable sources of data for understanding patterns of behavior and activity among patients with CFS.     

Secondary traumatic stress and self-care inextricably linked

ABSTRACT

Increasingly trauma scholars are exploring the susceptibility of mental health providers to secondary trauma reactions. The current study explores the relationship between clinical social work practice with trauma-exposed clients and secondary traumatic stress among social workers. The intent of this study is to identify the role various factors play in the development of secondary trauma (also known as compassion fatigue). A simple random sample of National Association of Social Workers members were asked to participate. Participants completed an online survey that explored their exposure and responses to secondary traumatic stress. The online survey consisted of standardized measures including the Secondary Traumatic Stress Scale and The Coping Strategies Inventory which assesses secondary trauma and self-care strategies, respectively (Bober, Regehr, & Zhou, 2006; Bride, Robinson, Yegidis, & Figley, 2003). The magnitude of work (the extent and intensity of time working with trauma-exposed clients) is assessed by a non-standardized measure which consists of clinical caseloads composition questions. Job satisfaction is measured by items taken from the National Association of Social Workers’ workplace questionnaire (Whitaker & Arrington, 2008). 161 social workers completed the online survey. It required approximately 35 minutes to complete. This project empirically demonstrated that high-magnitude social work practice (providing therapeutic intervention to trauma survivors, i.e. military service members and veterans) is associated with higher levels of secondary trauma. There is also empirical evidence that self-care strategies can mitigate the impact of the secondary trauma. Educational and workforce implications for study findings are discussed.     

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.     

Use of standardized assessment instruments in couple therapy: the role of attitudes and professional factors

The study examined therapeutic approach, professional affiliation, training, seniority, and work setting as predictors of attitudes toward standardized instruments and their use in couple therapy. Data were gathered from 163 certified marriage and family therapists in Israel. Results showed that 27.6% of marital therapists used standardized instruments for assessment. More positive attitudes toward standardized instruments were associated with the extent of training in their use and with a structural-strategic approach. Logistic regression analysis indicated that positive attitudes, training, and work setting best predict the application of standardized assessment instruments. Reasons for the relative lack of use of standardized assessment instruments are discussed. It is recommended that more training in assessment instruments be included in marriage and family therapy training.     

Only 37% of police officers give naloxone to OD victims

According to a recent study, among police officers who responded to overdose calls in the last six months, only 37% administered naloxone on the scene, and 36% made an arrest, despite the fact that some of the states had a Good Samaritan Law — which protects people who make calls to police for overdoses — in effect. The study, “Knowledge, preparedness, and compassion fatigue among law enforcement officers who respond to opioid overdose,” is in the current issue of Drug and Alcohol Dependence. Most of the officers knew whether or not their state had a Good Samaritan Law, but only 26% knew that the law protects people on the scene from arrest.     

Self-Care Practices and the Professional Self

ABSTRACT

Consistently and actively engaging in self-care has been shown to improve the performance of mental health practitioners by reducing burnout, vicarious trauma, compassion fatigue, and other stress-related psychological problems. Not only is this important to the individual practitioner’s well-being, but ethical standards also mandate the recognition and remediation of any physical, mental, or emotional self-impairment to maintain high standards of care for clients. Professionals in small communities, like the Deaf community, however, confront unique challenges in attending to their self-care. This article investigates these challenges—as well as the rewards—experienced by Deaf and hearing counselors working in mental health care with deaf clients.