Understanding and Coping with Compassion Fatigue in Social Work

What is compassion fatigue? Imagine a social worker who spends years hearing about and working with abused children. After a period of time, she starts to feel numb to that pain and experiences exhaustion and anxiety. This is compassion fatigue. More than 70% of social workers experience some level of compassion fatigue.

Compassion fatigue is a set of symptoms often characterized by emotional, physical, or spiritual exhaustion that leads to a loss in the ability to empathize or feel compassion for others. These symptoms are particularly common in individuals working in various care- and advocacy-driven fields, such as health care, education, and social work.

The ongoing COVID-19 pandemic has contributed to an increase in compassion fatigue among professionals in these fields. Because providers are frequently working virtually, experiencing an increase in caseloads, and helping individuals and families cope with illness and death, they are often struggling to manage their own stress levels.

If not properly addressed, this increase in compassion fatigue could have negative and lasting consequences for professionals, including burnout, decreased job performance, and high turnover rates. Compassion fatigue can also indirectly affect individuals in need by decreasing the number of providers and the efficiency of their care.

What Is Compassion Fatigue in Social Work?

Compassion fatigue is emotional, spiritual, or physical distress that comes from providing care for other people, particularly those in trying circumstances. Compassion fatigue can result from direct exposure to traumatic events, such as in the experiences of first responders who see trauma firsthand.

The symptoms of compassion fatigue in social workers can be similar to those of post-traumatic stress disorder (PTSD). PTSD is a mental health condition caused by experiencing trauma. Symptoms, which include flashbacks, extreme anxiety, and intrusive thoughts, can have significant impacts on work performance and personal well-being. If compassion fatigue goes untreated, workers may experience mental and physical health issues that impair their ability to care for their clients.

Consequences of Compassion Fatigue

Untreated compassion fatigue has several overarching consequences, both direct and indirect, for the field of social work.

Direct consequences (for the social worker) include:

• Poor job performance because of sleep deprivation, stress, and other unhealthy functioning
• Negativity, leading to low morale and a toxic work environment

Indirect consequences (for the social work system) include:

• Inability of organizations to deliver high-quality patient care
• High levels of employee turnover
• Inadequate social service provisions

Because of these negative repercussions, compassion fatigue should be recognized early and dealt with swiftly.

Compassion Fatigue vs. Burnout

While compassion fatigue and burnout have similar symptoms, the key difference is that compassion fatigue comes from primary or secondary exposure to trauma, while burnout comes from exhaustion. Understanding the relationship between the two is important so they can be recognized and treated properly.

Similarities Between Compassion Fatigue and Burnout

Individuals experiencing compassion fatigue or burnout generally struggle with the same work conditions, such as long hours, large workloads, and stressful work environments. For example, social workers employed in a public health setting may find that their caseloads increase year after year with less time allotted to complete paperwork. They are working more and more hours for the same amount of pay; these can be contributing factors to both compassion fatigue and burnout.

The two conditions also have similar results, including emotional, mental, and physical exhaustion; a reduced sense of meaning in work; and isolation from others.

Differences Between Compassion Fatigue and Burnout

Compassion fatigue has the potential to fundamentally reduce an individual’s level of empathy, while burnout is unlikely to have this result. For example, a school social worker making daily calls to Child Protective Services may find that he loses the ability to empathize, while an individual experiencing burnout may simply feel exhausted and overwhelmed.

The stages and timetables of compassion fatigue and burnout also differ. Burnout happens slowly over time while compassion fatigue can occur suddenly after exposure to a traumatic event. While burnout can be reduced or eliminated by switching jobs, compassion fatigue can follow a person from job to job, since it impacts the ability to feel empathy. Fortunately, if it is caught early and managed properly, compassion fatigue can have a faster recovery time than burnout.

Additional Resources

For more information on compassion fatigue and burnout, consider the following sources:

• Center for Care Innovations, Crisis & Trauma Resource Institute, Burnout, Compassion Fatigue and Vicarious Trauma Assessment. This assessment indicates an individual’s level of distress related to burnout, compassion fatigue, and vicarious trauma.
• Compassion Fatigue Awareness Project, Self Tests. This resource offers three tests to measure quality of life, stress, and empathy.
• Extinguish Burnout, “Is It Compassion Fatigue or Burnout?” This blog and video discuss the differences between compassion fatigue and burnout.
• International Journal of Cancer Management, “Social Workers’ Resilience: Preventing Burnout and Compassion Fatigue in Pediatric Oncology.” Learn strategies for preventing and dealing with compassion fatigue and burnout.

Compassion Fatigue vs. Vicarious Trauma

Vicarious trauma is another challenge for social workers and those in similar fields. Although compassion fatigue and vicarious trauma are sometimes used interchangeably, several key differences exist between the two.

Similarities Between Compassion Fatigue and Vicarious Trauma

Symptoms of both compassion fatigue and vicarious trauma may mimic the symptoms of traumatized clients with whom providers work. Symptoms can include difficulty concentrating, feelings of discouragement, hopelessness, exhaustion, and irritability. In social work fields, both issues can result in high levels of attrition, wherein qualified workers leave the  field. Also, both can cause negative outcomes for workers staying in the field. For example, a social worker suffering from compassion fatigue or vicarious trauma may complain frequently, miss work often, or cause co-workers to feel frustrated or stressed.

Differences Between Compassion Fatigue and Vicarious Trauma

When it comes to compassion fatigue vs. vicarious trauma, compassion fatigue can result in a decreased ability to feel empathy, but doesn’t usually result in a fundamental change in worldview. Conversely, vicarious trauma can result in both decreased empathy and a changed worldview, often with individuals viewing the world in a more negative light.

Just as with compassion fatigue and burnout, understanding the difference between compassion fatigue and vicarious trauma is important so that individuals experiencing the symptoms can be appropriately diagnosed and treated.

Additional Resources

For more information on compassion fatigue and vicarious trauma, consider the following sources:

• Intraconnections Counseling, “Skills to Reduce Burnout, Compassion Fatigue and Vicarious Trauma.” Gain skills to reduce the effects of vicarious trauma, burnout, and compassion fatigue.
• Policy Research Associates (YouTube), “Recognizing Compassion Fatigue, Vicarious Trauma, and Burnout in the Workplace.” This video describes compassion fatigue, vicarious trauma, and burnout in the workplace.
• Psychiatric Times, “Vicarious Trauma in Clinicians: Fostering Resilience and Preventing Burnout.” This article helps readers identify the differences between vicarious trauma and compassion fatigue and find resources to foster resilience.
• S. Department of Veterans Affairs, “Impact of Working with Trauma Survivors.” Learn about the impact of working with trauma survivors and the concepts of burnout, secondary traumatic stress, compassion fatigue, and vicarious traumatization.

The Signs of Compassion Fatigue

Compassion fatigue affects multiple dimensions of an individual’s well-being — emotional, physical, mental, and behavioral — and presents through both visible and invisible signs. Each of the signs of compassion fatigue can affect a social worker’s ability to optimally perform their tasks.

Emotional Signs

Common emotional signs of compassion fatigue include anger, irritability, hopelessness, and detachment. For each of these emotions, individuals experiencing compassion fatigue may notice that the intensity increases. For example, what once may have been a minor annoyance now triggers an extreme anger response. Caregivers with these symptoms may have difficulty working as part of a team without becoming irritable or angry.

Physical Signs

Compassion fatigue presents itself physically as well. Some common signs include abdominal pain, headaches, and high blood pressure. These physical symptoms may affect an individual’s quality of sleep or ability to maintain a balanced diet or regular exercise routine. Practitioners experiencing these physical symptoms may find that they lead to cognitive or emotional issues that make performing their professional duties difficult.

Mental Signs

Mental or cognitive signs are common indicators of compassion fatigue. Individuals may find that they are having difficulty concentrating on tasks. They may also experience increasing levels of self-blame or notice that their self-esteem is lower than usual. These issues can affect a worker’s ability to complete even routine paperwork or basic decision-making or problem-solving tasks.

Behavioral Signs

Compassion fatigue also may result in behavioral issues, such as substance abuse or chronic lateness. Other behavioral signs include isolation from friends and family or depressive symptoms like the inability to feel joy. These behavioral signs may be the most severe because they impact not only job performance but personal relationships and safety as well.

Compassion fatigue can affect social workers in many ways, and it is important to recognize the signs as soon as possible. The issue can manifest itself in the following categories: emotionally (anger, irritability, sense of hopelessness), physically (headaches, abdominal pain, hypertension), cognitively (difficulty concentrating, self-blame, low self-esteem), and behaviorally (substance abuse, chronic lateness, lack of joy).

How to Deal with Compassion Fatigue

Individuals in the social work field have a variety of compassion fatigue coping strategies available to them. When considering how to deal with compassion fatigue, different people may require different treatments, but treating the issue is essential. Coping strategies can have long-term positive effects for social workers, personally and professionally.

Recognizing the Signs

Recognizing the early signs of compassion fatigue is the first critical step to managing this condition. Individuals who think they may be experiencing compassion fatigue should find coping strategies immediately. Some early signs of compassion fatigue mimic the signs of professional burnout — emotional, mental, and physical exhaustion — even though the two conditions are different.

Developing and Practicing Self-Care Strategies

Self-care strategies can be hugely beneficial for anyone, but they are especially helpful for those experiencing compassion fatigue. While identifying and developing self-care strategies that work is important, finding time to actually put these strategies into practice on a regular basis is more important. These strategies not only enable professionals to cope with work stress, they help boost resilience, which is the ability to quickly recover from difficult or trying situations.

Eat a Balanced Diet

While some fatigued individuals may forget to eat or resort to unhealthy processed foods, maintaining a balanced diet is one of the simplest ways to practice self-care. For those on the go all week, finding a time on the weekend to shop for healthy food and prepare meals for the workweek can be extremely helpful. Individuals with compassion fatigue will also benefit from eating three solid meals each day and keeping these meals on a somewhat regular schedule.

Exercise Regularly

Exercise has been proven to reduce stress and increase endorphins, but finding time to exercise can be difficult, especially for individuals who haven’t previously had an exercise routine. Starting small with just a few minutes of walking each day and then building to longer workouts can be an effective and sustainable way to build physical activity into everyday life.

Get Consistent Sleep

Most adults need between seven and nine hours of sleep each night for optimal health and mental performance. Establishing and following a consistent sleep routine that includes going to bed and waking up around the same time each day, including weekends, is the best way to ensure a good night’s sleep. Individuals can also improve their sleep environment by eliminating distractors like reading the news or scrolling through social media before bed.

Establish Work-Life Balance

For workers experiencing compassion fatigue, maintaining an appropriate work-life balance can be incredibly difficult, made even more challenging by working from home due to COVID-19. To combat this, setting times each day that are off-limits for work tasks and checking work email can be helpful. If possible, work should be avoided on the weekends, but if this is not possible, setting work-free hours each day for family, friends, and self-care is important.

Address Emotional Needs

While social workers and others experiencing compassion fatigue may be tempted to neglect their own emotions, those emotions must be acknowledged and honored. This can take the form of simply naming the emotion (“I’m angry today”) and accepting it. Some individuals may find speaking with a therapist or faith leader to seek additional support helpful.

Cultivating Effective Coping Strategies in the Workplace

Those interested in how to deal with compassion fatigue are likely spending excessive hours in the workplace. That means cultivating effective coping strategies in the workplace can go a long way toward alleviating compassion fatigue’s symptoms.

Some effective strategies include:

• Taking regular breaks (including taking a full lunch break or a few minutes to talk to a colleague)
• Attending on-site support groups offered by human resources
• Taking mental health days and vacation days when needed
• Attending on-site counseling sessions if offered
• Taking a midday walk

Cultivating Effective Coping Strategies Away from the Workplace

Coping strategies outside the workplace are just as important as within the workplace. Cultivating these strategies can help individuals maintain their work-life balance and prevent workplace stressors from seeping into their personal lives and homes. In addition to the self-care tips listed above, other effective coping strategies include deep breathing, meditation, or practicing a hands-on hobby like gardening or baking.

Developing and deploying a well-designed self-care strategy can help social workers keep compassion fatigue in check, which enables them to provide better service and advocacy. Some of the key self-care strategies include eating a balanced diet, exercising regularly, creating a consistent sleep schedule, building a strong work-life balance, and recognizing and addressing emotional needs.

Combating Compassion Fatigue: Resources and Tools

Social work professionals can use a number of compassion fatigue resources and tools to cope with this condition. They should pick the best resource or tool for their personal learning styles and coping strategies.

Organizations and Support Groups

Organizations and support groups that allow people to connect can be a huge source of relief and comfort.

• Compassion Fatigue & Resiliency in Professionals. Professionals can collaborate and share resources in this Facebook group.
• Compassion Fatigue Awareness Project. This site connects people suffering from compassion fatigue and helps raise awareness.
• Educare. This organization is dedicated to enriching the lives of caregivers.

Toolkits and Brochures

For those who prefer to work on their own, toolkits and brochures can be helpful resources for learning about and combating compassion fatigue.

• Advisory Board, Compassion Fatigue Assessment. This resource includes a downloadable assessment to help individuals identify compassion fatigue, understand the causes, and find help if necessary.
• National Institutes of Health, Emotional Wellness Toolkit. Run by the NIH, this toolkit offers suggestions to cope with life’s stressors.
• The Network for Social Work Management, Self-Care Toolkit. This toolkit offers multiple assessment forms and worksheets for evaluating stress levels, measuring resilience, and improving self-care.

Books

• Many books have been published as resources for dealing with compassion fatigue in social work and other fields.
• Burnout and Self-Care in Social Work: A Guidebook for Students and Those in Mental Health and Related Professions. This book prepares social workers to deal with compassion fatigue and burnout in the workplace.
• The Resilient Practitioner: Burnout Prevention and Self-Care Strategies for Counselors, Therapists, Teachers, and Health Professionals. This book describes how to maintain resilience in the face of burnout, compassion fatigue, and secondary stress.
• Self-Care in Social Work: A Guide for Practitioners, Supervisors, and Administrators. This book supports social workers and their supervisors in their efforts to practice self-care.

Podcasts and Videos

• Watching videos or listening to podcasts can be a helpful way of learning new information.
• BBC News, “The Why Factor: Compassion Fatigue.” This podcast explains why individuals get overwhelmed caring for others.
• “Caregiver SOS” podcast. An hour-long weekly radio show, the “Caregiver SOS” podcast helps caregivers manage the stressors of their jobs.
• National Association of Social Workers, “NASW Social Work Talks Podcast, Episode 17: Self-Care and Avoiding Burnout.” This podcast helps social workers practice self-care and avoid burnout.Tend, The Edge of Compassion—Françoise Mathieu Giving a TEDTalk for TEDxQueensU. This video features a compassion fatigue educator discussing the balance between caring for others and maintaining empathy.
• Self-Care and Support for Compassion Fatigue
• Compassion fatigue is a serious issue in the social work field, and individuals experiencing it may face myriad physical, emotional, behavioral, and mental symptoms. Fortunately, with early diagnosis and self-care steps, compassion fatigue can be prevented and treated effectively.

Infographic Sources:

• The American Institute of Stress, Definitions
• Cigna, Compassion Fatigue
• DailyCaring, “How to Cope with Compassion Fatigue: 8 Tips for Caregivers”
• GoodTherapy, “The Cost of Caring: 10 Ways to Prevent Compassion Fatigue”
• PublicSource, “Helping Doesn’t Have to Hurt: Managing Compassion Fatigue in the Midst of the COVID-19 Pandemic”