The Human Face of

Compassion Fatigue in
Schools
Kathleen Beauchesne, PhD, MBA, MSW, LCSW-C
kbeauchesne@jhu.edu
April 27, 2006
Goals for Today
 Discuss the signs and symptoms of
compassion fatigue vs. burnout
 Understand the role and responsibility of
the work environment in situations of
burnout and compassion fatigue
 Understand and prepare for personal
reactions you may experience in situations
with students and their families
 Strategies teachers and staff can develop
to care for one another
 Specific coping strategies will be discussed
Elements of this Workshop
 Part One: Assess yourself.
Complete the Compassion
Satisfaction and Fatigue Subscales
of the Professional Quality of Life
Scale
 Part Two: Assess your situation at
work
 Part Three: Development of skills
and behavioral plans to interrupt
burnout
 Part Four: Wrap up
What would you like to learn in
this workshop?
Social Workers: At Risk
 Intensely involved with people
 Highly motivated and idealistic
 Meaningful work/most stress prone
 Tougher business
 Longer hours
 Poor pay
 Lack of control over clients
 Few second chances
 Agency red tape
 Poorly functioning clients
Part One: Self Assessment
 Please complete and score the
Compassion Satisfaction and Fatigue
Scales
 Score your results
 You will have 3 scores:
 1. ________Compassion satisfaction
 2. ________Burnout
 3. ________Compassion fatigue/
secondary trauma
 In pairs or threes, discuss the
following questions---
Signs and Symptoms: The Cost
of Caring (MacEwan, 2005)
 What are your experiences listening to
stories of trauma?
 What are the effects on you of listening to
these stories?
 How do you cope with listening to stories of
trauma?
_________________________________
 What are the benefits of doing this work?
 What strategies do you recommend to
maintain your health and well-being?
Compassion Fatigue: What is
it?
 Compassion fatigue (Figley, 1995): emotional
residue of exposure to working with the suffering—
particularly those suffering from traumatic events
 Parallels PTSD
 Described nurses worn down from dealing with hospital
emergencies
 “Bearing the suffering of clients” (Figley, 1992)
 The painful stories of sexual abuse, rape, physical and
emotional violence
 Can be thought of as secondary post-traumatic
stress
 Vicarious traumatization (McCann & Pearlman, 1990)
 Develops over time
 Constant out-putting of caring
 An accumulation of feeling
Compassion Fatigue: What is
it?
 Manifested in one or more ways including
 Re-experiencing the event
 Avoidance or numbing
 Persistent arousal
 Emotional blunting
 Physical, emotional and spiritual fatigue or
exhaustion
 Erosion in the ability to feel and care for others
 The double-edged sword of empathy
(MacEwan, 2005)
 Permanently change the psychological
constructs of workers
There is no “Returning from
the Field”
 Large Scale Traumatic Events
 Tendency to just work and work
and not take breaks
 Away from home
 Will leave the environment

 Differenceis that there is a natural

tendency to take care of yourself
when you return from the field
Signs and Symptoms
 Abusing drugs, alcohol or food
 Anger
 Blaming
 Chronic lateness
 Depression
 Diminished sense of personal accomplishment
 Exhaustion
 Frequent headaches
 Gastrointestinal complaints
 High expectations
 Hopelessness
 Hypertension
A Word about
Countertransference
 Countertransference: attributing to the client by the
worker, traits and behaviors of past and present
significant others or events in the worker’s own life
 The helping relationship becomes a chore
 Examples include
 Extending the session beyond the usual time limit
 Taking and responding to phone calls at all hours of
the night
 Experiencing hurt feelings over client failures
 Attempting dramatic cures on impossible cases
 Becoming angry or bored with clients
 Losing one’s sense of humor
 Refusing to withdraw from a case that is beyond the
worker’s purview
 Countertransference is necessary and transcient
Burnout: How is it different?
 Not easy to define
 Slow and insidious onset
 Experienced as a state of emotional, physical and
mental exhaustion caused by long-term involvement
in emotionally demanding situations
 Symptoms include physical depletion, feelings of
helplessness and hopelessness, disillusionment,
negative self-concept, negative attitudes towards
work, people and life
 Stages of burnout
 Enthusiasm
 Stagnation
 Frustration
 Apathy

James and Gilliland, 2001

Part 2: The Organization as
the Client
 Burnout should be viewed from a
systems perspective and as an
organizational problem
 The lack of positive features in the
workplace is significantly correlated with
burnout
 Organizational crises (funding, human
resources cutbacks, restructuring) create
organizational stress and hostility
How Organizations Cause
Personal Stress (Maslach &
Leiter, 1997)
A mismatch between the nature of
the person doing the work and the
job itself
 Overloaded work schedule
 Lack of control

 Breakdown in community

 Unfair treatment of workers

 Conflict of values
The Responsibility of the Work
Environment: The Cost of Caring
 Relationship between compassion
fatigue/high burnout and the ability of the
employing organization to recognize or do
anything about organizational problems
 Critical factors include:
 Impact on procedural or policy issues
 Lack of physical, human and financial resources
 Autonomy on the job
 Clarity of organizational mission, goals and
objectives/clear communication
 High intensity of work assignments over long
periods of time
 Restrictions in how clients may be treated
 Unappreciated by co-workers and supervisors
Problems in Schools

 Size of the system

 Lack of proactive intervention
 Vertical integration of programs
 School governance
 Diversity
 Safety
 Parent participation in schools
At Work: What Leads to
Burnout?
 Think about an organization you have
worked for and write down some specific
behaviors or concrete problems that
occurred at work. Answer the following
questions in pairs or threes--
 What observable stress did you see in
colleagues because of the problem?
 What stress responses did you have?
 How could these organizational issues lead to
burnout?
 Picture yourself as an outside consultant. How
would you have handled these issues?
Strategies: What Helps at
Work?
 Clear mission and purpose
 Easy access to supportive and positive
consultation and supervision
 Flexibility and emotional support
 Job clarity and job redesign
 Reduce rules, regulations and paperwork
 Facilitative managers/relational practice
 Realistic expectations for client progress
 Help workers solve problems associated
with high stress on the job
Simple Examples: Support at
Work
 Wellness Committee
 Massage
 Weight Watchers
 Walking groups
 Lunch and Learns
 Monthly retreats/fun days
 Normalizing activities
 Painting
 Golf
 Education and Training
 Employee Assistance Program
 Human Resources Services
 FMLA
 Vacations/Sick Leave
 Flexible schedules
 Bereavement Leave
Part 3: Development of Skills
and Behavioral Plans
 Social support
 Task focused behaviors
 Emotional distancing
 Cognitive self-talk
 Altruism

Holiday & Smith, 1995

Resources

 APS Behavioral Health

 Provides employee assistance
services to the Baltimore City
School system
References
 Eby, L.C. & Wallender, J.L. (2003). School staff and
crisis: Care for the caregiver. A Public Entity Risk
Institute Symposium.
 Figley, C. (1992). Compassion factigue: Coping with
secondary traumatic stress disorder in those who treat the
traumatized.
 James, R.K. & Gilliland, B. E. (2001). Crisis intervention
strategies. Wadsworth Publishing: Stamford, CT.
 MacEwan, L. (2005). Compassion fatigue.
 Thompson, R. (2003). Compassion fatigue: The
professional liability for caring too much. A Public Entity
Risk Institute Symposium.
 Stamm, B.H. (1997-2005) Professional Quality of Life:
Compassion and Fatigue Subscales, R-IV (ProQOL).
http://www.isu.edu/-bhstamm
 What is compassion fatigue? http://www.ace-
network.com
Wrap Up and Questions
 Kathleen Beauchesne
kbeauchesne@jhu.edu
Johns Hopkins Institutions
443-997-7000