Compassion Fatigue

E. Carol Webster, Ph.D. 
Copyright ©  2007

When you run a business or agency that provides care to the public, the strain of treating trials, traumas and tragedies can catch up with you and your staff.  The steady cries for help and exposure to the depths of others’ pain can give you pain too. Even those in non-caregiving service professions who handle taxing public demands can feel the strain. Look for the signs. Staff that never missed a day of work starts calling in sick repeatedly. Those who’ve been most empathic and protective of clients’ confidentiality begin gossiping about them and referring to their troubles with disdain and coldness.  Some may show obvious signs of substance abuse in an effort to cope. Others end up on disability leave for emotional or physical reasons due to the stress. Often they’re all victims of compassion fatigue to varying degrees. Caring for others – or just hearing about their traumas and plights regularly -- can result in exhaustion and inadequate reserve to restore and replenish. You can do a lot to help avoid this fate by making sure that the workplace enables your staff to take care of themselves too.

While most agencies have formal supervision and inservice training schedules in place, many fail to keep the appointments consistently. With slim staffing and high client demand the tendency may be to decide that, if something has to give, it’ll be the staff meeting, supervision or the training workshop so that more clients can be served.  Unfortunately, however, your staff needs dependable, ongoing support and help in balancing how to provide the help clients need while not getting overly enmeshed and absorbed in their troubles. This takes the skill, wisdom, and experience that you and senior supervisors can provide, so insist that the appointments take place no matter that both you and your workers feel pressed for time. Something is far better than nothing. Also, external trainers and consultants can supply outside objectivity to underscore the importance of boundaries and limits, and can surface issues and frustrations that may not be raised with those in the trenches.  Feelings of relief and recharge are typically expressed --- even if everyone must return to meet the many problems of clients with the same stresses and limited resources. Great feelings of comfort and trust in the organization can come from these forums when they are provided predictably, so make every effort to see that they take place. 

In addition to supervision and training, provide opportunities for staff to get together with one another for general support and validation of the hard work they’re doing. Many find leaderless “lunch and learn” groups a therapeutic forum for venting and discussing how colleagues are dealing with things. This reduces the feeling of being overwhelmed and isolated, and helps to affirm that many emotional reactions to the problems encountered are being experienced by peers too.  This is especially important for solo practitioners or those working in satellite offices who are particularly vulnerable because of their literal isolation. Connect them to peer support activities, but if operationally it is impossible for them to participate, be sure that they receive additional consultation and support.  

 Managers can do a lot to structure healthy workplace environments that expect – and help -- staff to take care of themselves. This means allowing flexible work scheduling where possible, break areas that offer or enable storing healthy meals and snacks, and insistence that staff get out of the office to stretch, exercise, and enjoy their lunchtime rather than planting in their offices and scoffing down food when they can. Some go through an entire week on gum and soda, and then wonder why they end up exhausted and sick. It’s possible to communicate the message that the client is, indeed, important but that staff well-being is essential too and that the workplace will support people taking care of themselves. Sometimes this means that you must step out of your comfort zone and advocate for policy and procedure changes that enable greater employee self-care. It may also mean authorizing caseload reductions and temporary or permanent reassignments and going to bat for replacements to give staff who are suffering compassion fatigue or who are severely at risk a chance to take a break from working with clients for a while. There needn’t be a flood of these requests if staff feel supported, understood, and able to shore up to handle the weight they have to deal with everyday.

 Compassion fatigue is to be expected in many fields. The nature of working with clients who are in distress takes its toll. Workplaces that understand this and provide consistent opportunities for staff to share the burdens they are carrying – and sometimes to unload them altogether – will enjoy greatest retention of workers who are adequately fortified to keep helping the clients they serve.

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