Combating Compassion Fatigue in Social Work

When Hurricane Katrina struck the Gulf Coast in August 2005, it became one of the worst natural disasters in United States history. What began as a tropical depression over the Bahamas evolved into a catastrophic Category 5 storm as it churned over the Gulf of Mexico, bearing down on Texas, Louisiana, Mississippi, and Alabama. By the time Katrina made landfall again on August 19, 2005, its intensity had dropped to Category 3, but that didn’t make it any less devastating. At least 1,800 people died during the hurricane itself and the flooding made worse by levee failures around New Orleans.

The cleanup and recovery efforts after Hurricane Katrina cost billions of dollars, as the storm destroyed more than 200,000 homes and displaced 800,000 citizens. Almost 15 years later, the city’s infrastructure and population are still experiencing the aftereffects of Katrina. Dr. Charles Figley, a Tulane University professor of social work and director of the Tulane University Traumatology Institute, applied the term compassion fatigue to what he was finding in his research of human service practitioners, including those working with Katrina survivors. He believes recovery from a natural disaster such as Katrina involves more than a focus on rebuilding infrastructure. It also requires addressing the effects of trauma on people’s lives, including social workers and others in helping professions.

Trauma can affect people who have not experienced it directly. Those who help others who have gone through trauma can experience a condition known as “compassion fatigue.” Compassion fatigue in social work is widespread and can have serious consequences.

What Is Compassion Fatigue?

Compassion fatigue is caused by the trauma of helping the traumatized. It is a consequence of a buildup of secondary traumatic stress, or “secondhand” trauma. Compassion fatigue is the emotional and physical exhaustion that occurs in aid workers over time. It is a condition often experienced by health services providers, social workers, and first responders, such as firefighters and police officers — professionals who work with traumatized individuals. It involves a set of symptoms and reactions that disrupt behavior and professional practice. As common as it is, the symptoms are not always obvious.

Social workers, counselors, and medical professionals can develop compassion fatigue from vicariously experiencing trauma, such as through emotionally supporting trauma survivors. This is due directly to providing human services to those who are suffering. In contrast to compassion fatigue, burnout is a consequence of many factors, beyond secondary trauma. It is weariness of the job generally (e.g., low pay, poor supervision, poor emotional support from the employer or fellow employees). This can result in social workers being irritable, rigid, and closed off from others.

Compassion fatigue, more than burnout, can also make social workers emotionally withdrawn or detached, which hurts their ability to provide quality care to those who need it. For example, social workers who have been working with rape survivors could become desensitized to the individual trauma of their clients and might inadvertently ask a triggering question.

How to Identify Compassion Fatigue

Individuals working in fields such as social work, counseling, and public health should familiarize themselves with the signs and symptoms of compassion fatigue and be able to identify them. According to the U.S. Department of Health and Human Services’ Administration for Children and Families, compassion fatigue symptoms can show up the following areas:

• Cognitive:
  Cognitive symptoms include apathy, difficulty concentrating, perfectionism, and obsession.
• Emotional:
  Emotional symptoms include persistent feelings of guilt, anger, sadness, numbness, or helplessness.
• Behavioral:
  Behavioral symptoms include becoming withdrawn, having difficulty sleeping, appetite changes, and hypervigilance (an elevated startle response, similar to that experienced by those with PTSD).
• Physical:
  Physical signs include increased heart rate, difficulty breathing, muscle and joint pain, and an impaired immune system.

How to Address Compassion Fatigue

Noticing, addressing, and managing compassion fatigue in social workers and other trauma specialists is important. Strategies for preventing and treating compassion fatigue follow.

Prevention

Individuals and organizations can use preventive strategies to reduce the severity of compassion fatigue. These include:

• Work-life balance:
  Individuals should make sure they are spending enough time doing leisure activities or connecting with people they care about.
• Assertiveness training:
  Organizations can teach those susceptible to compassion fatigue how to set boundaries — that is, when and how to say no to activities that would add stress to an individual’s personal or professional life, making the person feel overextended and inhibiting his or her ability to provide quality care.
• Coping skills:
  Individuals can apply coping strategies, including meditation, discussing issues and feelings with colleagues or friends, or adjusting their expectations for themselves or others
• Creative expression:
  Writing, painting, playing an instrument, or practicing other creative arts as an outlet for emotions is a powerful tool.
• Nutrition:
  Eating well, staying hydrated, and avoiding too much alcohol, sugar, and caffeine can help individuals reduce anxiety and fatigue, as well as maintain a positive outlook.

Treatment

Compassion fatigue can be treated. Some common methods include:

• Journaling:
  Writing down thoughts, emotions, and frustrations can help individuals manage negative feelings and focus on the positive aspects of their work.
• Support groups:
  Joining a support group can put those with compassion fatigue in touch with others who have experienced the condition firsthand. Talking through feelings and connecting with others who have shared similar experiences can be a useful coping mechanism.
• Counseling:
  The perspective of another professional can help individuals suffering from compassion fatigue develop new ways of coping or implement new treatment methods.
• Self-care:
  People with compassion fatigue can refocus by creating better boundaries and making more time for meaningful personal pursuits. Self-care looks different for each person, but many find activities such as exercise, reading, or spending time with friends or family effective means of decompressing.

Compassion Fatigue and Tulane University’s School of Social Work

Social workers are vulnerable to compassion fatigue because of the nature of their work. These professionals offer communities crucial services, so identifying and treating compassion fatigue is vital. Some social workers may also lend their skills to treating compassion fatigue in other social workers, caregivers, or first responders. Innovators in this field, such as Dr. Figley, are working at Tulane University, teaching, researching, and raising awareness about the effects of compassion fatigue. Learn more about the Master of Social Work at Tulane University, where you can explore how compassion fatigue in social workers is identified, managed, and treated.