Journal of Genetic Counseling

, Volume 17, Issue 5, pp 459–471 | Cite as

The Psychic Costs of Empathic Engagement: Personal and Demographic Predictors of Genetic Counselor Compassion Fatigue

  • Sharanya Udipi
  • Patricia McCarthy Veach
  • Juihsien Kao
  • Bonnie S. LeRoy
Original Research


Empathic connection with one’s patients is essential to genetic counselor clinical practice. However, repeatedly engaging with distressed patients may cause compassion fatigue, a phenomenon characterized as feeling overwhelmed by experiencing patients’ suffering. In order to extend findings of an initial qualitative study, we surveyed 222 genetic counselors about their compassion fatigue and factors that predict its occurrence. Multiple regression analysis identified seven significant predictors accounting for 53.7% of the variance in compassion fatigue. Respondents at higher risk of compassion fatigue were more likely to report being burned out, using self-criticism and giving up to manage stress, experiencing a greater variety of distressing clinical events, having larger patient caseloads, relying on religion as a coping strategy, having no children, and seeking support to manage stress. Respondents also provided critical incidents regarding their compassion fatigue and themes in these incidents are described. Practice and research recommendations are provided.


Genetic counselor compassion fatigue Empathy Stress Burnout Coping Self-care Countertransference 


  1. Azar, B. (1997). Defining the trait that makes us human. American Psychological Association Monitor, 28(1), 15.Google Scholar
  2. Baird, S., & Jenkins, S. R. (2003). Vicarious traumatization, secondary traumatic stress, and burnout in sexual assault and domestic violence agency staff. Violence and Victims, 18(1), 71–86.PubMedCrossRefGoogle Scholar
  3. Benoit, L., Veach, P. M., & LeRoy, B. S. (2007). When you care enough to do your very best: Genetic counselor experiences of compassion fatigue. Journal of Genetic Counseling, 16, 299–312.PubMedCrossRefGoogle Scholar
  4. Breggin, P. R. (2006). The heart of being helpful: Empathy and the creation of a healing presence. New York: Springer.Google Scholar
  5. Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 52, 267–283.CrossRefGoogle Scholar
  6. Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92–100.PubMedCrossRefGoogle Scholar
  7. Collins, S., & Long, A. (2003). Too tired to care? The psychological effects of working with trauma. Journal of Psychiatric and Mental Health Nursing, 10, 17–27.PubMedCrossRefGoogle Scholar
  8. Djurdjinovic, L. (1998). Psychosocial counseling. In D. L. Baker, J. L. Schuette, & W. R. Uhlmann (Eds.), A guide to genetic counseling (pp. 127–170). New York: Wiley.Google Scholar
  9. Farber, B. A. (1983). Introduction: A critical perspective on burnout. In B. A. Farber (Ed.), Stress and burnout in the human service professions (pp. 1–20). New York: Pergamon.Google Scholar
  10. Figley, C. R. (1995). Compassion fatigue. New York: Brunner/Mazel.Google Scholar
  11. Figley, C. R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self care. Journal of Clinical Psychology, 58, 1433–1441.PubMedCrossRefGoogle Scholar
  12. Figley, C. R. (2003). Compassion fatigue: An introduction. Retrieved June 5, 2005 from the Green Cross Foundation Web site:
  13. Gentry, J. E. (2005). Compassion fatigue: Prevention and resiliency. Eau Claire, WI: PESI Healthcare, LLC.Google Scholar
  14. Giarelli, E., & Tulman, L. (2003). Methodological issues in the use of published cartoon data. Qualitative Health Research, 13, 945–956.PubMedCrossRefGoogle Scholar
  15. Haggard, P. (2003). Compassion fatigue: How much can I give? Medical Education, 39, 163–164.CrossRefGoogle Scholar
  16. Jenkins, S. R., & Baird, S. (2002). Secondary traumatic stress and vicarious trauma: A validation study. Journal of Traumatic Stress, 15, 423–432.PubMedCrossRefGoogle Scholar
  17. Joinson, C. (1992). Coping with compassion fatigue. Nursing, 22, 116–122.PubMedGoogle Scholar
  18. Maslach, C. (1982). Burnout: The cost of caring. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  19. Maytum, J. C., Heiman, M. B., & Garwick, A. W. (2004). Compassion fatigue and burnout in nurses who work with children with chronic conditions and their families. Journal of Pediatric Health Care, 18, 171–179.PubMedGoogle Scholar
  20. McCarthy Veach, P., LeRoy, B. S., & Bartels, D. M. (2003). Facilitating the genetic counseling process: A practice manual. New York: Springer.Google Scholar
  21. Pines, A. M. (1993). Burnout. In L. Goldberger, & S. Breznitz (Eds.), Handbook of stress-theoretical and clinical aspects (pp. 386–402). New York: Free Press.Google Scholar
  22. Pines, A., & Aronson, E. (1988). Career burnout: Causes and cures. New York: The Free Press.Google Scholar
  23. Roberts, R. S. B., Flannelly, K. J., Weaver, A. J., & Figley, C. R. (2003). Compassion fatigue among chaplains, clergy, and other respondents after September 11th. The Journal of Nervous and Mental Disease, 191(11), 756–758.CrossRefGoogle Scholar
  24. Rudolph, J. M., Stamm, B. H., & Stamm, H. E. (1997). Compassion fatigue, a concern for mental health policy, providers and administration. Presented at the 13th Annual Meeting of the International Society for Traumatic Stress Studies, Montreal, CA.Google Scholar
  25. Sabin-Farrell, R., & Turpin, G. (2003). Vicarious traumatization: Implications for mental health of health workers. Clinical Psychology Review, 23, 449–480.PubMedCrossRefGoogle Scholar
  26. Skovholt, T. M. (2001). The resilient practitioner: Burnout prevention and self-care strategies for therapists, counselors, teachers, and health professionals. Boston, MA: Allyn & Bacon.Google Scholar
  27. Stamm, B. H. (2005). The ProQOL. Retrieved February 2, 2005 from∼bhstamm.
  28. Steed, L., & Bicknell, J. (2001). Trauma and the therapist: The experience of therapists working with the perpetrators of sexual abuse. Retrieved from∼trauma/issues/2001–1/steed.htm.
  29. Thomas, R. B., & Wilson, J. P. (2004). Issues and controversies in the understanding and diagnosis of compassion fatigue, vicarious traumatization, and secondary traumatic stress disorder. International Journal of Emergency Mental Health, 6, 81–92.PubMedGoogle Scholar
  30. Weil, J. (2000). Psychosocial genetic counseling. New York: Oxford University Press.Google Scholar
  31. Weiss, G. G. (2003). Do you care too much? Medical Economics, 80, 64–72.PubMedGoogle Scholar
  32. Zahm, K., McCarthy Veach, P., & LeRoy, B.S. (2008). An investigation of genetic counselor experiences in peer group supervision. Journal of Genetic Counseling, in press. Google Scholar

Copyright information

© National Society of Genetic Counselors, Inc. 2008

Authors and Affiliations

  • Sharanya Udipi
    • 1
  • Patricia McCarthy Veach
    • 2
  • Juihsien Kao
    • 1
  • Bonnie S. LeRoy
    • 3
  1. 1.Department of Educational PsychologyUniversity of MinnesotaMinneapolisUSA
  2. 2.Department of Educational PsychologyUniversity of MinnesotaMinneapolisUSA
  3. 3.Department of Genetics, Cell Biology, and Development, Institute of Human GeneticsUniversity of MinnesotaMinneapolisUSA

Personalised recommendations