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Compassion stress and fatigue model. Adapted from Figley (2002).
Source publication
Purpose
The aim of the study was to investigate the participating psychologists’ experiences with compassion fatigue, and to identify individual, interpersonal, and organizational factors and strategies perceived as contributing or protecting in relation to compassion fatigue.
Methods
Semi-structured telephone interviews were conducted with eight...
Citations
... Burnout usually has a gradual onset, while STS typically has a rapid onset following psychological overwhelm (Stamm, 2012). Burnout is usually more debilitating and associated with feelings of hopelessness and diminished work productivity and job satisfaction contributing to forced changes in work or career, with additional lifelong detrimental effects (Bhutani et al., 2012;Norrman Harling et al., 2020;Soderfelt & Soderfelt, 1995). With burnout, faculty members are susceptible to feeling cynical about their life's purpose and meaning and lacking a sense of personal accomplishment (Cordaro, 2020). ...
The mental health of faculty in the United States higher education system has been an overlooked area of concern. This study addresses the occupational health of faculty, specifically faculty mental health, (i.e., compassion fatigue, generalized anxiety disorder, major depression disorder, somatic symptom disorder) along with psychosocial and occupational factors. Two aspects of compassion fatigue (i.e., secondary traumatic stress and burnout) were used to classify participants into low or elevated secondary traumatic stress and burnout groups. Given the significant rates of compassion fatigue and psychopathology among faculty members, the importance of cultivating resilience at the individual and institutional levels are discussed.
Keywords: Compassion Fatigue, Faculty Mental Health, Generalized Anxiety Disorder, Major Depression Disorder, Resilience, Higher Education
... Pretende-se, neste tópico, elencar os principais resultados dos artigos selecionados para análise e discuti-los, como ilustra o fluxograma a seguir (Figura 2). (Capobianco-Santos, et al., 2023;Jilou et al., 2021;Norrman Harling et al., 2020;Barbosa et al., 2014). Além disso, em menor escala, outros fatores também foram identificados como estressores, como: atividades clínicas não faturáveis (por exemplo: telefonemas, documentação etc.), pessoal administrativo insuficiente, expectativas de produtividade de pesquisa, decisões institucionais tomadas sem comunicação, cortes de orçamento, equipe de apoio clínico insuficiente, taxas de promoção diferentes das dos médicos, má comunicação entre a liderança institucional e o corpo docente, relação insatisfatória entre psicólogos e médicos, comportamento médico inadequado e problemas de negligência (Williams et al., 2020). ...
... Ainda sobre a fadiga de compaixão, o estudo de Norrman Harling et al. (2020) concluiu que os principais sintomas são: irritação, ruminação mental, torpor, isolamento, falta de energia para socializar fora do trabalho e esgotamento mental. Os fatores que potencializam o desenvolvimento do fenômeno podem envolver má gestão e falta de apoio dos colegas, supervisores e gestores; falta de rede de apoio; alta carga de demanda; alto número de pacientes a serem atendidos; grande responsabilidade dentro do cargo. ...
... Um dos fatores de risco da fadiga de compaixão é a grande responsabilidade dentro do cargo. Foi também apontado que se o profissional tem maior liberdade dentro do cargo, mas sem orientações e direcionamentos específicos do que fazer, pode acabar se responsabilizando por mais atividades do que deveria, sendo isso mais um desencadeante para o estresse laboral (Norrman Harling et al., 2020). A responsabilidade no ambiente de trabalho pode gerar sentimentos contraditórios nos trabalhadores da saúde mental. ...
Work is an important dimension of life and a major influence on human identity and subjectivity. In this context, there are conditions that can damage the mental state of workers, leading to burnout syndrome. Burnout syndrome is a consequence of chronic exposure to stress in the workplace and can cause physical and psychological symptoms of exhaustion. The aim of this study was to gather significant articles found in the literature on burnout syndrome in psychologists and to discuss the specificities of the suffering of these professionals in their work experience. The research method was a review of the literature in the PePSIC, Spell and BVSaúde databases, in Portuguese and English, where three publications were found. The results suggest that burnout syndrome is related to the characteristics and peculiarities of the profession, the emotional aspects of each professional and working conditions. There was a positive relationship between exposure to human suffering, to which psychologists are subject, and burnout syndrome. In conclusion, the scarcity of publications on this subject may be an invitation to future studies.
... This strategy not only enhances their intervention capabilities but also nurtures their overall wellbeing within the work environment. This finding was echoed in various studies involving helping professionals, underlining the significance of continuous professional development in equipping workers with the necessary tools to effectively navigate the complex and emotionally demanding nature of their roles (Frieze et al. 2020;Norrman Harling et al. 2020;Salloum et al. 2015). Although participants in our study did not explicitly mention supervision as a coping strategy, other studies have addressed its importance in promoting professionals' general well-being (Melvin 2012;Mette et al. 2020;Norrman Harling et al. 2020;Salloum et al. 2015;Wood et al. 2019). ...
... This finding was echoed in various studies involving helping professionals, underlining the significance of continuous professional development in equipping workers with the necessary tools to effectively navigate the complex and emotionally demanding nature of their roles (Frieze et al. 2020;Norrman Harling et al. 2020;Salloum et al. 2015). Although participants in our study did not explicitly mention supervision as a coping strategy, other studies have addressed its importance in promoting professionals' general well-being (Melvin 2012;Mette et al. 2020;Norrman Harling et al. 2020;Salloum et al. 2015;Wood et al. 2019). ...
... The literature review also emphasized the paramount importance of establishing and maintaining emotional boundaries with clients and between work and personal life as a pivotal coping strategy. This finding was consistently supported by studies involving various helping professionals, including nurses (Melvin 2012), social workers (Mette et al. 2020), child welfare workers (Salloum et al. 2015), physicians (Bessen et al. 2019), and psychologists (Norrman Harling et al. 2020). Such emotional boundaries are considered by participants' study essential safeguards that enable these professionals to protect their own well-being while engaging in demanding and emotionally charged intervention work. ...
Domestic violence (DV) remains a significant public health concern and a violation of human rights. The complex challenges faced by professionals who directly engage DV victims, combined with their consistent exposure to distressing narratives, have the potential to significantly impact the well-being of these practitioners. This, in turn, can directly influence the quality of the support they provide to victims. The present study aims to explore the psychological impact of working with DV victims on these professionals while simultaneously investigating the coping mechanisms they employ. Twenty-four professionals from DV victim support in Portugal participated in this qualitative research. Through semi-structured interviews and thematic analysis, the study unveils that this line of work can indeed be profoundly impactful, potentially resulting in adverse outcomes such as fatigue, emotional exhaustion, frustration, and difficulties in emotional regulation. Nonetheless, the research also reveals that professionals are capable of developing coping strategies to mitigate the negative impact of their work. This study proposes a set of suggested measures that should not only be adopted by professionals but should also be smoothly incorporated into the strategies of organizations committed to supporting DV victims. Ultimately, by bolstering the welfare of DV professionals, this research strives to enhance the quality of support extended to victims and provide meaningful input for informed policymaking, improved practices, and effective training approaches.
... Contrary to popular belief, compassion fatigue manifests more quickly than burnout and impacts your relationships, but burnout results in physical and mental impairment and may call for more timeconsuming treatments, such as changing jobs or careers. (Harling et al, 2020). It is linked to a lack of job satisfaction and usually develops gradually rather than abruptly. ...
... In the beginning, helping clients and trying to save them felt like a necessary aspect of their job, which is known as the Christ or Jesus complex. A study conducted among Swedish psychologists found that their perceptions of their professional responsibilities and their experiences with the Jesus complex were identical (Harling et al., 2020). It also caused them to experience Imposter syndrome which is a psychological condition in which a person persistently harbors an internalized fear of coming across as a fraud and questions their abilities, talents, or accomplishments. ...
Therapists and counselors are at high risk of developing secondary trauma, burnout, and compassion fatigue. Continuous exposure to the trauma and pain of patients can have a negative impact on the wellbeing of therapists. Burnout is a state of mental, physical, and emotional exhaustion brought on by accumulated stress. Compassion fatigue is a condition in which someone becomes numb to the suffering of others and is unable or less able to display empathy towards them. The World Health Organization defines burnout as an occupational phenomenon that should not be applied to describe experiences in other areas of life. Burnout is included in the International Classification of Diseases 11 as an occupational phenomenon resulting from unmanaged, chronic workplace stress. Professional burnout is a multidimensional condition that includes exhaustion, detachment, and professional efficiency (Maslach burnout inventory). When counselors and therapists experience burnout, their patients are also negatively affected. Understanding the extent and incidence of burnout and compassion fatigue among therapists and counselors is the study's principal goal. A qualitative method-based study including therapists and counselors based in Bangalore, India. Detailed, semi-structured face-to-face (online) interviews were conducted through open ended questions with the help of an interview guide based on social situation, economic situation, and personal characteristics. A thematic analysis was undertaken. The majority of them explained difficulties faced in compartmentalizing work and personal life in the initial years of work, economic and family responsibilities associated with burnout, empathizing with clients more due to similar personal experiences, increased workload, and the Jesus complex. Keywords: burnout, compassion fatigue, counselor, therapists, exhaustion
... Psychologists strive to help others with an expectation that they will do so from a stance of unwavering empathy. Moreover, practitioner psychologists are frequently exposed to their patients' or clients' suffering, which particularly puts them at great risk for experiencing CF (Harling et al., 2020). A meta-analysis by Cavanagh et al. (2019) recognised that the consequences of CF on healthcare professionals are detrimental to their wellbeing, professional practice and the workforce. ...
... Research has shown that psychologists experience similar challenges. Harling et al. (2020) explored the experiences of CF in Swedish psychologists and identified key organisational, protective and contributing factors. These included organisational challenges such as high workloads and reduced autonomy in the work role. ...
... Many of the current findings coincide with past studies that have investigated contributory and inhibitory precursors to CF (Harling et al., 2020). According to Dattilio (2015), psychologists and other mental health professionals alike have a proclivity towards overlooking the importance of their own welfare, despite working within a profession that encourages concern for the health and well-being of others. ...
Practitioner psychologists are at risk of compassion fatigue (CF) due to the emotional demands of helping individuals who have experienced pain and suffering. Practitioner psychologists may also be impacted by wider socio-political events (such as the COVID-19 pandemic), which can lead to global compassion fatigue (GCF). While these concepts have been examined in various healthcare professionals, research exploring the impact of CF and GCF on practitioner psychologists has been very limited. This study therefore aimed to explore the impact of compassion fatigue (CF) and global compassion fatigue (GCF) on practitioner psychologists’ practice. Ten participants were recruited for online semi-structured interviews during the height of the COVID-19 pandemic. Data collected was thematically analysed. Five themes related to compassionate care were identified, which included: ‘How to be compassionate’, ‘Psychologists require TLC too!’, ‘Hindrances of compassionate care’, ‘Constraints within the NHS’ and ‘Indicators of compassion fatigue and burnout’. Three themes related to GCF were identified, which included: ‘Effects of news/social media’, ‘Management of news/social media’ and ‘Challenges faced by COVID-19’. The implications of CF and GCF and ways to mitigate their effects on practitioner psychologists’ wellbeing, development, and their practice are discussed.
... The results of that study suggested that organisational and task-specific factors such as perceived quantitative and qualitative workload and lack of managerial support produced feelings of compassion fatigue in participants (Norrman Harling, Högman, & Schad, 2020). In contrast, support provided by co-workers and provision of professional development opportunities were helpful in mitigating the risk of compassion fatigue (Norrman Harling, Högman, & Schad, 2020). ...
The imposition of nation-wide lockdowns and sporadic transition to remote work produced unforeseen psychological challenges likely to impact the medium of care and workload of mental health professionals. The present study explored the lived occupational experiences of clinical psychologists, counsellors, and psychotherapists working in the National Health Service (NHS) and private practice in the UK during COVID-19 pandemic. Nineteen professionals (11 employed in the NHS and 8 working in independent settings) were interviewed about their professional experiences during first and second waves of the pandemic. Data were analysed using interpretative phenomenological analysis. Three main themes emerged from the analysis: (i) transition from face to face to online therapy; (ii) novel changes and wellbeing; and (iii) uncertain professional support in uncertain times. The findings suggest that lack of experience in providing online or telephonic psychotherapeutic services from home negatively impacted professionals’ physical and psychological health and wellbeing. Thus, to cope with it, they availed psychological and structural support from colleagues, co-workers, clinical supervisors, managers, organisations, and professional bodies. This study adds to the existing body of research on the impact of the pandemic on UK-based mental health professionals and from an applied perspective, it highlights the need for skill-upgradation of professionals.
... Focus groups consisting of a variety of mental health professionals, including psychologists and clinical social workers, reported a theme around heavy caseloads which their participants related to experiencing CF (de Figueiredo et al., 2014). Similar results were reported by Killian (2008), Joubert et al. (2013) and Harling et al. (2020). Social workers interviewed by Joubert et al. (2013) further spoke of their desire for their department to develop both a caseload management system to prevent individual overload, and criteria for the prioritization of referrals. ...
... Peer support could, however, also be detrimental. Social workers in Caringi et al's (2017) study described how unsupportive interactions with peers could increase work stress and consequently increase one's vulnerability to VT. Clinical psychologists also described how peer support can lead to rumination when the group amplifies each other's concerns and issues (Harling et al., 2020). ...
... Further research identified useful strategies that organizations could adopt to address STS. Strategies included job sharing, case staffing teams, work improvement teams and increasing access to professional development opportunities (Caringi et al., 2017;Harling et al., 2020;Posselt et al., 2020). Having a variety of professional responsibilities, including direct practice, teaching, supervision, administration, and research was perceived as protective against VT (Harrison & Westwood, 2009). ...
Background:
The negative impact of trauma work has been well documented in mental health professionals. There are three main phenomena used to describe these effects: Secondary Traumatic Stress (STS), Vicarious Trauma (VT) and Compassion Fatigue (CF). To date, the majority of research has focused on the contribution of individual level factors. However, it is imperative to also understand the role of organizational factors.
Objectives:
This review examines the role of organizational factors in ameliorating or preventing STS, VT, and CF in mental health professionals. We further aimed to identify specific elements of these factors which are perceived to be beneficial and/or detrimental in mitigating against the effects of STS, VT, and CF.
Method:
Studies were identified by searching the electronic databases Medline, PsycINFO, Embase, Web of Science and SCOPUS with final searches taking place on 10 March 2021.
Results:
Twenty-three quantitative studies, eight qualitative studies, and five mixed methods studies were included in the final review. A narrative synthesis was conducted to analyse the findings. The results of the review highlight the importance of regular supervision within supportive supervisory relationships, strong peer support networks, and balanced and diverse caseloads. The value of having an organizational culture which acknowledges and validates the existence of STS was also imperative.
Conclusions:
Organizations have an ethical responsibility to support the mental health professionals they employ and provide a supportive environment which protects them against STS. This review provides preliminary evidence for the types of support that should be offered and highlights the gaps in the literature and where future research should be directed. Further research is needed to evaluate which strategies - and under what conditions - best ameliorate and prevent STS.
... While data saturation can be operationalised in different ways (Saunders et al., 2018), it is important for researchers to consider it in order to increase credibility and transparency (Fusch and Ness, 2015). Only 5 of the 9 studies (Clarke et al., 2020;Cramond et al., 2020;Hammond et al., 2018;Norrman Harling et al., 2020;Sciberras and Pilkington, 2018) referenced researcher reflexivity and its impact on the study, which impedes wider implications on their credibility (Dodgson, 2019). Three additional studies (Reitano, 2021;Sim et al., 2016;Turnbull and Rhodes, 2019) considered the position of the researcher to counter biases and assumptions but without referencing reflexivity. ...
... The findings in Sim et al. (2016) appeared to reflect the structure of the interview questions rather than providing an analytic narrative based on the data. All included studies employed at least one credibility check, including team debriefing and consultation amongst the authors and research supervisors (Clarke et al., 2020;Hammond et al., 2018;Papadomarkaki and Lewis, 2008;Sim et al., 2016), involving additional analysts (Norrman Harling et al., 2020), using memos and reflexive diaries (Cramond et al., 2020;Turnbull and Rhodes, 2019), carrying out multiple reviews of theme and code identification processes (Reitano, 2021), and participant validation procedures (Clarke et al., 2020;Sciberras and Pilkington, 2018). All the studies presented their findings in relation to their research questions. ...
... Participants described self-care as a set of tools to embed in their routine, including looking after themselves physically (e.g., eating and sleeping well), seeing family and friends, and nurturting hobbies and interests in their spare time. Participants saw self-care as an essential component in 'building resilience' (Norrman Harling et al., 2020;Reitano, 2021) and developing a true and 'authentic self' (Turnbull and Rhodes, 2019). One participant described how the implementation of self-care strategies helps to prevent stress and fatigue: 'I'm much better at noticing my compassion fatigue now. ...
Purpose
Psychological therapists are vulnerable to developing burnout due to the frequent exposure to emotive narratives of distress. Several quantitative systematic reviews have provided an overview of the risk and protective factors associated with therapist burnout. To date, however, no qualitative systematic reviews on therapist burnout have been carried out. This systematic review aimed to explore the experiences and impact of burnout in psychological therapists, and the strategies they use to adapt to it.
Design
Systematic searches of three electronic databases (CINHAL EBSCO, Medline EBSCO and PsycINFO EBSCO) were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Papers were screened at title and abstract and full-text review stages. The Critical Appraisal Skills Programme (CASP) qualitative checklist was used to evaluate the methodological quality of the included studies.
Results
Nine peer-reviewed papers met the eligibility criteria. The findings stressed the severe professional and personal impact that burnout can have on therapists. The quality of the study designs of the included papers was overall good. The main limitations included risk of recruitment and selection bias, transparency and credibility issues due to lack of reporting on data saturation and reflexivity, and reduced transferability due to the qualitative methodologies and small sample sizes used.
Conclusions
Further research is needed to expand on these findings and develop a greater understanding of the experiences and management of burnout in psychological therapists. Future studies could use mixed-method designs and larger sample sizes to increase transferability. Theoretical implications and clinical recommendations are discussed.
... However, Taylor (2019) argued that if individualfocused training is going to be successful it needs to teach health professionals to critically reflect on their practice and the practices of the healthcare system within which they operate. Training in self-monitoring may be beneficial to physiotherapists as it could improve their ability to recognize the early warning signs of empathetic distress fatigue and prompt them to seek help early (Lall et al., 2019;Norrman Harling, Högman, and Schad, 2020). Physiotherapists should be educated how to advocate for themselves at an organizational level so they can proactively reduce their risk of experiencing empathetic distress fatigue. ...
Background
Previous research suggests that physiotherapists frequently engage with patients who experience psychological distress (e.g. feelings of depression and anxiety) and that physiotherapists find supporting these patients challenging.
Objective
The aim of this study was to explore the experiences of Australian physiotherapists with patients they perceived were experiencing psychological distress.
Methods
A ‘Big Q’ qualitative research approach was used. Twenty interviews with physiotherapists were conducted. The data were then analyzed using iterative thematic inquiry.
Results
The analysis produced four interrelated themes: 1) encounters with patients in distress are common and varied; 2) becoming emotionally attuned with their patients meant that distress could invoke empathetic distress; 3) physiotherapists use emotional shields to protect themselves; and 4) physiotherapists found frequent encounters with patient distress to be emotionally exhausting. Viewed together, the themes highlight how patient distress can invoke transient empathetic distress in a physiotherapist; repeated experiences of empathetic distress may lead to empathetic distress fatigue.
Conclusion
While physiotherapists are sometimes viewed as ‘physical’ health professionals, the experiences of these physiotherapists suggest that patient psychological distress is highly relevant to physiotherapy practice. We recommend future research explores the relationships between patient distress, physiotherapists’ empathy, and physiotherapists’ wellbeing.
... Studies have found that one of the major negative factors in working life is perceived lack of influence at work leading to feelings of powerlessness, helplessness (Czuba et al., 2019), and compassion fatigue (Norrman Harling et al., 2020). Based on a multitude of quantitative studies, reviews have concluded that influence at work is one of the most important factors in the psychosocial working conditions to employees' mental health (Kivimäki et al., 2019;Madsen et al., 2017). ...
... Our study suggests that the experience of influence on work tasks increases the employees' experience of being able to perform and the ability to deliver high quality work. Previous studies have shown employees can become frustrated, stressed and develop compassion fatigue if they feel barred from solving their work tasks competently (Johansson & Theorell, 2003;Norrman Harling et al., 2020;Sasser & Sørensen, 2016). Our results unfold some of the reasons why a high degree of influence seems to be necessary for contemporary employees like knowledge and relational workers. ...
Purpose
Common mental health problems are a substantial burden in many western countries. Studies have pointed out that work related factors can both increase and decrease the risk of developing mental health problems. Influence at work is a key factor relating the psychosocial work environment to employees mental health. However, little is known regarding how contemporary employees experience and understand influence at work. The purpose of this study is to explore this in depth.
Methods
We conducted semi-structured interviews with 59 employees in knowledge and relational work and analysed the data using principles from Interpretative Phenomenological Analysis (IPA).
Findings
TWe identified three themes each consisting of two interrelated parts, where the second part describes the consequences of the identified type of influence for employees: 1) work tasks and performance, 2) relations and belonging, 3) identity and becoming.
Conclusions
The interviewed employees had a multifaceted understanding of influence at work and that influence at work mattered to them in different but important ways. Our hope is that managers, employees and consultants will be inspired by the three themes when designing work tasks, organizations and interventions in order to increase the level of influence and thereby help enhance the mental well-being of employees.
