Traumatic Compassion Fatigue

Masters' counseling programs promote continual self-improvement to become a more competent practitioner. However, that growth sometimes originates from difficult experiences, rather than learning new techniques. When a counselor engages daily with clients dealing with traumatic events, they can rapidly become influenced by the conversation to the point it starts to affect them personally. Figley (1995) coined the term 'compassion fatigue' to describe the process of being influenced by a traumatic event from being secondarily exposed to the mere knowledge of that event.

Several studies have researched the positive impact peer support has on a counselor dealing with secondary traumatic experiences.

Linley and Joseph (2007), for example, found that clinical supervision and peer support help mitigate the negative effects of the exposure to promote growth. Similarly, Sprang, Clark, and Whit-Woosley (2007) found that the support of other professionals reduced the effects of compassion fatigue among counselors. Given the apparent efficacy of peer support as a tool for clinicians to process experiences, it seems logical that supervision would provide a formal approach to dealing with perceived compassion fatigue. Supervision, therefore, becomes a unique outlet for counseling students, providing an opportunity for compassion fatigue to catalyze personal change and ongoing development of counselor competencies, both for interns and established professionals.

Conceptual Confusion

While reading through the research on compassion fatigue, it becomes apparent that there is some confusion about what encompasses compassion fatigue. When researching secondary traumatic stress, Figley (1995) chose to use the term 'compassion fatigue' to remove the negative association with secondary traumatic stress. Although the terms 'compassion fatigue' and 'secondary traumatic stress' are interchangeable, the literature often uses 'vicarious trauma', a similar construct, in place of both, causing theoretical misunderstanding (Boscarino, Figley, & Adams, 2004; Craig & Sprang, 2009). Notably, while researching mediation effects of social supports such as supervision on compassion fatigue, Killian (2008) used the terms 'vicarious trauma', 'secondary stress', and 'compassion fatigue' interchangeably. This led to misunderstanding regarding which construct the author was researching. Considering it can quickly become confusing what compassion fatigue entails, 'vicarious trauma' and 'compassion fatigue' must first be defined.

Prior to research on compassion fatigue, McCann and Pearlman (1990) investigated the concept of lasting traumatization through consistent traumatic narratives of clients in the context of the therapeutic relationship, something they referred to as 'vicarious trauma'. Vicarious trauma affects the counselor in an intellectual capacity where the counselor would start to question their beliefs about themselves and the world around them (McCann & Pearlman, 1990). The change in cognition can manifest itself through issues concerning trust, safety, power, independence, esteem, intimacy, and memory (McCann & Pearlman, 1990). Vicarious trauma and compassion fatigue conceptually differ in presentation. Where vicarious trauma affects thinking and cognitive frameworks over a gradual period (McCann & Pearlman, 1990), compassion fatigue presents as a quick onset of emotional and physical symptoms that mirror PTSD, from which recovery can be just as quick (Figley, 1995). 

The empathetic nature of the counselor makes them more predisposed to the development of compassion fatigue, specifically when they consistently see trauma clients, ruminate on previous traumatic memories, and experience unexpected changes in either their personal or professional lives (Figley, 2002). Counselors who are inexperienced and lack the technical knowledge to work with trauma clients put themselves at risk of developing compassion fatigue. This is where supervision can intervene, to promote education and help counselors, both experienced and inexperienced, work through the emotional reactions and symptomology from the clinical setting. 

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