History
Compassion fatigue has been studied by the field ofRisk factors
There are four key attributes to an individual being at risk for compassion fatigue; these include diminished endurance and/or energy, declined empathic ability, helplessness and/or hopelessness, as well as emotional exhaustion can suffer from secondary traumatic stress. In addition, previous histories of trauma that led to negative coping skills, such as bottling up or avoiding emotions, having small support systems, increase the risk for developing STS. Many organizational attributes in the fields where STS is most common, such as the healthcare field, contribute to compassion fatigue among the workers. For example, a “culture of silence” where stressful events such as deaths in an intensive-care unit are not discussed after the event is linked to compassion fatigue. Lack of awareness of symptoms and poor training in the risks associated with high-stress jobs can also contribute to high rates of STS. Compassion fatigue increases in intensity with increased interactions among the needy. Because of this, people living in urban cities are more likely to experience compassion fatigue. People in large cities interact with more people in general, and because of this, they become desensitized towards people's problems. Homeless people often make their way to larger cities. Ordinary people often become indifferent to homelessness when they see it regularly.Family
Recent studies reveal that the "overall compassion fatigue and compassion satisfaction levels were moderate, thus highlighting the potential risk of compassion fatigue for family caregivers", indicating that primary family caregivers of patients could also experience compassion fatigue or STS.In healthcare professionals
Between 16% and 85% of health care workers in various fields develop compassion fatigue. In one study, 86% of emergency room nurses met the criteria for compassion fatigue. In another study, more than 25% of ambulance paramedics were identified as having severe ranges of post-traumatic symptoms. In addition, 34% of hospice nurses in another study met the criteria for secondary traumatic stress/compassion fatigue. There is a strong relationship between work-related stress and compassion fatigue which include factors such as: attitude to life, work-related stress, how one works, amount of time working at a single occupation, type of work, and gender all play a role Compassion fatigue is the emotional and physical distress caused by treating and helping patients that are deeply in need. This can desensitize healthcare professionals to others' needs, causing them to develop a lack of empathy for future patients. There are three important components of Compassion Fatigue: Compassion satisfaction, secondary stress, and burnout. It is important to note that burnout is not the same as Compassion Fatigue; Burnout is the stress and mental exhaustion caused by the inability to cope with the environment and continuous physical and mental demands. Healthcare professionals experiencing compassion fatigue may find it difficult to continue doing their jobs. While many believe that these diagnoses affect workers who have been practicing in the field the longest, the opposite proves true. Young physicians and nurses are at an increased risk for both burnout and compassion fatigue. A study published in the Western Journal of Emergency Medicine revealed that medical residents who work overnight shifts or work more than eighty hours a week are at higher risk of developing Compassion Fatigue. Burnout was another major contributor to these professionals who had a higher risk of suffering from Compassion Fatigue. Burnout is a prevalent and critical contemporary problem that can be categorized as suffering fromC.N.A.s/Caregivers
Mental health professionals
Many that work in fields that require great amounts of empathy and compassion are exposed to these stressful experiences in their day-today work activities. These fields mentioned include: social workers, psychologists, oncologists, pediatrics, HIV/AIDs workers, EMS, law enforcement, and of course, and general healthcare workers like nurses, etc. Social workers are one group that can experience compassion fatigue or STS from experiencing a singular trauma or it can be from traumatic experiences building up over the years. This can also occur because of a connection with a client and a shared similar traumatic experience. Overall, healthcare professionals in general are finding that they are burnt out with the price of empathy and compassion, otherwise known as, Compassion Fatigue. Most often describe feelings of “running on empty”. The importance of the contribution of education and recognition cannot be negated in its import of counter of compassion fatigue. Other evidences support theories that meditation and reflection techniques such as Mindful-Based Stress Reduction Training and Compassion Cultivation Training, along with the support of administrators helps to fight and reduce STSCritical care personnel
Critical care personnel have the highest reported rates of burnout, a syndrome associated with progression to compassion fatigue. These providers witness high rates of patient disease and death, leaving them to question whether their work is truly meaningful. Additionally, top-tier providers are expected to know an increasing amount of medical information along with experienced high ethical dilemmas/medical demands. This has created a workload-reward imbalance—or decreased compassion satisfaction. Compassion satisfaction relates to the “positive payment” that comes from caring. With little compassion satisfaction, both critical care physicians and nurses have reported the above examples as leading factors for developing burnout and compassion fatigue. Those caring for people who have experienced trauma can experience a change in how they view the world; they see it more negatively. It can negatively affect the worker's sense of self, safety, and control. In ICU personnel, burnout and compassion fatigue has been associated with decreased quality of care and patient satisfaction, as well as increased medical errors, infection rates, and death rates, making this issue one of concern not only for providers but patients. These outcomes also impact organization finances. According to the Institute of Medicine, preventable adverse drug events or harmful medication errors (associated with compassion fatigue/burnout) occur in 1% to 10% of hospital admissions and account for a $3.5 billion cost. There are a total of four factors that are used to describe the underlying reasons for burnout, STS, and compassion fatigue: depressive mood, primary traumatic stress symptoms, responses to their patients' trauma, and sleep disturbances. Those with a better ability to empathize and be compassionate are at a higher risk of developing compassion fatigue. Because of that, healthcare professionals—especially those who work in critical care—who are regularly exposed to death, trauma, high stress environments, long work days, difficult patients, pressure from a patient's family, and conflicts with other staff members- are at higher risk. These exposures increase the risk for developing compassion fatigue and burnout, which often makes it hard for professionals to stay in the healthcare career field. Those who stay in the healthcare field after developing compassion fatigue or burnout are likely to experience a lack of energy, difficulty concentrating, unwanted images or thoughts, insomnia, stress, desensitization and irritability. As a result, these healthcare professionals may later develop substance abuse, depression, or commit suicide. A 2018 study that examined differences in compassion fatigue in nurses based on their substance use found significant increases for those who used cigarettes, sleeping pills, energy drinks, antidepressants, and anti-anxiety drugs. Unfortunately, despite recent, targeted efforts being made to reduce burnout, it appears that the problem is increasing. In 2011, a study conducted by the Department of Medicine Program on Physician Well-Being at Mayo Clinic reported that 45% of physicians in the United States had one or more symptoms of burnout. In 2014, that number had increased to 54%.In student affairs professionals
In response to the changing landscape of post-secondary institutions, sometimes as a result of having a more diverse and marginalized student population, both campus services and the roles of student affairs professionals have evolved. These changes are efforts to manage the increases in traumatic events and crises. Due to the exposure to student crises and traumatic events, student affairs professionals, as front line workers, are at risk for developing compassion fatigue. Such crises may include sexual violence, suicidal ideation, severe mental health episodes, and hate crimes/discrimination. Some research shows that almost half of all university staff named psychological distress as a factor contributing to overall occupational stress. This group also demonstrated emotional exhaustion, job dissatisfaction, and intention to quit their jobs within the next year, symptoms associated with compassion fatigue.Factors contributing to compassion fatigue in student affairs professionals
In lawyers
Burnout and compassion fatigue can occur in the profession of law; it may occur because of "a discrepancy between expectations and outcomes," or thinking one may have a larger task to achieve than provided resources and support. Recent research shows that a growing number of attorneys who work with victims of trauma are exhibiting a high rate of compassion fatigue symptoms. In fact, lawyers are four times more likely to suffer from depression than the general public. They also have a higher rate of suicide and substance abuse. Most attorneys, when asked, stated that their formal education lacked adequate training in dealing with trauma. Besides working directly with trauma victims, one of the main reasons attorneys can develop compassion fatigue is because of the demanding case loads, and long hours that are typical to this profession.Prevention
In an effort to prepare and combat compassion fatigue, especially within healthcare professions, many have been implementing resiliency training, educating workers in coping during stressful situations, being aware and conscious in their duties, working with integrity, creating a support system that includes individuals and resources that can provide understanding and are sensitive to the risks of compassion fatigue, and finally workers are learning how to decompress and destress, utilizing self-care, are all components.Personal self-care
Stress reduction and anxiety management practices have been shown to be effective in preventing and treating STS. Taking a break from work, participating in breathing exercises, exercising, and other recreational activities all help reduce the stress associated with STS. There is evidence that journaling and meditation can also mediate the effects of STS. Conceptualizing one's own ability with self-integration from a theoretical and practice perspective helps to combat criticized or devalued phase of STS. In addition, establishing clear professional boundaries and accepting the fact that successful outcomes are not always achievable can limit the effects of STS.Huggard, P. (2003). Secondary Traumatic Stress: Doctors at risk. New Ethicals Journal. http://home.cogeco.ca/~cmc/Huggard_NewEthJ_2003.pdfSocial self-care
Social support and emotional support can help practitioners maintain a balance in their worldview. Maintaining a diverse network of social support, from colleagues to pets, promotes a positive psychological state and can protect against STS. Some problems with compassion fatigue stem from a lack of fundamental communication skills; counseling and additional support can be beneficial to practitioners struggling with STS.Self-compassion as self-care
In order to be the best benefit for clients, practitioners must maintain a state of psychological well-being. Unaddressed compassion fatigue may decrease a practitioners ability to effectively help their clients. Some counselors who use self-compassion as part of their self-care regime have had higher instances of psychological functioning. The counselors use of self-compassion may lessen experiences of vicarious trauma that the counselor might experience through hearing clients stories. Self-compassion as a self-care method is beneficial for both clients and counselors.Mindfulness as self-care
Self-awareness as a method of self-care might help to alleviate the impact of vicarious trauma (compassion fatigue). Students who took a 15-week course that emphasized stress reduction techniques and the use of mindfulness in clinical practice had significant improvements in therapeutic relationships and counseling skills. The practice of mindfulness, according to Buddhist tradition is to release a person from “suffering” and to also come to a state of consciousness of and relationship to other people's suffering. Mindfulness utilizes the path to consciousness through the deliberate practice of engaging “the body, feelings, states of mind, and experiential phenomena (dharma).” The following therapeutic interventions may be used as mindfulness self-care practices: * Somatic therapy (body) * Psychotherapy (states of mind) * Emotion focused therapy (feelings) *Compassion fade
Compassion fatigue is defined as “the physical and mental exhaustion and emotional withdrawal experienced by those who care for sick or traumatized people over an extended period of time”. Compassion fatigue usually occurs with those whom we ''know''; whether that is because of a personal relationship or professional relationship. Compassion fade is defined as terminology to describe the way in which an individual’s compassion and empathy are reduced due to the amount or intricacy of the issue. This also includes when the need and tragedy in of the world goes up and the amount of desire to help goes down (similar to a see-saw). For example, an individual is more likely to donate more money, time, or other types of assistance to a single person suffering, than to disaster aid or when the population suffering is larger. It is a type of cognitive bias that helps people make their decision to help.Morris, S., & Cranney, J. (2018). Chapter 2 The imperfect mind. The Rubber Brain (pp. 19–42). Australian Academic Press.See also
References
Further reading
* *Barnes, M. F (1997). "Understanding the secondary traumatic stress of parents". In C. R. Figley (Ed). ''Burnout in Families: The Systemic Costs of Caring'', pp., 75–90. Boca Raton: CRC Press. *Beaton, R. D. and Murphy, S. A. (1995). "Working with people in crisis: Research implications". In C. R. Figley (Ed.), ''Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized'', 51–81. NY: Brunner/Mazel. * * * *Kottler, J. A. (1992). ''Compassionate Therapy: Working with Difficult Clients''. San Francisco: Jossey-Bass. * *Phillips, B. (2009). Social Psychological Recovery, Disaster Recovery. (p. 302). Boca Raton, FL: CRC Press - Taylor & Francis Group. *External links
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