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Empathic Distress Fatigue Rather Than Compassion Fatigue? Integrating Findings from Empathy Research in Psychology and Social Neuroscience
Abstract
In this chapter, we discuss the role of empathy as the main precursor for prosocial behavior, taking perspectives that span from social and developmental psychology to social neuroscience. We begin by introducing compassion fatigue in caregivers as a form of pathological altruism. We move on to introduce such relevant concepts as empathy, compassion, empathic concern, and distress; we then review relevant empirical findings from social and developmental psychology and social neuroscience. Finally, we propose a new integrative model that suggests that the term compassion fatigue should be replaced by the term empathic distress fatigue to more accurately account for symptoms of withdrawal and burnout. We conclude by outlining potential ways to circumvent the downside of too much empathy.
... Being empathic in these circumstances can be associated with suffering and personal stress, especially if the person is overwhelmed by the other person's negative emotions 2 . Excessive emotional identification with other people's suffering can lead to a state of exhaustion known as empathy fatigue 17 or compassion fatigue 18 , which in turn is related to stress and burnout in caring professions. ...
... The few studies involving teachers showed that high levels of empathy were associated with stress in both mainstream and special school teachers 19 and that the affective aspect of empathy in particular was a predictor of teacher stress 20 . Teachers dealing with students with special educational needs are at risk of developing empathy fatigue 17 , especially when dealing with students with mental health problems 21 . ...
... The literature has found 16,17 that prolonged exposure to stressful relational experiences, such as those experienced by support teachers, reduces professional empathic engagement. This reduction could be interpreted as a defense mechanism, but could also indicate an improved ability of experienced teachers to moderate their emotional engagement. ...
The role of teacher empathy is recognized as a key factor in improving teacher–student interaction, motivation and academic performance. Despite the importance of teacher empathy, its role in promoting inclusive education is still largely unknown. High levels of empathy are not necessarily associated with greater ability to implement inclusive education, as they can lead to excessive emotional engagement and stress, which negatively affect teachers' abilities. Therefore, the present study explored whether the relationship between high empathy and perceived ability to implement inclusive education could be moderated by other variables, such as emotional self-efficacy and gender. A large sample of Italian support teachers (N = 739; Mage = 37.7; females = 86.9%) was recruited for this study. We found that higher levels of empathy were related to higher levels of self-efficacy in inclusive education, especially when levels of emotional self-efficacy were higher. This relationship was only found for female teachers. The results contribute to knowledge about the role of teachers' empathy for inclusion as well as the moderating role of the ability to regulate negative emotions. The study has implications for pre-service teacher education and in-service teacher training.
... In addition to fantasy, empathic distress remains an underexamined dimension of empathy that may be pertinent to practitioners (Batson et al., 2015;Klimecki & Singer, 2011). Lack of attention to empathic distress is surprising since it may contribute to the avoidance of empathy, which can be detrimental to the helping relationship (Batson et al., 2015). ...
... Lack of attention to empathic distress is surprising since it may contribute to the avoidance of empathy, which can be detrimental to the helping relationship (Batson et al., 2015). Klimecki and Singer (2011) have proposed that when empathic distress occurs, practitioners become self-oriented in their responses to others in an attempt to alleviate the cumulative distress they experience from empathizing with others. Klimecki and Singer (2011) developed a model to show how, under different circumstances, empathy can produce positive outcomes, or the opposite-empathic distress and withdrawal (p. ...
... Klimecki and Singer (2011) have proposed that when empathic distress occurs, practitioners become self-oriented in their responses to others in an attempt to alleviate the cumulative distress they experience from empathizing with others. Klimecki and Singer (2011) developed a model to show how, under different circumstances, empathy can produce positive outcomes, or the opposite-empathic distress and withdrawal (p. 384). ...
This article focuses on the definition and application of empathy in psychotherapy to strengthen clinical social work’s understanding of the concept and improve consistency in how it is applied in clinical practice, psychotherapy, and research. We conducted a critical review of the conceptual and empirical literature to understand the meaning of empathy and its relation to other components of the helping relationship. Based on this review, we identified that there was lack of consensus regarding how empathy is defined and how it has been operationalized in research. This review also indicated the need to delineate empathy from closely related constructs (e.g., the therapeutic alliance) and focus on frequently overlooked empathy subdomains (e.g., fantasy) to enhance clinical social work practice.
... Workers who develop compassion fatigue and burnout may experience feelings of sadness, grief, and anxiety, leading to reduced functioning, suboptimal work performance, and difculties with personal and professional relationships [10]. Burnout and compassion fatigue are established constructs, with high rates reported in studies among helping professionals; for example, rates of compassion fatigue and burnout amongst physicians are said to be between 40% and 80% [11]. Mathieu [10], (p. ...
... Cognitive empathy-sometimes referred to as mentalising or perspective taking-is where one intentionally adopts another person's perspective in an attempt to cognitively understand how they are thinking or feeling [33], whereas afective empathy is said to occur via a vicarious sharing of another's emotions [33]. While empathy is considered to support positive therapeutic relationships and motivate altruistic behaviour, empirical evidence from social psychology and the neurosciences suggests that the reliance on afective empathy may be maladaptive and may contribute to empathic distress [11,34]. ...
... 20). Researchers propose that compassion fatigue is a misleading term, as compassion is said to foster emotional well-being and empathic distress is the primary source of workers' problems, arguing that "compassion fatigue should be replaced by the term "empathic distress fatigue" [11], (p. 368). ...
Helping professionals are at risk of experiencing adverse health and psychological problems when working in roles where they are continually exposed to the emotional distress of others. The term compassion fatigue was coined to describe symptoms of emotional and physical fatigue experienced by workers in these environments. However, empirical research contends that compassion does not cause fatigue, rather compassion is said to foster well-being and is neurologically rejuvenating. The objective of this review was to examine the scientific literature which investigated the compassion-enhancing practice of loving kindness meditation (LKM). This review suggests that LKM can be seen as an alternate strategy to reduce stress, ease empathic distress, and increase positive affect.
... Further, the tension between compassion fatigue and compassion satisfaction has been called an empathy paradox (Ludick & Figley, 2017). However, others have posited that compassion does not lead to fatigue and have described the term compassion fatigue as a misnomer (Dowling, 2018;Hofmeyer et al., 2020;Klimecki & Singer, 2012;Ledoux, 2015). These conceptual debates demonstrate a need for further examination of compassion among helping professionals such as social workers. ...
... They did not describe compassion as the antecedent to avoidance. Results from this study support what others have explained as a misrepresentation of compassion in naming the construct as the cause of negative wellbeing outcomes among helping professionals (Dowling, 2018;Hofmeyer et al., 2020;Klimecki & Singer, 2012;Ledoux, 2015). As Dowling (2018) directly expressed, "Compassion does not fatigue" (p. ...
... 749). Alongside other scholars (Dowling, 2018;Hofmeyer et al., 2020;Klimecki & Singer, 2012;Ledoux, 2015), we suggest a careful examination of language such as compassion fatigue that characterizes compassion as a root cause of negative well-being outcomes among helping professionals. ...
Purpose:
Evidence establishing the importance of compassion in the context of social work practice is emerging. Compassion, stemming from the Latin words com and pati, means to suffer with. Given the proximity social workers have to vast experiences of suffering, compassion may play a central role in providing meaningful care to individuals, communities, and systems. The purpose of this qualitative study was to explore social workers' definitions of and experiences with compassion.
Method:
Participants included 12 social workers working across levels of practice in two Midwestern states in the United States. Data were collected via semi-structured interviews.
Results:
Thematic analysis demonstrated three themes present in the data. Consistent with previous conceptual scholarship, the findings illustrated that compassion is a central component of social work practice. Additionally, results from the study demonstrated that social workers find compassion to be an imperative component of ethical practice and suggested that both barriers to and facilitators of compassion are present across levels of social work practice.
Discussion and conclusion:
This study adds to the growing body of social work scholarship exploring compassion and highlights implications for the social work discipline across levels of practice to more overtly center compassion in education, practice, and policy. Further research is needed to better understand multilevel barriers to compassion and develop strategies for overcoming them. Moreover, additional research is needed to holistically understand how to leverage and build upon the facilitators of compassion identified by participants in order to foster compassionate social workers, social work organizations, and systems.
... Compared to the emotion regulation perspective in compassion work, however, surprisingly little attention has been paid to the job characteristics that yield such emotion regulation. We propose the confrontation with human fates and suffering and peoples' capacity to experience empathy for pain and suffering of others they care for are core task characteristics in compassion work that poses risks for the health and well-being of human services workers (Klimecki & Singer, 2011;Miller et al., 1995) but that compassion work also poses opportunities for professional self-enhancement (Semmer et al., 2015). Moreover, we propose that compassion and distancing are two independent work styles in compassion work that are an essential part of the professional role in care work that confronts (Bolton, 2000;Mumford et al., 2019). ...
... Second, we complement the emotion regulation perspective that focuses on detached concern in compassion work (Lampert & Glaser, 2018;Lampert & Unterrainer, 2017) with our emphasis on job characteristics in compassion work that yield such emotion regulation. Third, we refine and extend theory and research on empathic concern (Davis, 1983) and compassion fatigue (Figley, 1995), two prominent concepts related to compassion work, but conflating empathy and compassion, which recent scholarly work suggests should be clearly distinguished (Cuff et al., 2016;Eklund & Meranius, 2021;Klimecki & Singer, 2011;Sinclair et al., 2017). Finally, our research contributes to our knowledge what human service organisations can do to foster the well-being of human service workers as well as the well-being of the targets of their service (Kahn, 1993). ...
... The compassion fatigue framework, however, has been repeatedly criticised for using a very wide definition of compassion that subsumes phenomena such as empathy, empathic concern, and contagion to describe the "cost of caring" (Klimecki & Singer, 2011;Sinclair et al., 2017). We believe the most important problem with the conceptualisation of compassion fatigue is its assumption that empathyfeeling what we think others are feelingis a necessity to care about and help others. ...
... Compared to the emotion regulation perspective in compassion work, however, surprisingly little attention has been paid to the job characteristics that yield such emotion regulation. We propose the confrontation with human fates and suffering and peoples' capacity to experience empathy for pain and suffering of others they care for are core task characteristics in compassion work that poses risks for the health and well-being of human services workers (Klimecki & Singer, 2011;Miller et al., 1995) but that compassion work also poses opportunities for professional self-enhancement (Semmer et al., 2015). Moreover, we propose that compassion and distancing are two independent work styles in compassion work that are an essential part of the professional role in care work that confronts (Bolton, 2000;Mumford et al., 2019). ...
... Second, we complement the emotion regulation perspective that focuses on detached concern in compassion work (Lampert & Glaser, 2018;Lampert & Unterrainer, 2017) with our emphasis on job characteristics in compassion work that yield such emotion regulation. Third, we refine and extend theory and research on empathic concern (Davis, 1983) and compassion fatigue (Figley, 1995), two prominent concepts related to compassion work, but conflating empathy and compassion, which recent scholarly work suggests should be clearly distinguished (Cuff et al., 2016;Eklund & Meranius, 2021;Klimecki & Singer, 2011;Sinclair et al., 2017). Finally, our research contributes to our knowledge what human service organisations can do to foster the well-being of human service workers as well as the well-being of the targets of their service (Kahn, 1993). ...
... The compassion fatigue framework, however, has been repeatedly criticised for using a very wide definition of compassion that subsumes phenomena such as empathy, empathic concern, and contagion to describe the "cost of caring" (Klimecki & Singer, 2011;Sinclair et al., 2017). We believe the most important problem with the conceptualisation of compassion fatigue is its assumption that empathyfeeling what we think others are feelingis a necessity to care about and help others. ...
... Compared to the emotion regulation perspective in compassion work, however, surprisingly little attention has been paid to the job characteristics that yield such emotion regulation. We propose the confrontation with human fates and suffering and peoples' capacity to experience empathy for pain and suffering of others they care for are core task characteristics in compassion work that poses risks for the health and well-being of human services workers (Klimecki & Singer, 2011;Miller et al., 1995) but that compassion work also poses opportunities for professional self-enhancement (Semmer et al., 2015). Moreover, we propose that compassion and distancing are two independent work styles in compassion work that are an essential part of the professional role in care work that confronts (Bolton, 2000;Mumford et al., 2019). ...
... Second, we complement the emotion regulation perspective that focuses on detached concern in compassion work (Lampert & Glaser, 2018;Lampert & Unterrainer, 2017) with our emphasis on job characteristics in compassion work that yield such emotion regulation. Third, we refine and extend theory and research on empathic concern (Davis, 1983) and compassion fatigue (Figley, 1995), two prominent concepts related to compassion work, but conflating empathy and compassion, which recent scholarly work suggests should be clearly distinguished (Cuff et al., 2016;Eklund & Meranius, 2021;Klimecki & Singer, 2011;Sinclair et al., 2017). Finally, our research contributes to our knowledge what human service organisations can do to foster the well-being of human service workers as well as the well-being of the targets of their service (Kahn, 1993). ...
... The compassion fatigue framework, however, has been repeatedly criticised for using a very wide definition of compassion that subsumes phenomena such as empathy, empathic concern, and contagion to describe the "cost of caring" (Klimecki & Singer, 2011;Sinclair et al., 2017). We believe the most important problem with the conceptualisation of compassion fatigue is its assumption that empathyfeeling what we think others are feelingis a necessity to care about and help others. ...
Previous research on compassion work has focused on the emotion regulation of human services workers. However, little attention has been paid to the job characteristics of this work. In this paper, we conceptualise a model of compassion work that differentiates the task characteristics (1) exposure and (2) empathy, and the work style requirements (3) compassion and (4) distancing. We tested an operationalisation of our compassion work model for its factor structure and validity in two studies (total N = 985). Our findings confirmed the proposed four-factor structure. Moreover, as expected, exposure was positively related to engagement and burnout, suggesting exposure is a challenge stressor in compassion work; empathy was positively related to burnout, suggesting empathy is a hindrance stressor in compassion work; compassion was positively related to work engagement and work meaningfulness, suggesting it supports self-enhancement in compassion work; and finally distancing was negatively related to burnout, suggesting it supports health and well-being in compassion work. Overall, these findings suggest our model is a promising vantage point for future research, job design, and health prevention in compassion work.
... In conclusion, empathy is a mix of the emotional, cognitive, and practical abilities needed to provide for a patient. What transforms women is the Model of Care, which uses terms like "kindness," "empathy," "compassion," or "love," which could appear unprofessional (Klimecki & Singer, 2011). ...
... There were no statistically significant correlations between personality characteristics and empathy ratings. Furthermore, they discovered a weaker positive correlation between empathy scores and stress levels, suggesting that people who experience more stress have higher empathy levels than people who experience less stress (Klimecki & Singer, 2011;Moore et al., 2002). ...
... In patient care, it's critical to distinguish between empathy, a cognitive quality, and sympathy, an emotional reaction, because compassion can negatively affect patients and doctors (objectivity in clinical decisions, exhaustion, and burnout) (Klimecki & Singer, 2011;Richardson, Percy, & Hughes, 2015). Because of its cognitive character, empathy is always advantageous to patient care, even in excess. ...
A woman's vulnerability is never greater than during pregnancy, childbirth, and the postnatal period. Quality healthcare delivery rest on actual interactions between patients and providers. Empathy has been acknowledged as a crucial component of patient care, benefiting both patients and medical staff. The patient-centered approach is considered an effective strategy to deliver successful patient care when healthcare professionals are more sensitive and attentive to the requirements of patients. Empathy means sharing another person's feelings and showing kindness to alleviate their misery or anguish. It is widely acknowledged as the essential component of nursing and midwifery care and regarded as the component of quality care. However, because it varies from practitioner to practitioner and from patient to patient, it is difficult to understand how compassion presents itself in the delivery of treatment. Midwives' compassionate attitudes and actions have a direct impact on obstetric outcomes. Even though scholars are studying the concept of empathy in nursing, little is known about what empathy in midwifery entails and how patients see it. Many advantages for patient communication, patient satisfaction, and treatment adherence are linked to healthcare professionals' empathy. This paper aims to examine the works of literature on the concept of empathy and highlight how crucial it is to provide care in the context of maternal healthcare.
... This phenomenon has been especially apparent among people in the caregiving profession. Klimecki and Singer (2011) identified compassion fatigue among people in the care giving profession as a form of pathological altruism. "Compassion fatigue is altruistic: caregivers with compassion fatigue were initially motivated by the pro-social aim of alleviating the suffering of others by means of their empathetic care" (Klimecki & Singer, 2011, p. 369). ...
... This lack of concern for the self also has been associated with detrimental effects on mental health (Emmerik et al., 2005;Helgeson & Fritz, 1999;Klimecki & Singer, 2011). Helgesson and Fritz (1999) distinguished unmitigated communion, defined as those who, subjugate their own needs to the needs of others, and who, help others even at their own expense, from communion and empathy (which does not exclude a concern for the self). ...
Advocates of servant leadership maintain that altruism is the foundational ethic fueling the success of the servant leader. Thus, the foremost requirement of a servant leader is the possession of a concern for others above and beyond his or herself. Researchers have largely neglected the possibility that servant leaders may be, at least partially, motivated by self-interest. We challenge the current foundational ethic attributed with servant leadership and put forth a new ethical perspective. Reviewing four motivational states, from purely other-centered to purely self-centered, we introduce a conceptual model and argue that the proper ethic to ascribe with servant leadership is a dual motivational perspective of rational self-interest and agapao love. A dual motivational perspective allows the servant leader to avoid the negative consequences of the self-sacrificial, altruistic motivation while maintaining the positive, pro-social behaviors that improve organizational outcomes associated with servant leadership.
... Compassion fatigue (CF) has its origins in nursing (Joinson, 1992) and can be described as a "cumulative and progressive absorption process of patient's pain and suffering formed from the caring interactions with patients and their families" (Jarrad et al., 2018, p. 1). Klimecki and Singer (2011) de ne CF as "pathological altruism" where a caregiver would alleviate the pain of others by giving empathic care, which could cause a negative impact on their own physical and mental health. Typically, symptoms related to CF are described as feeling lethargic, hopeless, helpless, as well as disengaged (Day & Anderson, 2011). ...
... What emerged was an understanding that most practitioners had experienced some type of professional fatigue, which in the context of this study they would readily de ne as empathy fatigue. There is a distinct possibility that had this term been replaced with empathic distress fatigue (Klimecki & Singer, 2011), the same observed phenomena might have been reported. ...
The ability to join a client on a collaborative, non-expert level is based on a counsellor’s empathy. Yet the very capacity to show empathy and deep understanding of a client’s problems may make counsellors vulnerable to professional fatigue. Experiencing this phenomenon will negatively influence the therapeutic relationship. Self-care measures are at the core of bolstering a therapist’s resilience to ensure a high standard of working with clients. Instead of the more frequently researched compassion fatigue, this qualitative study uses the term empathy fatigue to broaden the scope of reported experiences. It examines the effects of empathy fatigue and self-care strategies reported by six counsellors from Asia-Pacific and Europe. While the lack of conceptual clarity on the different constructs of professional fatigue became apparent, rich data helped to interpret how the individual made sense of this phenomenon. Findings showed that self-care was commonly viewed as a self-mandated regimen satisfying both needs for empathy-free zones and social engagement. To help others, therapists need to help themselves first. Self-directed solution-focussed questions to gauge how effectively self-care measures in place are working prove useful for counsellors in managing and maintaining equilibrium in both professional and private settings.
... Yielding access to others' inner mental states, empathy and ToM are crucial for daily social interactions (Singer, 2012). But in situations that involve sharing or reasoning about other people's suffering, they may lead to undesired emotional states such as interpersonal guilt or empathic distress (Klimecki & Singer, 2011). For instance, seeing that a friend is very sad can evoke either feelings of healthy empathic sadness or of empathic distress in the observer. ...
... As such, the insula's involvement spans a variety of emotions that arise particularly during social interactions, such as empathy and compassion (Singer et al., 2009) but also guilt, shame, and embarrassment (Bastin et al., 2016). Our results align with the expectation that "over-empathizing" can, under specific circumstances, result in higher levels of empathic stress and, in prolonged or extreme forms, even in empathic distress fatigue (Klimecki & Singer, 2011). The CERQ rumination scale mainly captures rumination about one's own feelings. ...
Internalizing symptoms such as elevated stress and sustained negative affect can be important warning signs for developing mental disorders. A recent theoretical framework suggests a complex interplay of empathy, theory of mind (ToM), and negative thinking processes as a crucial risk combination for internalizing symptoms. To disentangle these relationships, this study utilizes neural, behavioral, and self‐report data to examine how the interplay between empathy, ToM, and negative thinking processes relates to stress and negative affect. We reanalyzed the baseline data of N = 302 healthy participants (57% female, M age = 40.52, SD age = 9.30) who participated in a large‐scale mental training study, the ReSource project. Empathy and ToM were assessed using a validated fMRI paradigm featuring naturalistic video stimuli and via self‐report. Additional self‐report scales were employed to measure internalizing symptoms (perceived stress, negative affect) and negative thinking processes (rumination and self‐blame). Our results revealed linear associations of self‐reported ToM and empathic distress with stress and negative affect. Also, both lower and higher, compared to average, activation in the anterior insula during empathic processing and in the middle temporal gyrus during ToM performance was significantly associated with internalizing symptoms. These associations were dependent on rumination and self‐blame. Our findings indicate specific risk constellations for internalizing symptoms. Especially people with lower self‐reported ToM and higher empathic distress may be at risk for more internalizing symptoms. Quadratic associations of empathy‐ and ToM‐related brain activation with internalizing symptoms depended on negative thinking processes, suggesting differential effects of cognitive and affective functioning on internalizing symptoms. Using a multi‐method approach, these findings advance current research by shedding light on which complex risk combinations of cognitive and affective functioning are relevant for internalizing symptoms.
... First, investigators engage with negative expressions or envision the suffering of children depicted in the material, potentially eliciting empathetic suffering (de Vignemont & Singer, 2006;Singer & Lamm, 2009). Second, prolonged exposure to empathetic suffering can result in stress and anxiety (Klimecki & Singer, 2011), blurring the distinction between investigators and the victims and transforming the experienced suffering into their own (Klimecki & Singer, 2011;Singer & Lamm, 2009). Drawing on the JD-R model (Bakker et al., 2023;Schaufeli & Bakker, 2004), empathy for suffering depletes energy for tasks, subsequently leading to adverse health outcomes such as burnout and, at worst, posttraumatic stress disorder. ...
... First, investigators engage with negative expressions or envision the suffering of children depicted in the material, potentially eliciting empathetic suffering (de Vignemont & Singer, 2006;Singer & Lamm, 2009). Second, prolonged exposure to empathetic suffering can result in stress and anxiety (Klimecki & Singer, 2011), blurring the distinction between investigators and the victims and transforming the experienced suffering into their own (Klimecki & Singer, 2011;Singer & Lamm, 2009). Drawing on the JD-R model (Bakker et al., 2023;Schaufeli & Bakker, 2004), empathy for suffering depletes energy for tasks, subsequently leading to adverse health outcomes such as burnout and, at worst, posttraumatic stress disorder. ...
Investigating internet child exploitation cases poses unique challenges for law enforcement employees, particularly investigators, who are routinely exposed to traumatic material depicting the suffering of victims. We posit that the primary source of stress in internet child exploitation investigation stems not from the exposure to the material per se, but rather from investigators' empathy for the suffering of the victims depicted in the material. Drawing from the Job Demands-Resources (JD-R) model, our study investigates the relationship between empathy for suffering and the experiences of burnout and posttraumatic stress disorder among investigators in internet child exploitation cases. Additionally, we explore the moderating effect of social support from colleagues on these relationships. In our online study involving 168 investigators of internet child exploitation (90 women), we sought to emphasize the role of empathy for suffering as a key factor in stress reactions. Our findings indicate that, beyond mere exposure, empathy for suffering is positively correlated with posttraumatic stress disorder and burnout (i.e., emotional exhaustion and cynicism). Furthermore, our study provides partial support for the moderating effect of social support from colleagues on investigators' stress responses to both empathy for suffering and exposure. Our findings indicate that empathy for suffering emerges as a central job stressor, while social support serves as a crucial job resource for mitigating this stress in the context of child exploitation investigation. These results carry implications for risk assessment and health promotion within the realm of internet child exploitation investigations, opening up a broad avenue for further research.
... In their groundbreaking work, Klimecki and Singer (2011) clarified the distinction between empathy (the capacity to share another's feelings) and compassion (the feeling of concern for another who is suffering and the motivation to help). Empathy plays a role in compassion in that we cannot recognize and understand another's suffering without it, but empathy directed toward suffering can also be painful (Gilbert, 2010). ...
... Empathy plays a role in compassion in that we cannot recognize and understand another's suffering without it, but empathy directed toward suffering can also be painful (Gilbert, 2010). Similar to earlier research (Batson, 1991;Eisenberg et al., 2006), Klimecki and Singer (2011) found that when directed toward someone who is suffering, empathy can easily lead to distress and withdrawal, whereas compassion leads to positive affect and altruism. They also found important differences in brain activity between these two states related to these emotional and behavioral outcomes. ...
Objectives
Teachers play a critical role in preparing our children and adolescents for a successful future. However, despite the large number of students impacted by trauma and adversity, teachers are often not well prepared to provide trauma-sensitive support. Furthermore, while working to support students exposed to trauma and adversity, teachers may experience empathy-based stress exacerbating already high levels of stress among them. This narrative review explores the issue of empathy-based stress within the context of the prosocial classroom model which proposes that teachers’ social and emotional competence and well-being are key to their ability to create and maintain supportive learning environments critical to student academic and behavioral outcomes.
Methods
Recent findings in neuroscience and education research are applied to support teachers’ development of these competencies.
Results
We propose that shifting from empathy-based stress to compassionate responding may be one such competency to help teachers’ respond effectively to their students’ needs while protecting their own wellbeing.
Conclusion
We review research that supports this proposition and explore implications for teacher professional learning, educational policy, and further research.
... Helping professionals might benefit from an intervention that not only cultivates both compassion for others and selfcompassion and combats self-criticism but also helps participants cope with compassion fatigue as well (Ondrejková and Halamová, 2022a). According to Klimecki and Singer (2011) cultivating compassion for others may offer protection against compassion fatigue and burnout, as compassionate responding allows professionals to empathize, but not identify with, suffering. Therefore, they should be able to contain their clients' negative feelings. ...
... Furthermore, in our study we investigated the effect of the EFT-HP intervention on levels of self-criticism, self-compassion and compassion for others. Previous authors have indicated the importance of these factors in relation to compassion fatigue (e.g., Klimecki and Singer, 2011;Ondrejková and Halamová, 2022a). As found in our study, after completing the intervention participants reported a significant decrease in self-criticism and increase in self-compassion. ...
Introduction
The aim of this study was to examine the short- and long-term effectiveness of the novel Emotion-focused Training for Helping Professions on levels of compassion fatigue (secondary traumatic stress & burnout), self-criticism, self-compassion, and compassion for others.
Methods
A randomized controlled trial study was conducted. A total of 253 participants were recruited and randomly assigned to either the experimental group or the control group. The experimental group attended a 14-day online training. The control group did not perform any tasks.
Results
Results showed that after completing the intervention the experimental group participants reported significantly lower scores for secondary traumatic stress, burnout and self-criticism, and higher scores for self-compassion and that these lasted for two months after completion. Compared to the control group, the experimental group participants had significantly lower scores of secondary traumatic stress, burnout, self-criticism, and higher scores of self-compassion after the intervention. No significant changes were found for the control group, except a significant increase in time in the reported score for one dimension of burnout – exhaustion.
Discussion
The novel EFT-HP training was shown to be effective in reducing levels of compassion fatigue (secondary traumatic stress and burnout) and self-criticism and increasing self-compassion.
... While the precise relationship between perception, experience and reality is debated (Shottenkirk, Curado, and Gouveia, 2019), it is generally accepted that "it is through perception that the world meets our minds" (Crane, 1992). According to Klimecki andSinger (2011) andFigley (2012) it is not the patient's distress that directly invokes an empathetic response in the clinician but rather the clinician's perception of patient distress. Therefore, whether or not the subjective perceptions of the participating physiotherapists accurately correspond with the emotional states of their patients, these perceptions form a part of the physiotherapists' lived experience. ...
... While the precise relationship between perception, experience and reality is debated (Shottenkirk, Curado, and Gouveia, 2019), it is generally accepted that "it is through perception that the world meets our minds" (Crane, 1992). According to Klimecki andSinger (2011) andFigley (2012) it is not the patient's distress that directly invokes an empathetic response in the clinician but rather the clinician's perception of patient distress. Therefore, whether or not the subjective perceptions of the participating physiotherapists accurately correspond with the emotional states of their patients, these perceptions form a part of the physiotherapists' lived experience. ...
Background
Psychological distress is a common response to many conditions physiotherapists treat. It is also common for a person’s experience of distress to be associated with multiple stressors.
Objective
This qualitative study explored physiotherapists’ perceptions of the types of patient psychological distress they encountered in their clinical practice.
Methods
A qualitative research approach was adopted. Twenty-three physiotherapists were recruited through purposive maximum variation sampling. To participate, physiotherapists had to self-report having encountered at least one patient they perceived to be experiencing psychological distress in the last 12 months. Data analysis was completed using Iterative Thematic Inquiry.
Results
Five themes were identified in the study: 1) distress extends beyond physical health issues; 2) fear of the future; 3) the emotional toll of loss; 4) trauma is often part of the story; and 5) losing hope.
Conclusion
The results of this study highlight that patient psychological distress presents in a variety of forms and appears to be multifaceted and multifactorial in nature. As patients’ experiences of psychological distress are relevant to physiotherapy practice, mental health capabilities need to be embedded within physiotherapy training.
... Empathic distress is characterized by a solid aversive and self-oriented response to the suffering of others, accompanied by a desire to withdraw from a situation to protect oneself from developing excessive negative emotions [7]. To prevent the overwhelming sharing of suffering and its impact on personal distress, research has shown that empathic distress can be reversed by responding to the suffering of others with compassion [10]. ...
Hospital social workers commonly experience empathy fatigue and burnout at work. However, empathic distress can be reversed by cultivating compassion as a skill and learning how to turn empathy into compassion. This report explores how 60 staff used Compassion Mind Training (CMT) to promote workplace mental health for hospital social workers. It recommends building a workplace culture of compassion through CMT using various ways to reinforce individual and organizational commitments. This helps create a sense of psychological safety that leads to positive ripple effects in the mental health of staff.
... In contrast to self-centeredness, being other-focused highlights an individual's QIN and WANG | 3 ability and willingness to care about the well-being of others. Extant research has pointed out that other-focused concern is associated with decreased negative feelings and ruminative thoughts as well as maintaining mental health (Klimecki & Singer, 2011), reduced levels of burnout (Gerber & Anaki, 2021), reduced chances of distress fatigue (Boellinghaus et al., 2014), and greater physical well-being (Lee et al., 2021). ...
There are plenty of cute products in the marketplace even in difficult times. Yet, cute products do not always capture people's attention. Does insecure economic perception affect people's choice of cute products? To address this unexamined research gap, we propose that economic insecurity negatively influences cute product choice preference via the serial mediation effects of other‐focused concern and the need to connect with others. Desire for emotional support is proposed to moderate the focal relationship. We demonstrate these effects using four studies. Studies 1a and 1b tested the causal relationship between primed economic insecurity and choice preference towards cute products as well as ruling out several possible mechanisms (i.e., sense of control, affect, parental caring motives, risk aversion, the desire for cuteness, and the need for protection). Study 2 demonstrated that other‐focused concern and the need to connect with others serially mediated the above effect. Study 3 explored the moderating effect of desire for emotional support. Companies that manufacture cute products can benefit from our findings on how to communicate with consumers in times of economic downturn.
... "Compassionate empathy" [27,28] may enhance the quality of care, but also increases the emotional burden and the risk of burnout [29]. Klimecki and Singer emphasize the importance of striking a balance between empathy and emotional distance to prevent burnout [30]. ...
The primary objective of this study was to investigate how the tendency to make emotionally urgent decisions influences the perception of stressful situations in military nursing students during their clinical practice. A correlational cross-sectional design was employed, and data were collected from 79 cadets who were enrolled in a nursing program at the only Argentine military institution offering this degree. Two instruments were utilized: the Kezkak Inventory of Clinical Practice Stressors and the Inventory of Bases for Urgent Decision-Making in Extreme Circumstances. Simple linear regression analyses were conducted to assess the relationship between decision-making styles and specific stressful situations. The results indicated that the inclination to make emotionally urgent decisions was a significant predictor of overall stress perceptions and of specific situations in clinical practice, such as patient suffering, the inability to control the nurse-patient relationship, and the helplessness and uncertainty of not knowing how to proceed. This study highlighted the importance of developing emotional management skills in nursing students, particularly in military contexts, to assist them in making balanced and effective decisions in challenging clinical situations.
... The findings of this study hold potential implications for interventions and preventive programmes, highlighting that individuals with diverse empathic traits may have distinct needs and responses to stress that require targeted approaches. Clinicians should be mindful of the impact of affective empathy and focus on helping individuals respond to others' hardships without internalizing their pain, potentially mitigating empathic distress fatigue (Klimecki & Singer, 2012). A constructive approach may involve finding ways to translate affective empathy into compassion and active kindness, which has been shown to contribute to positive affect and emotional well-being (e.g., Weng et al., 2013). ...
Background: Evidence overwhelmingly suggests that adverse childhood experiences (ACEs) is a risk factor for poor mental health outcomes. However, the specific mechanisms via which ACEs confer an increased risk of psychopathology are less well understood. Objective: The study modelled the effect of empathy and perceived social support (PSS) on mental health outcomes in a mixed clinical and non-clinical population, within the context of exposure to ACEs. Participants and setting: A total of 575 participants (comprising a treatment-receiving and community-based sample), aged 18 to 65 completed self-report measures assessing early adversity, PSS, empathy, and mental health outcomes. Methods: Multiple mediation analyses were used to investigate whether empathy and PSS mediated the relationship between self-reported ACEs and mental health outcomes, and whether affective and cognitive empathy affected differentially the link between emotional neglect and psychological distress. Results: Results revealed a statistically significant indirect effect of ACEs on adult mental health through affective empathy and PSS. Emotional neglect was the only type of adversity significantly correlated with both dimensions of empathy. The indirect effect of emotional neglect on mental health outcomes via cognitive and affective empathy was also statistically significant. Conclusions:
Study results highlight the role of affective empathy and PSS as transdiagnostic mechanisms influencing the pathway between early adversity and adult mental health, and the importance of taking these into account when designing interventions aiming to promote well-being among those who have experienced childhood adversity.
... It has been suggested that effective emotional management is crucial in order to experience the healthy empathic concern that inhibits personal distress (Decety & Lamm, 2009;O. Klimecki & Singer, 2012), while personal distress has been proposed as indicative of poor emotion regulation (Eisenberg, 2000). The establishment of a secure base and internal equilibrium is fundamental in enabling individuals to sustain their empathic responses without becoming overwhelmed by the suffering of others (Bellosta-Batalla et al., 2019). Along with ...
Violence and offending pose significant public health concerns, and understanding the factors associated with these behaviors is crucial for effective intervention and prevention programs. While extensive research has focused on risk factors, the role of protective factors, such as empathy and self-compassion, has received less attention. This study examines the predictive value of cognitive and affective empathy on aggression and explores the mediating role of self-compassion in the relationship between personal distress and aggression within an offender population. A sample of 120 offenders (90 men and 30 women) completed self-report measures of aggression (Aggression Questionnaire), empathy (Interpersonal Reactivity Index) and self-compassion (Self-compassion scale – Short Form). Additionally, a semi-structured interview was conducted to collect sociodemographic information and criminal history. Results showed a negative association between perspective-taking (a cognitive empathy component) and aggression, while personal distress (an affective empathy component) positively predicted aggression. Self-compassion partially mediated the relationship between personal distress and aggression, indicating its potential role in reducing violent tendencies. These findings highlight the importance of considering empathy and self-compassion in understanding and addressing aggression in offenders. Specifically, a deeper understanding of the affective empathy construct and considering self-compassion as a complementary tool could enhance gender-inclusive prevention and intervention programs, potentially reducing recidivism rates.
Keywords: aggression; offenders; empathy; self-compassion.
... Compassion is conceptualized as generally positive, and "more is better" in terms of health and well-being. Empathy on the other hand can lead to positive outcomes such as empathic concern, compassion, and prosocial motivations and behaviors, whereas unregulated empathic distress can be aversive, decrease helping behaviors, and lead to burnout [32]. Compassion and empathy also appear to differ in underlying brain structure [33] as well as brain function [34]. ...
Evidence to date indicates that compassion and empathy are health-enhancing qualities. Research points to interventions and practices involving compassion and empathy being beneficial, as well as being salient outcomes of contemplative practices such as mindfulness. Advancing the science of compassion and empathy requires that we select measures best suited to evaluating effectiveness of training and answering research questions. The objective of this scoping review was to 1) determine what instruments are currently available for measuring empathy and compassion, 2) assess how and to what extent they have been validated, and 3) provide an online tool to assist researchers and program evaluators in selecting appropriate measures for their settings and populations. A scoping review and broad evidence map were employed to systematically search and present an overview of the large and diverse body of literature pertaining to measuring compassion and empathy. A search string yielded 19,446 articles, and screening resulted in 559 measure development or validation articles reporting on 503 measures focusing on or containing subscales designed to measure empathy and/or compassion. For each measure, we identified the type of measure, construct being measured, in what context or population it was validated, response set, sample items, and how many different types of psychometrics had been assessed for that measure. We provide tables summarizing these data, as well as an open-source online interactive data visualization allowing viewers to search for measures of empathy and compassion, review their basic qualities, and access original citations containing more detail. Finally, we provide a rubric to help readers determine which measure(s) might best fit their context.
... Compassion fatigue arises from stress -work-related stress and compassion stress (Stoewen, 2021). The question has been raised as to whether compassion fatigue is more accurately described as "empathic distress" fatigue (Klimecki & Singer, 2012). Exposure to the suffering of others can lead to two different emotional reactions: empathic concern, with sympathy and compassion, or empathic distress (Stoewen, 2021). ...
... En particular, promover el desarrollo de la empatía entre poblaciones vulnerables, como las víctimas de violencia o los migrantes, puede tener un efecto contraproducente y conducir al distanciamiento, a comportamientos evitativos, al aislamiento social, o a estados de depresión o ansiedad. Por ello, algunos autores han propuesto reemplazar el termino fatiga por compasión por conceptos que están más sustentados en la evidencia científica, como la fatiga por distrés empático (Hofmeyer et al., 2020;Klimecki & Singer, 2011) o simplemente el distrés empático (Chikovani et al., 2015). ...
Este artículo cuestiona el uso excesivo y acrítico de la empatía en proyectos de investigación creación aplicada con población vulnerable debido al riesgo de generar fatiga por distrés empático. Se cuestiona el uso inadecuado del término fatiga por compasión, pues se ha demostrado que la compasión no produce fatiga. En este contexto, se propone recurrir al concepto de amor compasivo, que ha tenido un interesante desarrollo conceptual tanto desde las neurociencias como desde el campo de las artes aplicadas al desarrollo del bienestar en poblaciones vulnerables. Este concepto, además, cuenta con novedosas herramientas psicométricas de evaluación que permiten determinar la efectividad de un proceso formativo en amor compasivo basado en las artes.
... Taking another person's point of view, also known as mentalizing, is the ability to see another person's situation from one's perspective through imagination, allowing oneself to generate an abstract understanding of the other person's mental state, which can thereby stimulate oneself empathy to enhance their well-being [6]. FMRI studies have shown that exposure to the distress of others can activate two distinct emotional empathetic responses, which either led to pro-social behavior and empathy through social cognitive pathways or to empathetic distress due to the blurring of the 'self-other' distinction as a result of poor emotional regulation [4,5,7,8]. The results of behavioral studies complement neurosurgical findings suggesting that empathy is associated with helping, rewarding, and forgiving behaviors, while compassion fatigue reduces helping behaviors and is associated with increased aggression [4,5]. ...
In a state of compassion fatigue, peoples work performance and social status are easily affected, and in severe cases, they may even cause some influence and harm to others. Therefore, it is important to study the factors that tend to affect empathy fatigue, the people who are prone to empathy fatigue and how to alleviate empathy fatigue, so as to reduce the occurrence of empathy fatigue. In this paper, the relationship between hypersensitive people and empathy fatigue and how to intervene and alleviate this fatigue phenomenon is studied through theoretical analysis and questionnaire survey. The analysis of the data from the questionnaire revealed that the more oversensitive people are, the more likely they are to develop the phenomenon of empathy fatigue, as well as the explanation that self-care and self-compassion can effectively intervene and alleviate empathy fatigue. This study has some limitations, which are explained at the end of this paper.
... Individuals with higher levels of maladaptive empathy may also experience internalizing psychopathology marked by negative affect (Tone & Tully, 2014). This includes anxiety and depression (O'Connor et al., 2012), neuroticism (Mooradian et al., 2011), and burnout (Klimecki & Singer, 2012). High scores of Personal Distress are related to interpersonal guilt, discomfort in social situations, difficulty maintaining relationships and even need for diverse participants for prevention and therapeutic implications to reach these populations. ...
Adverse childhood experiences (ACEs) have been proven to affect overall well-being, impacting physiological, psychological, and interpersonal functioning. Empathy is often regarded as cooperative behavior, but empathy is not always adaptive. Empathy becomes maladaptive when one disregards personal needs to care for another individual. Pathological concern, a compulsive need to care for another person, seems conceptually related to maladaptive empathy. The current study intended to assess the ability to predict pathological concern based on adverse childhood experiences (ACEs) and empathy. Participants (N = 171) completed a sequence of self-report questionnaires to assess ACEs, empathy, and pathological concern. Multiple regression analyses confirmed ACEs and empathy simultaneously predict pathological concern. The unique role of maladaptive empathy was revealed through exploratory analyses. Clinical and empirical implications are discussed, and future research directions are suggested to help understand this predictive relationship.
... The experience of trauma may be aggravated when empathic responses are not appropriately moderated by the social context (Levy et al., 2019;Couette et al., 2020). Broadly, empathy comprises emotion sharing and mentalizing (Singer and Lamm, 2009;Yu and Chou, 2018) and is essential for social living; however, it may exacerbate certain traumatic experiences (Klimecki and Singer, 2012;Branson, 2019). Maladaptive affective empathy (AffEMP; Figure 1) can prompt a disproportionate affective intrusion of others' distress, which can trigger traumatic experiences, whereas maladaptive cognitive empathy (CogEMP) can augment cognitive bias or incorrect knowledge of the contents of another person's mind (Naor et al., 2020;Hinnekens et al., 2021) and amplify interpersonal fear. ...
... Compassion is discussed as having an important role to play in helping humans to understand the emergency of the planet's ecology and climate, and compassion can help people to act with courage and acceptance of their limitations (Klimecki & Singer, 2012). Communicating compassion in action can motivate us to help (Leiberg et al., 2011); visual elements can be essential in this context. ...
During the past years, activist movements have increasingly turned to social media to raise awareness and critically discuss current development and future scenarios. As a contribution to the discussion of new social movements and activism in the digital age, this study aims to explore and critically discuss how environmental risks and crisis are visually communicated in activism campaigns on Instagram, through a case study on Extinction Rebellion Sweden (XRsv). The study is delimited to the first 334 posts on XRsv's Instagram between November 14, 2018 and March 1, 2020. Methods used are interview and content analysis. In conclusion, XRsv has adopted aspects of design activism including visual tactics of Informing, Activating and Explaining. These three visual aspects are used by XRsv in an online context enabling interactivity and participatory actions, which in turn forms the core of design activism.
... Family claudication, which is applied in the care context, is an expression that defines "the inability of family members to offer an adequate response to the patient's multiple demands and needs" (Cárdenas 2009). Furthermore, the imbalance between the care provided to the other and the self-care can lead the person who cares to an emotional disconnection and apathetic attitude as a form of self-protection from empathic suffering (Klimecki and Singer 2011). ...
In recent years, interest in topics related to disabilities has grown. However, little attention has been devoted to people who constantly care for family members with an intellectual disability (ID). Thus, this study evaluated the relationship between the caregiver burden of people with intellectual disabilities and spirituality. The applied method was quantitative, exploratory, descriptive, and cross-sectional. The instruments used to collect data were a sociodemographic questionnaire, including questions extracted from the WHOQOL-100 (spiritual domain), and the following scales: Centrality of Religiosity; Brief Spiritual Religious Coping; Religious and Spiritual Struggles; Zarit Burden Interview and Satisfaction with Life Scale. One hundred twenty-nine people participated in the study. The sample was categorized as “highly religious” (57.3%), and 61.24% had an overload classified between moderate (36.43%) and severe (24.81%). The use of positive spiritual/religious coping methods was considered medium (M = 3.44), and religious and spiritual struggles were low (M = 1.71). Results show that those who considered themselves “spiritual and religious” highly use positive spiritual religious coping and score light burden and more life satisfaction. Such results indicate the importance of being attentive to the role of this dimension when planning emotional, psychological, and existential/spiritual support assistance. Public policies should consider the spiritual and religious dimension of those exclusively caring for people with intellectual disabilities. Studies focusing on how spiritual care can be provided to this population should be intensified.
... In this study, the demonstration of empathy [41,42], communication skills, and professional competence of PT students were assessed simultaneously from different perspectives of different raters (i.e., SPTs, SP, and participants themselves). This application of 360degree evaluation and multi-dimension assessment is rare in the literature. ...
(1) Background: Empathetic communicative skills are the first step in establishing a good therapeutic relationship. The purpose of this study is to understand the effectiveness of improving the empathetic communicative skills applied to obtain accurate and precise information from patients via compound stimulus-drama in education. (2) Methods: A cross-sectional, one-group, pre- and post-test design was used for this study. In the two-day workshop, four clinical physiotherapists acted as tutors for the “Compound Stimulus-Drama in Education” module and assessed students’ performances. The Standard Patient Rating Scale (SPRS), Objective Structured Clinical Examination Scale (OSCES), Professional and Communication Self-Assessment Scale (PCSS), Patients’ Information (PI), and the Jefferson Scale of Empathy (JSE) were used to assess the students’ empathy scores and communication skills, before and after the course. (3) Results: Fifty-seven students participated in this study. The results showed that there were significant improvements in the SPRS, OSCES, PCSS, PI, and JSE (p < 0.05). Both the quantitative data and the participants’ reflection feedback suggest that this novel module was more helpful than traditional clinical practice courses for improving clinical empathy communication skills. (4) Conclusions: This study provided an innovative teaching model and assessment tools for learning clinic empathetic communicative skills in future education training.
... Earlier fMRI findings suggest that empathy and compassion are not identical concepts since the two have distinctive neurological pathways (Singer and Klimecki 2014;Vrticka et al. 2017). Empathy is a socioaffective path by which to 'feel with' others which increases negative emotions and distress when sharing the suffering of others too much, whereas compassion is a sociocognitive path by which to 'feel for' others which is linked to increases in helping, reward, and forgiveness behaviors (Klimecki and Singer 2012). Compassion can be trained through self-care practices (Hofmeyer et al. 2020). ...
Self-care is how nurses promote their own physical and mental health. Effective self-care is any strategy practiced on a regular basis to prevent stress and anxiety and to enhance the health and well-being. Self-care ranges from getting more rest to seeking professional help. Meditation practice is known to be an effective self-care strategy. The purpose of this study is to assess the effect of meditation as a self-care strategy among Korean nurses. Two groups of nurses at the university hospital, one with meditation experience and the other without, were selected as study participants, and their depression and resilience were analyzed. The results of the study show that, first, depressive symptoms were more prevalent among the nurses in the non-meditative group (62.2%) than the ones in the meditative group (15.6%), and resilience positivity was higher in the meditative group (4.01 ± 0.44) than in non-meditative group (3.04 ± 0.41). Second, nurses with depressive symptoms demonstrated particularly low resilience in both groups, indicating that resilience is inversely associated with other metal disorders. Third, after one and a half years since the study, the turnover rate of the non-meditative group (17.8%) was twice that of meditative group (8.9%). As stated in the earlier self-care literature that stressed the benefits of meditation, this study confirms that consistent meditation experience on a regular basis has an effect on nurses’ well-being via lower depression and promotes higher psychological well-being via resilience. This study is expected to provide the data collected from the field, including personal narratives, to establish more effective self-care strategies in personal and professional settings.
The role of teacher empathy is recognized as a key factor in improving teacher-student interaction, motivation and academic performance. Despite the importance of teacher empathy, its role in promoting inclusive education is still largely unknown. High levels of empathy are not necessarily associated with greater ability to implement inclusive education, as they can lead to excessive emotional engagement and stress, which negatively affect teachers' abilities. Therefore, the present study explored whether the relationship between high empathy and perceived ability to implement inclusive education could be moderated by other variables, such as emotional self-efficacy and gender. A large sample of Italian support teachers (N=739; M age =37.7; females= 86.9%) was recruited for this study. We found that higher levels of empathy were related to higher levels of self-efficacy in inclusive education, especially when levels of emotional self-efficacy were higher. This relationship was only found for female teachers. The results contribute to knowledge about the role of teachers' empathy for inclusion as well as the moderating role of the ability to regulate negative emotions. The study has implications for pre-service teacher education and in-service teacher training.
Brain-compatible employee leadership is an attitude. At its center is the relationship design with the knowledge that people form a complex, dynamic unit in the work context. Effective listening accompanies all communication processes. Leaders know that it is important for members of teams to be able to transform empathy (feeling with) into compassion (feeling for). The honest intention to strengthen the basic need for self-preservation is based on sincere appreciation and recognition. Relationship design is central to resilience promotion. In addition, it helps to provide social support, to show ways to self-efficacy and coherence and also to encourage active coping strategies. Mindful Leadership is another important influence on brain compatible leadership.
Mindfulness and self-compassion practices and programs are evidence-based practices that have positive effects for HCPs as they can be used to build resilience and minimize burnout. Detailed examples and vignettes of the practices are provided. Implementing these practices in the individual, academic, and healthcare system have yielded positive results, but must be balanced with other factors. Knowing when and how to implement or use these programs and practices requires discernment.KeywordsMindfulnessHealthcare professionalsEmpathyMeditation
The role of compassion in healthcare has become increasingly important, especially since it is now considered one of the six “Core Values” in the United Kingdom’s National Health Service [1]. This chapter will present a psychological theory and approach which places building compassion (for self and others) at the heart of its aims: Compassion Focused Therapy (CFT) [2, 3]. The role of building compassion for people living with HIV and health professionals working in this field will be explored.KeywordsHIVCompassionPsychological distressHealth outcomesStaff self-careCompassion fatigueShame
Since the first edition of The Handbook of Psychiatry in Palliative Medicine was released in 2000, it has come to occupy an important and distinctive niche within the literary anthology of palliative medicine. The Handbook is widely regarded as the definitive reference on psychosocial issues affecting patients with life-threatening and life-limiting conditions and their families. The formula for achieving this status has been simple and overwhelmingly successful: gather the world’s preeminent leaders in palliative care—the very best of the very best—and give them an impeccable platform from which to declare the state of the art within their respective areas of expertise. Simply put, there is no more authoritative reference for psychosocial palliative care than will be found between these pages. The book is divided into 45 chapters and seven distinct sections, including Psychiatric and Psychosocial Palliative Care: Overview; Psychiatric Complications of Terminal Illness; Psychosocial Issues in Palliative Care; Ethical, Existential, and Spiritual Issues in Palliative Care; Understanding and Managing Symptoms; Psychotherapeutic Interventions in Palliative Care; and Life Cycle Considerations in Palliative Care. A subtitle has been added to the third edition: Psychosocial Care of the Terminally Ill. This revision was made to declare an expanded mandate for the Handbook, one reaching across varied professionals with a vested interest in supporting and caring for the terminally ill. The past two decades have seen an all-encompassing, multidisciplinary approach to care for the dying take hold. The Handbook of Psychiatry in Palliative Medicine: Psychosocial Care of the Terminally Ill is an attempt to affirm the importance of this approach for all patients, and their families, moving toward death.
Compassionate care is vital to quality palliative care and integral to the provision of spiritual care at the end of life. But is sustaining compassion costly for healthcare providers (HCP), impacting their emotional and spiritual wellbeing, professional purpose, and moral self-image? Concerns about the costs of compassion for carers have gathered pace in a growing healthcare literature on compassion fatigue. Critics, however, argue that compassion fatigue lacks adequate conceptualisation, querying whether it fits with HCP’s own perceptions and suggesting it lacks utility for identifying interventions. This article contributes to this debate about moving beyond compassion fatigue, by bringing new psychological research on compassion as a motivated choice to bear on these questions and demonstrating its potential for illuminating interventions to support compassion in palliative care contexts. It proposes a focus on motive-based interventions which serve to tip the cost–benefit analysis in relation to compassion and thus support HCP motivation to feel and act compassionately. A key implication of this approach is that sustaining compassion is not up to individuals alone, as can often seem to be the case with ‘self-care’ paradigms. Rather, there are multiple ways institutions and society can play a role in motive-based interventions to sustain HCP compassion and wellbeing. The final section explores one example in the form of institutional support for spiritual care education.
Organisations consist of people and people are beings guided not only by rational cognitive processes but also by emotions and seemingly irrational motives based on affect. This chapter elucidates the matter of intra-and interpersonal emotion regulation at work through the prism of employees and their leaders. It provides a critical overview of multiple aspects of the topic, outlining their importance in terms of subjective wellbeing in the workplace and objective performance at work as well as contemporary theoretical frameworks and empirically-based practical solutions. It helps readers to understand conscious and subconscious processes of regulating own and others' emotions in occupational settings and explain various subsequent outcomes for organisations and their employees.
This paper reports a study on the impact of a smartphone meditation app (M-App) in building resilience and competencies among social workers with aging in place (AIP) initiatives. Compared to a control group who used the leisure app (L-App), M-App users reported greater resilience and gerontological social work competencies 6 months posttest (T2). Women social workers, Christians, who specialized in home-based care, and whose core clientele comprised older adults with acquired disability and long-term illness, reported greater resilience at T2. Women social workers and those who specialized in home-based care exhibited greater gerontological competencies at T2. Disciplined M-App usage and self-practice mediated the association between socio-demographic moderators and outcomes. Clients of women and Christian social workers, home-based care specialists and those who diligently adhered to the intervention reported higher satisfaction. The interesting finding was that this satisfaction was reported by Christian clients and those who lived with family members as compared to Hindu and Muslim clients and those who lived alone with formal caregivers. For gerontological social workers with AIP initiatives, the M-App could be used in a continuing education training with some refinements for men, non-Christian social workers and engaged in AIP programs through community and neighborhood support practice.
Compassionate work can be greatly rewarding yet also costly. It can incur a cost, “the cost of caring,” commonly known as compassion fatigue. Over the last two decades, compassion fatigue has increasingly come to be recognized as a significant stress-related occupational hazard for those in the animal care community, including those who work in animal health, animal welfare, and biomedical research. Compassion fatigue arises from the duality of providing care and being exposed to trauma as a part of the work. The symptoms and consequences – personal, professional, and organizational – vary from person to person and within different contexts. In order to address compassion fatigue, it needs to be recognized. Although it cannot be prevented, it can be mitigated, transformed, and treated. This is centered in the concept of resilience, which starts with awareness of compassion fatigue, and grows with implementing personal and organizational approaches, strategies, and practices. Importantly, resilience in the animal care community can be built on the back of veterinary social work. By attending to the causes, signs, and consequences of compassion fatigue, veterinary social workers can support the health and well-being of those who work in animal care and promote personal, interpersonal, and organizational resilience.KeywordsAnimal healthAnimal welfareBiomedical researchCompassion fatigueEuthanasiaSelf-careSocial support
A simple model of work stressors, perceived stress, burnout, affect, general health and clinical competence was tested in 46 internal medicine and surgical residents across the course of one year of residency training. As predicted by the model, increased perceptions of stress were associated with increased levels of both job- and patient-related burnout later in the residency year. This pattern was especially pronounced in male residents. Furthermore, increased levels of patient-related burnout were associated with greater mood disturbance, as well as poorer general health, while higher levels of job-related burnout were found among those individuals with the lowest ratings of clinical competency at the end of the residency year. Despite self-reported decreases in hours worked across the year, and increases in reported sleep, depression was found to increase in this group of residents. The results of the present study suggest that interventions designed to assess and address perceived stress, health, mood and level of burnout may be most effective in alleviating the professional and personal difficulties often associated with medical residency.
Understanding the effects of prolonged contact, in a professional role, with trauma victims has led to conceptualizations of helper stress. Various terms such as compassion fatigue, vicarious traumatization, secondary traumatic stress reactions, empathic strains, burn out, and Type land Type II countertransference have been proposed These terms required conceptual classification to make a proper diagnosis and classification of their impact on the helping process. It is proposed that Traumatoid States is a more inclusive and accurate term to define sub-types of occupationally-related stress response syndromes (OSRS).