Compassion Fatigue
Dara Bergel Bourassa, PhD, LSW
PA Behavioral Health and Aging Coalition
May 21, 2013
Is this Compassion Fatigue?
http://muttscomics.com/art/dailyarchive.asp
June 4, 2007 The Patriot-News
What is Compassion Fatigue?
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Relatively new concept
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Also known as Secondary Traumatic Stress Disorder
 Many professions susceptible
Natural behaviors and emotions resulting from learning
about a client’s traumatizing event (Figley, 1995)
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The resulting stress from helping a traumatized person
Traumatizing Events: Rape, neglect, abuse, domestic
violence, sexual, verbal, financial abuse, natural or
man-made disasters
Compassion Satisfaction
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Risk Factors for Compassion Fatigue
Symptoms and Effects of
Compassion Fatigue
27% of professionals who work with
traumatized victims experience extreme
distress (Meldrum, King, & Spooner, 2002)
 Symptoms
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http://www.giftfromwithin.org/html/CFChart.htm
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Ethical issues
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May encounter disturbances in degree of empathy
Ultimately jeopardizing clients
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Other ethical issues
Effects of Compassion Fatigue cont.
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Problems with coping skills
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Decrease in sense of accomplishment
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Loss of confidence when working with clientele
Damaged spirituality
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More likely to engage in avoidance of client and self
May weaken and destroy one’s faith
Personal problems
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Within personal and professional life
 Emotionally withdrawn from friends, family, colleagues, &
clients
Vicarious Traumatization vs. Compassion
Fatigue
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Vicarious traumatization (McCann &  Compassion Fatigue
Pearlman, 1999; Jenkins & Baird, 2002)
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Psychotherapy with sexual assault
victims
Accumulation over long periods
of time and across many clients
Involves permanent changes in
the cognitive processing of the
therapist
Based in Constructivist SelfDevelopment Theory
(Figley, 1995; Bell, 2003)
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All professions are
susceptible
One acute exposure
to traumatic material
Can be treated if
caught early
Focuses on PTSD
symptomatology
Burnout vs. Compassion Fatigue
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Burnout (Maslach, 1982)
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Linked to stressors in
the occupational
environment
Emerges gradually over
time
Easily identified
Can affect any
profession regardless of
client group
Is about being “worn
out” (Stamm, 2009-2012)

Compassion Fatigue (Figley,
1995)
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Results from listening to
clients’ traumatic stories
Can emerge suddenly and
without warning
May not be easily
identified
Only affects those who
work with traumatized
victims
Is about being “afraid”
(Stamm, 2009-2012)
Ways to Protect Against CF…
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General Self-Care
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Develop a “buddy system” among group members to provide
constant support (Myers & Wee, 2002)
Increasing exercise/activity levels and taking time for yourself
(Dutton & Rubenstein, 1995; Myers, 1994)
Meditation/yoga (Politsky, 2007)
Importance of positive self-talk and self-encouragement
(Myers, 1994)
Appropriate use of humor (Moran, 2002)
Refer to individual counseling if more services are needed
Self-assessment tool for Compassion
Fatigue
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Professional Quality of Life Scale (PROQOL),Version 5
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http://www.proqol.org/uploads/ProQOL_5_English_SelfScore_3-2012.pdf
Created by B. Hudnall Stamm. Version 5 is copyrighted
from 2009-2012.
The ProQOL is free to use!
A 30 item self report measure of the positive and negative
aspects of caring (CF and compassion satisfaction)
It is also published in many other languages

Check out this web page
http://www.proqol.org/ProQol_Test.html for additional
languages
Any Questions???
Contact Information:
Dara Bergel Bourassa, PhD, LSW
dpbourassa@ship.edu
717-477-1969
References
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Bell, H., Kulkarni, S., & Dalton, L. (2003). Organizational prevention of vicarious
trauma. Families in Society, 84(4), 463-470.
Cunningham, M. (1999). The impact of sexual abuse treatment on the social work
clinician. Child and Adolescent Social Work Journal, 16(4), 277-290.
Cunningham, M. (2003). Impact of trauma work on social work clinicians:
Empirical findings. Social Work, 48(4), 451-459.
Dane, B. & Chachkes, E. (2001). The cost of caring for patients with an illness:
Contagion to the social worker. Social Work in Health Care, 33(2), 31-51.
Figley, C.R. (1995). Compassion fatigue as secondary traumatic stress disorder: An
overview. In C.R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic
stress disorder in those who treat the traumatized (pp. 1-20). New York:
Brunner/Mazel.
Figley, C.R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self care.
Journal of Clinical Psychology, 58(11), 1433-1441.
Iliffe, G. & Steed, L.G. (2000). Exploring the counselor’s experience of working
with perpetrators and survivors of domestic violence. Journal of Interpersonal
Violence, 15(4), 393-412.
References cont.
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Jenkins, S.R. & Baird, S. (2002). Secondary traumatic stress and vicarious trauma:
A validational study. Journal of Traumatic Stress, 15(5), 423-432.
Jacobson, J. M. (2004). Compassion fatigue among employee assistance program
counselors. Unpublished doctoral dissertation, University of Maryland at
Baltimore, Baltimore, MD.
Leon, A.M., Altholz, J.A.S., & Dziegielewski, S.F. (1999). Compassion fatigue:
Considerations for working with the elderly. Journal of Gerontological Social Work,
32(1), 43-62.
Maslach, C. (1982). Burnout:The cost of caring. Englewood Cliffs, NJ: PrenticeHall.
McCann, L.I. & Pearlman, L.A. (1999). Vicarious traumatization: A framework for
understanding the psychological effects of working with victims. In M.J.
Horowitz (Ed.), Essential papers on posttraumatic stress disorder (pp. 498-517).
New York: New York University Press.
Meldrum, L., King, R., & Spooner, D. (2002). Secondary traumatic stress in case
managers working in community mental health services. In C.R. Figley (Ed.),
Treating compassion fatigue (pp. 85-106). New York: Brunner-Routledge.
References cont.
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Mitchell, J. T., & Everly, G. S. (1995). Critical incident stress debriefing: An operations
manual for the prevention of trauma among emergency service and disaster workers
(2nd ed.). Baltimore, MD: Chevron.
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Moran, C.C. (2002). Humor as a moderator of compassion fatigue. In C.R. Figley (Ed.),
Treating compassion fatigue (pp. 139-154). New York: Brunner-Routledge.
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Myers, D. (1994). Disaster response and recovery: A handbook for mental health
professionals. Rockville, MD: Center for Mental Health Services. Retrieved May 25, 2010
from http://www.empowermentzone.com/disaster.txt
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Politsky, S. (2007). Revitalizing yourself: Making time 4u. Oncology Nursing Forum, 34(2),
494.
References cont.
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Nelson-Gardell, D. & Harris, D. (2003). Childhood abuse history, secondary
traumatic stress, and child welfare workers. Child Welfare, 82(1), 5-26.
Salston, M. & Figley, C.R. (2003). Secondary traumatic stress effects of
working with survivors of criminal victimization. Journal of Traumatic Stress,
16(2), 167-174.
Stamm, B.H. (2009-2012). The PROQOL: Professional quality of life scale:
Compassion satisfaction burnout and fatigue scale-Version V. Retrieved May 13,
2013, from http://www.proqol.org/uploads/ProQOL_5_English_SelfScore_3-2012.pdf
Trippany, R.L., Kress,V.E.W., & Wilcoxon, S.A. (2004). Preventing vicarious
trauma: What counselors should know when working with trauma
survivors. Journal of Counseling and Development, 82, 31-37.
Wee, D. & Myers, D. (2003). Compassion satisfaction, compassion fatigue,
and critical incident stress management. International Journal of Emergency
Mental Health, 5(1), 33-37.