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.
Cerney, M. S. (1995). Treating the “heroic treaters”. In C. R. Figley (Ed.). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized, (pp. 131-148). New York: Brunner/ Mazel.
Danieli, Y. (1982). Psychotherapists’ participation in the conspiracy of silence about the Holocaust. Psychoanalytic Psychology, 1(1), 23-46.
Deutsch, C. J. (1984). Self-reported sources of stress among psychotherapists. Professional Psychology: Research & Practice, 15, 833-845.
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 Press.
Figley, C. R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Bruner/Mazel: New York.
Figley, C. R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self care. JCLP/In Session: Psychotherapy in Practice, 58 (11), 1433-1441.
Figley, C.R. & Stamm, B.H. (1996). Psychometric Review of Compassion Fatigue Self Test. In B.H. Stamm (Ed), Measurement of Stress, Trauma and Adaptation. Lutherville, MD: Sidran Press. 127-130.
Folette, V. M., Polusny, M. M., & Milbeck, K. (1994). Mental health and law enforcement professionals: Trauma history, psychological symptoms, and impact of providing services to sexual abuse survivors. Professional Psychology: Research and Practice, 25, (3), 275-282.
Gentry, J. E. (2002). Compassion fatigue: A crucible of transformation. Journal of Trauma Practice, 1 (3), 37-61.
Gentry, E., Baggerly, J., & Baranowsky, A. (2004). Training-as-treatment: Effectiveness of the Certified Compassion Fatigue Specialist Training. Manuscript submitted for publication.
Gentry, J. E. & Baranowsky, A., (1998). Treatment manual for the Accelerated Recovery Program: Set II. Toronto: Psych Ink Resources.
Gentry, J. E. & Baranowsky, A. (1999). Compassion satisfaction manual: 1-Day group workshop, Set III-B. Toronto: Psych Ink Resources.
Gentry, J. E. & Baranowsky, A. (1999, November). Accelerated recovery program for Compassion Fatigue. Pre-conference workshop presented at the 15th Annual meeting of the International Society for Traumatic Stress Studies, Miami, FL.
Gentry, J. E., Baranowsky, A., & Dunning, K. (1997, November). Accelerated recovery program for Compassion Fatigue. Paper presented at the meeting of the International Society for Traumatic Stress Studies, Montreal, QB, CAN.
Gentry, J. E., Baranowsky, A., & Dunning, K. (2002). The accelerated recovery program for compassion fatigue. In C. R. Figley (Ed).), Compassion fatigue II: Treating compassion fatigue. New York: Brunner/Mazel.
Harris, C. J. (1995). Sensory-based therapy for crisis counselors. In C. R. Figley (Ed.). Compassion Fatigue (pp. 101-114). New York: Brunner/ Mazel.
Hellman, I. D., Morrison, T. L., & Abramowitz, S. L. (1986). The stresses of psychotherapeutic work: A replication and extension. Journal of Clinical Psychology, 42, (1), 197-205.
Marsh, D. (1997). Serious mental illness: Ethical issues in working with families. In D.T. Marsh & R.T. Magee (Eds.), Ethical and legal issues in professional practice with families. Wiley series in couples and family dynamics and treatment.
New York: John Wiley & Sons, Inc. 217-237.
McCann, I. L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3, (1), 131-149.
Pearlman, L.A. (1995). Self-care for trauma therapists: Ameliorating vicarious traumatization. In B. H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators. Lutherville, MD: Sidran Press. 51-64.
Pearlman, L. A. & Mac Ian, P. S. (1995). Vicarious traumatization: An empirical study of the effects of trauma work on trauma therapists. Professional Psychology: Research & Practice, 26, 558-565.
Pearlman, L. A., & Saakvitne, K.W. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors. New York: W.W. Norton.
Rodolfa, E. R., Kraft, W. A., & Reilley, R. R. (1988). Stressors of professionals and trainees at APA-approved counseling and VA medical center internship sites. Professional Psychology: Research and Practice, 19, 43-49.
Saakvitne, K.W. (1996). Transforming the pain: A workbook on vicarious traumatization. Norton: New York.
Schauben, L. J. & Frazier, P. A. (1995). Vicarious trauma: The effects on female counselors of working with sexual violence survivors. Psychology of Women Quarterly, 19, 49-64.
Sexton, L. (1999). Vicarious traumatization of counselors and effects on their workplaces. British Journal of Guidance and Counseling, 27, 393-303.
Stamm, B.H. (1995). Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators. Lutherville, MD: Sidran.