Compassion Fatigue

Dara Bergel Bourassa, PhD, LSWPA Behavioral Health and Aging CoalitionMay 21, 2013

Is this Compassion Fatigue?

http://muttscomics.com/art/dailyarchive.aspJune 4, 2007 The Patriot-News

What is Compassion Fatigue?

Relatively new concept Also known as Secondary Traumatic Stress Disorder

Many professions susceptible Natural behaviors and emotions resulting from

learning about a client’s traumatizing event (Figley, 1995)

The resulting stress from helping a traumatized person Traumatizing Events: Rape, neglect, abuse,

domestic violence, sexual, verbal, financial abuse, natural or man-made disasters

Compassion Satisfaction

Risk Factors for Compassion Fatigue

Symptoms and Effects of Compassion Fatigue

27% of professionals who work with traumatized victims experience extreme distress (Meldrum, King, & Spooner,

2002) Symptoms

http://www.giftfromwithin.org/html/CFChart.htm Ethical issues

May encounter disturbances in degree of empathy

Ultimately jeopardizing clients Other ethical issues

Effects of Compassion Fatigue cont.

Problems with coping skills More likely to engage in avoidance of client and

self Decrease in sense of accomplishment

Loss of confidence when working with clientele Damaged spirituality

May weaken and destroy one’s faith Personal problems

Within personal and professional life Emotionally withdrawn from friends, family,

colleagues, & clients

Vicarious Traumatization vs. Compassion Fatigue

Vicarious traumatization (McCann & Pearlman, 1999; Jenkins & Baird, 2002)

Psychotherapy with sexual assault victims

Accumulation over long periods of time and across many clients

Involves permanent changes in the cognitive processing of the therapist

Based in Constructivist Self-Development Theory

Compassion Fatigue (Figley, 1995; Bell, 2003)

All professions are susceptible

One acute exposure to traumatic material

Can be treated if caught early

Focuses on PTSD symptomatology

Burnout vs. Compassion Fatigue Burnout (Maslach, 1982)

Linked to stressors in the occupational environment

Emerges gradually over time

Easily identified Can affect any

profession regardless of client group

Is about being “worn out” (Stamm, 2009-2012)

Compassion Fatigue (Figley, 1995)

Results from listening to clients’ traumatic stories

Can emerge suddenly and without warning

May not be easily identified

Only affects those who work with traumatized victims

Is about being “afraid” (Stamm, 2009-2012)

Ways to Protect Against CF… General Self-Care

Develop a “buddy system” among group members to provide constant support (Myers & Wee, 2002)

Increasing exercise/activity levels and taking time for yourself (Dutton & Rubenstein, 1995; Myers, 1994)

Meditation/yoga (Politsky, 2007) Importance of positive self-talk and self-

encouragement (Myers, 1994) Appropriate use of humor (Moran, 2002) Refer to individual counseling if more services

are needed

Self-assessment tool for Compassion Fatigue Professional Quality of Life Scale (PROQOL),

Version 5 http://www.proqol.org/uploads/

ProQOL_5_English_Self-Score_3-2012.pdf Created by B. Hudnall Stamm. Version 5 is

copyrighted from 2009-2012. The ProQOL is free to use! A 30 item self report measure of the positive and

negative aspects of caring (CF and compassion satisfaction)

It is also published in many other languages Check out this web page

http://www.proqol.org/ProQol_Test.html for additional languages

Any Questions???Contact Information:Dara Bergel Bourassa, PhD, LSW

dpbourassa@ship.edu717-477-1969

References

Bell, H., Kulkarni, S., & Dalton, L. (2003). Organizational prevention of vicarious trauma. Families in Society, 84(4), 463-470.

Cunningham, M. (1999). The impact of sexual abuse treatment on the social work clinician. Child and Adolescent Social Work Journal, 16(4), 277-290.

Cunningham, M. (2003). Impact of trauma work on social work clinicians: Empirical findings. Social Work, 48(4), 451-459.

Dane, B. & Chachkes, E. (2001). The cost of caring for patients with an illness: Contagion to the social worker. Social Work in Health Care, 33(2), 31-51.

Figley, C.R. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In C.R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 1-20). New York: Brunner/Mazel.

Figley, C.R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self care. Journal of Clinical Psychology, 58(11), 1433-1441.

Iliffe, G. & Steed, L.G. (2000). Exploring the counselor’s experience of working with perpetrators and survivors of domestic violence. Journal of Interpersonal Violence, 15(4), 393-412.

References cont. Jenkins, S.R. & Baird, S. (2002). Secondary traumatic stress and

vicarious trauma: A validational study. Journal of Traumatic Stress, 15(5), 423-432.

Jacobson, J. M. (2004). Compassion fatigue among employee assistance program counselors. Unpublished doctoral dissertation, University of Maryland at Baltimore, Baltimore, MD.

Leon, A.M., Altholz, J.A.S., & Dziegielewski, S.F. (1999). Compassion fatigue: Considerations for working with the elderly. Journal of Gerontological Social Work, 32(1), 43-62.

Maslach, C. (1982). Burnout: The cost of caring. Englewood Cliffs, NJ: Prentice-Hall.

McCann, L.I. & Pearlman, L.A. (1999). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. In M.J. Horowitz (Ed.), Essential papers on posttraumatic stress disorder (pp. 498-517). New York: New York University Press.

Meldrum, L., King, R., & Spooner, D. (2002). Secondary traumatic stress in case managers working in community mental health services. In C.R. Figley (Ed.), Treating compassion fatigue (pp. 85-106). New York: Brunner-Routledge.

References cont. Mitchell, J. T., & Everly, G. S. (1995). Critical incident stress debriefing:

An operations manual for the prevention of trauma among emergency service and disaster workers (2nd ed.). Baltimore, MD: Chevron.

Moran, C.C. (2002). Humor as a moderator of compassion fatigue. In C.R. Figley (Ed.), Treating compassion fatigue (pp. 139-154). New York: Brunner-Routledge.

Myers, D. (1994). Disaster response and recovery: A handbook for mental health professionals. Rockville, MD: Center for Mental Health Services. Retrieved May 25, 2010 from http://www.empowermentzone.com/disaster.txt

Politsky, S. (2007). Revitalizing yourself: Making time 4u. Oncology Nursing Forum, 34(2), 494.

References cont.

Nelson-Gardell, D. & Harris, D. (2003). Childhood abuse history, secondary traumatic stress, and child welfare workers. Child Welfare, 82(1), 5-26.

Salston, M. & Figley, C.R. (2003). Secondary traumatic stress effects of working with survivors of criminal victimization. Journal of Traumatic Stress, 16(2), 167-174.

Stamm, B.H. (2009-2012). The PROQOL: Professional quality of life scale: Compassion satisfaction burnout and fatigue scale-Version V. Retrieved May 13, 2013, from http://www.proqol.org/uploads/ProQOL_5_English_Self-Score_3-2012.pdf

Trippany, R.L., Kress, V.E.W., & Wilcoxon, S.A. (2004). Preventing vicarious trauma: What counselors should know when working with trauma survivors. Journal of Counseling and Development, 82, 31-37.

Wee, D. & Myers, D. (2003). Compassion satisfaction, compassion fatigue, and critical incident stress management. International Journal of Emergency Mental Health, 5(1), 33-37.