Compassion Fatigue, Secondary Traumatic Stress, and Vicarious Traumatization: a Qualitative Review and Research Agenda

Abstract

There has been growing research interest in what we term empathy-based stress, a process of traumatic stressor exposure, empathic experience, and adverse reactions among particular empathy-related professions, captured in the literatures on compassion fatigue, secondary traumatic stress, and vicarious traumatization in trauma-related lines of work. Although these three empathy-based strain constructs are highly related, each represents different components of similar strain responses. Unfortunately, extant reviews of the empathy-based stress literature are non-comprehensive and/or out of date. This qualitative review thus aims to synthesize and summarize the current literature on empathy-based stress at work and contribute to theoretical, methodological, and practical improvements in this area of research and practice. After introducing empathy-based strain constructs and their defining characteristics, we detail our review methodology and the primary theoretical and empirical themes derived through our review of the past decade of published literature. Then, we summarize conceptual, methodological, and analytical gaps in the empathy-based stress literature, helping to generate recommendations for the literature moving forward.

A Systematic Review of Job Demands and Resources Associated with Compassion Fatigue in Mental Health Professionals

“…The combination of secondary traumatic stress and burnout is commonly referred to as compassion fatigue [ 13 , 22 , 23 ]. Although the term is used synonymously with burnout [ 15 ], secondary traumatic stress [ 23 ], vicarious traumatisation [ 24 ] and traumatic countertransference [ 9 ], the present review focuses exclusively on compassion fatigue for the purpose of consistency and because some researchers have attempted to distinguish it from other similar constructs, e.g., [ 10 , 25 ].…”

“…Depression, chronic health impairment and work-related stress have all been found to be associated with compassion fatigue [ 11 , 28 , 29 , 32 ]. In spite of this, the existing literature has paid more attention to the role of relatively stable individual-level characteristics (such as gender, age, history of trauma, negative life events, coping style and attachment style, among others) [ 22 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], as opposed to more dynamic, extrinsic and potentially alterable work-related factors. A relatively small body of research that has investigated the association of work-related factors has found that workload, client-related difficulties, relationships with other health professionals, emotional labour and support from supervisors and/or co-workers are some of the work-related factors that have been found to be associated with compassion fatigue in mental health professionals [ 44 , 45 , 46 , 47 , 48 , 49 ].…”

Breaking the taboo: eight Swedish clinical psychologists’ experiences of compassion fatigue

“…Such second hand experiences may cause symptoms associated with PTSD, e.g., intrusive thoughts, or hyperarousal (Diehm et al, 2019 ). In recent research, it has been suggested that compassion fatigue, secondary traumatic stress, and vicarious traumatization can be grouped under the term empathy-based stress (Rauvola et al, 2019 ).…”

A Scoping Review of Vicarious Trauma Interventions for Service Providers Working With People Who Have Experienced Traumatic Events

“…Given that VT, STS, and CF share common causes and consequences for service provision, these terms are understandably used interchangeably. However, many researchers have urged the conceptual differentiation of these constructs and some researchers have identified them as symptomatically different constructs (Molnar et al, 2017;Newell & MacNeil, 2010;Rauvola et al, 2019). Pearlman and Saakvitne (1995) defined VT as a change of cognitive schemas resulting from consistent empathic engagement with traumatized individuals (Newell & MacNeil, 2010).…”