Implications For Future Research
This review indicates that there is some promising evidence emerging about interventions to reduce CF, in particular in nurses. However, given the small number of published studies to date, it is difficult to determine the impact on this or other occupations. The review has shown that in particular, there is a gap in research conducted in many emergency occupations such as police and fire fighters, and other health community services such child protection and disability support workers, and disability and human service workers, and further research is needed using more rigorous study designs and representative samples. These groups are particularly susceptible to developing CF due to the nature of their work. In addition, future research could focus on the impact of CF interventions in a more diverse range of at-risk occupation groups, over-sample younger aged workers and men in order to the determine the effectiveness of interventions designed to reduce CF, or prevent and manage known risk factors, in these established at-risk populations.
Why Does Burnout Happen
Burnout is a form of exhaustion caused by constantly feeling swamped. Its a result of excessive and prolonged emotional, physical, and mental stress. In many cases, burnout is related to ones job. Burnout happens when youre overwhelmed, emotionally drained, and unable to keep up with lifes incessant demands.
What Is Compassion Fatigue
Compassion fatigue has been described as the cost of caring for others in emotional pain . The helping field has gradually begun to recognize that workers are profoundly affected by the work they do, whether it is by direct exposure to traumatic events secondary exposure and the full gamut in between such as working with clients who are chronically in despair, witnessing peoples inability to improve their very difficult life circumstances or feeling helpless in the face of poverty and emotional anguish. The work of helping requires professionals to open their hearts and minds to their clients and patients unfortunately, this very process is what makes helpers vulnerable to being profoundly affected and even possibly damaged by their work and yet it is an essential skill to maintain in order to be effective, ethical and compassionate.
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Vicarious Trauma And Compassion Fatigue
Recent studies have indicated that vicarious trauma is a major challenge capable of affecting counselors professional and personal outcomes . The term vicious trauma refers to the distressing reaction to the experiences of a client .
First responders and counselors are usually vulnerable to clients experiences or stories. The control can be taken from the counselor and eventually make him or her helpless. This development can result in shattered identity. Affected counselors and first responders will find it hard to interact positively with their family members. Hayden, Williams, Canto, and Finklea believe that vicious trauma makes it hard for responders to develop meaningful relations with their clients due to guilt. Counselors who are vulnerable to this kind of trauma might commit therapeutic impasses or clinical errors.
Increased levels of vicarious trauma can eventually result in countertransference . When a counselor is exposed to high levels of trauma, his or her cognitive schema is disrupted. Countertransference usually occurs when the counselor unearths traumatic events during therapeutic sessions. First responders and counselors therefore tend to have higher chances of developing vicarious trauma
Factors Contributing To Compassion Fatigue In Student Affairs Professionals
Student affairs professionals who are more emotionally connected to the students with whom they work and who display an internal locus of control are found to be more likely to develop compassion fatigue as compared to individuals who have an external locus of control and are able to maintain boundaries between themselves and those with whom they work.
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Developing A Warning System
Say that you were to learn to identify your CF/STS symptoms on a scale of 1 to 10 .
Then, you learn to identify what an 8 or a 9 looks like for you i.e. when Im getting up to an 8, I notice it because I dont return phone calls, think about calling in sick a lot and cant watch any violence on TV or I know that Im moving towards a 7 when I turn down my best friends invitation to go out for dinner because Im too drained to talk to someone else, and when I stop exercising.
Being able to recognize that your level of CF/STS is creeping up to the red zone is the most effective way to implement strategies immediately before things get worse.
But look back to what also emerges in this process: you are starting to identify the solutions to your depletion.
If I know that I am getting close to an 8, I may not take on new clients with a trauma history, I may take a day off a week, or I may return to see my own therapist.
In order for you to develop your warning scale, you need to develop an understanding and an increased awareness of your own symptoms of compassion fatigue and vicarious trauma/STS.
Coping And Management Strategies
Identifying compassion fatigue can help you start taking steps to manage it. British Columbias Compass Mental Health Program has provided some tips for coping during these stressful times:
- Practise mindfulness throughout the day by being aware of your thoughts, feelings and physical sensations.
- When you start to feel anxious, help yourself calm down by focusing on your breath and slowing down your breathing rate.
- If you feel overwhelmed and out of control, take a moment to think about what you do have control over and what you can change.
- Establish a good self-care routine that includes eating healthy, getting more exercise and getting enough sleep.
- Reach out to others for support, whether thats friends, family or a peer support group.
- Set aside time for meaningful activity and find ways to connect with loved ones.
- Take a break from the news and limit the time you spend online every day.
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Warning Signs Of Secondary Trauma And Compassion Fatigue
Learning to recognise ones own warning signs of compassion fatigue and vicarious/secondary trauma serves a two-fold purpose:
First, it can serve as an important check-in process for someone who has been feeling unhappy and dissatisfied, but does not have the words to explain what is happening to them.
Secondly, developing a warning system allows you to track your levels of emotional and physical depletion. It also offers you tools and strategies that you can implement right away.
Who Coined The Term Compassion Fatigue
The understanding that exposure to the trauma of others could put people at risk has long been understoodhistorian Samuel Moyn has said, Compassion fatigue is as old as compassion, but the term was coined by historian Carla Joinson in 1992, and further defined and researched by psychologist Charles Figley, who describes it as a state of exhaustion and dysfunction, biologically, physiologically and emotionally, as a result of prolonged exposure to compassion stress.
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What Factors Contribute To Cf/vt And Burnout
There are many reasons for which helping professionals can develop compassion fatigue and vicarious trauma. These are described in Saakvitne and Pearlmans book Transforming the Pain :
Your current life circumstances, your history, your coping style and your personality type all affect how compassion fatigue may impact you.
Most helpers also have other life stressors to deal with. Many are in the sandwich generation meaning that they take care of both young children and aging parents in addition to managing a heavy and complex workload. Helpers are not immune to pain in their own lives and, in fact, some studies show that they are more vulnerable to life changes than people who do less stressful work.
Helpers often do work that other people dont want to hear about. They spend their time caring for people who are not valued or understood in our society. This may include individuals who are homeless, abused, incarcerated or chronically ill.
Furthermore, our working environments are often stressful and fraught with workplace negativity. This negativity is often a result of individual compassion fatigue, burnout and general unhappiness. The work itself is also very stressful. Dealing with clients/patients who are experiencing chronic crises, who have difficulty controlling their emotions, and/or those who may not get better can be draining.
Tips For Dealing With Burnout
- spend time celebrating wins
- trust the recovery process
IMAGE DESCRIPTION: Two columns are shown, in the first column are listed symptoms of trauma, and the second column is symptoms of secondary trauma. The first column consists of the following list: depression, insomnia, hypervigilance, nightmares, anxiety, obsessive thinking about the trauma, PTSD symptoms. The second column, which contains symptoms of secondary trauma, repeats the exact same list as symptoms of trauma visually indicating how the symptoms of secondary trauma can be virtually identical to the symptoms of primary or firsthand trauma.
Visually translated by Lindsay Braman. Adapted from a psychological first aid online training offered by
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Lessons From The 2003 Sars Outbreak
The SARS outbreak of 2003 can offer important insights into mitigating compassion fatigue. According to an article in the Canadian Journal of Public Health, there are two evidence-based interventions for reducing pandemic-related stress by fostering individual resilience.
Limitations And Directions For Future Research
Second, we limited our study to only focus on teachers, rather than educators as a whole. Given the demands placed on teachers, and their daily interaction with students, we wanted to examine CF and STS specifically within this population. Thus, we excluded 18 articles that had educators more broadly as the sample . Because of the unique roles various professionals hold within a building, experiences of CF and STS may differ based on those roles. Expanding the research base to concretely examine these constructs separately by role may offer insight into the risk and protective factors that may contribute to or mitigate CF and STS in educators. Finally, because studies were limited to those published in English, international studies examining these constructs may have been excluded. Thus, the generalizability of these studies may be limited.
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The Difference Between Burnout And Depression
Although burnout and depression share some commonalities, they are different diagnoses with different treatments. While burnout is recognized by the World Health Organization as a legitimate diagnosis, its not yet in the diagnostic manual that clinicians use in the United States while depression is resulting in burnout being often diagnosed as simply depression.
While untreated burnout can lead to depression, the relationship between burnout and depression looks a little bit like this ven diagram. Burnout can include depression, but isnt quite the same thing nor are depression and burnout always linked.
Understanding Vicarious Trauma And Compassion Fatigue
Research shows how profoundly influenced we are by other peoples emotional states and how rapidly our interpersonal affective responses occur, and how dynamically our physiology responds to others emotional states. This is why trauma can be emotionally contagious. I have experienced it personally. When I was working doing assessments of very violent and sexually abusive men, I was exposed to many kinds of trauma and abuse inflicted on children, young people and adults. Over time, the distress I was witnessing and hearing about began to intrude into my inner life and personal sense of parental security. I only really noticed what was happening to me when I found myself becoming overly protective of my children. This became intrusive and culminated in my waking up on the floor of my daughters bedroom and my partner asking me what was wrong. The vulnerability of the children I was working with had surfaced within me as a need to demonstrate my protection for my children. I had realised a very important fact: the bad guys look just like everyone else. That was when I fully realised what exposure to trauma can do.
Dealing with the trauma that the young people you work with have experienced and in some cases continue to experience is difficult however, that is also a reminder of how important the work is. Ensuring that you take care of yourself is equally important.
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Theoretical Perspectives On Empathy
In reviewing the literature, three primary theoretical approaches to the discussion and study of empathy-based strain constructs are apparent. We adopt the following terms for each theory in turn: an experiential, a resiliency, and a fatigue etiological perspective .
Table 2 Theoretical frameworks in the empathy-based stress literature
What Causes Cf And Vt
There are many reasons why helping professionals and addicted individuals loved ones have the potential to develop compassion fatigue and vicarious trauma. The 1996 book, Transforming the Pain written by Saakvitne and Pearlman states that an individuals current life circumstances, history, coping style, and personality type all affect how compassion fatigue may impact them. Helpers are not immune to the pain in their own lives and, in fact, many studies have shown that those who help other people are more vulnerable to life changes, such as divorce and addiction than people who deal with less stressful situations.
Those in the helper role often deal with things that most other people do not want to hear about or deal with. Such people spend their time caring for people who are not seen, valued, or understood in society because of their disease and addiction. Exposure to these constant negative environments often results in compassion fatigue, burnout, and general unhappiness. Dealing with people on a daily basis who are experiencing chronic crises and who have difficulty controlling their emotions can be draining and hopeless. The good news is that individuals can protect themselves from these feelings when dealing with an addicted individual in their life.
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What Are The Symptoms
Those who regularly experience vicarious trauma often neglect their own self-care and inner life as they struggle with images and stories that cant be forgotten. Symptoms of compassion fatigue can include exhaustion, disrupted sleep, anxiety, headaches, stomach upset, irritability, numbness, a decreased sense of purpose, emotional disconnection, self-contempt, and difficulties with personal relationships.
What Is Vicarious Trauma Training
Vicarious Trauma Training provides participants with the knowledge, skills and tools to look after their own personal mental health and wellbeing, when dealing with people who have experienced trauma, or when working with difficult, emotional, sensitive or potentially traumatic material and information.
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Appendix A Search Strategy
Search parameters were created to identify studies that met the following criteria:
Promoted the reduction of CF or related work and/or non-work risk factors:
Targeting a known risk factor or a protective factor for CF
See key words below for CF and related concepts OR
Targeting CF directly
Included a valid outcome measure of CF
Targeted an at-risk occupational group
See key words below for At-risk occupations
Used methodology that included quantitative longitudinal measurement such as a quasi-experimental or experimental design
See key words below for Design
Targeting employed individuals as the population of interest.
See key words below for Employment type
Major database search engines used:
EMBASE, CINHAL, PsychInfo, Web of Science, PubMed, Scopus, Google Scholar
Exclude the following papers:
Unpublished work, opinion pieces, grey literature, editorials, qualitative researchJournals searched by hand:
Journal of Traumatic Stress
Burnout May Happen In Days Weeks Or Years
Burnout looks different for every individual. Essentially, burnout occurs when we no longer have the tools to cope with the stress we experience. For some, burnout may occur quickly in response to enormous amounts of stress or very slowly .
Both types of burnout are serious though, for many, its far more difficult to recognize burnout when the onset is gradual.
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Managing Vicarious Trauma And Compassion Fatigue
Organizational health researchers are working on finding the most effective strategies to reduce, mitigate, and prevent CF and VT in helping those closest to addicts. First off, if the helper can better control their schedule when they help the addict, then they are more likely to relieve symptoms of CF and VT. In addition, this helps reduce trauma exposure and direct contact with the addicted individual in an environment that only causes more harm than good.
Those who constantly lend support to an addicted individual can also decrease their risk of burnout, CF, and VT by debriefing such emotions through conversation with a secure supportive person or by journaling about their emotions. This strategy is used by many health professionals and hospital staff to release any lingering trauma left on their shoulders after helping someone. The most simple way to reduce the risk of burnout, compassion fatigue, and vicarious trauma is to reduce the amount of time an individual spends helping an addict.
Preventing the consequences of being an addicted individuals helper is do-able. It is important to focus on oneself as much as one would focus on others. It is very easy for the parent or family member of a drug addict to forget about themselves entirely in an effort to help their loved one in every way, but doing so only leads to burnout. In sum, here are practical ways to prevent and cope:
Ology For The Present Review
A detailed coding guide was developed by the first author to direct the review process of interest), the construct definition provided and the specific core constructs considered , the methodology used , the predictor and outcome variables measured in the study , and a general summary of the results. These coded components were then translated directly into sections of the present review, as described below.
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