Model of Compassion Stress and Fatigue
Figley first published an etiological model in 1995 (subsequently revised) that offers a way to prevent and mitigate compassion fatigue in those that are most susceptible to it (Figley, 2002). The model assumes that empathy and emotional energy are the driving force behind effectively working with the suffering. However, being compassionate and empathic involves costs to the therapist. Following are ten variables that, together, form a causal model that predicts compassion fatigue. The model not only shows what causes compassion fatigue, but also what is required to prevent and treat it (Figley, 2002).
- Empathic Ability is the aptitude of the therapist for noticing the pain of others. The model suggests that without empathy there will be little to no compassion stress and no compassion fatigue. However, without empathy there will be little to no empathic response to suffering clients.
- Empathic Concern is the motivation to respond to people in need. The ability to be empathic is meaningless unless there is motivation to help others who require a therapist's services.
- Exposure to the Client is experiencing the emotional energy of the suffering clients through direct exposure. The costs of direct exposure to the suffering of others is high for the therapist.
- Empathic Response is the extent to which the therapist makes an effort to reduce the suffering of the sufferer through empathic understanding. The therapist might experience hurt, fear, anger, or other emotions experienced by the client, which obviously has inherent benefits and costs.
- Compassion Stress is the residue of emotional energy from the empathic response to the client and is the on-going demand for action to relieve the suffering of the client. With sufficient intensity, it can have a negative impact on the immune system and life in general.
- Sense of Achievement lowers or prevents compassion stress. It is the extent to which the therapist is satisfied with his/her efforts to help the client.
- Disengagement is the other factor that lowers or prevents compassion stress. It is the extent to which the psychotherapist can distance himself or herself from the ongoing misery of the client between sessions. A therapist's ability to disengage demands a conscious, rational effort to "let go" of emotions associated with the sessions
If compassion stress is allowed to build, the therapist is a greater risk of compassion fatigue. Three other factors play a role in increasing compassion fatigue.
- Prolonged Exposure is the ongoing sense of responsibility for the care of the suffering, over a protracted period of time. The longer the period of time between breaks from being a professional service provider the better-at least a day of appointments and as much as a week's vacation.
- Traumatic Recollections are memories that trigger the symptoms of PTSD and associated reactions, such as depression and anxiety.
- Life Disruption is the unexpected changes in schedule, routine, and managing life responsibilities that demand attention (illnesses, changes in lifestyle, social status, or professional or personal responsibilities). When combined with the other seven factors, these normally tolerable disruptions can increase the chances of the therapist developing compassion fatigue.
We believe that the knowledge of this model will help in preventing and mitigating compassion fatigue for the therapist.