Compassion fatigue: when the helpers need help

The Halifax Examiner is providing all COVID-19 coverage for free. Please help us continue this coverage by subscribing.

Public health orders, restrictions, shutdowns, lockdowns. It’s no secret the uncertainty and stress created by the pandemic has upped our anxieties and kept mental health professionals busy.

“Right now the waiting lists are exploding because of the stresses of this pandemic on people,” Halifax-based psychologist Lesley Hartman said in an interview.

“I don’t know a counsellor, therapist, or psychologist in the city that doesn’t have a really long waiting list. And we’re also dealing with our own stress related to the pandemic.”

Being immersed in highly emotionally supportive and emotionally draining work over a period of time can be challenging. Hartman said for some, feeling stressed or overwhelmed can lead to a sense of shame. That’s because there’s a sense that because they help others deal with a variety of issues, they should know how to cope themselves — without any outside help.

“With this pandemic right now, we’re all going through the same stuff. We’re helping our clients with things that maybe we’re having to deal with too,” Hartman said.

“We’re coached in school to avoid taking on clients when we’re going through those same things ourselves. And those are smart and wise words. But they’re not always possible, like for example in this pandemic.”

Up to 60% of NS counsellors experience work-related ‘compassion fatigue’

So how can we best support the mental health professionals who support us? How can we ensure they remain in the counseling field and don’t burn out?

There are few studies that investigate the factors that promote resilience and help counsellors thrive. But a new Acadia University-based research project aims to find answers to those and other related questions.

Acadia University professor and researcher Tanya Surette is leading the project. A psychologist for 15 years, she also educates students entering the profession. Over a five-year period, she plans to follow 30 of her counselling graduate students through their education, internship, and into their early careers.

Surette said this research is unique because it will follow the development of counsellors over a sustained period of time to learn more about what helps and what hinders their mental wellness and ability to thrive.

This is particularly important in Nova Scotia, which has one of the highest lifetime prevalence rates of mental health disorders in the country.

Surette said current literature suggests up to 60% of counselling professionals experience occupational health concerns due to compassion fatigue. That term refers to “the significant negative emotional and psychological impacts that stem from supporting others through trauma and emotional distress.” This can lead to anxiety, depression and other mental health conditions among counsellors.

“How do counsellors arrive at a thriving, resilient practise versus feeling impaired or not having the wellness to sustain the work,” Surette said in an interview.

While most counselling research tends to focus on clients — something Surette said is important and necessary — we’re missing a “very important” part of the equation when we don’t examine the wellness and mental health of the counselling professionals who support those clients.

“There’s already strain on particular systems. The health system, the child welfare system, the criminal system. Those are all influenced by people’s mental health,” Surette said.

“When counsellors are not well enough to do effective work, it has broader systemic influences beyond the client…There are substantial systemic impacts of that as well.”

She also noted the research that does consider counsellors tends to focus more on their level of wellness at a single moment in time. This misses the important parts of the journey that brought the counsellor to the point where they’re either thriving or struggling.

“Developing towards a professional trajectory of resilience or wellness or thriving happens over time. You don’t just show up there. Same with burnout or impairment or compassion fatigue,” Surette explained.

“There’s a progression. And so there really isn’t any research that’s followed counsellors developmentally over a long trajectory to see what are those risk and protective factors.”

Implications far beyond Nova Scotia

Surette said the comprehensive data generation from this project will provide valuable theoretical and practical direction to clinical supervisors, employers, public health authorities, and individual practitioners to better support the preparation, education, and sustainability of counsellors. This will also ensure more of them are better prepared to remain in the profession on a long term basis.

Following students through their education and their first few years working in the field will help researchers pin down what factors promote their success and ability to thrive and which create the opposite. That will allow educators to not only better prepare students to support their clients, but ensure they support their own wellness and flourish professionally.

While the data set will focus on counsellors in Nova Scotia, Surette said the research has implications far beyond this province.

“There aren’t sufficient mental health practitioners to support the need (in Nova Scotia) and so not only do we need well-trained mental health professionals, but they need to be resilient enough to stick around to support the need within our province,” Surette said.

“But understanding how counsellors develop towards resilience or impairment has implications nationally and globally for counsellor educators, for counsellor supervisors, for management, for large organisations, from an occupational health and safety perspective, as well as for counsellors themselves.”

Announced last month, Surette’s study is one of 21 research projects from eight Nova Scotia universities and health care centres being funded by Research Nova Scotia’s New Health Investigator Grant. Her project received $99,909.56 from a pot of more than $2 million.

This project will get underway later this year when the new cohort of students enter Acadia University’s Master of Education in Counselling program this July. In addition to students from this year’s intensive full-time program, she’ll have students from the 2022 intake. She expects to follow at least 30 students (15 from each year) throughout their 14-month program at Acadia through to five years post-graduation.

“We’ll watch how their wellness and how their resilience and how any impairment or compassion fatigue develop over time,” she said. “What are some of the factors that have protected them as well as have been a risk for them and their trajectory after they leave us?”

For counsellors like Hartman, a practicing psychologist for 30 years, Surette’s work is welcome news. There are many things she wished she’d known at the beginning of her career. She believes providing information and resources to facilitate wellness for those entering the profession will help in many ways, including reducing the sense of shame some feel when it comes to seeking help.

Hartman also hopes the research will provide a roadmap for policy makers.

“You may know what to do and you may know what people need,” Hartman said.

“But to have the people in power within hospital systems or institutions or not-for-profit or private practice or the leaders of private practices or wherever we work to know and understand what we need to be doing for each other and to have that be documented? I think that’s really powerful.”

The Halifax Examiner is an advertising-free, subscriber-supported news site. Your subscription makes this work possible; please subscribe.

Some people have asked that we additionally allow for one-time donations from readers, so we’ve created that opportunity, via the PayPal button below. We also accept e-transfers, cheques, and donations with your credit card; please contact iris “at” halifaxexaminer “dot” ca for details.

Thank you!