Compassion fatigue in clinical practice can be defined as secondary trauma resulting from the internalization of the client’s traumatic experiences. Counselors, therapists, case managers, recovery coaches, and other frontline helping professionals are particularly vulnerable to compassion fatigue (Teater, Ludgate, 2014). According to research, helping professionals often experience trauma in childhood which increases the chance of being triggered by traumatic experiences shared by clients (Menakem, 2017).
Signs of compassion fatigue include:
Helping professionals who are vulnerable to compassion fatigue in clinical practice include: individuals with personal trauma histories, with large caseloads, who are trauma therapists, who are dealing with death and dying among clients, who work with traumatized kids and individuals, and who hear lots of traumatic stories without establishing long term relationships with clients, such as intake specialists and crisis workers.
Below are a number of strategies you might find helpful in preventing and recovering from compassion fatigue.
Utilize Evidence-Based Trauma-Informed Counseling Approaches
Approaches such as Dialectical Behavioral Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), and Acceptance and Commitment Therapy have been found to improve clinical outcomes. Getting good clinical results can increase compassion satisfaction, which is defined as the pleasure you derive from your work. Compassion satisfaction is a protective factor against compassion fatigue (Sodeke-Gregson, Holttum, Billings, 2013). Getting better results also helps counselors maintain hope, energy, and optimism in the midst of working with clients with trauma histories.
Laughter
Stories of trauma can be debilitating for helping professionals and decrease hope and optimism. Laughter at home and at work can create some relief from absorbing their clients’ traumatic experiences. To learn more about how to use laughter and humor to support your well-being, check out the Great Lakes ATTC's webinar The Therapeutic Use of Humor in Treatment and Recovery (Farley and Sanders, 2024).
Practice Mindfulness
Experiencing flashbacks and other traumatic stress disorder symptoms more commonly occur among helping professionals as client disclosures of trauma can trigger memories of professionals' own traumatic experiences. Mindfulness practices can ground the clinician into the here and now.
Consider Therapy
Being triggered by clients’ traumatic experiences can provide an opportunity for clinicians to continue personal healing around their own traumatic experiences.
Centering Rituals
Many trauma specialists have found relief in daily centering rituals. Examples include taking a walk, meditation, quiet time, a daily break, lunch, prayer, etc.
Strive for Life Balance
Many clinicians can become overwhelmed by addressing trauma in therapy. One clinician stated, "It feels like I am dealing with trauma every waking moment!" Creating balance in other areas of our life can help us prevent and recover from compassion fatigue (Mathieu, 2012). This balance can include nurturing other dimensions of our life including physical, recreational, social, spiritual and emotional dimensions.
There are a number of strategies organizations can use to help frontline staff prevent and recover from compassion fatigue, including: providing frequent and supportive supervision, striving to create an organization with high staff morale which can serve as a protective factor against compassion fatigue, provide training on trauma-informed evidence-based practices, offer an employee assistance program for staff experiencing compassion fatigue and other personal and professional challenges, and if possible, offer a good vacation package and encourage staff to take full advantage of their personal time off without worrying about feeling burdened by an accumulating workload.
Farley, T., & Sanders, M. (2025, January 30). The Therapeutic Use of Humor in Treatment and Recovery. Great Lakes ATTC. https://attcnetwork.org/products_and_resources/the-therapeutic-use-of-humor-in-treatment-and-recovery/
Mathieu, F. (2012). The Compassion Fatigue Workbook. Routledge.
Menakem, R. (2017). My Grandmother’s Hands. Central Recovery Press.
Sodeke-Gregson, E. A., Holttum, S., & Billings, J. (2013). Compassion satisfaction, burnout, and secondary traumatic stress in UK therapists who work with adult trauma clients. European Journal of Psychotraumatology, 4(1), 21869. https://doi.org/10.3402/ejpt.v4i0.21869
Teater, M., & Ludgate, J. W. (2014). Overcoming compassion fatigue: a practical resilience workbook. Pesi Publishing & Media.
Mark Sanders, LCSW, CADC, is an international speaker in behavioral health whose presentations have reached thousands throughout the United States, England, Canada, Spain, Lithuania, West Indies, and Guam. He is the recipient of five behavioral health lifetime achievement awards, including the prestigious NAADAC Enlightenment Award. He is the founder of The Museum of African American Addictions, Treatment and Recovery, which was honored as the 2023 winner of the Faces and Voices of Recovery Innovations In Recovery Award. He is the author of 5 books on recovery and has enjoyed a 30-year career as a university educator.
Isa Vélez Echevarria, PsyD, is a Puerto Rican clinical psychologist. She is the Ohio State Project Manager for the Great Lakes Addiction, Mental Health, and Prevention Technology Transfer Centers managed by the Center for Health Enhancement Systems Studies at the University of Wisconsin-Madison. During her pre-doctoral internship at Children’s Institute in Los Angeles, CA, she was certified as an Interpersonal Psychotherapy Clinician. She was trained in Trauma-Focused Cognitive Behavioral Therapy and Family Therapy. In addition, she provides telehealth services to underserved communities in Massachusetts and Puerto Rico.
