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'{{short description|Condition characterized by emotional and physical exhaustion}} '''Compassion fatigue (CF)''' is an evolving concept in the field of traumatology. The term has been used interchangeably with '''secondary traumatic stress''' ('''STS'''),<ref name=":25" /> which can be simply described as the negative cost of caring.<ref name=":25">{{Cite book|editor-last=Figley|editor-first=Charles |title=Treating compassion fatigue|publisher=Brunner-Routledge|year=2002|location=New York}}</ref> Secondary traumatic stress is a term commonly employed in academic literature,<ref>{{Cite book |last=R. |first=Figley, Charles |url=http://worldcat.org/oclc/852757689 |title=Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder In Those Who Treat The Traumatized |date=2013 |publisher=Taylor and Francis |isbn=978-1-134-86254-2 |oclc=852757689}}</ref> although recent assessments have identified certain distinctions between compassion fatigue (CF) and secondary traumatic stress (STS).<ref>{{Cite journal |last=Meadors |first=Patrick |last2=Lamson |first2=Angela |last3=Swanson |first3=Mel |last4=White |first4=Mark |last5=Sira |first5=Natalia |date=2009-2010 |title=Secondary traumatization in pediatric healthcare providers: compassion fatigue, burnout, and secondary traumatic stress |url=https://pubmed.ncbi.nlm.nih.gov/20222232/ |journal=Omega |volume=60 |issue=2 |pages=103–128 |doi=10.2190/om.60.2.a |issn=0030-2228 |pmid=20222232}}</ref> Compassion fatigue (CF) is a form of traumatic stress resulting from repeated exposure to traumatized individuals<ref>{{Cite journal |last=Cocker |first=Fiona |last2=Joss |first2=Nerida |date=June 2016 |title=Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4924075/ |journal=International Journal of Environmental Research and Public Health |volume=13 |issue=6 |pages=618 |doi=10.3390/ijerph13060618 |issn=1661-7827 |pmc=4924075 |pmid=27338436}}</ref> or aversive details of traumatic events while working in a helping or protecting profession.<ref>{{Cite book |last=Russo, Papazoglou, Blumberg |first=Chuck, Konstantinos, Daniel |title=Power; Police Officer Wellness, Ethics, and Resilience |publisher=Academic Press |year=2022 |isbn=978-0-12-817872-0 |location=U.S. |pages=95-115 |language=English}}</ref> This indirect form of trauma exposure differs from experiencing trauma oneself.<ref name=":25" /> 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 |last1=Pathan |first1=S. |last2=Ford |first2=C. |last3=Benson |first3=S. |last4=Illingworth |first4=C. |last5=Jackson |first5=C. |last6=Trickey |first6=D. |last7=Mallak |first7=L. |last8=O'Curry |first8=S. |year=2022 |title=The impact of a hospital staff supervision group on well-being, sense-making, and compassion fatigue. |url=https://doi.org/10.1037/trm0000405 |journal=Traumatology|doi=10.1037/trm0000405 |s2cid=251855769 }}</ref> Individuals working in other helping professions are also at risk for experiencing compassion fatigue.<ref name=":6">{{Cite book|last=Figley|first=Charles|title=Compassion fatigue: Coping with secondary traumatic stress disorder |publisher=Brunner/Mazel |year=1995 |location=New York}}</ref> These include child protection workers,<ref>{{Cite journal |last1=Conrad|first1=David |last2=Kellar-Guenther|first2=Yvonne |date=2006|title=Compassion Fatigue, Burnout, and Compassion Satisfaction among Colorado Child Protection Workers|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|last1=Holcombe|first1=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|journal=Journal of Human Behavior in the Social Environment|volume=26|issue=1|pages=69|doi=10.1080/10911359.2015.1059170|s2cid=146338069}}</ref> clergy, [[teacher]]s,<ref>{{Cite journal|last1=Sharp Donahoo|first1=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|s2cid=35250882|issn=1059-8405}}</ref> [[social work]]ers, [[palliative care]] workers,<ref>{{Cite journal|last1=Samson|first1=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=en|volume=56|issue=2|pages=245–251|doi=10.1016/j.jpainsymman.2018.04.012|issn=0885-3924|pmid=29729350|doi-access=free}}</ref> [[journalist]]s,<ref>{{Cite journal|last1=Backholm|first1=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|s2cid=144580678}}</ref> [[police officer]]s,<ref>{{Cite journal|last1=Turgoose|first1=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|s2cid=55719767|url=https://discovery.ucl.ac.uk/id/eprint/1540106/}}</ref> [[firefighter]]s, [[paramedic]]s, animal welfare workers, public [[librarian]]s, health unit coordinators,<ref>{{Cite journal|last1=Cocker|first1=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|doi-access=free}}</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|s2cid=189989010|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"/> == Symptoms == People who experience compassion fatigue may exhibit a variety of symptoms including, but not limited to, lowered concentration, numbness or feelings of helplessness, irritability, lack of self-satisfaction, withdrawal, aches and pains,<ref name=":252">{{Cite book |title=Treating compassion fatigue |publisher=Brunner-Routledge |year=2002 |editor-last=Figley |editor-first=Charles |location=New York}}</ref> exhaustion, anger, or a reduced ability to feel empathy.<ref name=":5">{{Cite journal |last=Cocker |first=Fiona |last2=Joss |first2=Nerida |date=June 2016 |title=Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4924075/ |journal=International Journal of Environmental Research and Public Health |volume=13 |issue=6 |pages=618 |doi=10.3390/ijerph13060618 |issn=1661-7827 |pmc=4924075 |pmid=27338436}}</ref> Those affected may experience an increase in negative coping behaviors such as alcohol and drug usage.<ref name=":5" /> Professionals who work in trauma-exposed roles may begin requesting more time off and consider leaving their profession.<ref>{{Cite journal |last=Cocker |first=Fiona |last2=Joss |first2=Nerida |date=June 2016 |title=Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4924075/ |journal=International Journal of Environmental Research and Public Health |volume=13 |issue=6 |pages=618 |doi=10.3390/ijerph13060618 |issn=1661-7827 |pmc=4924075 |pmid=27338436}}</ref> Significant symptom overlap exists between compassion fatigue and other manifestations, such as posttraumatic stress disorder (PTSD).<ref>{{Cite journal |last=Paiva-Salisbury |first=Melissa L. |last2=Schwanz |first2=Kerry A. |date=2022-02-01 |title=Building Compassion Fatigue Resilience: Awareness, Prevention, and Intervention for Pre-Professionals and Current Practitioners |url=https://doi.org/10.1007/s42843-022-00054-9 |journal=Journal of Health Service Psychology |language=en |volume=48 |issue=1 |pages=39–46 |doi=10.1007/s42843-022-00054-9 |issn=2662-2653 |pmc=PMC8812061 |pmid=35136862}}</ref> One distinguishing factor lies in the origin of these conditions, with PTSD stemming from primary or direct trauma, while compassion fatigue arises from secondary or indirect trauma.<ref name=":6" /> ==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"/> 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" /> To a certain extent, the term "compassion fatigue" is considered somewhat euphemistic and is used as a substitute for its academic counterpart, secondary traumatic stress. 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><ref name="Compassion Fatigue">{{Cite web |title=Compassion Fatigue |url=https://psynso.com/compassion-fatigue/ |access-date=2022-07-17 |website=Psynso |language=en-US}}</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|last1=Lisa McCann|first1=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>{{cite journal |last1=Remer |first1=R. |last2=Elliott |first2=J. E. |year=1988 |title=Characteristics of secondary victims of sexual assault |journal=International Journal of Family Psychiatry |volume=9 |issue=4 |pages=373–387}}</ref> Other related conditions are rape-related family crisis<ref>{{cite book |last=Erickson |first=C. A. |year=1989 |chapter=Rape and Family |editor-last1=Figley |editor-first1=Charles |title=Treating Stress in Families |url=https://www.taylorfrancis.com/chapters/mono/10.4324/9780203776544-18/rape-family-charles-figley |pages=257–289|doi=10.4324/9780203776544|isbn=9781134848829 }}</ref> and "proximity" effects on female partners of war veterans.<ref>{{Cite journal|last1=Verbosky|first1=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> <ref name="a2">{{cite journal | last1 = Beck | first1 = C | year = 2011 | title = Secondary Traumatic Stress in Nurses: A Systematic Review | 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 were 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> In popular parlance the term has been in use at least since the early 1970s: [[Walter Robinson (bishop)]], in an annual report, observed "'Compassion fatigue' is the phrase coined to describe the tendency to get weary or bored about the unfortunate plight of many people in the world today."<ref>[[Walter Robinson (bishop)]] Address to the First Session of the Thirty-Seventh Synod of the Diocese of Dunedin, 23rd July 1972, at [[Invercargill]], 26. Records held by [[Anglican Diocese of Dunedin]]. </ref> Robinson unfortunately does not reference the origins of the term, though his use of "coined" indicates common knowledge. Compassion fatigue also carries sociological connotations, especially when used to analyze behavior in response to media coverage of disasters.<ref>{{Cite journal|last1=Hopwood|first1=Tanya L.|last2=Schutte|first2=Nicola S.|last3=Loi|first3=Natasha M.|date=2019-09-01|title=Stress responses to secondary trauma: Compassion fatigue and anticipatory traumatic reaction among youth workers|url=https://www.tandfonline.com/doi/full/10.1016/j.soscij.2018.08.008|journal=The Social Science Journal|language=en|volume=56|issue=3|pages=337–348|doi=10.1016/j.soscij.2018.08.008|s2cid=150063268|issn=0362-3319}}</ref> 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 [[Desensitization (psychology)|desensitized]] or resistant to helping people who are suffering.<ref>{{cite web |title=Traumatic Stress & The News Audience |url=http://www.dartcenter.org/training/selfstudy/3_photojournalism/04.php |url-status=dead |archive-url=https://web.archive.org/web/20080715015000/http://www.dartcenter.org/training/selfstudy/3_photojournalism/04.php |archive-date=2008-07-15 |access-date=1 June 2008 |publisher=[[Dart Center for Journalism and Trauma]]}}</ref> Over a quarter of Americans have even changed where they get their news from due to compassion fatigue.<ref>{{cite web |title=Surveying Americans on Empathy Burnout |url=https://unitedwaynca.org/blog/empathy-burnout-survey/ |access-date=May 31, 2022 |publisher=United Way of the National Capital Area}}</ref> Measures of compassion fatigue include the ProQOL (or Professional Quality of Life Scale), Secondary Traumatic Stress Scale, Compassion Fatigue Self Test for Helpers, and the Compassion Fatigue Scale—Revised.<ref>{{cite web |url=https://proqol.org/ProQol_Test.html |title=Professional Quality of Life |website=proqol.org |url-status=dead |archive-url=https://web.archive.org/web/20090514022454/http://www.proqol.org/ProQol_Test.html |archive-date=2009-05-14}}</ref><ref>{{Cite journal|last=Beck|first=Cheryl Tatano|date=2011|title=Secondary Traumatic Stress in Nurses: A Systematic Review|url=https://doi.org/10.1016/j.apnu.2010.05.005|journal=Archives of Psychiatric Nursing|volume=25|issue=1|pages=1–10|doi=10.1016/j.apnu.2010.05.005|pmid=21251596|issn=0883-9417}}</ref> ==Risk 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.<ref>{{Cite web |title=Causes and Effects of Compassion Fatigue |url=https://nursinganswers.net/essays/causes-and-effects-of-compassion-fatigue.php |access-date=2022-07-17 |website=NursingAnswers.net |language=en}}</ref> In addition, previous histories of trauma that led to negative [[coping skills]], such as bottling up or avoiding emotions or 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 | 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.<ref>{{Cite journal|last1=University of Stavanger, Norway|last2=Ramvi|first2=Ellen|last3=Gripsrud|first3=Birgitta Haga|last4=University of Stavanger, Norway|date=2017-09-20|title=Silence about encounters with dying among healthcare professionals in a society that 'de-tabooises' death|url=https://www.fons.org/library/journal/volume7-suppl/article9|journal=International Practice Development Journal|volume=7|issue=Suppl|pages=1–12|doi=10.19043/ipdj.7SP.009|doi-access=free}}</ref> 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" /> 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.<ref>{{Cite journal|last1=Levine|first1=Robert V.|last2=Martinez|first2=Todd Simon|last3=Brase|first3=Gary|last4=Sorenson|first4=Kerry|date=1994|title=Helping in 36 U.S. cities.|url=http://dx.doi.org/10.1037/0022-3514.67.1.69|journal=Journal of Personality and Social Psychology|volume=67|issue=1|pages=69–82|doi=10.1037/0022-3514.67.1.69|issn=0022-3514}}</ref> == 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.<ref>{{Cite journal |last1=Liao |first1=Xinqi |last2=Wang |first2=Jinfeng |last3=Zhang |first3=Fengying |last4=Luo |first4=Zhipeng |last5=Zeng |first5=Yanli |last6=Wang |first6=Guofu |date=May 2022 |title=The levels and related factors of compassion fatigue and compassion satisfaction among family caregivers: A systematic review and meta-analysis of observational studies |journal=Geriatric Nursing |volume=45 |pages=1–8 |doi=10.1016/j.gerinurse.2022.02.016 |pmid=35279623 |s2cid=247403757 |issn=1528-3984}}</ref> ==In healthcare professionals<ref>{{Cite journal |last=Erbe |first=Afton M |date=June 2022 |title=Compassion Fatigue and Mental Health in Health Care Professionals |journal=Workplace Health & Safety |volume=70 |issue=6 |pages=303 |doi=10.1177/21650799221081237 |pmid=35486498 |s2cid=248430440 |issn=2165-0969}}</ref>== 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 | 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" /> 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<ref>{{Cite journal |last1=Aslan |first1=Hakime |last2=Erci |first2=Behice |last3=Pekince |first3=Hatice |date=June 2022 |title=Relationship Between Compassion Fatigue in Nurses, and Work-Related Stress and the Meaning of Life |url=https://dx.doi.org/10.1007/s10943-020-01142-0 |journal=Journal of Religion and Health |volume=61 |issue=3 |pages=1848–1860 |doi=10.1007/s10943-020-01142-0 |pmid=33386572 |pmc=7775832 |issn=1573-6571}}</ref> 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.<ref>{{cite journal |last1=Marshman |first1=C. |last2=Hansen |first2=A. |last3=Munro |first3=I. |year=2022 |title=Compassion fatigue in mental health nurses: A systematic review. |url=https://doi.org/10.1111/jpm.12812 |journal=Journal of Psychiatric and Mental Health Nursing|volume=29 |issue=4 |pages=529–543 |doi=10.1111/jpm.12812 |pmid=34874593 |s2cid=245109708 }}</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>{{cite journal | doi=10.1188/10.CJON.E56-E62 | title=Compassion Fatigue and Burnout | year=2010 | last1=Olsen | first1=Sarah | last2=Norris | first2=Lori | last3=Cipriano | first3=Doreen | last4=Berger | first4=Julie | last5=Divanbeigi | first5=Joyce | last6=Deshields | first6=Teresa | last7=Potter | first7=Patricia | journal=Clinical Journal of Oncology Nursing | volume=14 | issue=5 | pages=E56–E62 | pmid=20880809 | s2cid=3871989 }}</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>{{cite journal | doi=10.1177/1751143717713088 | title=Psychological burnout and the intensive care practitioner: A practical and candid review for those who care | year=2017 | last1=Brindley | first1=PG | journal=Journal of the Intensive Care Society | volume=18 | issue=4 | pages=270–275 | pmid=29123554 | pmc=5661791 | s2cid=46006920 }}</ref> 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.<ref>{{cite journal | doi=10.5811/westjem.2014.5.21624 | title=Compassion Fatigue is Similar in Emergency Medicine Residents Compared to other Medical and Surgical Specialties | year=2014 | last1=Fernanda | first1=Bellolio | last2=Cabrera | first2=Daniel | last3=Sadosty | first3=Annie | last4=Hess | first4=Erik | last5=Campbell | first5=Ronna | last6=Lohse | first6=Christine | last7=Sunga | first7=Kharmene | journal=Western Journal of Emergency Medicine | volume=15 | issue=6 | pages=629–635 | pmid=25247031 | pmc=4162717 }}</ref> 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 from [[emotional exhaustion]], de-personalization, and a 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 amid compassion fatigue. Because of this, healthcare institutions are placing increased importance on supporting their employee's emotional needs so they can better care for patients.<ref>{{Cite journal|last1=Sorenson|first1=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|s2cid=24007348}}</ref> Studies compiled in 2018 by Zang et al.<ref>{{Cite journal |last1=Zhang |first1=Ying-Ying |last2=Han |first2=Wen-Li |last3=Qin |first3=Wen |last4=Yin |first4=Hai-Xia |last5=Zhang |first5=Chong-Fang |last6=Kong |first6=Cui |last7=Wang |first7=Ying-Lei |date=October 2018 |title=Extent of compassion satisfaction, compassion fatigue and burnout in nursing: A meta-analysis |url=https://onlinelibrary.wiley.com/doi/10.1111/jonm.12589 |journal=Journal of Nursing Management |language=en |volume=26 |issue=7 |pages=810–819 |doi=10.1111/jonm.12589|pmid=30129106 |s2cid=52051780 }}</ref> indicate that the level of education one obtains in the field of healthcare has an effect on levels of burnout, compassion satisfaction, and compassion fatigue. Studies show, it is indicated that those with higher levels of education in their respective field will experience lower rates of burnout and compassion fatigue, while also having increased levels of compassion satisfaction. 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 go 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 student loans, the requirements for patient load through the hospital, and 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 the 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. === C.N.A.s/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, causing desensitization and lack of enthusiasm for patient care.<ref name=":2">{{cite journal | doi=10.1097/CNQ.0b013e318268fe09 | title=Concept Analysis | year=2012 | last1=Jenkins | first1=Belinda | last2=Warren | first2=Nancy A. | journal=Critical Care Nursing Quarterly | volume=35 | issue=4 | pages=388–395 | pmid=22948373 }}</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. === 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.<ref>{{Cite news |date=2019-08-28 |title=Social work: 'I had a parent screaming foul names at me' |language=en-GB |work=BBC News |url=https://www.bbc.com/news/uk-49451745 |access-date=2022-07-17}}</ref><ref>{{Cite web |title=Combating Compassion Fatigue in Social Work |url=https://socialwork.tulane.edu/blog/compassion-fatigue-in-social-work |access-date=2022-07-17 |website=socialwork.tulane.edu |date=30 January 2020 |language=en-us}}</ref> 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.<ref name="hazeldenbettyford.org">{{Cite web |title=Healthcare Professionals and Compassion Fatigue |url=https://www.hazeldenbettyford.org/education/bcr/addiction-research/healthcare-professionals-compassion-fatigue |access-date=2022-07-17 |website=www.hazeldenbettyford.org |language=en}}</ref> 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.<ref name="socialworkonline.uky.edu">{{Cite web |date=2021-11-12 |title=Compassion Fatigue in Social Work {{!}} Secondary Trauma {{!}} UK Online |url=https://socialworkonline.uky.edu/resources/article/compassion-fatigue-social-work/ |access-date=2022-07-17 |website=UK College of Social Work |language=en-US}}</ref> This can also occur because of a connection with a client and a shared similar traumatic experience.<ref name="socialworkonline.uky.edu"/> 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”.<ref name="hazeldenbettyford.org"/> The importance of the contribution of education and recognition cannot be negated in its import  of counter of compassion fatigue.<ref name="hazeldenbettyford.org"/> 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 STS<ref name="hazeldenbettyford.org"/><ref>{{Cite web |title=Compassion Fatigue {{!}} Psychology Today |url=https://www.psychologytoday.com/us/basics/compassion-fatigue |access-date=2022-07-17 |website=www.psychologytoday.com |language=en}}</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.<ref>{{Cite journal|last=Browning|first=Stacey G.|date=December 2019|title=Burnout in Critical Care Nurses|url=http://dx.doi.org/10.1016/j.cnc.2019.07.008|journal=Critical Care Nursing Clinics of North America|volume=31|issue=4|pages=527–536|doi=10.1016/j.cnc.2019.07.008|pmid=31685119|s2cid=204047636|issn=0899-5885}}</ref> 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">{{cite journal | doi=10.1097/01.CCN.0000490957.22107.50 | title=An inverse relationship | year=2016 | last1=Fahey | first1=Donna M. | last2=Glasofer | first2=Amy | journal=Nursing Critical Care | volume=11 | issue=5 | pages=30–35 | s2cid=79378848 }}</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>{{cite journal | doi=10.1186/s13613-017-0293-2 | title=Moral distress and its contribution to the development of burnout syndrome among critical care providers | year=2017 | last1=Fumis | first1=Renata Rego Lins | last2=Junqueira Amarante | first2=Gustavo Adolpho | last3=De Fátima Nascimento | first3=Andréia | last4=Vieira Junior | first4=José Mauro | journal=Annals of Intensive Care | volume=7 | issue=1 | page=71 | pmid=28639161 | pmc=5479870 | s2cid=13011218 }}</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=Mott |first1=J. |last2=Martin |first2=L.A. |year=2019 |title=Adverse childhood experiences, self‐care, and compassion outcomes in mental health providers working with trauma. |url=https://doi.org/10.1002/jclp.22752 |journal=Journal of Clinical Psychology|volume=75 |issue=6 |pages=1066–1083 |doi=10.1002/jclp.22752 |pmid=30720876 |s2cid=73424690 }}</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">{{cite journal | last1=Maiden | first1=Jeanne | last2=Georges | first2=Jane M. | last3=Connelly | first3=Cynthia D. | title=Moral Distress, Compassion Fatigue, and Perceptions About Medication Errors in Certified Critical Care Nurses | journal=Dimensions of Critical Care Nursing | volume=30 | issue=6 | year=2011 | issn=0730-4625 | doi=10.1097/dcc.0b013e31822fab2a | pages=339–345| pmid=21983510 | s2cid=44752540 }}</ref> 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.<ref>{{Cite journal |last1=Ahmed |first1=Fadwa |last2=Baruch |first2=Jay |last3=Armstrong |first3=Paul |date=2022-05-06 |title=Examining the Constructs of Burnout, Compassion Fatigue, Secondary Traumatic Stress in Physicians Using Factor Analyses |journal=Frontiers in Public Health |volume=10 |pages=893165 |doi=10.3389/fpubh.2022.893165 |pmid=35602123 |pmc=9120964 |issn=2296-2565|doi-access=free }}</ref> Those with a better ability to empathize and be compassionate are at a higher risk of developing compassion fatigue.<ref>{{cite book |author1=Figley |author1-link=C. R. |editor1-last=Figley |editor1-first=C. R. |title=Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized |date=1995 |publisher=Brunner/Mazel |isbn=9780203777381 |pages=1–20 |chapter=Compassion fatigue as secondary traumatic stress disorder: An overview |doi=10.4324/9780203777381}}</ref> 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.<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, or commit suicide.<ref>{{cite journal | last1=Moss | first1=Marc | last2=Good | first2=Vicki S. | last3=Gozal | first3=David | last4=Kleinpell | first4=Ruth | last5=Sessler | first5=Curtis N. | title=An Official Critical Care Societies Collaborative Statement—Burnout Syndrome in Critical Care Health-care Professionals | journal=Chest | volume=150 | issue=1 | year=2016 | issn=0012-3692 | doi=10.1016/j.chest.2016.02.649 | pages=17–26 | pmid=27396776| doi-access=free }}</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>{{cite journal|last1=Seifert|first1=T. A. |last2=Perozzi|first2=B. |last3=Li|first3=W. |year=2015 |title=Issues and challenges in student affairs and services work : a comparison of perspectives from Canada, the United Kingdom, Australia and New Zealand |journal=Journal of the Australian and New Zealand Student Services Association |issue=45 |pages=41–51 |url=https://search.informit.org/doi/10.3316/aeipt.207729 }}</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|website=ProQuest Dissertations and Theses database}}</ref> Such crises may include sexual violence, suicidal ideation, severe mental health episodes, and hate crimes/discrimination.<ref name=":32">{{Cite journal |last1=Lynch |first1=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 |s2cid=149942045 |issn=1949-6591 |url=http://libres.uncg.edu/ir/asu/f/Lynch_Jason_Glass_2018_Development%20Secondary%20Trauma.pdf }}</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>{{cite journal | last1=Biron | first1=C | last2=Brun | first2=JP | last3=Ivers | first3=H | title=Extent and sources of occupational stress in university staff. | journal=Work: A Journal of Prevention, Assessment and Rehabilitation | volume=30 | issue=4 | year=2008 | issn=1051-9815 | pmid=18725713 | pages=511–22 |publication-place=Reading, Mass.}}</ref> symptoms associated with compassion fatigue.<ref name=":26">{{Cite book|editor-last=Figley|editor-first=C |title=Treating compassion fatigue|publisher=Brunner-Routledge|year=2002|location=New York}}</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 == 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.<ref>{{Cite journal |last1=Norton |first1=Lee |last2=Johnson |first2=Jennifer |last3=Woods |first3=George |date=2015–2016 |title=Burnout and Compassion Fatigue: What Lawyers Need to Know |url=https://heinonline.org/HOL/Page?handle=hein.journals/umkc84&id=1013&div=&collection= |journal=UMKC Law Review |volume=84 |pages=987}}</ref> 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|archive-url=https://web.archive.org/web/20081120225541/http://www.transitionsandyou.com/Compassion_Fatigue.pdf|archive-date=November 20, 2008|access-date=1 February 2007}}</ref> ==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.<ref>{{Cite journal|last1=Potter|first1=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. There is evidence that journaling and meditation can also mediate the effects of STS.<ref>{{Cite journal|last1=Radziewicz|first1=RM|date=2001|title=Self-care for the caregiver|url=https://pubmed.ncbi.nlm.nih.gov/11726358/|journal=Nursing Clinics of North America |volume=36|issue=4|pages=855–869 |doi=10.1016/S0029-6465(22)02676-7 |pmid=11726358|s2cid=33585653 |via=PubMed |issn=0029-6465}}</ref> 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 {{Webarchive|url=https://web.archive.org/web/20141225233126/http://home.cogeco.ca/~cmc/Huggard_NewEthJ_2003.pdf |date=2014-12-25 }}</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 |access-date=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" /> 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.<ref>{{Cite journal|last1=Boyle|first1=Deborah A.|date=2011|title=Countering Compassion Fatigue: A Requisite Nursing Agenda|url=https://doi.org/10.3912/OJIN.Vol16No01Man02|journal=Online Journal of Issues in Nursing|volume=16|issue=1|page=2|doi=10.3912/OJIN.Vol16No01Man02|pmid=21800933|s2cid=19168904}}</ref> ===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|last1=Barnett|first1=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|last1=Neff|first1=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|doi-access=free}}</ref> Self-compassion as a self-care method is beneficial for both clients and counselors.<ref>{{Cite journal|last1=Patsiopoulos|first1=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).”<ref>{{cite journal | last1=Williams | first1=J. Mark G. | last2=Kabat-Zinn | first2=Jon | title=Mindfulness: diverse perspectives on its meaning, origins, and multiple applications at the intersection of science and dharma | journal=Contemporary Buddhism | publisher=Informa UK Limited | volume=12 | issue=1 | date=2011-05-01 | issn=1463-9947 | doi=10.1080/14639947.2011.564811 | pages=1–18}}</ref> 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|s2cid=145248337|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>{{citation | last1=Stamm | first1=B. H. | last2=Figley | first2=C. R. | title=Compassion Fatigue Self-Test | publisher=[[American Psychological Association]] | year=1996 | doi=10.1037/t66725-000 | page=}}</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 |} == Compassion fade == {{Main|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”.<ref>{{Cite web |title=Definition of COMPASSION FATIGUE |url=https://www.merriam-webster.com/dictionary/compassion+fatigue |access-date=2022-07-17 |website=www.merriam-webster.com |language=en}}</ref> Compassion fatigue usually occurs with those whom we ''know''; whether that is because of a personal relationship or professional relationship.<ref name="LisaNotes">{{Cite web |last=LisaNotes |date=2020-10-16 |title=How to Prevent Compassion Fade During a Pandemic |url=https://lisanotes.com/prevent-compassion-fade-during-pandemic/ |access-date=2022-07-17 |website=Lisa notes |language=en-US}}</ref> 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.<ref name="Jerry">{{Cite web |last=Jerry |date=2017-12-31 |title=Compassion Fade |url=https://fccmelrose.org/2017/12/31/compassion-fade/ |access-date=2022-07-17 |language=en}}</ref> 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).<ref>{{cite journal | last1=Butts | first1=Marcus M. | last2=Lunt | first2=Devin C. | last3=Freling | first3=Traci L. | last4=Gabriel | first4=Allison S. | title=Helping one or helping many? A theoretical integration and meta-analytic review of the compassion fade literature | journal=Organizational Behavior and Human Decision Processes | publisher=Elsevier BV | volume=151 | year=2019 | issn=0749-5978 | doi=10.1016/j.obhdp.2018.12.006 | pages=16–33| s2cid=149806445 }}</ref> 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.<ref name="LisaNotes"/><ref name="Jerry"/><ref>{{cite journal | last1=Västfjäll | first1=Daniel | last2=Slovic | first2=Paul | last3=Mayorga | first3=Marcus | last4=Peters | first4=Ellen | editor-last=Lamm | editor-first=Claus | title=Compassion Fade: Affect and Charity Are Greatest for a Single Child in Need | journal=PLOS ONE | publisher=Public Library of Science (PLoS) | volume=9 | issue=6 | date=2014-06-18 | issn=1932-6203 | doi=10.1371/journal.pone.0100115 | page=e100115 | pmid=24940738 | pmc=4062481 | bibcode=2014PLoSO...9j0115V| doi-access=free }}</ref> It is a type of cognitive bias that helps people make their decision to help.<ref>Morris, S., & Cranney, J. (2018). Chapter 2 The imperfect mind. The Rubber Brain (pp. 19–42). Australian Academic Press.</ref> == See also == {{Portal|Psychology}} {{columns-list|colwidth=30em| * [[Bystander effect]] * [[Caregiver stress]] * [[Compassion fatigue in journalism]] * [[Countertransference]] * [[Diffusion of responsibility]] * [[Donor fatigue]] * [[Post-traumatic stress disorder]] * [[Self-licensing]] * [[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 | 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 |chapter-url=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 | 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 | journal = Journalism & Mass Communication Quarterly | volume = 73 | issue = 3| pages = 687–707 | doi=10.1177/107769909607300314| s2cid = 144481370 }} *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 | journal = Nursing | volume = 22 | issue = 4| pages = 116–122 | doi = 10.1097/00152193-199204000-00035 | pmid = 1570090 }} *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 | journal = Juvenile and Family Court Journal | volume = 59 | issue = 4| pages = 91–102 | doi = 10.1111/j.1755-6988.2008.00023.x }} == External links == * {{Commons category-inline}} * [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:Occupational stress]] [[Category:Interpersonal relationships]] [[Category:Emotion]] [[Category:Moral psychology]]'