Skip to main content

Working with Providers and Healthcare Systems Experiencing Compassion Fatigue and Burnout

  • Chapter
  • First Online:
Medical Family Therapy

Abstract

Caring for families who have experienced trauma, loss, or chronic conditions can have lasting effects on providers, especially when faced with complex situations for extended periods of time. Training programs often do not prepare providers to avoid common challenges such as burnout (BRN) and compassion fatigue (CF). In this chapter, the authors provide operational definitions for these conditions in healthcare based on research conducted with diverse medical and behavioral health providers. The authors include personal and professional recommendations that promote self-care in medical family therapists (MedFTs), that can be taught to other healthcare staff and providers within workplace contexts that are emotionally charged, psychologically draining, and oftentimes physically demanding.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Notes

  1. 1.

    An asterisk has been used to note references that the chapter authors recommend for further reading.

References

An asterisk has been used to note references that the chapter authors recommend for further reading.

  • Abendroth, M., & Flannery, J. (2006). Predicting the risk of compassion fatigue. Journal of Hospice and Palliative Nursing, 8, 346–356. doi:10.1097/00129191-200611000-00007.

    Article  Google Scholar 

  • Acker, G. M. (2012). Burnout among mental health care providers. Journal of Social Work, 12, 475–490. doi:10.1177/1468017310392418.

    Article  Google Scholar 

  • Adams, R., Boscarino, J., & Figley, C. (2006). Compassion fatigue and psychological distress among social workers: A validation study. American Journal of Orthopsychiatry, 76, 103–108. doi:10.1037/0002-9432.76.1.103.

    Article  PubMed Central  PubMed  Google Scholar 

  • Baird, K., & Kracen, A. (2006). Vicarious traumatization and secondary traumatic stress: A research synthesis. Counseling Psychology Quarterly, 19, 181–188. doi:10.1080/09515070600811899.

    Article  Google Scholar 

  • Breslau, N., Davis, G., Peterson, E., & Schultz, L. (1997). Psychiatric sequelae of posttraumatic stress disorder in women. Archives of General Psychiatry, 54, 81–87. doi:10.1001/archpsyc.1997.01830130087016.

    Article  PubMed  Google Scholar 

  • *Bride, B. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52, 63–70. doi:10.1093/sw/52.1.63.

    Article  PubMed  Google Scholar 

  • *Bride, B., Robinson, M., Yegidis, B., & Figley, C. (2004). Development and validation of the secondary traumatic stress scale. Research on Social Work Practice, 14, 27–35. doi:10.1177/1049731503254106.

    Article  Google Scholar 

  • Brief, A., & Weiss, H. (2002). Organizational behavior: Affect in the workplace. Annual Review in Psychology, 53, 279–307. doi:10.1146/annurev.psych.53.100901.135156.

    Article  Google Scholar 

  • Brosche, T. (2003). Death, dying, and the ICU nurse. Dimensions of Critical Care Nursing, 22, 173–179. doi:10.1097/00003465-200307000-00006.

    Article  PubMed  Google Scholar 

  • Chang, E. M., Daly, J., Hancock, K. M., Bidewell, J. W., Johnson, A., Lambert, V. A., & Lambert, C. E. (2006). The relationships among workplace stressors, coping methods, demographic characteristics, and health in Australian nurses. Journal of Professional Nursing, 22, 30–38. doi: 10.1016/j.profnurs.2005.12.002.

    Google Scholar 

  • Cho, Y.-N., Rutherford, B. N., & Park, J. (2013). The impact of emotional labor in a retail environment. Journal of Business Research, 66, 670–677. doi:10.1016/j.jbusres.2012.04.001.

    Article  Google Scholar 

  • Chung, T., Rutherford, B., & Park, J. (2012). Understanding multifaceted job satisfaction of retail employees. International Journal of Retail & Distribution Management, 40, 699–716. doi:10.1108/09590551211255974.

    Article  Google Scholar 

  • Clark, M., & Gioro, S. (1998). Nurses, indirect trauma, and prevention. Image, 30, 85–87. doi:10.1111/j.1547-5069.1998.tb01242.x.

    Google Scholar 

  • Collins, S., & Long, A. (2003). Working with the psychological effects of trauma: Consequences for mental health-care workers – A literature review. Journal of Psychiatric and Mental Health Nursing, 10, 417–424. doi:10.1046/j.1365-2850.2003.00620.x.

    Article  PubMed  Google Scholar 

  • Day, J. R., & Anderson, R. A. (2011). Compassion fatigue: An application of the concept to informal caregivers of family members with dementia. Nursing Research and Practice. doi:10.1155/2011/408024.

    PubMed Central  PubMed  Google Scholar 

  • Demerouti, E., Bakker, A., Nachreiner, F., & Ebbinghaus, M. (2002). From mental strain to burnout. European Journal of Work and Organizational Psychology, 11, 423–441. doi:10.1080/13594320244000274.

    Article  Google Scholar 

  • Department of Defense. (2012). DoD101: An introductory overview of the Department of Defense. Retrieved from http://www.defense.gov/pubs/dod101/index.html#evolved.

  • Everly, G., & Mitchell, J. (2003). Critical incident stress management (CISM): Individual crisis intervention and peer support (2nd ed.). Ellicott City, MD: International Critical Stress Incident Foundation.

    Google Scholar 

  • Figley, C. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder. New York, NY: Brunner/Mazel.

    Google Scholar 

  • Figley, C. R. (1997). Burnout in families: The systemic costs of caring. Boca Raton, FL: CRC Press.

    Google Scholar 

  • Figley, C. (1999). Compassion fatigue: Toward a new understanding of the costs of caring. In B. H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators (2nd ed., pp. 3–28). Luthersville, MD: Sidran Press.

    Google Scholar 

  • Figley, C. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self-care. Journal of Clinical Psychology/In Session: Psychotherapy in Practice, 58, 1433–1441. doi:10.1002/jclp.10090.

    Article  Google Scholar 

  • *Figley, C. (Ed.). (2013). Treating compassion fatigue. New York, NY: Brunner-Routledge.

    Google Scholar 

  • Gawande, A. (2004). Casualties of war: Military care for the wounded from Iraq and Afghanistan. New England Journal of Medicine, 351, 2471–2475. doi:10.1056/NEJMp048317.

    Article  PubMed  Google Scholar 

  • Grandey, A., Foo, S. C., Groth, M., & Goodwin, R. E. (2012). Free to be you and me: A climate of authenticity alleviates burnout from emotional labor. Journal of Occupational Health Psychology, 17, 1–14. doi:10.1037/a0025102.

    Article  PubMed  Google Scholar 

  • *Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006). Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. Journal of Medical Association, 295, 1023–1032. doi:10.1001/jama.295.9.1023.

    Article  Google Scholar 

  • Hoge, W., Castro, A., Messer, C., McGurk, D., Cotting, I., & Koffman, L. (2008). Combat duty in Iraq and Afghanistan, mental health problems and barriers to care. U.S. Army Medical Department Journal, 7–17. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=mth&AN=35600233&site=ehost-live.

  • Hooper, C., Craig, J., Janvrin, D. R., Wetsel, M. A., & Reimels, E. (2010). Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. Journal of Emergency Nursing, 36, 420–427. doi:10.1016/j.jen.2009.11.027.

    Article  PubMed  Google Scholar 

  • Jenkins, S., & Baird, S. (2002). Secondary traumatic stress and vicarious trauma: A validational study. Journal of Traumatic Stress, 15, 423–432. doi:10.1023/A:1020193526843.

    Article  PubMed  Google Scholar 

  • Joinson, C. (1992). Coping with compassion fatigue. Nursing, 22, 116–122.

    PubMed  Google Scholar 

  • Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry, 52, 1048–1060. doi:10.1001/archpsyc.1995.03950240066012.

    Article  PubMed  Google Scholar 

  • Lim, N., Kim, E. K., Kim, H., Yang, E., & Lee, S. M. (2010). Individual and work-related factors influencing burnout of mental health professionals: A meta-analysis. Journal of Employment Counseling, 47, 86–96. doi:10.1002/j.2161-1920.2010.tb00093.x.

    Article  Google Scholar 

  • Lynch, S. H., & Lobo, M. L. (2012). Compassion fatigue in family caregivers: A Wilsonian concept analysis. Journal of Advanced Nursing, 68, 2125–2134. doi:10.1111/j.1365-2648.2012.05985.x.

    Article  PubMed  Google Scholar 

  • Maslach, C., & Leiter, M. P. (2008). Early predictors of job burnout and engagement. Journal of Applied Psychology, 93, 498–512. doi:10.1037/0021-9010.93.3.498.

    Article  PubMed  Google Scholar 

  • Maytum, J., Heiman, M., & Garwick, A. (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. doi:10.1016/j.pedhc.2003.12.005.

    PubMed  Google Scholar 

  • *McCann, L., & Pearlman, L. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3, 131–149. doi:10.1007/BF00975140.

    Article  Google Scholar 

  • *Meadors, P., & Lamson, A. (2008). Compassion fatigue and secondary traumatization: Provider self-care on intensive care units for children. Journal of Pediatric Healthcare, 22, 24–34. doi:10.1016/j.pedhc.2007.01.006.

    Article  Google Scholar 

  • *Meadors, P., Lamson, A., & Sira, N. (2010). Development of an educational module on provider self-care. Journal of Nurses in Staff Development, 26, 152–158. doi:10.1097/NND.0b013e3181b1b9e4.

    Article  Google Scholar 

  • *Meadors, P., Lamson, A., Swanson, M., White, M., & Sira, N. (2009). Secondary traumatization in pediatric healthcare providers and staff: Compassion fatigue, burnout, and secondary traumatic stress. Journal of Death and Dying, 60, 103–128. doi:10.2190/OM.60.2.a.

    Article  PubMed  Google Scholar 

  • *Mendenhall, T. (2006a). Trauma-response teams: Inherent challenges and practical strategies in interdisciplinary fieldwork. Families, Systems, & Health, 24, 357–362. doi:10.1037/1091-7527.24.3.357.

    Article  Google Scholar 

  • Mendenhall, T. (2006b). Reflections from the field: With Green Cross in Sri Lanka. Traumatology, 11, 141–142. doi:10.1177/153476560501100207.

    Article  Google Scholar 

  • *Mendenhall, T. (2012). Practicing what we preach: Answering the call for responder self care and resiliency. The Dialogue (SAMHSA/DTAC), 8(3), 2–4. http://www.samhsa.gov/dtac/dialogue/Dialogue_vol8_issue3_Final.pdf.

  • *Mendenhall, T., & Berge, J. (2010). Family therapists in trauma-response teams: Bringing systems thinking into interdisciplinary fieldwork. Journal of Family Therapy, 32, 40–54. doi:10.1111/j.1467-6427.2009.00482.x.

    Google Scholar 

  • *Morse, G., Salyers, M. P., Rollins, A. L., Monroe-DeVita, M., & Pfahler, C. (2012). Burnout in mental health services: A review of the problem and its remediation. Administration and Policy in Mental Health, 39, 341–352. doi:10.1007/s10488-011-0352-1.

    Article  PubMed Central  PubMed  Google Scholar 

  • National Archives and Records Administration. (2013). Statistical information about casualties of the Vietnam War: Electronic and special media records services division reference report. College Park, MD: National Archives and Records Administration. Retrieved from http://www.archives.gov/research/military/vietnam-war/casualty-statistics.html.

  • Paris, M., & Hoge, M. A. (2010). Burnout in the mental health workforce: A review. The Journal of Behavioral Health Services and Research, 37, 519–528. doi:10.1007/s11414-009-9202-2.

    Article  PubMed  Google Scholar 

  • Peckham, C. (2013). Physician lifestyles linking to burnout: A Medscape survey. Medscape. Retrieved from http://www.medscape.com/features/slideshow/lifestyle/2013/public#1.

  • Pfifferling, J., & Gilley, K. (2000). Overcoming compassion fatigue. Family Practice Management, 7, 39–45. http://www.aafp.org/fpm/2000/0400/p39.html.

  • *Rossler, W. (2012). Stress, burnout, and job dissatisfaction in mental health workers. European Archives of Psychiatry and Clinical Neuroscience, 262(2), 65–69. doi:10.1007/s00406-012-0353-4.

    Article  Google Scholar 

  • Rutherford, B. N., Hamwi, G. A., Friend, S. B., & Hartmann, N. N. (2011). Measuring salesperson burnout: A reduced Maslach burnout inventory for sales researchers. Journal of Personal Selling and Sales Management, 31, 429–440. doi:10.2753/PSS0885-3134310405.

    Article  Google Scholar 

  • Sabin-Farrell, R., & Turpin, G. (2003). Vicarious traumatization: Implications for mental health of health workers? Clinical Psychology Review, 23, 449–480. doi:10.1016/S0272-7358(03)00030-8.

    Article  PubMed  Google Scholar 

  • Sabo, B. (2006). Compassion fatigue and nursing work: Can we accurately capture the consequences of caring work? International Journal of Nursing Practice, 12, 136–142. doi:10.1111/j.1440-172X.2006.00562.x.

    Article  PubMed  Google Scholar 

  • Salyers, M. P., Hudson, C., Morse, G., Rollins, A. L., Monroe-DeVita, M., Wilson, C., & Freeland, L. (2011). BREATHE: A pilot study of a one-day retreat to reduce burnout among mental health professionals. Psychiatric Services, 62, 214–217. doi: 10.1176/appi.ps.62.2.214.

  • Schwam, K. (1998). The phenomenon of compassion fatigue in perioperative nursing. Association of Operating Room Nurses Journal, 68, 642–645. doi:10.1016/S0001-2092(06)62569-6.

    Article  PubMed  Google Scholar 

  • Showalter, S. E. (2010). Compassion fatigue: What is it? Why does it matter? Recognizing the symptoms, acknowledging the impact, developing the tools to prevent compassion fatigue, and strengthen the professional already suffering from the effects. American Journal of Hospice & Palliative Medicine, 27, 239–242. doi:10.1177/1049909109354096.

    Article  Google Scholar 

  • Spickard, A., Gabbe, S., & Christensen, J. (2002). Mid-career burnout in generalist and specialist physicians. Journal of the American Medical Association, 288, 1447–1450. doi:10.1001/jama.288.12.1447.

    Article  PubMed  Google Scholar 

  • *Stamm, B. H. (2002). Measuring compassion satisfaction as well as fatigue: Developmental history of the compassion fatigue and satisfaction and fatigue test. In C. R. Figley (Ed.), Treating compassion fatigue (pp. 107–119). New York, NY: Brunner/Mazel.-Routledge.

    Google Scholar 

  • Stein, M., Walker, J., Hazen, A., & Forde, A. (1997). Full and partial posttraumatic stress disorder: Findings from a community survey. American Journal of Psychiatry, 154, 1114–1119. http://www.cme.psychiatryonline.org/data/Journals/AJP/3679/1114.pdf.

    Google Scholar 

  • United States Army Surgeon General. (2005). Mental Health Advisory Team (MHAT-II): Report (pp. 1–30). Washington, DC: Department of the Army, Office of the Surgeon General.

    Google Scholar 

  • Valent, P. (2002). Diagnosis and treatment of helper stresses, traumas, and illnesses. In C. Figley (Ed.), Treating compassion fatigue (pp. 13–37). New York, NY: Brunner/Routledge.

    Google Scholar 

  • Veninga, R. L., & Spradley, J. P. (1981). The work stress connection: How to cope with job burnout. Boston, MA: Little, Brown.

    Google Scholar 

  • Weiss, D. S., & Marmar, C. R. (1997). The impact of event scale – revised. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD: A handbook for practitioners (pp. 399–411). New York, NY: Guilford Press.

    Google Scholar 

  • Wright, B. (2004). Compassion fatigue: How to avoid it. Palliative Medicine, 18, 3–4. doi:10.1191/0269216304pm866ed.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Angela Lamson .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Lamson, A., Meadors, P., Mendenhall, T. (2014). Working with Providers and Healthcare Systems Experiencing Compassion Fatigue and Burnout. In: Hodgson, J., Lamson, A., Mendenhall, T., Crane, D. (eds) Medical Family Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-03482-9_7

Download citation

Publish with us

Policies and ethics