Compassion Fatigue Resiliency Training for Rehabilitation Counselors

Reprinted with Author Permission from

Gentry, E., Baggerly, J. & Baranowsky, A. B. (2004, Summer). Compassion Fatigue Resilience Training for Rehabilitation Counselors. Rehab Review, 24(10), 12-14.

Professional counselors along with other service professionals often experience emotional, physical, cognitive, behavioral, relational, and spiritual symptoms as a result of working with traumatized and troubled clients (Farber, 1983; Hellman, Morrison, & Abramowitz, 1986; McCann & Pearlman, 1990; Marsh, 1997; Rodolfa, Kraft, & Reiley, 1988; Sexton, 1999). While the literature does not specifically address rehabilitation counselor’s experience of these symptoms, it is likely that they do manifest these negative effects as well. This phenomenon has been labeled with a variety of terms including “vicarious traumatization” (McCann & Pearlman, 1990; Pearlman & Saakvitne, 1995), “secondary traumatic stress” (Figley, 1995; Stamm, 1995) and “compassion fatigue” (Figley, 1995). According to Figley (2002), compassion fatigue is defined as “a state of tension and preoccupation with the traumatized patients by re-experiencing traumatic events, avoidance/numbing of reminders, and persistent arousal (e.g., anxiety) associated with the patient” (p. 1435). Gentry & Baranowsky (1998) further described compassion fatigue as an interactive, or synergistic, effect among primary traumatic stress, secondary traumatic stress, and burnout symptoms in the life of afflicted care providers.

Since compassion fatigue is a common experience among various counselors and service professionals, obtaining assistance to cope with the negative effects of counseling clients should be standard protocol for rehabilitation counselors (Figley, 1995, 2000; Gentry, 2002, Gentry, Baranowsky & Dunning, 1997, 2002; Pearlman & Saakvitne, 1995; Saakvitne, 1996). In order to ensure rehabilitation counselors receive effective treatment for compassion fatigue, empirically validated interventions should be obtained (Pearlman & Saakvitne, 1995; Cerney, 1995; Figley, 1995; Harris, 1995; Pearlman, 1995; Stamm, 1995).

Accelerated Recovery Program. One empirically validated intervention is the Accelerated Recovery Program (ARP) (Gentry & Baranowsky, 1998; Gentry, Baranowsky & Dunning, 1997, 2002), which is a five-session manualized and copyrighted protocol that addresses the symptoms of secondary traumatic stress and burnout, or compassion fatigue, in caregivers. Gentry & Baranowsky (1999, November) reported that when the ARP was implemented with 10 professional helpers of Oklahoma City bombing survivors, a significant difference between their pretest and posttest mean scores on the compassion fatigue, compassion satisfaction and burnout subscales of the Compassion Satisfaction/Fatigue Self-Test (Figley, 1995; Figley & Stamm, 1996; Stamm, 1995) was found.

Certified Compassion Fatigue Specialist Training (CCFST). Since the ARP was a successful approach, Gentry & Baranowsky (1998) developed a method of training other counselors to implement the ARP with their colleagues and other professional helpers. Their approach termed the Certified Compassion Fatigue Specialist Training (CCFST) provides helping professionals with comprehensive training in interventions for other caregivers suffering the effects of compassion fatigue (Gentry & Baranowsky, 1998). Along with learning skills to implement the ARP, participants also learn theory and research on compassion fatigue, countertransference, posttraumatic stress disorder, secondary traumatic stress, vicarious traumatization and burnout. After successfully completing the training, participants are recognized by the Traumatology Institute (Canada) as Compassion Fatigue Specialists.

Training includes intensive experiential involvement by participants in each of the techniques utilized in the ARP. Group members will be taught to assess and treat professionals and other caregivers who are experiencing Compassion Fatigue as well as to develop prevention and resiliency skills in themselves and others.

Program participants learn:

- The meaning of Compassion Fatigue in their lives.

- Signs and symptoms of Compassion Fatigue.

- How to recognize common risk factors and who is at risk.

- What to do when feeling overwhelmed by work.

- Useful, appropriate and effective stress-reduction methods.

- To recognize blocks to self-care.

- To understand how to commit to a wellness and resiliency prevention plan.

- Resolution exercises that assist in the release of old and new emotional wounds that have limited one’s ability to do as well as they wish in their work and personal life.

Gentry, Baggerly and Baranowsky’s (2004) research on the effectiveness of the CCFST revealed 83 participants’ mean scores significantly decreased in compassion fatigue and burnout sub-scale scores and significantly increased in compassion satisfaction subscale of the Compassion Satisfaction/Fatigue Self-Test (CSFST) (Figley, 1995; Figley & Stamm, 1996). In addition to statistically significant differences, the CCFST resulted in clinically significant differences as participants’
pre-training scores indicated a “high risk” for compassion fatigue while their post-training scores indicated a “low risk.” Thus, CCFST enabled participants to not only receive skills in reducing compassion fatigue in others, but more importantly, the training-as-treatment effect enabled them to reduce compassion fatigue in themselves.

Implications for Rehabilitation Counselors

Empirical research has demonstrated that caregiving professionals who work with traumatized populations are at-risk for the deleterious effects of compassion fatigue, including secondary traumatic stress/vicarious traumatization and burnout symptoms (Deutsch, 1984; Farber, 1983; Follette, Polusny, & Milbeck, 1994; Pearlman & Mc Ian, 1995; Schauben and Frazier, 1995). Fortunately, empirical research also established that the ARP and CCFST are effective treatments for compassion fatigue (Gentry, Baggerly, & Baranowsky, 2004; Gentry & Baranowsky, 1998; Gentry, Baranowsky & Dunning, 1997, 2002). Therefore, rehabilitation counselors do not need to silently suffer with compassion fatigue. Rather, agency and private practice counselors can develop healthy systems within their work environments by proactively participating in compassion fatigue prevention and treatment trainings such as ARP and CCFST. (Training information can be obtained through Corporate Crisis Management at www.CorporateCrisis.net and the Traumatology Institute (Canada) at www.psychink.com).

As role models for their clients, rehabilitation counselors are in a key position to demonstrate the importance of maintaining their mental health. They can do so by developing compassion fatigue resiliency skills through the ARP and the CCFST. As a result, counselors will not only be able to maintain a non-anxious presence with their clients but will be able to teach their clients stress management skills.

In an effort to make compassion fatigue resiliency skills training available to all counselors, two additional resources were developed. First, Gentry and Baranowsky (1999) designed a one-day, large group presentation called “Compassion Fatigue Prevention & Resiliency Training” that synthesizes the preventative and resiliency factors from the CCFST. Second, a website http://lists.fsu.edu/mailman/listinfo/compassionfatigue was developed so all counselors can find support in addressing compassion fatigue through up-to-date information on trainings, publications, and a virtual community where helping professionals from all over the world can share their experiences of hardship and recovery from compassion fatigue.

In conclusion, rehabilitation counselors are encouraged to obtain training in compassion fatigue resiliency. The ARP and CCFST provide an excellent delivery system for educating mental health professionals about compassion fatigue and for developing the resiliency needed to assess, prevent, and resolve symptoms that they may suffer anytime during their professional trajectory.

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