Creating A Culture Of Care

The Cost of Caring in the Helping Professions: Taking a look at the Impact of Compassion Fatigue, Secondary Trauma, and Burnout.

What is Compassion Fatigue?

Compassion Fatigue was a concept developed by Johnson (1992) when describing nurses who were worn down by the daily hospital emergencies. It is now best understood as a function of the combined effects of secondary traumatisation and burnout, caused by long term involvement in emotionally demanding situations (Figley, 1995).

Should secondary traumatic stress (STS) and burnout be a concern for mental health administration and policy?

  • Studies have indicated that approximately 38% of social workers experience moderate to high levels of secondary traumatic stress (Cornille & Meyers, 1999; Dalton, 2001).
  • A study that involved both mental health practitioners and nurses showed that 1 in 3 providers reported high risk of developing STS and, 1in2 providers reported high risk for developing burnout ( Rudolph, Stamm, Bh.H.,& Stamm, H.E., 1997). One can assume these numbers might be higher for those who work in remote Aboriginal communities, due to the likelihood of dual relationships, isolation and historical trauma.
  • STS theory predicts that professionals affected by STS are at a higher risk to make poor professional judgements than those professionals who are not affected (Munroe, 1995; Pearlman & Saakvitne, 1995; Williams & Sommer, 1995). Examples of poor professional judgement could include misdiagnosis, not assessing for risk properly, poor treatment planning, or abuse/neglect of clients. Besides quality of care towards clients, STS and burnout can impact job satisfaction, sick time, and retainment of staff.

The Good News:

There is clinical evidence that suggests STS and burnout can be managed or prevented with a combination of personal, professional and administrative or policy interventions.

Learn How in:

For Managers/Supervisors:

Creating a Culture of Care: Supervision Skills to Address Compassion Fatigue

  • Understanding and distinguish between burn out and secondary traumatic stress
  • Learn of organizational strategies for managing or preventing compassion fatigue
  • Learn which models of supervision are more likely to prevent or intervene with staff’s vulnerability towards compassion fatigue.
  • Looking at the northern, rural and/or aboriginal context

For the Helping Professionals:

Compassion Fatigue: The Cost of Caring

  • The biology of stress
  • Understanding and distinguishing between burnout and secondary traumatic stress
  • Assessment of Compassion Satisfaction, Compassion Fatigue and Burnout
  • Increasing resiliency and self care
  • Looking at the northern, rural and/or aboriginal context



Cornille, T.A., & Meyers,.T.W.(1999). Secondary traumatic stress among child protective workers: Prevalence, severity and predictive factors. Traumatology, 5, 1-17.

Dalton, L.E. (2001). Secondary traumatic stress and Texas social workers. Unpublished doctoral dissertation, The University of Texas at Arlington.

Figley, C (1995). Compassion Fatigue: Coping with secondary traumatic disorder in those who treat the traumatized. New York: Brunner/Mazel

Johnson, C. (1992). Coping with compassion fatigue. Nursing, 22(4), 116-122

Munroe,J.F. (1995). Ethical issues associated with secondary trauma in therapists. In B.H. Stamm (Ed.)., Secondary Traumatic Stress: Self Care Issues for Clinicians, Researchers, and Educators. Lutherville, MD.: Sidran Press.

Munroe, J., Shay, J., Fisher, L., Makary, C., Rapperport, K., & Zimering, R. (1995). Preventing compassion fatigue: A team treatment model. In C.Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 209–231). New York: Bruner/Mazel

Pearlman, L. A., & Saakvitne, K. W. (1995). Treating therapists with vicarious and secondary traumatic stress disorders. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp.150–177). New York: Brunner/Mazel.

Rudolph, Stamm,Bh.H.,& Stamm,H.E. ( 1997) Compassion Fatigue: A Concern for Mental health Policy, Providers, & Administration. 13th Annual Meeting of the International Society for traumatic Stress Studies, Montreal, PQ,CA.

Williams, M.B. and Sommer, J.F. (1995). Self Care and the vulnerable therapist. In B.H. Stamm (Ed.)., Secondary Traumatic Stress: Self Care Issues for Clinicians, researchers, and Educators. Lutherville, MD.: Sidran Press.