Article 50
The Relationship Between Resilience and Compassion Fatigue
in Counselors
Susan Marcus and Michael Dubi
Recent studies have attempted to understand the workers, including the possible risk and protective
stresses and risks associated with providing mental factors that can affect experience of compassion fatigue
health counseling. These stresses have been and burnout. According to Bride, the most commonly
conceptualized as vicarious stress or trauma (Bride, studied variables include age, gender, exposure levels,
2004; Collins & Long, 2003), burnout (Figley, 1995), training, occupation, personal trauma history, and
and compassion fatigue (Collins & Long, 2004; Figley, trauma symptoms. The results of his examination
1995; Pearlman & Saakvitne, 1995). All of the reveals mixed results, with no clear patterns with respect
conceptualizations have in common the theme that to demographics, exposure, or the type of clients. It
mental health workers are vulnerable to physical and was suggested that there is some consistency regarding
psychological consequences when dealing with the personal trauma, that “personal trauma history,
traumatic life events of others. This vulnerability, particularly in childhood, is a significant risk factor”
according to Figley (1995), is the natural consequence (p. 42).
of behaviors and emotions resulting from knowing The purpose of this study was to examine if the
about and listening to the narratives about a traumatizing experience of personal trauma is associated with several
event experienced by a significant other. These of the psychological consequences of secondary trauma,
consequences are thought to be cumulative, and should specifically depression, anxiety, and coping ability. In
vary in intensity depending on helper characteristics addition, other demographic characteristics were
and the characteristics of the client population. This examined for their relationship to the experience of
condition can be serious and produces symptoms similar personal trauma as well as the ability to cope.
to posttraumatic stress disorder (PTSD).
In their review, Collins and Long (2003) clarified Methods
the similarities and differences in how these
consequences have been conceptualized. “A synthesis The instruments were the Compassion
of these descriptions demonstrates that the term Satisfaction and Fatigue Test (CSF; Stamm, 2002),
‘compassion fatigue’ can be used interchangeably with Trauma Recovery Scale (TRS; Gentry, 1999), Burns
the term ‘secondary traumatic stress’” (p. 421). This Anxiety Inventory (BAI; Burns, 1999), and Burns
condition is serious enough that counselors may Depression Checklist (BDC; Burns, 1999). They were
themselves be in need of assistance to cope with the distributed to 197 professional counselors, graduate
effects of listening to others’ traumatic experiences counseling students, and mental health workers. The
(Figley, 1995; Pearlman & Saakvitne, 1995). Other instruments were collected immediately upon
authors have suggested that compassion fatigue may completion. All instruments were completed in 2004.
have a less negative connotation (Figley, 1995). The CSF consists of 66 questions broken down
Burnout is conceptualized as being a syndrome into three scales: compassion satisfaction, burnout, and
of physical, emotional, and mental exhaustion compassion fatigue. Reported psychometric
(Maslach, Jackson, & Leiter, 1996; Pines & Aronson, information was based on a pooled sample of 370
1988). The literature seems to maintain a distinction people. Multivariate analysis of variance did not provide
between compassion fatigue and burnout, and self- evidence of differences based on country of origin, type
report measures have been developed to assess them. of work, or sex when age was used as a control variable
Bride (2004) reviewed 17 quantitative studies that (Stamm, 2002). The mean age was 35.4, and the median
addressed the impact of providing “psychosocial was 36%. Gender was broken down as 56% female,
services to traumatized populations” on mental health 33% male, with the remainder being unknown. The
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countries of origin of the sample were the United States scores on both tests. At this time the BDC is
(rural-urban mix) 43%, Canada (urban) 8%, South recommended for clinical use only as it has not been
Africa (urban) 35%, and Internet (unknown origin) used in formal research studies.
13%. The alpha score for the compassion satisfaction
scale was .87, for the burnout scale .90, and for the Results
compassion fatigue scale .87.
The TRS (Gentry, 1999) is a three-part A total of 197 sets of self-report data were
multipurpose self-report clinical instrument that was collected in 2004. There were 45 men (22.84%) and
originally developed in 1995 at West Virginia 152 women (77.16%). About 25.4% were single; 51.3%
University’s School of Medicine. Part I was added in were married; 19.8% were divorced; and the remaining
1997 to allow respondents to determine if they met the 3.5% were separated, widowed, or other. In this sample,
Diagnostic and Statistical Manual of Mental Disorders 53.3% were Caucasian; 39.1% were African American;
(DSM-IV; American Psychiatric Association, 1994) and the remaining 7.1% were other ethnic backgrounds.
Criterion A for posttraumatic stress disorder. Part II asks The mean age was 40.79 (SD = 9.68). About 67.7% of
respondents to indicate whether they have experienced the participants had a master’s degree or higher level
any of the 20 listed traumatic experiences and the of education. Over 80% identified themselves as
number of times they have experienced these events. currently working in a helping profession. The
Part III functions as a baseline/outcome measure for remainder were graduate counseling students.
individuals with PTSD. It is a Likert-scaled 11-item Of particular interest in this sample was the report
instrument. The respondent is asked to provide a mark that 65.5% of the sample reported at least one event
on a 100mm line that best represents his or her that was characterized as a traumatic event on the TRS.
experience relative to that item during the previous There were no significant differences in the reporting
week. The TRS utilized a convenient sample of 91 of trauma between men and women (chi-square
university students in Florida and 56 mental health [1] = 0.037, p = 0.85); marital status (chi-square [2] =
professionals from Oklahoma for a total of 147. Of this 1.158, p = 0.56); profession (chi-square [1] = 0.183, p
sample 63.9% (94) responded affirmatively that they = 0.67).
met Criterion A, from the DSM-IV, for PTSD. The Differences in age, and scores on the Total Coping
validity for Part II is questionable and will not be Inventory, Burns Depression Inventory, and Burns
discussed in this article. The alpha score for Part III is Anxiety Inventory between participants who had, versus
.88. The TRS achieved significant validity when who had not, experienced trauma were examined using
compared with other instruments such as the Impact of t-tests. Participants who had experienced trauma were
Events Scale (IES). slightly older than those who had not (mean ages =
The Burns Anxiety Inventory (BAI; Burns, 1999) 41.44 and 39.00, respectively); and had rated
is a self-report that measures 33 symptoms of anxiety themselves as slightly lower in coping (mean coping
which fall into the categories of anxious feelings, scores = 84.49 and 87.49, respectively), as slightly more
anxious thoughts, and somatic manifestations of depressed (Burns Depression Inventory mean scores
anxiety. The scores of 498 outpatients seeking treatment 2.00 and 2.69, respectively), and as slightly more
for mood disorders suggested excellent reliability and anxious (Burns Anxiety Inventory mean scores 1.33
internal consistency with an alpha score of .94. The and .95, respectively). The t-test for differences between
BAI scores correlated highly with the anxiety subscale means on the anxiety measure approached significance
of the Hopkins Symptom Checklist (Green, Walkey, (t = 1.94, p = .06), while the other differences were
McCormick, & Taylor, 1988). nonsignificant (≥.07).
The Burns Depression Checklist (BDC; Burns,
1999) asks respondents about 15 common symptoms Discussion
of depression including sadness, low self-esteem, and
hopelessness. This instrument was designed to be used The results of this study suggest that the prior
to track client progress between therapy sessions. The experience of trauma in mental health professionals
BDC was validated in an unpublished pilot study with does not necessarily coincide with experience of
a group of 50 outpatients being treated for mood psychological consequences such as compassion
disorders. The subjects completed the BDC and the fatigue, burnout, anxiety and depression. Further,
Beck Depression Inventory (Beck & Steer, 1993) at demographic characteristics of age, marital status, and
the same time. Test administration was reversed in half profession are not associated with the presence or
of the subjects to prevent bias based on order of absence of trauma. This tends to be consistent with
administration. Most subjects had almost identical published data.
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The data related to compassion satisfaction Pearlman, L. A., & Saakvitne, K.W. (1995). Trauma
suggest that mental health professionals and graduate and the therapist: Countertransference and
students, whether meeting the conditions for Criterion vicarious traumatization in psychotherapy with
A of the DSM-IV for PTSD or not, may have at least as incest survivors. New York: Norton.
high a degree of compassion satisfaction as the general
population. Pines, A. M., & Aronson, E. (1988). Career burnout:
Causes and cures. New York: Free Press.
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