“When practicing medicine feels more like labour than a labour of love, take steps to heal the healer.”

~ Pfifferling & Gilley

Preventing Compassion Fatigue in Caregiving Professions

If you ask someone in a caregiving profession (i.e., medicine, manual therapy, nursing, counselling, social work, etc.) why they chose their field, you’ll often hear them say in response that they want to help others. Careers with a large component of caregiving can be the source of great fulfillment, insight, and human connection. Working with people that require care on a near-daily basis can be predictably challenging at times as well, particularly if the caregiver is struggling to maintain a sense of harmony between the various aspects of their own lives. Left unchecked, this consistent disharmony can lead to compassion fatigue (sometimes called “vicarious trauma”), a form of burnout that depletes the caregiver and can, at worst, leave them feeling incapable of continuing their work. In this article, I define compassion fatigue and provide tips for avoiding it in caregiving professions.

What is compassion fatigue?

Compassion fatigue is defined as “a form of burnout that manifests itself as physical, emotional, and spiritual exhaustion” (Pfifferling and Gilley, 2000). There are two stages of compassion fatigue: the first is “burnout”, which is characterized by the “slow onset of feelings of hopelessness that one’s work has little positive impact”, followed by “secondary traumatic stress” which refers to a “rapid onset of symptoms…such as nightmares, difficulty sleeping, and flashes of intrusive images and/or thoughts due to secondary exposure to…stressful events” (O’Malley, 2022). It is estimated that between 40% and 85% of individuals in caregiving professions will at some point experience compassion fatigue (Mathieu, 2012). Aside from the depleting effect of compassion fatigue on people, it’s also a major contributor to workplace absenteeism, poor bedside manner, decreased productivity, lack of engagement, and healthcare system strain/inefficiency. With the impacts of compassion fatigue being as serious as they are, many healthcare professions have stressed  the importance of maintaining “work-life balance” while training new therapists- but the concept can be problematic, and has since been replaced with a more attainable notion, that of “work-life harmony”.

What’s the problem with the “work-life balance”?

The term “work-life balance” has come under fire over recent years; some have argued that the term sets us up for failure due to “balance” requiring a measure of perfectionism in order to attain it. Instead, the term “work-life harmony” might serve us better. Work-life harmony is a state where a person is “able to achieve both professional and personal goals” and views work and life as “interdependent elements that are increasingly intertwined” given the changing expectations around achieving satisfaction and contentment in both areas of life (Tripartite Alliance for Fair and Progressive Employment Practices, 2019). 

How do we create work-life harmony and prevent compassion fatigue?

There are a number of strategies we can use to create work-life harmony and prevent compassion fatigue. These strategies can be divided into five major categories, as is described below (O’Malley, 2022):

Self-care: any activity that takes care of mental, emotional, and physical health (i.e., yoga, counselling therapy, taking a bath, a warm cup of tea, journalling.

Healthy boundaries: a setting of mental, emotional, and physical limits, and saying “no” in order to prioritize the well-being of the self, asking for help when needed, delegating tasks.

Support network: identifying friends, colleagues, family, or any others who can provide support when needed.

Self-awareness: paying attention to thoughts and feelings, interactions with others, and general stress and anxiety level through activities such as meditating, mindfulness, self-reflection, or journaling.

Maintaining balance: managing time so that work and life responsibilities are maintained without one or the other becoming all-consuming for a prolonged period of time.

Beyond an individual responsibility, workplaces have also been changing to meet the needs of their workers by supporting their mental health. Some workplaces provide training sessions on compassion fatigue and burnout after realizing that “better education and training may have a moderating effect on compassion fatigue” (Ying-ying, 2018). Personally, the clinic where I work has invested time and effort in bringing in counsellors that provided education for our manual therapists on burnout and compassion fatigue, and it created a sense within the workplace that the company values and is willing to work with therapists who need to take time to heal from such a depleting state. We all know that we can’t care for others to our best ability if we feel depleted ourselves, and a company that invests in the wellbeing of its staff ultimately invests in their business functioning optimally. These strategies are supported by research, since “professional risk factors” to experiencing compassion fatigue have been shown to be “a lack of professional support or supervision, inadequate training, and a high number of clients with severe traumatic experiences” (Bonach and Heckert, 2012; Bell et. al., 2003).

Understanding the way that compassion fatigue and burnout function allows people in caretaking professions to identify and contextualize their experience, and offers a chance to take action in a way that will prevent further harm. Having been through burnout myself, I know that contextualizing the experience is a great help. It’s my hope that this article may be an entry point to further reading for others that are going through a similar experience.


Bell, H., Kulkarni, S., and Dalton, L. (2003). Organizational prevention of vicarious trauma. Families in Society: The Journal of Contemporary Social Services, 84(4), 463-470.

Bonach, K., & Heckert, A. (2012). Predictors of secondary traumatic stress among children’s advocacy center forensic interviewers. Journal of Child Sexual Abuse: Research, Treatment, & Program Innovations for Victims, Survivors, & Offenders, 21(3), 295-314.

Mathieu, F. (2012). The Compassion Fatigue Workbook. New York, NY: Routledge.

O’Malley, Mandy. (2022). “What is Compassion Fatigue?”. Resilient Retreat. Available: https://www.resilientretreat.org/what-is-compassion-fatigue/. Accessed: March 26, 2023.

Pfifferling, J.H., and Gilley, K. (2000). “Overcoming Compassion Fatigue”. Fam Practice Management. 7(4):39-44. 

Tripartite Alliance for Fair and Progressive Employment Practices. (2019). “About Work-Life Harmony”. Available: https://www.tal.sg/tafep/employment-practices/work-life-harmony/about#. Accessed: March 25, 2023.

Ying-ying, Z., Wen-Li, H., Wen, Q., Hai-Xia, Y., Ching-Fang, Z., Cui, K., Ying-Lei, W. (2018). “Extent of compassion satisfaction, compassion fatigue, and burnout in nursing: a meta-analysis”. Journal of Nursing Management. https://doi.org/10.1111/jonm.12589.


About the Author

Ashley is a Massage Therapist from Moncton, New Brunswick with a special interest in massage therapy in palliative and hospice care, and managing concussions. Outside of clinical practice, she is a Lead Instructor in our “Understanding the Complexity of Concussion” courses as well as the Editor of this website’s blog. She volunteers her time as a member of the Board of Directors of the Association of New Brunswick Massage Therapists. 

Ashley decided to pursue massage therapy as a second career in order to help others. With prior experience in the field of Archaeology at the Master’s level, Ashley is an integral part of course development, helping to improve and assess the quality of our course delivery.