Examine individual changes

''''Compassion fatigue''' is a condition characterized by emotional and physical exhaustion leading to a diminished ability to empathize or feel [[compassion]] for others, often described as the negative cost of caring.<ref name=":25">{{Cite book|last=Figley|first=Charles (Ed)|title=Treating compassion fatigue|publisher=Brunner-Routledge.|year=2002|isbn=|location=New York|pages=}}</ref> It is sometimes referred to as '''secondary traumatic stress''' ('''STS''').<ref name=":25"/> According to the Professional Quality of Life Scale, burnout and secondary traumatic stress are two interwoven elements of compassion fatigue.<ref>{{Cite web|url=https://www.proqol.org/Home_Page.php|title=Professional Quality of Life|last=|first=|date=|website=Professional Quality of Life Measure|language=en-US|url-status=live|archive-url=|archive-date=|access-date=2020-02-13}}</ref> Compassion fatigue is considered to be the result of working directly with victims of disasters, trauma, or illness, especially in the health care industry.<ref name=":022">{{Cite journal|last=Day|first=Jennifer R.|last2=Anderson|first2=Ruth A.|date=2011-09-08|title=Compassion Fatigue: An Application of the Concept to Informal Caregivers of Family Members with Dementia|journal=Nursing Research and Practice|volume=2011|pages=408024|doi=10.1155/2011/408024|pmc=3170786|pmid=22229086}}</ref> Individuals working in other helping professions are also at risk for experiencing compassion fatigue.<ref>{{Cite book|last=Figley|first=Charles|title=Compassion fatigue: Coping with secondary traumatic stress disorder|publisher=Brunner/Mazel|year=1995|isbn=|location=New York|pages=}}</ref> These include child protection workers,<ref>{{Cite journal|last=Conrad|first=David|last2=Kellar-Guenther|first2=Yvonne|date=2006|title=Compassion Fatigue, Burnout, and Compassion Satisfaction among Colorado Child Protection Workers|url=|journal=Child Abuse & Neglect|volume=30|issue=10|pages=1071–1080|doi=10.1016/j.chiabu.2006.03.009|pmid=17014908}}</ref> veterinarians,<ref>{{Cite journal|last=Holcombe|first=T. Melissa|last2=Strand|first2=Elizabeth B.|last3=Nugent|first3=William R.|last4=Ng|first4=Zenithson Y.|date=2016|title=Veterinary social work: Practice within veterinary settings|url=|journal=Journal of Human Behavior in the Social Environment|volume=26|issue=1|pages=69|doi=10.1080/10911359.2015.1059170}}</ref> [[teacher]]s,<ref>{{Cite journal|last=Sharp Donahoo|first=Lori M.|last2=Siegrist|first2=Beverly|last3=Garrett-Wright|first3=Dawn|date=2017-08-16|title=Addressing Compassion Fatigue and Stress of Special Education Teachers and Professional Staff Using Mindfulness and Prayer|journal=The Journal of School Nursing|language=en-US|volume=34|issue=6|pages=442–448|doi=10.1177/1059840517725789|pmid=28812432|issn=1059-8405}}</ref> [[palliative care]] workers,<ref>{{Cite journal|last=Samson|first=Tali|last2=Shvartzman|first2=Pesach|date=2018-08-01|title=Secondary Traumatization and Proneness to Dissociation Among Palliative Care Workers: A Cross-Sectional Study|url=https://www.jpsmjournal.com/article/S0885-3924(18)30229-X/abstract|journal=Journal of Pain and Symptom Management|language=English|volume=56|issue=2|pages=245–251|doi=10.1016/j.jpainsymman.2018.04.012|issn=0885-3924|pmid=29729350}}</ref> [[Journalist|journalists]],<ref>{{Cite journal|last=Backholm|first=K.|last2=Björkqvist|first2=K.|title=The effects of exposure to crisis on well-being of journalists: a study of crisis-related factors predicting psychological health in a sample of Finnish journalists|journal=Media, War & Conflict|language=en|volume=3|issue=2|pages=138–151|doi=10.1177/1750635210368309|issn=1750-6352|year=2010}}</ref> [[police officer]]s,<ref>{{Cite journal|last=Turgoose|first=David|last2=Glover|first2=Naomi|last3=Barker|first3=Chris|last4=Maddox|first4=Lucy|title=Empathy, compassion fatigue, and burnout in police officers working with rape victims.|journal=Traumatology|language=en|volume=23|issue=2|pages=205–213|doi=10.1037/trm0000118|issn=1085-9373|year=2017}}</ref> [[firefighter]]s, animal welfare workers, public [[librarian]]s, health unit coordinators,<ref>{{Cite journal|last=Cocker|first=Fiona|last2=Joss|first2=Nerida|date=2016-06-22|title=Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review|journal=International Journal of Environmental Research and Public Health|volume=13|issue=6|pages=618|doi=10.3390/ijerph13060618|issn=1660-4601|pmc=4924075|pmid=27338436}}</ref> and [[Student Affairs]] professionals.<ref name=":12">{{Cite journal|last=Raimondi|first=Thomas P.|date=2019-05-04|title=Compassion Fatigue in Higher Education: Lessons From Other Helping Fields|journal=Change: The Magazine of Higher Learning|language=en|volume=51|issue=3|pages=52–58|doi=10.1080/00091383.2019.1606609|issn=0009-1383}}</ref> Non-professionals, such as family members and other informal caregivers of people who have a chronic illness, may also experience compassion fatigue.<ref name=":022"/> The term was first coined in 1992 by Carla Joinson to describe the negative impact hospital nurses were experiencing as a result of their repeated, daily exposure to patient emergencies.<ref name=":25"/> People who experience compassion fatigue may exhibit a variety of symptoms including lowered concentration, numbness or feelings of helplessness, irritability, lack of self-satisfaction, withdrawal, aches and pains, or work absenteeism.<ref name=":25"/> Journalism analysts argue that news media have caused widespread compassion fatigue in society by saturating newspapers and news shows with decontextualized images and stories of tragedy and suffering. This has caused the public to become desensitized or resistant to helping people who are suffering.<ref>{{cite web| url=http://www.dartcenter.org/training/selfstudy/3_photojournalism/04.php| title=Traumatic Stress & The News Audience| accessdate=June 2008| publisher=[[Dart Center for Journalism and Trauma]]| archive-url=https://web.archive.org/web/20080715015000/http://www.dartcenter.org/training/selfstudy/3_photojournalism/04.php| archive-date=2008-07-15| url-status=dead}}</ref> ==History== Compassion fatigue has been studied by the field of traumatology, where it has been called the "cost of caring" for people facing emotional pain.<ref name=":25"/> Compassion fatigue has also been called secondary victimization,<ref>Figley, C. (1982). Traumatization and comfort: Close relationships may be hazardous to your health. Keynote presentation at the Conference, Families and close relationships: Individuals in social interaction, Texas Tech University, Lubbock, Texas, February.</ref> secondary traumatic stress,<ref>Figley, C. R. (1983). Catastrophes: A overview of family reactions. In C. R. Figley and H. I. McCubbin (Eds.), Stress and the Family: Volume II: Coping with Catastrophe. New York: Brunner/Mazel, 3-20.</ref> [[vicarious traumatization]],<ref>{{Cite journal|last=Lisa McCann|first=I.|last2=Pearlman|first2=Laurie Anne|date=1990-01-01|title=Vicarious traumatization: A framework for understanding the psychological effects of working with victims|journal=Journal of Traumatic Stress|volume=3|issue=1|pages=131–149|doi=10.1002/jts.2490030110|issn=1573-6598}}</ref> and secondary survivor.<ref>Remer, R., & Elliott, J. E. (1988). Characteristics of secondary victims of sexual assault. International Journal of Family Psychiatry, 9(4), 373-387.</ref> Other related conditions are rape-related family crisis<ref>Erickson, C. A. (1989). Rape and the family. ''Treating stress in families'', 257-289.</ref> and "proximity" effects on female partners of war veterans.<ref>{{Cite journal|last=Verbosky|first=S. J.|last2=Ryan|first2=D. A.|date=1988|title=Female partners of Vietnam veterans: stress by proximity|journal=Issues in Mental Health Nursing|volume=9|issue=1|pages=95–104|issn=0161-2840|pmid=3356550|doi=10.3109/01612848809140912}}</ref> Compassion fatigue has been called a form of [[Burnout (psychology)|burnout]] in some literature. However, unlike compassion fatigue, “burnout” is related to chronic tedium in careers and the workplace, rather than exposure to specific kinds of client problems such as trauma.<ref name="a2">{{cite journal | last1 = Beck | first1 = C | year = 2011 | title = Secondary Traumatic Stress in Nurses: A Systematic Review | url = | journal = Archives of Psychiatric Nursing | volume = 25 | issue = 1| pages = 1–10 | doi = 10.1016/j.apnu.2010.05.005 | pmid = 21251596 }}</ref> fMRI-rt research suggests the idea of compassion without engaging in real-life trauma is not exhausting itself. According to these, when [[empathy]] was analyzed with compassion through [[neuroimaging]], empathy showed brain region activations where previously identified to be related to pain whereas compassion showed warped neural activations.<ref name="Altruism: Ricard">{{cite book |last=Ricard |first=Matthieu|title=Altruism: The Power of Compassion to Change Yourself and the World|chapter=IV|chapter-url=http://info-buddhism.com/Empathy-Compassion-Neuroscience-Ricard-Altruism.html|pages=56–64|year=2015|publisher=Brown and Company|isbn=978-0316208246}}</ref><ref>[http://www.matthieuricard.org/system/resources/W1siZiIsIjIwMTMvMDYvMDQvMTBfMjNfNDNfNjIxX0tsaW1lY2tpX0xlaWJlcmdfUmljYXJkX1Npbmdlcl8yMDEzX1NDQU4ucGRmIl1d/Klimecki_Leiberg_Ricard_Singer_2013_SCAN.pdf Differential pattern of functional brain plasticity after compassion and empathy training], Olga M. Klimecki, Susanne Leiberg, Matthieu Ricard, and Tania Singer, Department of Social Neuroscience, Max Planck Institute for Human Cognitive and Brain Sciences</ref> There is some recent academic literature suggesting that compassion fatigue is a misnomer and should be replaced with the term, empathy fatigue. Evidence supporting this change comes from a burgeoning literature examining the neurophysiology of empathy versus compassion meditation practices.<ref>https://info-buddhism.com/Empathy-Compassion-Neuroscience-Ricard-Altruism.html</ref> Whereas empathy can be defined as feeling what another feels and cumulative negative effects over time can come from the accretion of the assumptions of others painful emotions and experience. Compassion relates to a feeling of caring, loving or desire to improve the lot of others and may or may not require awareness of others feeling and emotions, but instead arises from a humanistic or even altruistic desire for subject to be free of suffering. Studies of training of compassion practices among health care provides has demonstrated positive effects compared to empathy practices which do not improve provider functioning.<ref>Felton, J. S. Burnout as a clinical entity—its importance in health care workers. Occupational Medicine, 48(4), 1998, pp. 237–250</ref> In academic literature, the more technical term ''secondary traumatic stress disorder'' may be used. The term "compassion fatigue" is considered somewhat [[euphemism|euphemistic]]. Compassion fatigue also carries sociological connotations, especially when used to analyse the behavior of mass donations in response to the media response to disasters. One measure of compassion fatigue is in the ProQOL, or Professional Quality of Life Scale. Another is the Secondary Traumatic Stress Scale.{{citation needed|date=November 2019}} ==Risk factors== Several personal attributes place a person at risk for developing compassion fatigue. Persons who are overly conscientious, perfectionists,<ref>D’Souza, Egan, & Rees, 2011</ref> and self-giving are more likely to suffer from secondary traumatic stress. Those who have low levels of social support or high levels of stress in personal life are also more likely to develop STS. 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.<ref name="a3">{{cite journal | last1 = Meadors |display-authors=et al | year = 2008 | title = Compassion Fatigue and Secondary Traumatization: Provider Self Care on the Intensive Care Units for Children | url = | journal = Journal of Pediatric Health | volume = 22 | issue = 1|pages=24–34 |doi=10.1016/j.pedhc.2007.01.006 |pmid=18174086 }}</ref> 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.<ref name="a3" /> ==In healthcare professionals== Between 16% and 85% of [[Health care provider|health care workers]] in various fields develop compassion fatigue. In one study, 86% of emergency room nurses met the criteria for compassion fatigue.<ref>{{cite journal | last1 = Hooper |display-authors=et al | year = 2010 | title = Compassion Satisfaction, Burnout, and Compassion Fatigue Among Emergency Nurses Compared With Nurses in Other Selected Inpatient Specialties | url = | journal = Journal of Emergency Nursing | volume = 36 | issue = 5| pages = 420–427 | doi = 10.1016/j.jen.2009.11.027 | pmid = 20837210}}</ref> In another study, more than 25% of ambulance paramedics were identified as having severe ranges of post-traumatic symptoms.<ref name="a2" /> In addition, 34% of hospice nurses in another study met the criteria for secondary traumatic stress/compassion fatigue.<ref name="a2" /> Compassion Fatigue is the emotional and physical distress caused by treating and helping patients that are deeply in need, which can desensitize healthcare professionals causing them a lack of empathy for future patients.<ref>Adams R.E., Boscarino J.A., Figley CR. (2006). Compassion Fatigue and Psychological Distress Among Social Workers: A Validation Study. Am J Orthopsychiatry. 76(1):103–108.</ref> There are three important components of Compassion Fatigue: Compassion satisfaction, secondary stress and burnout.<ref>Stamm BH. (2010). The concise ProQOL manual. Pocatello ID ProQOL Org.</ref> 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.<ref>Potter P, Deshields T, Divanbeigi J, Berger J, Cipriano D, Norris L, Olsen S. Compassion Fatigue and Burnout.(2010). Clin J Oncol Nurs. 14(5):E56–E62.</ref> 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.<ref>Brindley, P.G., ''Psychological burnout and the intensive care practitioner: A practical and candid review for those who care.'' J Intensive Care Soc, 2017. '''18'''(4): p. 270-275.</ref> A study published in the Western Journal of Emergency Medicine revealed that medical residents develop Compassion Fatigue and within this group medical residents who work overnight shifts and that work more than eighty hours a week are in higher risk of developing Compassion Fatigue.<ref>Bellolio M. F., Cabrera D., Sadosty A. T., Hess E. P., Campbell R. L., Lohse C. M., & Sunga K. L. (2014). Compassion fatigue is similar in emergency medicine residents compared to other medical and surgical specialties. ''Western Journal of Emergency Medicine'', 15(6), 629–635.</ref> In these professionals with higher risk of suffering from Compassion Fatigue, burnout was one of the major components. Burnout is a prevalent and critical contemporary problem that can be categorized as suffering from: emotional exhaustion, de-personalization, and low sense of personal accomplishment.<ref name=":1">McKoldrick, K. (2018) Physician Burnout and Well-being: Why They Matter. Current Reviews in Clinical Anesthesia: Lesson 9, Volume 39.</ref> They can be exposed to trauma while trying to deal with compassion fatigue, potentially pushing them out of their career field. If they decide to stay, it can negatively affect the therapeutic relationship they have with patients because it depends on forming an empathetic, trusting relationship that could be difficult to make in the midst of compassion fatigue. Because of this, healthcare institutions are placing increased importance on supporting their employees emotional needs so they can better care for patients.<ref>{{Cite journal|last=Sorenson|first=Claire|last2=Bolick|first2=Beth|last3=Wright|first3=Karen|last4=Hamilton|first4=Rebekah|year=2017|title=An Evolutionary Concept Analysis of Compassion Fatigue|journal=Journal of Nursing Scholarship|volume=49|issue=5|pages=557–563|doi=10.1111/jnu.12312|pmid=28598011}}</ref> Another name and concept directly tied to compassion fatigue is moral injury. Moral injury in the context of healthcare was directly named in the ''Stat News'' article by Drs. Wendy Dean and Simon Talbot, entitled "Physicians aren’t ‘burning out.’ They’re suffering from moral injury."<ref>{{Cite news|url=https://www.statnews.com/2018/07/26/physicians-not-burning-out-they-are-suffering-moral-injury/|title=Physicians aren't 'burning out.' They're suffering from moral injury - STAT|date=2018-07-26|work=STAT|access-date=2018-09-27}}</ref> The article and concept goes on to explain that physicians (in the United States) are caught in double and triple and quadruple binds between their obligations of electronic health records, their own student loans, the requirements for patient load through the hospital and number of procedures performed – all while working towards the goal of trying to provide the best care and healing to patients possible. However, the systemic issues facing physicians often cause deep distress because the patients are suffering, despite a physician's best efforts. This concept of Moral Injury in healthcare<ref>{{Cite web|url=https://www.moralinjury.healthcare/|title=Moral Injury of Healthcare|last=Talbot, Dean}}</ref> is the expansion of the discussion around compassion fatigue and 'burnout.' === Caregivers === [[Caregiver]]s for dependent people can also experience compassion fatigue, which can become a cause of abusive behavior in caring professions. It results from the taxing nature of showing compassion for someone whose [[suffering]] is continuous and unresolvable. One may still care for the person as required by policy, however, the natural human desire to help them is significantly diminished desensitization and lack of enthusiasm for patient care.<ref name=":2">Jenkins, B. & Warren, N.A. Concept analysis: compassion fatigue and effects upon critical care nurses. Crit Care Nurs Q, 2012. 35(4):388-95. Doi: 10.1097/CNQ.0b013e318268fe09</ref> This phenomenon also occurs among professionals involved in long-term [[health care]], and for those who have institutionalized family members. These people may develop symptoms of [[clinical depression|depression]], [[Stress (medicine)|stress]], and [[Psychological trauma|trauma]]. Those who are [[primary care]] providers for patients with [[terminal illness]]es are at a higher risk of developing these symptoms. In the medical profession, this is often described as "[[Burnout (psychology)|burnout]]": the more specific terms secondary traumatic stress and [[Vicarious traumatization|vicarious trauma]] are also used. Some professionals may be predisposed to compassion fatigue due to personal trauma.{{citation needed|date=November 2019}} === Mental Health Professionals === Mental health professionals are another group that often suffer from compassion fatigue, particularly when they treat those who have suffered extensive trauma. A study on mental health professionals that were providing clinical services to Katrina victims found that rates of negative psychological symptoms increased in the group. Of those interviewed, 72% reported experiencing anxiety, 62% experienced increased suspicion about the world around them, and 42% reported feeling increasingly vulnerable after treating the Katrina victims.<ref>Culver, L., McKinney, B., Paradise, L. (2011). Mental Health Professionals' Experiences of Vicarious Traumatization in Post-Hurricane Katrina New Orleans, 16(1), 33-42.</ref> Social workers are being exposed to stressful experiences in their day to day work activities. Many social workers are at a constant battle not only within their casework but within themselves. A social worker's career comes at a personal price with putting personal beliefs aside, managing compassion fatigue, and getting the mental help needed to cope with the traumas that are dealt with daily. The way a social worker feels must be put aside when in the field due to the possibility of those feeling swaying the appropriate action that must be taken. If a social worker is consciously aware of compassion fatigue and burnout happening within themselves early on, then they hold capability to seek the help needed to combat them before any negative impression is felt externally. Being able to objectively evaluate situations at work aides in keeping social workers professionally safe. Self-awareness of compassion fatigue and burnout flow into the mental and physical management that keep those feelings under control. When a social worker puts in the time to take care of themselves their personal life and work life are both positively influenced.<ref>BBC News - 'I had a parent screaming foul names at me' https://www.bbc.co.uk/news/uk-49451745</ref> === Critical 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.<ref name=":3">Fahey, D.M. & Glasofer, A. (2016) An inverse relationship- compassion satisfaction, compassion fatigue, and critical care nurses. Nursing Critical Care. 11(5):30-35.</ref> With little compassion satisfaction, both critical care physicians and nurses have reported the above examples as leading factors for developing burnout and compassion fatigue.<ref>Fumis, R.R.L., et al., (2017) ''Moral distress and its contribution to the development of burnout syndrome among critical care providers.'' Ann Intensive Care. '''7'''(1): p. 71</ref> 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.<ref>{{cite journal | last1 = Van Hook | first1 = M. P. | last2 = Rothenberg | first2 = M. | year = 2009 | title = Quality of life and compassion satisfaction/fatigue and burnout in child welfare workers: A study of the child welfare workers in community based care organizations in Central Florida | url = http://0-search.ebscohost.com.cals.evergreen.edu/login.aspx?direct=true&db=sih&AN=36917554&site=ehost-live | journal = Social Work & Christianity | volume = 36 | issue = 1 | pages = 36–54 }}{{Dead link|date=July 2019 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> 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.<ref name=":1" /> These outcomes also impact organization finances.<ref name=":3" /> 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.<ref name=":4">Maiden, J., Georges, J.M., & Connelly, C.D. (2011). Moral Distress, Compassion Fatigue, and Perceptions About Medication Errors in Certified Critical Care Nurses. Dimensions of Critical Care Nursing. 30(6):339-345. Doi: 10.1097/DCC.0b013e31822fab2a</ref> Those with a better ability to empathize and be compassionate are at a higher risk of developing compassion fatigue.<ref>Figley, C. R. (1995). Compassion fatigue as secondary stress disorder: An overview. Compassion fatigue: coping with secondary traumatic stress disorder in those who treat the traumatized (1-20). New York: Brunner/Mazel.</ref> Because of that, healthcare professionals—especially those who work in critical care, 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.<ref name=":4" /> 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.<ref name=":2" /> As a result, these healthcare professionals may later develop substance abuse, depression, and suicide.<ref>Moss, M., et al., (2016) ''An Official Critical Care Societies Collaborative Statement-Burnout Syndrome in Critical Care Health-care Professionals: A Call for Action.'' Chest. '''150'''(1): p. 17-26.</ref> 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%.<ref name=":1" /> == 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.<ref>Seifert, Tricia, Perozzi, Brett, & Li, Wincy. (2015). Issues and Challenges in Student Affairs and Services Work: A Comparison of Perspectives from Canada, the United Kingdom, Australia and New Zealand. ''Journal of the Australian & New Zealand Student Services Association'', ''45'', 41–51.</ref> Due to the exposure to student crises and traumatic events, student affairs professionals, as front line workers, are at risk for developing compassion fatigue.<ref name=":0">{{Cite web|url=http://www.proquest.com/en-US/products/dissertations/individuals.shtml|title=Compelled to Act: The Negotiation of Compassion Fatigue among Student Affairs Professionals|last=Stoves|first=Douglas|date=|website=ProQuest Dissertations and Theses database|url-status=live|archive-url=|archive-date=|access-date=}}</ref> Such crises may include sexual violence, suicidal ideation, severe mental health episodes, and hate crimes/discrimination.<ref name=":32">{{Cite journal|last=Lynch|first=R. Jason|last2=Glass|first2=Chris R.|date=January 2019|title=The Development of the Secondary Trauma in Student Affairs Professionals Scale (STSAP)|journal=Journal of Student Affairs Research and Practice|language=en|volume=56|issue=1|pages=1–18|doi=10.1080/19496591.2018.1474757|issn=1949-6591}}</ref> 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,<ref>Biron, Caroline, Brun, Jean-Pierre, & Ivers, Hans. (2008). Extent and sources of occupational stress in university staff. ''Work: A Journal of Prevention, Assessment and Rehabilitation, 30''(4), 511-522. <nowiki>https://www.worldcat.org/</nowiki></ref> symptoms associated with compassion fatigue.<ref name=":26">{{Cite book|last=Figley|first=C (Ed)|title=Treating compassion fatigue|publisher=Brunner-Routledge.|year=2002|isbn=|location=New York|pages=}}</ref> === 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.<ref name=":0" /> == In lawyers == 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.<ref name="a1">{{cite web|url=http://www.transitionsandyou.com/Compassion_Fatigue.pdf|title=Compassion Fatigue - Because You Care|work=St. Petersburg Bar Association Magazine|url-status=dead|archiveurl=https://web.archive.org/web/20081120225541/http://www.transitionsandyou.com/Compassion_Fatigue.pdf|archivedate=November 20, 2008|accessdate=February 2007}}</ref> ==Prevention== There is an effort to prepare those in the healthcare professions to combat compassion fatigue through resiliency training. Teaching workers how to relax in stressful situations, be intentional in their duties and work with integrity, find people and resources who are supportive and understand the risks of compassion fatigue, and focus on self-care are all components of this training.<ref>{{Cite journal|last=Potter|first=Patricia|last2=Pion|first2=Sarah|last3=Gentry|first3=J. Eric|title=Compassion Fatigue Resiliency Training: The Experience of Facilitators|journal=The Journal of Continuing Education in Nursing|volume=46|issue=2|pages=83–88|doi=10.3928/00220124-20151217-03|pmid=25522376|year=2015}}</ref> ===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. 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.<ref name="a4">Huggard, P. (2003). Secondary Traumatic Stress: Doctors at risk. New Ethicals Journal. http://home.cogeco.ca/~cmc/Huggard_NewEthJ_2003.pdf</ref> ===Social self-care=== [[Social support]] and emotional support can help practitioners maintain a balance in their worldview.<ref name="pat">{{cite web |url=http://health.usnews.com/health-care/for-better/articles/2017-02-27/politically-active-4-tips-for-incorporating-self-care |title=Politically Active? 4 Tips for Incorporating Self-Care, US News |date=27 February 2017 |work=US News |accessdate=5 March 2017 }}</ref> Maintaining a diverse network of social support, from colleagues to pets, promotes a positive psychological state and can protect against STS.<ref name="a4" /> ===Self-compassion as self-care=== In order to be the best benefit for clients, practitioners must maintain a state of psychological well-being.<ref>{{Cite journal|last=Barnett|first=Jeffrey E.|last2=Baker|first2=Ellen K.|last3=Elman|first3=Nancy S.|last4=Schoener|first4=Gary R.|date=2007|title=In pursuit of wellness: The self-care imperative.|journal=Professional Psychology: Research and Practice|volume=38|issue=6|pages=603–612|doi=10.1037/0735-7028.38.6.603|issn=1939-1323}}</ref> 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.<ref>{{Cite journal|last=Neff|first=K.D.|last2=Kirkpatrick|first2=K.L.|last3=& Rude|first3=S.S.|date=2007-02-01|title=Self-compassion and adaptive psychological functioning|journal=Journal of Research in Personality|volume=41|issue=1|pages=139–154|doi=10.1016/j.jrp.2006.03.004|issn=0092-6566}}</ref> The counselors use of self-compassion may lessen experiences of vicarious trauma that the counselor might experience through hearing clients stories.<ref>{{Cite journal|last=Coaston|first=Susannah C.|date=October 2017|title=Self-Care Through Self-Compassion: A Balm for Burnout|journal=The Professional Counselor|volume=7|issue=3|pages=285–297|doi=10.15241/scc.7.3.285|issn=2164-3989}}</ref> Self-compassion as a self-care method is beneficial for both clients and counselors.<ref>{{Cite journal|last=Patsiopoulos|first=Ariadne T.|last2=Buchanan|first2=Marla J.|date=2011|title=The practice of self-compassion in counseling: A narrative inquiry.|journal=Professional Psychology: Research and Practice|volume=42|issue=4|pages=301–307|doi=10.1037/a0024482|issn=1939-1323|citeseerx=10.1.1.362.4676}}</ref> ===Mindfulness as self-care=== Self-awareness as a method of self-care might help to alleviate the impact of vicarious trauma (compassion fatigue).<ref>{{Cite journal|last=Hernandez-Wolfe|first=Pilar|date=October 2018|title=Vicarious Resilience: A Comprehensive Review|journal=Revista de Estudios Sociales|issue=66|pages=9–17|doi=10.7440/res66.2018.02|issn=0123-885X|doi-access=free}}</ref> 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.<ref>{{Cite journal|last=Merriman|first=J.|date=2015|title=Enhancing counselor supervision through compassion fatigue education.|journal=Journal of Counseling and Development|volume=93|issue=3|pages=370–378|doi=10.1002/jcad.12035}}</ref> 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).”{{citation needed|date=November 2019}} The following therapeutic interventions may be used as mindfulness self-care practices: * Somatic therapy (body) * [[Psychotherapy]] (states of mind) * [[Emotionally focused therapy|Emotion focused therapy]] (feelings) * [[Gestalt therapy]] (experiential phenomena)<ref>{{Cite journal|last=Sun|first=Jessie|date=2014-07-03|title=Mindfulness in Context: A Historical Discourse Analysis|journal=Contemporary Buddhism|volume=15|issue=2|pages=394–415|doi=10.1080/14639947.2014.978088|issn=1463-9947|url=http://mindrxiv.org/r6m4w/}}</ref> {| class="wikitable" |+ !Scales Used for Assessment !Administration !Measure !Accessible |- |Professional Quality of Life Measure ProQOL<ref>{{Cite web|url=https://www.proqol.org/Home_Page.php|title=Professional Quality of Life|website=www.proqol|language=en-US|access-date=2020-02-09}}</ref> |self -test |compassion satisfaction, burnout, and secondary traumatic stress |online, available |- |Compassion Fatigue and/Satisfaction Self Test for Helpers<ref>{{Cite document|title=Compassion Fatigue Self-Test|last=Stamm|first=B. H.|last2=Figley|first2=C. R.|doi=10.1037/t66725-000|year=2018}}</ref> |self-test |compassion fatigue |online, available |- |[[Maslach Burnout Inventory]]<ref>{{Cite web|url=https://www.mindgarden.com/117-maslach-burnout-inventory|title=Maslach Burnout Inventory (MBI) - Assessments, Tests {{!}} Mind Garden - Mind Garden|website=www.mindgarden.com|language=en|access-date=2020-02-09}}</ref> |administered |burnout |available for purchase |} == See also == {{columns-list|colwidth=30em| * [[Vicarious traumatization]] * [[Donor fatigue]] * [[Bystander effect]] * [[Emotional exhaustion]] * [[Diffusion of responsibility]] * [[Post-traumatic stress disorder]] * [[Countertransference]] * [[Burnout (psychology)]] * [[Self-licensing]] *[[Compassion fatigue in journalism]] *[[Alexander Mitscherlich (psychologist)|Alexander Mitscherlich]] / [[Margarete Mitscherlich]]: wrote about the "inability to mourn". }} ==References== {{reflist}} ==Further reading== *{{cite journal | last1 = Adams | first1 = R. | last2 = Boscarino | first2 = J. | last3 = Figley | first3 = J. | year = 2006 | title = Compassion Fatigue and Psychological distress among social workers: a validation study | url = | journal = [[American Journal of Orthopsychiatry]] | volume = 76 | issue = 1| pages = 103–108 | doi=10.1037/0002-9432.76.1.103| pmid = 16569133 | pmc = 2699394 }} *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. * {{cite book |last=Figley |first=C. R. |date=1995 |chapter=Survival Strategies: A Framework for Understanding Secondary Traumatic Stress and Coping in Helpers |title=Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized |location=NY|publisher=Brunner/Mazel |pages=21–50 |isbn=9780876307595 |chapterurl=https://books.google.com/books?id=2Cwo47uOEq4C&pg=PA21}} *{{cite journal | last1 = Hall | first1 = J. | last2 = Rankin | first2 = J. | year = 2008 | title = Secondary Traumatic Stress and Child Welfare | url = | journal = International Journal of Child and Family Welfare | volume = 11 | issue = 4| pages = 172–184 }} *{{cite journal | last1 = Kinnick | first1 = K | last2 = Krugman | first2 = D. | last3 = Cameron | first3 = G. | year = 1996 | title = Compassion fatigue: Communication and burnout toward social problems | url = | journal = Journalism & Mass Communication Quarterly | volume = 73 | issue = 3| pages = 687–707 | doi=10.1177/107769909607300314}} *Kottler, J. A. (1992). ''Compassionate Therapy: Working with Difficult Clients''. San Francisco: Jossey-Bass. *{{cite journal | last1 = Joinson | first1 = C | year = 1992 | title = Coping with compassion fatigue | url = | journal = Nursing | volume = 22 | issue = 4| pages = 116–122 | doi = 10.1097/00152193-199204000-00035 }} *Phillips, B. (2009). Social Psychological Recovery, Disaster Recovery. (p.&nbsp;302). Boca Raton, FL: CRC Press - Taylor & Francis Group. *{{cite journal | last1 = Putman | first1 = J. | last2 = Lederman | first2 = F. | year = 2008 | title = How to Maintain Emotional Health. When Working with Trauma | url = | journal = Juvenile and Family Court Journal | volume = 59 | issue = 4| pages = 91–102 | doi = 10.1111/j.1755-6988.2008.00023.x }} == External links == * [http://www.compassionfatigue.org Compassion Fatigue Awareness Project] * [http://www.proqol.org ProQOL.org, Professional Quality of Life Organization] * [http://magazine.uchicago.edu/0604/features/emotion.shtml Mirrored emotion] by Jean Decety from the University of Chicago. * [http://www.socialworker.com/feature-articles/ethics-articles/Compassion_Fatigue%3A_Being_an_Ethical_Social_Worker/ Compassion Fatigue: Being an Ethical Social Worker] by Tracy C. Wharton, from The New Social Worker, Winter 2008. * [http://onlineprograms.ollusa.edu/msw/resources/the-signs-symptoms-and-treatment-of-compassion-fatigue The Signs Symptoms and Treatment of Compassion Fatigue] [[Category:Social psychology]] [[Category:Giving]] [[Category:Stress]] [[Category:Interpersonal relationships]] [[Category:Emotion]] [[Category:Moral psychology]]'