As a future social or healthcare worker, your life will be dedicated to providing compassion and care to other humans at their most traumatic and vulnerable times. It’s only natural that dealing with such upsetting events day after day would cause stress on your mental and physical health, negatively affecting your personal life and well-being. In fact, you may have already begun to experience the symptoms of compassion fatigue while completing the fieldwork necessary to earn your degree.
According to researchers from Baylor and Texas A&M, those who provide social work services are likely to experience physical and emotional side effects, putting them at higher risk for compassion fatigue. In fact, more than 70% of social workers will experience this phenomenon, which is also called “secondary traumatic stress,” in their careers. Social workers aren’t the only ones who suffer from compassion fatigue — The University of Rochester Medical Center reports that 25-50% of healthcare workers also experience these symptoms.
While providing support through negative events comes with unique challenges, you chose to pursue a degree in social work or healthcare so you could help others. By taking special care to understand, identify, and mitigate the signs and symptoms of compassion fatigue, you can continue caring for others while meeting your own needs. To that end, we’ve put together this guide to provide new MSW graduates and healthcare workers with a solid resource for recognizing and combating compassion fatigue.
Compassion Fatigue vs. Caregiver Burnout
It’s natural to feel empathy for the people you are helping, but sometimes the weight of taking on others’ trauma becomes overwhelming, causing compassion fatigue or caregiver burnout. While these conditions are similar, you’ll find they have nuanced differences — which will be explained in detail below. However, overlapping symptoms include:
- Emotional, mental, and physical exhaustion
- Reduced sense of personal accomplishment or meaning in work
- Decreased interactions with others (isolation)
- Depersonalization (symptoms disconnected from real causes)
Caregiver Burnout Defined
Spending extensive amounts of time on one task, especially over an extended period of time, can trigger feelings of emotional and physical exhaustion. While a long shift or challenging day might trigger surface-level stress, caregiver burnout is different because it builds cumulatively while you’re tending to the needs of others.
Rather than feeling worn out and like you need a good night’s rest or vacation away from work, burnout presents more like extended fatigue. You may feel overwhelmed with your job duties, begin falling behind at work, and feel unable to keep up with your usual personal responsibilities. Common signs of caregiver burnout include:
- Losing interest in previously enjoyable activities
- Feeling depressed, irritable, or hopeless
- Fluctuating appetite or weight
- Changing sleep patterns
- Getting sick more often
Unlike compassion fatigue, however, burnout is less likely to lower your threshold for expressing empathy for those in your care.
Compassion Fatigue Defined
Compassion fatigue describes the negative impact of working closely with individuals who have experienced trauma or suffering. Though it’s commonly used interchangeably with “caregiver burnout,” it’s a more severe condition that results when burnout is magnified by secondary traumatic stress (STS). STS affects those who have experienced indirect trauma, such as working with traumatized patients, and it’s a significant contributing factor to compassion fatigue.
While burnout usually develops gradually, compassion fatigue can occur suddenly, especially if you’ve been exposed to traumatic events. Consequently, it’s considered more severe than burnout. If affected by compassion fatigue, you may experience:
- Nervous system arousal
- Increased emotional intensity
- Decreased cognitive ability
- Impaired behavior and judgment
- Depression and post-traumatic stress disorder (PTSD)
- Loss of self-worth and emotional modulation
- Negatively impacted identity, worldview, and spirituality
- Loss of hope and meaning; existential despair
- Anger toward perpetrators or causal events
Clearly, compassion fatigue can even affect your thoughts, sleep, and health habits. Moreover, while burnout may be solved by leaving a job, untreated compassion fatigue can follow you across professional roles.
Who is Susceptible to Compassion Fatigue?
Anyone who is regularly exposed to the traumatic experiences of their clients, patients, or loved ones is potentially susceptible to compassion fatigue. It can be overwhelming to step into these roles, especially for the first time. Those who are new to these positions, like students performing field work or recent graduates launching their careers, are especially at risk of developing compassion fatigue.
Social Workers
Social workers often step into people’s lives to deal with severe cases, such as child abuse, addiction, poverty, or mental health issues. It’s their job to be the bridge between individuals or families and the resources and support they need, which requires them to become involved with carrying the emotional burden of their client’s distress. This consistent exposure to suffering, along with a high-stress work environment and workload, can lead to compassion fatigue.
Nurses
Nurses are an integral population at the frontlines of healthcare. In their professional capacity, they manage emergency room scenarios, care for critically ill or dying patients, comfort distressed family members, and often witness death and suffering. The emotional toll of continually providing empathetic care, coupled with long hours and a physically demanding job, can result in compassion fatigue. It’s especially prevalent among nurses in high-stress specializations, such as the ICU or oncology.
Caregivers
Caregivers, especially those who look after older adults or individuals with chronic illnesses or disabilities, often deal with high stress levels and emotional exhaustion. They carry the responsibility of managing someone’s well-being, facing potential loss, and dealing with unmet expectations, all of which can contribute significantly to compassion fatigue. Additionally, the isolated nature of this work can amplify feelings of exhaustion and stress, as caregivers feel obligated to prioritize the well-being of the person in their care.
Mental Health Professionals
Mental health professionals are continually exposed to their clients’ traumas, anxieties, and depressive episodes as they provide support. The intense emotional engagement required in therapy and the responsibility of managing clients’ mental health can lead to compassion fatigue. This can be especially true if a patient’s progress seems slow, the professional feels unable to effect significant change, or their client load is exceptionally high.
Educators/Teachers
Teachers not only educate students, but they also often serve in the role of counselor, mentor, and even surrogate parent. Each student in a classroom has unique needs, home life environments, and educational challenges. Dealing with these diverse needs, family issues, and learning paths requires significant emotional labor and time. When coupled with the high demands of the educational system — like the pressure to meet testing standards and operate on limited resources — this may result in compassion fatigue.
Emergency Responders
Emergency responders such as EMTs, firefighters, and police officers are repeatedly exposed to traumatic situations, including accidents, violence, and life-threatening conditions. They’re often the first ones on the scene at events requiring immediate, life-saving action. The high-stress nature of their work and the necessity to maintain composure and professionalism in a crisis can often lead to compassion fatigue. This can be further exacerbated by working irregular shifts and encountering personal risk on the job.
The Signs and Symptoms of Compassion Fatigue
Recognizing and addressing the symptoms of compassion fatigue enhances your ability to care for your clients and patients and safeguards your mental and emotional well-being as you provide care and support to others. Below, we’ve listed some of the significant symptoms of compassion fatigue — which fall along a continuum from worrisome to extreme — for self-reflection and assessment.
Apathy
Apathy is a significant indicator of compassion fatigue. After giving so much of their own time and energy, caregivers may begin to display a lack of concern for their own well-being or those in their care. This indifference can also show up as a loss of motivation, decreased engagement with coworkers and loved ones, or a diminished sense of empathy. People often use emotional numbing tendencies as an automatic defense mechanism against overwhelming stress or trauma.
Emotional Exhaustion
Emotional exhaustion is feeling overextended and totally depleted of emotional resources. Caregivers may feel that their “cup is empty” and that they have nothing left to give to clients. While suffering from compassion fatigue, people may have a chronic feeling of being emotionally drained, overwhelmed, or unable to meet the demands of a job, leading to a sense of powerlessness, inability to cope, and reduced ability to complete day-to-day obligations.
Increased Anger/Irritability
A heightened sense of irritability or a lowered threshold for anger can also be a warning sign for compassion fatigue. Those who are affected may find themselves reacting disproportionately to previously minor annoyances, exhibiting a shorter temper than usual, or constantly feeling frustrated. Things that would once roll off someone’s back might trigger more significant emotional responses than they ever would have before. This change in mood and behavior can also increase stress and strain in personal and professional relationships.
Poor Physical Health
A sudden or dramatic decline in physical health may indicate compassion fatigue in caregivers. Persistent exhaustion, trouble sleeping, frequent headaches, gastrointestinal issues, and unexplained weight changes can all present as physical manifestations of compassion fatigue. These symptoms are also associated with chronic stress and insufficient self-care, often making keeping up with typical healthy routines more challenging. These symptoms can significantly affect an individual’s quality of life, long-term health, and work performance.
Declining Mental Health
The mental and emotional toll of sustained caregiving can be stressful, and that stress can exacerbate or lead to mental health issues like depression, anxiety, hopelessness, and persistent pessimism. These symptoms may further manifest as constant sadness, overwhelming fear, a sense of impending doom, or a cynical worldview. Those experiencing mental health challenges may have difficulty concentrating on tasks, notice increased self-blame, or experience lower self-confidence than usual.
Deteriorating Relationships
The chronic stress and emotional exhaustion that are so common with compassion fatigue may drive individuals to socially withdraw or lash out at loved ones, causing their most intimate relationships to suffer. They might find themselves increasingly isolated, struggling to maintain personal and professional relationships, or hanging back from participating in activities they once enjoyed. Maintaining positive relationships with a support system is vital for combating compassion fatigue, and stepping back from these relationships can compound other stressors and adverse effects.
Substance Abuse
In the wake of traumatic experiences, some caregivers turn to drugs and alcohol to disconnect from their emotions, unwind at the end of the day, or dull frustration. Increased reliance on these substances can indicate compassion fatigue, manifesting as increased consumption, using substances as a coping mechanism, or an inability to reduce usage despite the potential negative consequences. Over-reliance on drugs and alcohol for any length of time also comes with an elevated risk of long-term health consequences.
Violence
In extreme cases, unchecked and untreated compassion fatigue may lead to violent behavior. Those experiencing compassion fatigue may turn to self-harm or become aggressive with others. They may even commit domestic violence on their children or partner or acts of workplace violence. These outcomes are severe and serious, so it’s incredibly important to recognize and address compassion fatigue as early as possible as a preventive measure for such instances.
Actions to Minimize Compassion Fatigue
Awareness of the signs of compassion fatigue is a crucial first step toward healing, but taking proactive measures can help prevent you from experiencing the most severe effects. Implementing self-care strategies is an excellent way to foster resilience to compassion fatigue, enhance your overall wellness, and help you sustain empathetic responses. Caring for yourself can also help you recover from stress and nurture your ability to be more compassionate to yourself and others.
Check in With Yourself
Strengthening self-awareness is the first step in recognizing the potential onset of compassion fatigue. Check in with yourself regularly, and be honest about your feelings, mood, habits, and routines. Journaling can be a fantastic tool for self-reflection and expressing emotions. Still, if that’s not your thing, there are free or low-cost apps — like Daylio Journal — that allow you to gather helpful data over time so you can hone in on potential triggers or troubling trends before they worsen.
Focus on Your Wins
Especially when you’re working with high-risk or traumatized clients, sometimes it’s difficult to see past what you wish you could do differently or change that’s slow to come. Switching up your approach to challenges can provide a much-needed perspective shift, enabling you to view things in a new light. Instead of focusing all your attention on one end result, celebrate the small wins that happen each day. Break down a larger goal into smaller milestones, track progress, and reward yourself along the way.
Practice Self-care
Establishing and maintaining a self-care routine gives you a baseline habit of making space for activities that restore your health and energy. As a result, you’ll have more mental and physical capacity to do your best and experience compassion satisfaction. Self-care looks different for each person, but the most important thing is choosing a routine that fits your needs, then blocking time to make space for those things regularly.
Prioritize Your Health
When you’re working long hours that leave you feeling emotionally and physically exhausted, it can be tempting to place your own needs on the back burner. Deprioritizing your health can put you on the fast track to burnout and compassion fatigue, so make room for healthy eating habits, an exercise routine, and deep breathing or meditation exercises that help manage stress. Maintaining a consistent sleep schedule can also help your overall health.
Establish Boundaries
Many caregivers feel pressure to give their clients every ounce of their time and energy, but maintaining boundaries is key to protecting your mental well-being. Take adequate time off from your job, establish times that are off-limits for work tasks, and try to avoid work entirely on days off. Prioritize recognizing and honoring your emotional needs and taking time to get the space and support you need. For example, if you’ve set aside time for exercise or a day off, stick to the plan and step away from client work during those times.
Find a Healthy Outlet
Engaging in activities that release stress can significantly improve your overall health. Try creative and expressive outlets like creating art, writing, or playing an instrument, which can provide a therapeutic emotional outlet. Hands-on hobbies can act as a form of meditation that fosters mindfulness and a sense of balance amidst the challenges of caregiving, while physical activities like running, hiking, or yoga are beneficial for your bodily health and burning off accumulated stress.
Lean on Your Support System
Not having a support system is one of the most common risk factors for compassion fatigue, which means your family, friends, and professional colleagues are one of your best resources for sustaining resilience as you work in a caregiving field. Make time to connect with them regularly, share your experiences, and draw strength from their support. If you’d like to connect with other caregivers who understand your work life, consider joining a support group for those in the field.
Speak With a Professional
There’s no shame in needing help and support from a professional who is dedicated to your needs. Therapy provides a safe space to express your feelings, reflect on experiences, and form new coping strategies. Therapists are trained to listen with empathy, helping you identify and validate your emotions. They can also guide you in building better boundaries, developing adequate self-care routines, and finding tools to manage and mitigate the effects of compassion fatigue.
Resources for MSW Students and Future Caregivers
As you study for your MSW or prepare for your caregiving career, arming yourself with reliable resources is paramount to your professional success and personal well-being. The following resources have been curated to offer valuable insights, guidance, and support on your journey. These tools can equip you to understand, recognize, and combat compassion fatigue, fostering a fulfilling career in caregiving.
- Calm App: The Calm App offers guided meditations, sleep stories, breathing exercises, and relaxing music to help reduce stress and anxiety, improve sleep, and encourage mindfulness.
- Compassion Fatigue Assessment: Advisory Board provides a downloadable compassion fatigue self-assessment to help you recognize both the apparent and invisible symptoms of compassion fatigue.
- The Compassion Fatigue Awareness Project: This organization exists to raise awareness of compassion fatigue and its effects. You can find resources for identifying and coping with compassion fatigue on its website.
- Compassion Fatigue Podcast: This short podcast from the BBC explains why caregivers experience compassion fatigue and how feelings of overwhelm can cause emotional numbing or burnout.
- Compassion Resilience Toolkit: Wise Initiative created this online resource to promote well-being in caregiving individuals and teams. You can choose between specialized toolkits for schools, health and human services, or parents and caregivers.
- Emotional Wellness Toolkit: The National Institutes of Health maintains this emotional wellness resource, outlining six core strategies for improving emotional health. You can also download handy checklists for each plan.
- National Association of Social Workers: The NASW is the largest membership organization of professional social workers, offering resources for social work students on ethical standards, advocacy efforts, and continuing education opportunities. You’ll also find links to the organization’s blog and research about many factors social workers face in their career.
- Self-Care for the Caregiver: This blog from Harvard University explains how self-care combats stress, providing five practical examples of how caregivers can practice better self-care.
- Tips for Better Sleep: Maintaining good sleep hygiene is one of the most powerful ways to lower stress levels and practice positive self-care. This guide from the CDC outlines how to form stronger sleep habits.
- When We’re Not OK: Understanding and Managing Compassion Fatigue: In this podcast from Clearly Clinical, Dr. Dain Kloner, LMFT, discusses strategies for self-assessing, identifying, and resolving compassion fatigue.
Interview with An Expert: Compassion Fatigue
Are there any unexpected or subtle signs of compassion fatigue that people may not commonly recognize?
Compassion fatigue may manifest subtly and can vary from person to person. Initially, it can feel like having a stretch of days where you feel “not yourself” or “off.” Work and general tasks begin to feel more tedious, but because there are other symptoms that emerge, it’s easy to explain the feelings away because of exhaustion or sleep issues. The combination of symptoms is unique, and not all signs may manifest in every individual. Also, the symptoms may change over time.
Some subtle signs of compassion fatigue could include:
- A decrease in self-care
- Feeling guilty about taking breaks or time off
- Constantly thinking about work
- Over-identifying with the pain or suffering of others
- Experiencing a sense of hopelessness
What are some of the ethical considerations or challenges that arise when professionals experience compassion fatigue? How can these challenges be navigated while maintaining quality care?
There are multiple ethical challenges that can arise when a professional is experiencing compassion fatigue. The symptoms can impair decision-making, decrease empathy, and increase the chance of professional errors that can cause potential harm to clients. Boundary issues and breaches of confidentiality may be more likely, and the individual can be more susceptible to vicarious trauma.
To navigate these challenges while maintaining quality care, it is essential to be mindful of one’s well-being, prioritize self-care, set boundaries, and engage in stress-reducing activities. Regular supervision and support can provide guidance and emotional assistance.
Workplaces play a vital role in preventing and managing compassion fatigue. It is important for managers/supervisors to not only encourage self-care, time off, and setting boundaries with work, but also to model these behaviors. By proactively addressing compassion fatigue, professionals can maintain care standards while safeguarding their own well-being and that of their clients.
In your experience, what is the potential impact of compassion fatigue on individuals’ personal lives and relationships outside of their work or studies, and what strategies can they use to safeguard against these impacts?
Compassion fatigue not only impacts professionals at work, but also significantly affects their personal lives and relationships. In severe cases, compassion fatigue can even result in the breakdown of relationships, health problems, work-related issues, and financial challenges.
To safeguard against compassion fatigue, prioritizing self-care, managing stress, setting appropriate boundaries, and regularly checking in with oneself to identify and address issues early on are essential. Preventative measures can be highly effective in protecting against its negative effects. However, if the symptoms become increasingly difficult to manage or persist over time, seeking support from mental health professionals or supervisors is crucial.
By proactively addressing compassion fatigue and implementing supportive strategies, professionals can safeguard their personal well-being and maintain healthier relationships both within and outside of their work or studies.
Are there any specific tools or assessments available that can help professionals in social work and caregiving professions measure their level of compassion fatigue and track their well-being over time?
There are a few assessments designed to identify and evaluate the symptoms associated with compassion fatigue, burnout, and related stressors. The Professional Quality of Life (ProQOL) Scale, Compassion Fatigue Self-Test, and the Brief Resilience Scale (BRS) can be found online for free. Additionally, there may be resources available through your workplace or school.
Can you share some techniques or strategies that are particularly effective in preventing or coping with compassion fatigue specifically for students who are still in the learning phase and might feel overwhelmed?
Coping with compassion fatigue is crucial for students in caregiving professions, especially during clinical rotations and fieldwork assignments, where challenging situations may be encountered for the first time. In addition to self-care practices, setting clear boundaries, and practicing mindfulness and stress management techniques, some effective coping techniques and strategies to prevent and manage compassion fatigue specifically tailored for students include:
- Education and awareness — Learn about compassion fatigue, what it is, its signs, and possible impact on caregivers. Becoming aware of the risks can help students recognize early warning signs and take proactive steps to address them.
- Seek supervision and support — Utilize available supervision and support systems during clinical rotations and fieldwork. Discuss challenging cases or emotions with supervisors, mentors, or trusted colleagues to process feelings and gain insights.
- Peer support — Connect with classmates and colleagues who are also experiencing similar challenges. Sharing experiences and offering mutual support can be beneficial in managing compassion fatigue.
- Utilize resources — Many universities have resources on campus or through organizations that support students in caregiving professions. These resources may include counseling services, workshops, or support groups.
Are there any ways that organizational culture and leadership in workplaces such as hospitals, care homes, and therapy centers can play a role in mitigating the risk of compassion fatigue among employees?
I absolutely love this question, and the answer is yes! I work with many professionals in healthcare industries who are intelligent, hardworking, and habitually prioritize the needs of others over their own — sometimes to their detriment. Organizations should be intentional about creating a supportive and nurturing work environment to help employees cope with the emotional demands of their roles and reduce the likelihood of compassion fatigue. Some ways organizational culture and leadership can contribute to this:
- Promote a culture of safe and open communication between employees and their supervisors.
- Provide training and education on compassion fatigue, stress management, and self-care.
- Make self-care a regular topic of discussion and encourage employees to prioritize their well-being. I also like the idea of making certain self-care activities obligatory, such as employees must use vacation time or having the policy that the last hour of a shift is for completing paperwork so that employees can leave on time.
- Walk the talk: Organizational leaders should model self-care and emotional well-being.
- Set realistic work expectations.
- Recognize and appreciate employees.
- Promote work-life balance.
- Identify and address organizational stressors that contribute to compassion fatigue, such as ineffective communication, conflicts, or inadequate resources.
- Monitor employee well-being with surveys and check-ins.
How can therapy help people prevent, overcome, and/or form better coping techniques for navigating compassion fatigue?
Therapy can help healthcare professionals learn to identify symptoms of compassion fatigue, establish healthy boundaries, use stress management techniques, and build self-care practices to prevent emotional exhaustion. It’s also a safe space to explore emotions, identify causes, and develop effective strategies. It may also be helpful to explore personality characteristics and tendencies that make caregivers more susceptible to compassion fatigue. Coping strategies like mindfulness, relaxation, and communication skills are often taught to manage stress.
Therapy builds resilience, empowering individuals to overcome challenges, providing them with emotional support to process work-related experiences, and addressing personal and professional conflicts that contribute to compassion fatigue. It aids in career reflection and decision-making.
For those working with trauma survivors, therapy can help the individual process their emotions to prevent vicarious trauma. Ongoing support helps sustain emotional well-being. While many of my clients begin therapy because they are experiencing distress, ongoing therapy can be helpful in learning how to prevent it from occurring again.
