Compassion Strengths

Workshops, consultations, education and support for care givers.



(From Vicarious Traumatization and Burnout Survey Report prepared by Mary-Louise Gould, MEd., Consultant)

So while vicarious traumatization refers to a certain type of job stressor for providers, the more familiar term for the consequences of work-related strain is burnout. These two conditions are closely related, and yet they are distinctly different. Vicarious traumatization refers to unique connections with traumatized people. It emphasizes the inroads that a relational undertaking can make on the helper’s sense of self, meaning, efficacy, and personal adaptation in the world. It is an inner experience, “a human consequence of knowing, caring and facing the reality of trauma.” (Saakvitne & Pearlman, 1996)  Burnout, on the other hand, can be experienced in numerous work settings, including, but not limited to, social service organizations. Unlike VT, which is based primarily on interpersonal relationships, burnout results from environmental conditions in the workplace and the nature of job expectations. In The Truth About Burnout, Maslach and Leiter, among the most widely respected authorities on this well-researched subject, share their conclusions:

The conventional wisdom is that burnout is primarily a problem of the individual. That is, people burnout because of flaws in their characters, behavior, or productivity. According to this perspective, people are the problem, and the solution is to change them or get rid of them.

But our research argues most emphatically otherwise. As a result of extensive study, we believe that burnout is not a problem of the people themselves but of the social environment in which people work.

We argue that burnout in individual workers says more about the conditions of their job than it does about them. Contrary to popular opinion, it’s not the individual but the organization that needs change….

-       Maslach, C. & Leiter, M.P. (1997) The Truth About Burnout: How Organizations Cause Personal Stress and What To Do About It, San Francisco: Jossey-Bass.

What is it about the workplace that creates the conditions for burnout? Maslach and Leiter cite six “mismatches” between person and job.

  1. Work overload is perhaps the most obvious indication of a mismatch between person and job. We have to do too much in too little time with too few resources. It is not a matter of stretching to meet new challenges but of going far beyond human limits… The pace increases further as people take on a second job or moonlight on the side in an attempt to meet financial pressures and keep their job options open… The faster pace hurts quality, disrupts collegial relationships, kills innovation – and brings on burnout.
  2. Lack of control over one’s work…. People want the opportunity to make choices and decisions, use their ability to think and solve problems, and have some input in the process of achieving the outcomes for which they will be held accountable. There is a world of difference between being accountable and being constrained by rigid policies and tight monitoring. [The latter] sends the message that ‘you can’t be trusted, we don’t respect your judgment, you aren’t very smart, you are incapable of doing this by yourself.’
  3. Lack of reward for contributions on the job…. When we don’t get recognition, both the work we do and we ourselves as workers are devalued. Although everyone knows that rewards are important, this knowledge does not necessarily translate into action. Most devastating for workers, however, is the loss of the internal reward that comes when a person [can take] pride in doing something of importance and value to others, and doing that job well.
  4. Lack of community … results when people lose a positive connection with others in the workplace. People thrive in community, and they function best when praise, comfort, happiness, and humor are shared with others they like and respect… Sometimes the job has a chilling effect on what people can say or do because of explicit or implicit prohibitions…However, what is most destructive to a sense of community is chronic and unresolved conflict. It tears apart the fabric of social support, making it less likely that people will help each other out when things get tough.
  5. Lack of fairness. Fairness in the workplace means that people are shown respect and their self-worth is confirmed… Unfairness is most evident during the evaluation and promotion process. But day-to-day interactions may also be unfair – when people get blamed for things they didn’t do, for example. Lack of fairness is also evident when there is inequity of workload or pay, or when people bend the rules or cheat in order to get ahead… [O]rganizational policies that send the message that money takes precedence over employees cause mutual respect and shared values to erode.
  6. A value conflict occurs when there is a mismatch between the requirements of the job and personal principles… People do their best when they believe in what they are doing and when they can maintain their pride, integrity, and self-respect. (Maslach & Leiter, 1997)

Burnout can take a terrible toll on workers. In 1988 Kahill* made a comprehensive review of the empirical research on burnout and identified five categories of symptoms:

  1. Physical symptoms (fatigue and physical depletion/exhaustion, sleep difficulties,  specific somatic problems such as headaches, gastrointestinal disturbances, colds, and flu).
  2. Emotional symptoms (e.g., irritability, anxiety, depression, guilt, sense of helplessness).
  3. Behavioral symptoms (e.g., aggression, callousness, pessimism, defensiveness, cynicism, substance abuse).
  4. Work-related symptoms (e.g., quitting the job, poor work performance, absenteeism, tardiness, misuse of work breaks, thefts).
  5. Interpersonal symptoms (e.g., perfunctory communication with, inability to concentrate/focus on, withdrawal from clients/coworkers, and then dehumanizing, intellectualizing clients).

Perhaps the most deeply troubling result of burnout is a form of “soul erosion,” not unlike some of the impacts of VT. “In addition to depersonalization, burnout has been associated with a reduced sense of personal accomplishment and discouragement as an employee.”

-       Figley, C.R. (1995b) Compassion fatigue as secondary traumatic stress disorder: An overview. In Figley, C.R. Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized, Bristol, PA: Brunner/Mazel, 11-12.

It can be detrimental to your health, your ability to cope, and your personal lifestyle. It can lead to a serious deterioration in your job performance. And these costs are not just yours alone – they are felt by everyone who is affected by you, both on the job and at home.

* Kahill, S. (1998). Interventions for burnout in the helping professions: A review of the empirical evidence. Canadian Journal of Counseling Review  22 (3), 162-169.


Four Recommendations for Organizations       

1. The Consensus Panel [a panel of non-Federal clinical researchers, clinicians, program administrators, and client advocates that debated and discussed their particular area of expertise until they reached a consensus on best practice] makes the following recommendations about how the agency can support the counselor:

  • Provide a sense of mission.
  • Provide (or facilitate) ongoing, clinical supervision – if possible, by someone with a specialty in the area of compassion fatigue, abuse and neglect.
  • Provide trauma training to the counselors that standardizes the procedures for handling trauma cases.
  • Empower staff members by encouraging them to share their ideas on improving the program and incorporating, as appropriate, those ideas that enhance the stated mission of the agency.
  • Support staff members in their efforts to stay within the limitations of their roles so that they do not take on responsibilities likely to lead to burnout.
  • Support staff members in their efforts to keep caseloads at manageable levels and, at the same time, work to educate managed care about the drawback of limiting the length or intensity of services.
  • Model the supportive role that the agency wants the counselors to have with their clients.
  • Allow counselors unstructured time to talk to each other to give and receive support.
  • Train staff on such topics as new assessment tools, research findings, suicide intervention, crisis and nonviolent management of assaultive behavior, and liability issues related to abuse and false memory accusations.
  • Bring in an outside professional occasionally to hold a group session with the staff (this can encourage staff members who have been holding in or minimizing the impact of their work on themselves to open up).
  • Recognize and reward the work of the staff on a regular basis (e.g., ceremonies to recognize ongoing and special contributions).
  • Hold regular social events (e.g. picnics, softball games).

 * US Department of Health & Human Services, 2000, “Substance Abuse Treatment for Persons with Childhood Abuse and Neglect Issues.”


2. The organizations and agencies that employ helping professionals and offer clinical service to survivors of trauma and abuse also must incorporate an awareness of the cost of trauma work on staff, and the toll of VT on organizations or agencies. Such recognition is evident when organizations achieve the following:

  • Provide adequate clinical supervision for all staff.
  • Create a climate that accepts that the work will elicit strong feelings and provides a safe setting in which to discuss such feelings.
  • Offer health benefits that include good coverage for mental health services.
  • Explicitly acknowledge the difficulty of the work.
  • Use staffing patterns that allow backup and sharing of clinical responsibility and coverage.
  • Set reasonable expectations for clinical caseloads, i.e. expectations that take into account the effects of VT.
  • Affirm the reality, pervasiveness, and severity of the effects of childhood trauma.
  • Work with staff to identify and address signs of VT.
  • Provide opportunities for continuing education in the area of trauma and of stress management (such as training).

Some of these helpful responses reflect attitude and time management. Others require changes in the allocation of money and personnel. It is helpful for administrators to be able to justify changes in resource allotment on the basis of such factors as treatment efficacy, personnel longevity and reliability, decreased liability, and long-term cost effectiveness.

-          Saakvitne, et al, 1999, Risking Connection                                                                    


3. The following describes the institutional environment that is most facilitative for the recovery of traumatized personnel.

  • The stressors are accepted as real and legitimate.
  • The problem is viewed as a problem for the entire group and not as a problem that is limited to the individual.
  • The general approach to the problem is to seek solutions, not to assign blame.
  • There is a high level of tolerance for individual disturbance.
  • Support is expressed clearly, directly, and abundantly in the form of praise commitment, and affection.
  • Communication is open and effective; there are few sanctions against what can be said. The quality of communication is good and messages are clear and direct.
  • There is a high degree of cohesion.
  • There is considerable flexibility of roles and individuals are not rigidly restricted from assuming different roles.
  • Resources – material, social, and institutional – are utilized efficiently.
  • There is no subculture of violence (emotional outbursts are not a form of violence).
  • There is no substance abuse.      

Catherall, 1995, “Preventing Institutional Secondary Traumatic Stress Disorder,” referring to Figley, 1989.                      


4. [W]e present six policy changes implied by the chapters in this book [Secondary Traumatic Stress: Self-care Issues for Clinicians, Researchers, and Educators]:

  • Lower caseloads
  • Telehealth support (making confidential online usage available)
  • Increased staff time (regular time to discuss day-to-day operations)
  • Leave time (access to adequate amount of vacation, sick, and family leave time)
  • Mental health care (access to professional mental health services outside the employing organization)
  • Supervision (the provision of regular professional clinical and/or administrative support from senior staff member) 

* Rudolph & Stamm, 1995, Revised 1999a, “Maximizing Human Capital: Moderating Secondary Traumatic Stress Through Administrative and Policy Action.”

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