1. Compassion Fatigue Dara Bergel Bourassa, PhD, LSW
PA Behavioral Health and Aging Coalition
May 21, 2013

2. Is this Compassion Fatigue?
June 4, 2007 The Patriot-News

3. 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

4. Risk Factors for Compassion Fatigue

5. Symptoms and Effects of Compassion Fatigue
27% of professionals who work with traumatized victims experience extreme distress (Meldrum, King, & Spooner, 2002)
Symptoms
Ethical issues
May encounter disturbances in degree of empathy
Ultimately jeopardizing clients
Other ethical issues

6. 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Emotionally withdrawn from friends, family, colleagues, & clients

7. 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

8. 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, )
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, )

9. 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

10. Self-assessment tool for Compassion Fatigue
Professional Quality of Life Scale (PROQOL), Version 5
Score_ pdf
Created by B. Hudnall Stamm. Version 5 is copyrighted from
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 for additional languages

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

12. References
Bell, H., Kulkarni, S., & Dalton, L. (2003). Organizational prevention of vicarious trauma. Families in Society, 84(4),
Cunningham, M. (1999). The impact of sexual abuse treatment on the social work clinician. Child and Adolescent Social Work Journal, 16(4),
Cunningham, M. (2003). Impact of trauma work on social work clinicians: Empirical findings. Social Work, 48(4),
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),
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),
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),

13. References cont.
Jenkins, S.R. & Baird, S. (2002). Secondary traumatic stress and vicarious trauma: A validational study. Journal of Traumatic Stress, 15(5),
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),
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 ). 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 ). New York: Brunner-Routledge.

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

15. 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),
Stamm, B.H. ( ). The PROQOL: Professional quality of life scale: Compassion satisfaction burnout and fatigue scale-Version V. Retrieved May 13, 2013, from Score_ 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,
Wee, D. & Myers, D. (2003). Compassion satisfaction, compassion fatigue, and critical incident stress management. International Journal of Emergency Mental Health, 5(1),