Uses of Compassion Fatigue: Findings of Two Ethnographic Studies of Human Service Workers

Background and Purpose: Compassion fatigue, vicarious traumatization, and secondary traumatic stress (CF/VT/STS) are used with considerable overlap (Bride, Radey, & Figley, 2007) to describe harms experienced by human service workers who serve people who have experienced trauma or other distress. These expectable “costs of caring” (Figley, 1995) have been linked to psychological distress (Bride, 2007), impaired work functioning (Penix 2019), and job turnover (Figley, 1999). As awareness of CF/VT/STS increases, little is known about how these constructs are used by workers in real-world human services agencies. This study asks: How are the constructs of CF/VT/STS mobilized by workers and organizational leadership to respond to the demands of challenging workplaces?

Methods: This study integrates ethnographic data from two studies of human service workers. At site 1, a therapeutic residential care facility for children in the U.S., 490 hours of participant observation and 65 semi-structured interviews with youth care workers, crisis intervention workers, in-service trainers, managers, and organizational leadership were conducted. At site 2, a humanitarian migrant shelter in central Mexico, 20 months of participant observation and 108 interviews with migrants, shelter workers, and volunteers were conducted. Data relevant to the research question were analyzed by each author respectively, checking and nuancing theories developed inductively during fieldwork. The authors collaboratively identified concordances on the use of CF/VT/STS in their respective sites.

Results: In both field sites, workers knew that CF/VT/STS was a possible consequence of their work, but they also used the constructs strategically. At site 1, youth care workers were explicitly taught to associate a range of negative experiences with CF/VT/STS and, in the presence of administrators, produced accounts that framed children’s violent behavior and worker distress as consequences of trauma. Some administrators expressed skepticism about the role of CF/VT/STS in youth care worker job stress and turnover, but worried that workers would use knowledge of CF/VT/STS to make claims of psychological harm against the organization. Workers themselves reported that client violence, low pay, and intrusive regulatory oversight were in fact more salient stressors of their work. At site 2, more privileged volunteers regularly expressed concern about CF/VT/STS when observing shelter workers’ apparent indifference to migrant’s traumas. Shelter workers resisted these concerns, which they saw as reifying border security discourses that frame migrants and smugglers as either traumatized victims or traumatizing victimizers. As shelter work professionalized, newer workers began to “own” CF/VT/STS concepts as a means of demonstrating professional competency while veteran workers remained skeptical. These shifting understandings demonstrate that CF/VT/STS is not just experienced, it is also used strategically toward different interpersonal aims in the context of shifting professional moral economies.

Conclusions: Assumptions about the salience of CF/VT/STS in human service organizations may obscure a range of other effects of working with distressed people, including practical organizational features, primary threats to worker safety, and unexpected pleasures. Nevertheless, workers are aware that CF/VT/STS, as academically recognized constructs, may be powerful tools in meeting their needs. Further study of CF/VT/STS as a tool in real-world settings of practice is warranted.