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Compassion Fatigue: Psychotherapists' Chronic Lack of Self Care



Psychotherapists who work with the chronic illness tend to disregard their own self-care needs when focusing on the needs of clients. The article discusses the concept of compassion fatigue, a form of caregiver burnout among psychotherapists and contrasts it with simple burnout and countertransference. It includes a multi-factor model of compassion fatigue that emphasizes the costs of caring, empathy, and emotional investment in helping the suffering. The model suggests that psychotherapists that limiting compassion stress, dealing with traumatic memories, and more effectively managing case loads are effective ways of avoiding compassion fatigue. The model also suggests that, to limit compassion stress, psychotherapists with chronic illness need to development methods for both enhancing satisfaction and learning to separate from the work emotionally and physically in order to feel renewed. A case study illustrates how to help someone with compassion fatigue.
Compassion Fatigue: Psychotherapists’ Chronic
Lack of Self Care
Charles R. Figley
School of Social Work, Traumatology Institute
Florida State University, Tallahassee
Psychotherapists who work with the chronic illness tend to disregard their
own self-care needs when focusing on the needs of clients. The article
discusses the concept of compassion fatigue, a form of caregiver burnout
among psychotherapists and contrasts it with simple burnout and coun-
tertransference. It includes a multi-factor model of compassion fatigue
that emphasizes the costs of caring, empathy, and emotional investment
in helping the suffering. The model suggests that psychotherapists that
limiting compassion stress, dealing with traumatic memories, and more
effectively managing case loads are effective ways of avoiding compas-
sion fatigue. The model also suggests that, to limit compassion stress,
psychotherapists with chronic illness need to development methods for
both enhancing satisfaction and learning to separate from the work emo-
tionally and physically in order to feel renewed. A case study illustrates
how to help someone with compassion fatigue. © 2002 Wiley Periodi-
cals, Inc. J Clin Psychol/ In Session 58: 1433–1441, 2002.
Keywords: compassion fatigue; burnout; self-care for psychotherapists;
Compassion Fatigue: Psychotherapists’ Chronic Lack of Self Care
There is a cost to caring for those with chronic illness just as there is a realization that
these clients will never fully recover. As psychotherapists, we learn to be on the one hand
objective and analytical in our professional role as helper. We must put our personal
feelings aside and objectively evaluate our clients and administer the best treatments
Correspondence concerning this article should be addressed to: Charles R. Figley, Ph.D., Professor, School of
Social Work and Director of the Traumatology Institute at Florida State University, 1303 Broome St., Tallahas-
see, FL 32301; telephone: (850) 656–7158; e-mail:
1This essay is dedicated to all those psychotherapists who have worked with clients over many sessions who
were diagnosed with some kind of chronic problem and it left a lasting impression on the psychologist. Also,
this is dedicated to those psychotherapists who either have a chronic illness or live with or love someone with
JCLP/In Session: Psychotherapy in Practice, Vol. 58(11), 1433–1441 (2002) © 2002 Wiley Periodicals, Inc.
Published online in Wiley InterScience ( DOI: 10.1002/jclp.10090
according to best practice guidelines. But on the other hand we cannot avoid our com-
passion and empathy. They provide the tools required in the art of human service. To see
the world as our clients see it enable us to calibrate our services to fit them and to adjust
our services to fit how they are responding.
Case Illustration
“My professors think I need therapy . . . maybe they are right.” This statement greeted me
as I checked my voice mail Monday morning in April. It turned out to be a counseling
psychology Ph.D. student from a smaller university in the region. According to two of her
clinical supervisors she was not responding well to an assigned client. Although Jane (not
her real name) had five years of experience as a licensed mental health counselor, she was
missing important aspects of the client’s story. When Jane finally faced the fact that she
was failing in a profession she loved, she began to recognize that her clinical errors were
associated more with how the client’s story was upsetting her than her abilities as a
Jane’s client was a young, female college student who was away from home for the
first time and sought Jane’s help with adjusting to the changes. Only after more than a
half dozen sessions did Jane’s supervisors notice and mention to her that her client felt
guilty about leaving her mother; that the client had been over-functioning while the mother
had developed a considerable dependency that needed addressing. Jane most often shifted
the focus of therapy to other issues. Jane wanted to talk about and face these clinical
errors, her resentment toward the faculty members who challenge her, and, reluctantly,
her mother’s chronic illness. We quickly moved to Jane’s feelings of guilt about her own
mother’s condition and her inability to or ambivalence toward addressing her dysfunc-
tional relationship with her mother.
We will return to Jane shortly after introducing some terms and a conceptual model.
These are what I drew upon in treating Jane.
Compassion Fatigue
The very act of being compassionate and empathic extracts a cost under most circum-
stances. In our effort to view the world from the perspective of the suffering we suffer.
The meaning of compassion is to bear suffering. Compassion fatigue, like any other kind
of fatigue, reduces our capacity or our interest in bearing the suffering of others.
I first studied the consequences of helping the traumatized in 1971 (Figley, 2002b).
It was the first interview I conducted with a Vietnam War veteran named “Doc.” He
served as a corpsman, a nurse attached to a Marine Corps unit between 1969–1970. His
memories of the war were dominated by guilt and regrets associated with not saving or
not helping or not doing enough for his patients. These burdensome memories were
associated with lots of psychological problems that would later be diagnosed as war-
related Post-Traumatic Stress Disorder (PTSD).
We were both in Washington, D.C., on a mission. We were both there as members of
the Vietnam Veterans Against the War in an effort to convince Congress to stop the war.
I found that I was far more effective as a researcher than as a war protestor.Although my
research expanded from combat veterans (Figley, 1978) to others exposed to distress in
the line of duty to civilians and victims who experienced a wide variety of calamities, I
never forgot Doc.
1434 JCLP/In Session, November 2002
In 1980, when the Diagnostic and Statistical Manual of Mental Disorders was pub-
lished, it contained for the first time the diagnosis of PTSD. Included in the description of
the diagnosis was the provision that one could be traumatized both by being in harms way
and by bearing the distress of others who are. This does not only include the family and
close friends of the suffering but also professionals involved in helping the suffering.
This includes those suffering from chronic illness.
In the first example, Jane is experiencing secondary traumatic stress reaction called
compassion fatigue associated with both her mother and her client. Jane must effectively
face and deal with it before she can effectively help her client.
Secondary Traumatic Stress is “the natural consequent behaviors and emotions result-
ing from knowing about a traumatizing event experienced by a significant other—the
stress resulting from helping or wanting to help a traumatized or suffering person (Figley,
1993)” (Figley, 1995b, p. 7). STSD is a syndrome with symptoms nearly identical to
PTSD, except that exposure to knowledge about the traumatizing event experienced by
the significant other is associated with the set of STSD symptoms, and PTSD symptoms
are directly connected to the sufferer, the person in harms way. Specifically, compassion
fatigue is defined as a state of tension and preoccupation with the traumatized patients by
re-experiencing the traumatic events, avoidance/numbing of reminders persistent arousal
(e.g., anxiety) associated with the patient. It is a function of bearing witness to the suf-
fering of others.
Prevalence of STS and STSD
A recent study (Meldrum, King, and Spooner, 2002) in Australia found 27 percent of
professionals who work with the traumatized experienced extreme distress from this
work. In all, 54.8 percent were distressed at the time of the study and 35.1 percent were
very or extremely emotionally drained. In another study 17.7 percent had STSD and 18
percent were just below cut off for the diagnosis. In a study of rural mental health pro-
fessionals, the prevalence rate was 24.1 percent for STSD and 21.4 percent sub-clinical.
In a study of Oklahoma City trauma workers (Wee & Myers, 2002), 64.7 percent
exhibited some degree of severity for posttraumatic stress disorder, as measured by the
Frederick Reaction Index (Fredrick, 1987). Among the findings were that 44.1 percent of
counselors exhibited “caseness” (scores at or above the 90th percentile for non-patient
norms on the SCL-90-R Global Severity Index score or two dimensional T scores greater
than or equal to 63). Most (73.5 percent) of counselors were rated as being at moderate
risk (23.5 percent), high risk (29.4 percent), or extremely high risk (20.6 percent) for
compassion fatigue, as measured by the Compassion Fatigue Self Test for Psychothera-
pists (Figley, 1995). Also most (76.5 percent) of counselors were rated as being at mod-
erate risk (35.3 percent), high risk (26.5 percent), or extremely high risk (14.7 percent)
for burnout, using the same Compassion Fatigue Self Test. Similarly, in a study (Myers &
Zunin, 1994) of Northridge Earthquake mental health workers, 60.5 percent met criteria
for PTSD.
Forms of Secondary Stress?
Some would argue that both Doc and Jane suffer from countertransference. Countertrans-
ference is from psychodynamic therapy and an emotional reaction to a client by the
therapist—irrespective of empathy, the trauma, or suffering. It is defined as the process
of seeing oneself in the client, of over identifying with the client, or of meeting needs
through the client (Corey, 1991). In contrast to compassion fatigue, countertransference
Compassion Fatigue: Psychotherapists’ Chronic Lack of Self Care 1435
is chronic attachment associated with family of origin relationships and has much less to
do with empathy toward the client that causes trauma. In the case of Jane it had more to
do with Jane’s exposure to a traumatic event involving her mother than to attachment
In contrast to compassion fatigue, simple burnout is “. . . a state of physical, emo-
tional, and mental exhaustion caused by long term involvement in emotionally demand-
ing situations” (Pines & Aronson, 1988, p. 9) rather than the specific exposure to the
trauma and suffering of a specific client. Neither Jane nor Doc reported characteristic
symptoms of burnout. These symptoms go far beyond the symptoms of traumatic stress
However, both Jane and Doc had the characteristic pattern of compassion fatigue, in
contrast to burnout and countertransference (Figley, 2002a): Compassion fatigue and
countertransference have a faster onset of symptoms. Compassion fatigue and standard
burnout have a faster recovery from symptoms. Compassion fatigue, in contrast to both
burnout and countertransference, is associated with a sense of helplessness and confu-
sion; there is a greater sense of isolation from supporters. The symptoms disconnected
from real causes and are triggered by other experiences. Burnout may require changing
jobs or careers. However, compassion fatigue is highly treatable once workers recognize
it and act accordingly.
Etiological Model
Since the publication of the first book on compassion fatigue (Figley, 1995) there has
been an emergence of newfound appreciation for the costs of caring, and the relationship
between the role of empathy and previous traumatic experiences. A model first intro-
duced in 1995 and revised subsequently offers a way for those most susceptible to com-
passion fatigue to prevent and mitigate it quickly.
This model is based on the assumption that empathy and emotional energy are the
driving force in effective working with the suffering in general, establishing and main-
taining an effectively therapeutic alliance, and delivering effective services including an
empathic response (Figley, 1995; Figley, 2002a). However, being compassionate and
empathic involves costs in addition to the energy required to provide these services.
Following are the eleven variables that, together, form a causal model that predicts com-
passion fatigue. Herein lies both an appreciation for what causes compassion fatigue and
what is required to prevent and treat it.
Empathic Ability is the aptitude of the psychotherapist for noticing the pain of others.
The model suggests that without empathy there will be little if any compassion stress and
no compassion fatigue. However, without empathy there will be little if any empathic
response to the suffering clients. Thus, the ability to empathize is a keystone both to
helping others and being vulnerable to the costs of caring.
Empathic Concern is the motivation to respond to people in need. The ability to be
empathic is insufficient unless there is motivation to help others who require the services
of a concerned psychotherapist. With sufficient concern, the empathic psychotherapist
2Burnout symptoms are categorized as Physical Symptoms (e.g., physical exhaustion, Sleeping difficulties, and
Somatic problems); Emotional Symptoms (e.g., irritability, anxiety, depression, guilt, and a sense of helpless-
ness); Behavioral Symptoms (e.g., Aggression, Callousness, Pessimism, Defensiveness, Cynicism, Avoidance
of clients, Substance abuse); Work-Related Symptoms (e.g., Quitting the job, Poor work performance, Absen-
teeism, Tardiness, Constantly seeking avoidance of work, and Risk-taking), and; Interpersonal Symptoms (e.g.,
Perfunctory communication, Inability to concentrate, Social withdrawal, Lack of a sense of humor, Dehuman-
ization, and Poor patient interactions)
1436 JCLP/In Session, November 2002
draws upon her or his talent, training, and knowledge to deliver the highest quality of
services possible to those who seek it.
Exposure to the Client is experiencing the emotional energy of the suffering of cli-
ents through direct exposure. One of the reasons why those in direct practice of human
services become supervisors, administrators, or teachers in mental health professions is
due directly to the costs of direct exposure to clients. Some make the shift for direct
practice because of additional pay, improved working conditions, and higher status. How-
ever, the costs of direct exposure to the suffering of others is high and it is impossible to
know how many have chosen to abandon direct practice because the price was too high
for them.
Empathic Response is the extent to which the psychotherapist makes an effort to
reduce the suffering of the sufferer through empathic understanding. This insight into
feelings, thoughts, and behaviors of the client is achieved by projecting one’s self into the
perspective of the client. In doing so, the psychotherapist might experience the hurt, fear,
anger, or other emotions experienced by the client. Therein lie both the benefits and the
costs of such a powerful therapeutic response. The benefits are immediately obvious to
every graduate student who practices her or his new skills with another. The costs are
rarely discussed and must be experienced to elicit efforts on the part of the psychother-
apist to guard against or mitigate the effects on the self.
Compassion Stress is the residue of emotional energy from the empathic response to
the client and is the on-going demand for action to relieve the suffering of a client. Like
any stress, with sufficient intensity it can have a negative impact on the human immune
system and the quality of life in general. Together with other factors it can contribute to
compassion fatigue unless the psychotherapist acts to control compassion stress. There
appear to be two major sets of coping actions that can do this.
Sense of Achievement is one factor that lowers or prevents compassion stress and is
the extent to which the psychotherapist is satisfied with his or her efforts to help the
client. A psychotherapist with a sense of achievement regarding the delivery of services
Figure 1. Compassion Stress and Fatigue Model (Figley, 1995, 1997).
Compassion Fatigue: Psychotherapists’ Chronic Lack of Self Care 1437
to the client demands a conscious, rational effort to recognize where the psychothera-
pists’ responsibilities end and the client’s responsibilities begin.
Disengagement is the other factor that lowers or prevents compassion stress. It is the
extent to which the psychotherapist can distance himself or herself from the ongoing
misery of the client between sessions in which services are being delivered. A psycho-
therapist’s ability to disengage the client also demands a conscious, rational effort to
recognize that she or he must “let go” of the thoughts, feelings, and sensations associated
with the sessions with the client in order to live their own life. Disengagement is the
recognition on the part of the psychotherapist for importance of self-care and to carry out
a deliberate program of self-care.
If compassion stress is permitted to build, despite the psychotherapist’s effort at
disengagement and a sense of work satisfaction, the psychotherapist is at a greater risk of
compassion fatigue. Three other factors play a role in increasing compassion fatigue.
Prolonged Exposure is the ongoing sense of responsibility for the care of the suffer-
ing, over a protracted period of time. The longer the period of time between breaks the
better—at least a day of appointments and as much as a week’s vacation. These breaks are
specifically viewed as such; a respite from being compassionate and empathic toward
clients; a break from being a professional service provider.
Traumatic Recollections are memories that trigger the symptoms of PTSD and asso-
ciated reactions, such as depression and anxiety. These memories may be from the psy-
chotherapist’s experiences with other, rather demanding or threatening clients or clients
who were especially sad or suffering. These memories are events that, when recalled,
cause an emotional reaction. These memories can be provoked by certain types of clients
and client experiences that have a connection to the traumatic events experienced by the
Life Disruption is the unexpected changes in schedule, routine, and managing life
responsibilities that demand attention (e.g., illness, changes in life style, social status, or
professional or personal responsibilities). Normally such disruptions would cause a cer-
tain but tolerable level of distress. However, when combined with the other seven factors,
these disruptions can increase the chances of the therapist developing compassion fatigue.
Managing and Treating Compassion Fatigue
Just as this model of compassion fatigue can help to predict its onset, the model can also
help in preventing and mitigating this fatigue. With Doc or Jane or any psychotherapist
who works with the suffering, there are five implications derived from this model to
do so.
First, if it is clear that the therapist has compassion fatigue, providing a comprehen-
sive overview of compassion fatigue for educational purposes is vital. A copy of this
article could be the first step. The therapist can find more on the Web, at the library, and
in professional journals, such as Professional Psychology.
Second, it is important to desensitize the therapist to traumatic stressors. In doing so,
she or he has greater ability to face and work through the various issues associated with
causing and retaining the traumatic stress reactions. The methods for desensitization
psychotherapists are no different that those for other traumatized clients. There should be
a good match between the preferences of the therapist-client and the desensitization method
utilized by the treating therapist. The method should minimize the degree of discomfort
and should maximize the exposure to the stimuli which most accounts for the distressing
reactions. The result of such methods, of course, should substantially decrease or elimi-
nate the unwanted emotional reactivity linked to the traumatic stressor(s). In Jane’s case,
1438 JCLP/In Session, November 2002
it was female clients’ disclosures about their mothers, particularly a sense of responsibil-
ity, or a fear for safety. In Doc’s case it was any reminders of the war and especially war
The third issue is associated with exposure dosage. There is considerable evidence
that the primary active ingredient in effective desensitization is exposure (Figley, 2002b).
Utilizing the right therapeutic dosage of exposure is challenging. One effective method is
to combine exposure with relaxation, thereby activating the reciprocal inhibiting reflex.
A number of treatment methods are effective primarily because of this reflex (Figley,
A fourth issue in treating compassion fatigue is assessing and enhancing social sup-
port. Psychotherapists gradually view themselves as others view them: someone who is
an expert at helping others cope with life’s challenges. They seem to forget that they are
human beings as well. A physician sometimes gets sick and needs another physician’s
services, for example. Often the therapist has a rather limited social support system com-
posed of colleagues and only a few intimate relationships. It is vital to increase the
therapist’s support system in both numbers and variety of relationships so that she or he
is viewed apart from the therapist persona. Moreover, some relationships may be a source
of strain and stress. These toxic relationships are an additional demand and should be
addressed (Figley, 1997).
Mitigating Jane’s Compassion Fatigue
In returning to Jane’s case, we quickly moved in the initial interview to Jane’s feelings of
guilt about her mother’s condition and her inability to address her ambivalence toward
confronting her dysfunctional relationship with her mother.
After the first session, Jane completed a battery of tests including the Purdue Social
Support Scale (Burge & Figley, 1987; Figley, 1989), the Compassion Fatigue Self Test
(Figley, 1995; Stamm & Figley, 1999; Stamm, 2002), and a measure of PTSD. She also
completed a structured clinical interview to determine her current relationship with her
mother and the degree of systemic enmeshment. Her results confirmed our (Jane and the
treating team’s) assessment that she was suffering from compassion fatigue, a restricted
social support network, and from considerable traumatic stress. But rather than being the
classic struggle between mother and daughter, it became obvious that there was some
secret she had not disclosed yet. This secret was the fact that her mother was attacked by
a dog and nearly killed.
During the next session we shared the results with Jane, discussed the treatment
options, and agreed upon a treatment plan. The plan entailed increasing her self-soothing
and stress management skills (e.g., workbooks, video training), enhancing the number
and variety of social supporters (e.g., through volunteer work and involvement in extra-
curricular activities), and utilizing cognitive-behavioral therapy that minimized exposure
and clinical time that would result in desensitization (i.e., reduction or elimination of
traumatic stress). She selected the Eye Movement Desensitization and Reprocessing
(EMDR) as the method for addressing the secondary traumatic stress associated with her
own experiences that were affecting her effectiveness as a professional. EMDR proce-
dures call for the client to select a “target memory” that represents the worst and most
stressful aspect of the trauma. She selected the dog attack as the initial experience. As an
indicator of success, we would use the same case material she used in class (the young,
female college student adjusting to being away and feeling guilty about leaving her mother).
For the next five sessions, using EMDR, Jane worked through the dog attack, the
first signs of her mother’s chronic illness, Jane’s sacrifices, feelings of resentment toward
Compassion Fatigue: Psychotherapists’ Chronic Lack of Self Care 1439
her mother, and the embarrassments she felt—particularly during her teenage years—
having to take care of her mother.
By the final session Jane’s symptoms subsided (desensitization). She shifted from
self-blame and self-hatred to a more realistic view of herself and her mother. Discus-
sions about the clinical cases she found challenging were now interesting but rather
routine. Jane recognized that she still has work to do. She still is reactive around her
mother and knows that patience and practice are necessary to be fully differentiated
from her mother emotionally and, as a result, it will be easier to love and appreciate
her. Her test scores showed significant reductions in symptom prevalence and inten-
sity, confirming what we could see ourselves. At our request she checks in with us
periodically. After more than a year she is thriving in both her own practice and her
personal life.
How We Help Our Fellow Therapists?
There are things that we can do to help our colleagues who work with clients with chronic
illnesses. The first is to speak openly about our own struggles with compassion stress and
compassion fatigue. The conspiracy of silence among the profession about this compas-
sion fatigue is no different than the silence about family violence, racism, and sexual
harassment in the past. Today there are videotapes, books, and articles on the topic. Of
special note have been the series of articles published in Professional Psychology in the
last several years. Have these handy and available to our colleagues who are interested or
should be. The first step is completing the Self Test for Psychotherapists that is available
free on the Internet at The test will
provide a rough estimate of the respondent’s level of satisfaction with their work as a
psychotherapist, their risk of burnout, and their risk of compassion fatigue. Hopefully, the
results will motivate the psychotherapists to take action to correct any concerns and
enhance satisfaction for their work.
Stress management and self-soothing techniques are critical for surviving modern
work—no matter the focus of the work. In Jane’s case and with other psychotherapists
experiencing compassion fatigue burnout, it is vital to be able to gain mastery of distress.
This is true during sessions when working directly with clients or outside the session in
the privacy of one’s office, automobile, or home.
The psychotherapist also needs ways to desensitize from distressing memories; mem-
ories that invoke traumatic stress symptoms and are the hallmark of compassion fatigue.
Most often, the psychotherapist needs the services of another to effectively treat this
through some type of desensitization program.
It is vital that today’s psychotherapist continue to work with empathy and compassion.
Yet, there is a cost to this work that is obvious to any one practitioner working with the
suffering. As the evidence mounts proving the negative consequences of a lack of self-
care and the presence of compassion fatigue, so will the ethical imperative for the suf-
fering practitioner to do something, or something will be done for them. We cannot afford
to not attend to the mistakes, misjudgments, and blatant clinical errors of psychothera-
pists who suffer from compassion fatigue. It is, therefore, up to all of us to elevate these
issues to a greater level of awareness in the helping professions. Otherwise we will lose
clients and compassionate psychotherapists.
1440 JCLP/In Session, November 2002
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Compassion Fatigue: Psychotherapists’ Chronic Lack of Self Care 1441
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... Aspects like inadequacy in curative interaction, incorporate of situation of patients and relatives, pressure caused by not being able to help, exposure to traumatic situation/situations, inability to spare time for themselves in daily life impose some burdens on health professionals related to treatment and care provision services [1]. Figley cited this burden generically as compassion fatigue and described the idea thoroughly as a secondary traumatic stress response resulting from helping or desiring to help individuals suffering from traumatic events [2]. ...
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Compassion fatigue explains the reduced caregiving capacity of healthcare workers as a consequence of repeated exposure to patients' suffering. It is aimed to evaluate compassion fatigue and factors affecting this situation in forensic medicine specialists who evaluate cases that are victims of permanent trauma due to their profession. Data collection forms including demographic data and a short compassion fatigue scale (SCFS) in healthcare workers were filled out online by volunteer forensic experts. 113 forensic experts participated. It was determined that participants' total SCFS score average was 36.86±21.01, secondary trauma sub-dimension average was 12.39±7.74, occupational burnout sub-dimension average was 24.47±14.52. The total mean score of SCFS of the participants who evaluated less sexual assault was statistically significantly higher. The total mean score of SCFS and the mean of occupational burnout sub-dimension of the participants who did autopsy were found to be statistically significantly lower. The occupational burnout sub-dimension average of those who performed autopsy above the monthly autopsy median value was found to be statistically significantly lower. Sub-dimension average of burnout of participants in the first five years of their professional life was found to be statistically significantly higher. It is noteworthy that total and sub-dimension average scores of forensic medicine specialists in Turkey are significantly lower than those of different professions, especially health workers, in different countries. While this may be an indication that occupational depersonalization has developed over the years among forensic medicine specialists in Turkey, especially those who evaluate autopsy and sexual assault cases, from a different perspective, it can be said that increasing professional experience and working in harmony with the education received have a positive effect on compassion fatigue and burnout.
... Bu bağlamda eşler arasındaki ilişkinin güçlü olması ve karşılıklı destek üzerinden aile ilişkisinin geliştirilmesi gerekli görülmektedir. Özellikle de merhamet yorgunluğunun azaltılması noktasında sosyal desteğin etkili bir faktör olduğu ifade edilmektedir (Figley, 2002(Figley, , s.1439. Bunun yanı sıra ailedeki manevi atmosferin ve birlikteliğin artırılması, güven hissinin geliştirilmesi, aile dışındaki uğraşların çeşitlendirilmesi, iyi rol modellere sahip olunması ve olumlu sosyal çevre edinilmesi de merhamet yorgunluğuna/korkusuna karşı tedbirler olarak sunulabilir (Berzoff ve Kita, 2010, s.348;Sayar ve Manisalıgil, 2016, s.121). ...
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Bu çalışmada ebeveynlik tutumunun yeni bir bakış açısıyla ele alınması ve merhametli ebeveynlik tutumu konusunda aileler, aile danışmanları, aile-çocuk ruh sağlığı çalışanları ve araştırmacılar açısından farkındalık oluşturulması amaçlanmıştır. Bu amaç kapsamında alanyazındaki mevcut ebeveyn tutumlarından hareketle ebeveynliğin farklı stillerinden bahsedilmiştir. Ebeveynliğin çeşitli sınıflandırmalar bağlamında incelendiği anlaşılmakla birlikte genel anlamda otoriter, izin verici, kararsız, aşırı koruyucu, ihmalkâr ve demokratik tutum olmak üzere altı ebeveynlik yaklaşımının bulunduğu ortaya konulmuştur. Ayrıca ebeveyn tutumlarıyla ilişkili olan ebeveynlik uygulamaları ele alınmıştır. Ebeveynlik uygulamaları içinde özellikle ebeveyn desteği ve ebeveyn kontrolünün önemine değinilmiştir. Ardından ebeveynlerin kendilerini geliştirebilmeleri, çocuk eğitimi ve yetiştirme açısından farkındalık kazanmaları, aile içi sorunları sağlıklı bir zeminde çözüme kavuşturmaları ve çocuklarını geleceğe hazırlamada yeni yaklaşımlar edinmeleri amacıyla birtakım eğitim ve programların hazırlanıp sunulduğu tespit edilmiştir. Bu çalışmada merhamet kavramının, bir ebeveynlik tutumu çerçevesinde işlenmesi önemli görülmüştür. Merhametli ebeveynlik tutumunun anlaşılması noktasında bilgi sunulmuştur. Bu bağlamda, merhametli ebeveynlik, bir ebeveynin olayları ve durumları çocuğun bakış açısından ele alabilmesi, çocuğa gerekli sevgi, ilgi ve şefkati sunabilmesi ve çocuğun hata, başarısızlık ve yetersizliklerine karşı duyarlılık ve anlayış gösterebilmesi şeklinde özetlenmiştir. Merhametli ebeveynlik davranışsal, duygusal ve bilişsel olmak üzere üç yönden ele alınmıştır. Merhametli bir ebeveynin, merhamet içeren hedeflere sahip olabileceği göz önünde bulundurularak merhametli hedeflerin öneminden bahsedilmiştir. Bununla birlikte merhametli ebeveynlik sürecinde ortaya çıkabilecek muhtemel engeller ele alınmıştır. Söz konusu engeller, ebeveynlerin merhamet korkusu yaşayabilmeleri ve merhamet yorgunluğunu deneyimleyebilmeleri ile açıklanmıştır. Bu engeller dikkate alınarak merhametli ebeveynlik tutumunda yer alması gerekli görülen önemli bir kavramdan, öz-merhametten bahsedilmiştir. Öz-merhametli ebeveynlerin hem kendilerine karşı hem de çocuklarına yönelik merhametli duygu, düşünce ve eylemler geliştirebilmesinin mümkün olabileceği belirtilmiştir. Böylece merhametli ebeveynlik tutumunun önemli bir parçasının, ebeveynlerin kendilerine karşı merhametli olmalarıyla açıklanabileceği anlaşılmıştır. Son olarak ebeveynlerin merhametli ebeveynlik tutumunu geliştirebilmeleri noktasında katkı sağlayabilecek potansiyel eğitimler ve programlar önerilmiştir.
... Healthcare professionals frequently witness such sufferings due to the nature of their work (Cingel, 2009). Moreover, the act of delivering healthcare services to patients is correlated with adverse psychological consequences, including but not limited to burnout, secondary traumatic stress, and post-traumatic stress disorder (Figley, 2002;Şirin & Yurttaş, 2015). The favorable consequences arising from this process can be elucidated by the theoretical construct of "compassion satisfaction" (Polat & Erdem, 2017). ...
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Healthcare professionals must be compassionate when providing care to patients. When the scientific studies are examined, it is clearly stated that the psychological resilience of the health workers who witness the bad events experienced by the patients is affected. This study aimed to reveal the state of compassion and psychological resilience in health workers. The study was conducted online with 328 people from 7 regions of Turkey with different socio-demographic characteristics with snowball sampling method. In our findings, it was determined that there was a weak negative significant relationship between compassion and psychological resilience. Accordingly, it can be said that as their state of compassion increases, their psychological resilience decreases. It was also found that the compassion levels of health workers were moderate. As a result, it is recommended to organize and maintain training programs to strengthen the psychological resilience of health workers who are trying to provide compassionate care under intense and stressful working conditions.
... Furthermore, the persistent pattern of concern and arousal described by the participants as an impact of constant exposure to the stories and suffering of the victims aligns with the concept of compassion fatigue described in the literature (Figley 2002;Fontin et al. 2021;Stamm 2010). The same literature indicates that compassion fatigue symptoms can affect personal relationships, leading to decreased interest in intimacy, isolation from others, and an increase in interpersonal conflicts, which corresponds with the reported consequences by two participants. ...
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Domestic violence (DV) remains a significant public health concern and a violation of human rights. The complex challenges faced by professionals who directly engage DV victims, combined with their consistent exposure to distressing narratives, have the potential to significantly impact the well-being of these practitioners. This, in turn, can directly influence the quality of the support they provide to victims. The present study aims to explore the psychological impact of working with DV victims on these professionals while simultaneously investigating the coping mechanisms they employ. Twenty-four professionals from DV victim support in Portugal participated in this qualitative research. Through semi-structured interviews and thematic analysis, the study unveils that this line of work can indeed be profoundly impactful, potentially resulting in adverse outcomes such as fatigue, emotional exhaustion, frustration, and difficulties in emotional regulation. Nonetheless, the research also reveals that professionals are capable of developing coping strategies to mitigate the negative impact of their work. This study proposes a set of suggested measures that should not only be adopted by professionals but should also be smoothly incorporated into the strategies of organizations committed to supporting DV victims. Ultimately, by bolstering the welfare of DV professionals, this research strives to enhance the quality of support extended to victims and provide meaningful input for informed policymaking, improved practices, and effective training approaches.
Problem A gap in the literature exists attempting to understand the impact that the influx of pediatric psychiatric patients has had on inpatient general medicine pediatric nursing staff. Methods A mixed‐method research study was conducted among full‐ and part‐time pediatric nurses and nursing assistants working on general pediatric units. Quantitative data was collected via an anonymous survey using the Professional Quality of Life Scale version 5 and Support Appraisal for Work Stressors scale. Surveys were followed by semistructured interviews. Findings Of the 158 staff eligible, 47 (23.5%) participated in the quantitative portion. Significant differences were found between roles, with nurses experiencing lower levels of compassion satisfaction and higher levels of burnout. Role differences were seen in supervisor support and nonwork support, with nurses reporting less support from both. Supervisor support showed a significant correlational relationship with compassion satisfaction and burnout. nonwork support showed similar correlations with compassion satisfaction and burnout. Themes that emerged from the interviews were Barriers to Care, Emotional Impact, and “Help Me Help You.” Conclusion Nurses may be at greater risk for compassion fatigue due to perceived inadequate support from leadership, unclear role expectations, and lack of resources.
Victims of violence and interpreters share one trait: they are susceptible to trauma-related sequelae. Direct victims may develop PTSD while interpreters may develop vicarious trauma. This chapter sets out the legal basis for language access in healthcare, noting the important quality dimension added by the ACA. It then reviews the statistics for various forms of violence and presents some of its enormous societal costs. It also highlights the similarity of some of the symptoms observed in persons suffering from vicarious trauma, PTSD and burnout, but notes the difference in the genesis of these three conditions. This is followed by an introduction to trauma-informed approaches in delivering victim services. Finally, it lays the basis for identifying VT symptoms, mentions two online instruments that might be useful in assessing the likelihood of vicarious trauma, and reviews types of self-care techniques for creating a personal self-care plan.
Amaç: Bu çalışma, Covid-19 salgını döneminde hemşirelerdeki şefkat yorgunluğu ve tükenmişlik düzeyleri arasındaki ilişkinin belirlenmesi amacıyla yapıldı. Yöntem: Tanımlayıcı ve kesitsel olan bu çalışmanın evrenini Turgutlu Devlet Hastanesi'nde çalışan hemşireler (N = 248) , örneklemini ise çalışmaya gönüllü olarak katılmayı kabul eden hemşireler (n = 181) oluşturdu. Araştırma verileri, Ağustos-Kasım 2020 tarihleri arasında toplandı. Araştırmanın veri toplama araçları olarak, Hemşire Bilgi Formu, Şefkat Yorgunluğu Ölçeği ve Masclach Tükenmişlik Ölçeği kullanıldı. Verilerin değerlendirilmesi SPSS 15.0 paket programında yapıldı. Bulgular: Hemşirelerin şefkat yorgunluğu ölçeği toplam puanı 2,01±0,31, değer bilinci alt boyutu puan ortalaması 2,14±0,37, başkalarına değer verme alt boyutu puan ortalaması 1,69±0,26, güç algısı alt boyutu puan ortalaması 1,97±0,43 ve özdeğer alt boyutu puan ortalaması 2,05±0,51 olarak bulundu. Hemşirelerin Masclach Tükenmişlik Ölçeği alt boyutları puan ortalamaları; duygusal tükenme alt boyutu 20,32±8,09, duyarsızlaşma alt boyutu 7,46±4,27 ve kişisel başarı alt boyutu 20,30±7,87 olarak belirlendi. Sonuç: Hemşirelerin Şefkat Yorgunluğu ve Masclach Tükenmişlik ölçekleri alt boyutları arasındaki korelasyonlarda genel olarak pozitif yönde zayıf ve çok zayıf korelasyonlar bulundu. Benzer çalışmaların pandeminin ilerleyen süreçlerinde belli aralıklarla daha büyük örneklem ile yapılması önerilir.
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The editors of Beyond Trauma: Cultural and Societal Dynamics have created a volume that goes beyond the individual's psychological dynamics of trauma, exploring its social, cultural, politica!, and ethical dimensions from an international as well as a global perspective. In the opening address as International Chair of the First World Conference of the International Society for Traumatic Stress Studies on Trauma and Tragedy: The Origins, Management, and Prevention of Traumatic Stress in Today's World, June 22-26, 1992, Amsterdam, The Netherlands, the conference that formed the foundation for the col­ lected chapters in this volume, 1 commented: This meeting is a landmark in accomplishing the Society's universal mission. Our distinguished International Scientific Advisory Committee and Honor­ ary Committee, whose membership was drawn from over 60 countries, the cooperation of six United Nations bodies, and the participation anei endorse­ ment of numerous nongovernmental organizations and institutions attest to the Society's emerging presence as a major international forum for profes­ sionals of ali disciplines working with victims and trauma survivors.
Part I: Understanding the Impact of Trauma on Families. The Family as a Living System. Individual Responses to Trauma. Spreading Beyond the Individual: Family Adaption to Stress and Trauma. Part II: Empowering Families. Foundations of the Empowerment Treatment Approach. Phase I: Joining the Family. Phase II: Understanding and Framing the Family's Trauma Response. Phase III: Building Healing Skills. Phase IV: Sharing and Healing. Phase V: Moving Forward. Part III: Empowering Family Trauma Therapists. The Family Trauma Therapist. Epilogue: Looking Back and Looking Forward. References.
The authors studied the disaster mental health (DMH) workers involved in long-term mental health recovery activities, providing crisis-counseling services to victims of the Oklahoma City bombing disaster. Each received the Alfred P. Murrah Federal Building Bombing Reaction Questionnaire packet nine months after the bombing. The most significant psychological feature of this bombing disaster for these DMH workers was that someone they knew might have died in the bombing. Most the DMH workers reported some degree of severity for stress disorder. More than half the workers studied indicated that the work was more stressful than other jobs. Only a small percentage of the sample had levels of distress that were within the clinical range of symptoms. The factors most associated with increased severity of stress disorder are the type of job and larger number of mo providing disaster mental health services to bombing survivors. Scores indicated that the entire sample was at risk of developing both compassion fatigue and burnout. The risks increased with the number of mo worked with bombing survivors. The DMH workers' distress levels were higher than those found in almost all other groups of emergency and rescue workers studied in the last 14 yrs. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Our work had a dual focus: research on the causes and consequences of burnout, and application of our findings to the real-life problems of people. This book combines both features—insight and action. In it we tried to convey both the feel and the psychological dynamics underlying the experience of burnout. The first part of the book provides a description of the experience and the process of burnout. . . . The second part of the book addresses its second purpose—to describe common causes of burnout in business, in social service work, in bureaucratic organizations, and in women. The third part is devoted to "what to do with it," because we strongly believe that it is not enough to be aware of a problem and its causes. The crucial step is to find and apply solutions. Some of the solutions we offer are for individuals, some are for support groups at work places, and some are for the organization. All three perspectives are combined in the description of our burnout workshops. (PsycINFO Database Record (c) 2012 APA, all rights reserved)