Professional Documents
Culture Documents
Social workers are at risk for experiencing burnout and secondary traumatic stress (STS) as
a result of the nature of their work and the contexts within which they work. Little attention
has been paid to the factors within a social workers control that may prevent burnout and
STS and increase compassion satisfaction. Empathy, which is a combination of physiological
and cognitive processes, may be a tool to help address burnout and STS. This article reports
on the findings of a study of social workers (N=173) that explored the relationship between
the components of empathy, burnout, STS, and compassion satisfaction using the Empathy
Assessment Index and the Professional Quality of Life instruments. It was hypothesized that
higher levels of empathy would be associated with lower levels of burnout and STS, and
higher levels of compassion satisfaction. Findings suggest that components of empathy may
prevent or reduce burnout and STS while increasing compassion satisfaction, and that em-
pathy should be incorporated into training and education throughout the course of a social
workers career.
Wagaman et al. / The Role of Empathy in Burnout, Compassion Satisfaction, and Secondary Traumatic Stress 203
and the practitioners own physiological reactions, that includes four subscales measuring the components
use those feelings to engage in deep understanding, of interpersonal empathy (affective response, self
and simultaneously regulate her or his own emotions other awareness, perspective taking, and emotion
so as not to be overwhelmed. For the full array of regulation), with five items each. Items were measured
empathy to occur, all four components need to be on a six-point Likert scale ranging from 1=never
well functioning. Each component, and conse- to 6=always. The Professional Quality of Life Scale
quently empathy as a whole, involves skills that can (ProQOL) consists of three subscales: Compassion
be learned. Satisfaction, Burnout, and STS. Each subscale has
The purpose of this study was to examine the 10 questions. As conceptualized by the scale devel-
relationship between social workers empathy and opers, both burnout and STS are components of a
level of (a) burnout, (b) STS, and (c) compassion latent construct, compassion fatigue. Each item was
satisfaction. The authors hypothesized that the com- measured on a five-point Likert scale ranging from
ponents of empathy would be significant predictors 1=never to 5=very often, and included items such
of lower levels of burnout and STS, and higher lev- as I am preoccupied with more than one person I
els of compassion satisfaction. serve. The ProQOL has been identified as a reliable
and valid measure of compassion satisfaction and the
METHOD components of compassion fatigue (Stamm, 2010).
Data Collection
Field instructors from a large southwestern univer- Sample
sitys school of social work were invited via e-mail to The sample (N=173) was predominantly female
participate in an online, Qualtrics-based survey (87.8 percent, n=151) and white/Caucasian (73.8
(Qualtrics Online Survey Software, 2014). Field in- percent, n=127). Twelve percent (n=21) identified
structors were community-based practitioners who as Latino; 5.8 percent (n=10) identified as African
voluntarily supervised social work students in their American. Participants ranged in age from 20 years
field placements. Field instructors were asked to sup- to over 70 years, with a majority (58 percent,
port a snowball sampling technique by forwarding n=101) being between the ages of 40 and 60. A
the invitation e-mail to other services providers in majority of the sample (97.1 percent, n=168) had
their agencies or communities. Data were collected in a masters degree or higher, and 93.6 percent
July and August of 2011. A total of 185 participants (n=161) of the participants highest degrees were
responded. Of those, 173 reported having at least one in social work. Time working in the profession
degree in social work, and these were included in the ranged from two to over 40 years, with approxi-
analysis for the current study. The study was approved mately 75 percent of the participants (n=131) hav-
by the universitys institutional review board. ing been in the profession for 10 years or longer.
Participants reported working in a broad range of
Measures contexts at the time of the survey, with the most
The online survey included demographic items, common being child welfare (12.1 percent, n=20),
such as gender, race or ethnicity, age, and highest behavioral health (18.8 percent, n=31), health or
level of education. Participants also responded to medical services (18.8 percent, n=31), and school-
items about their professional career and current based services (8.5 percent, n=14). Other work
work: years they had worked as a social services contexts reported by participants included policy/
professional overall; the nature of their current work advocacy, early childhood development, crisis re-
(such as child welfare, behavioral health); whether sponse services, aging, and veteran services. The
their current work was in a direct practice position, largest proportion of participants (42.1 percent,
administrative or supervisory position, or a combi- n=69) reported working in direct practice, with an
nation of both; and years they had worked in their additional 33.5 percent (n=55) reporting doing su-
current position. pervisory or administrative work, and 24.4 percent
Participants also completed measures of empa- (n=40) reporting both. Time having worked in
thy,burnout, compassion satisfaction, and STS. The their current positions ranged from less than a year
Empathy Assessment Index (EAI) is a valid and reli- to 28 years. The majority (58 percent, n=93) re-
able 20-item, self-report instrument (Gerdes, Geiger, ported having been in their current position five
Lietz, Wagaman, & Segal, 2012; Lietz et al., 2011) years or less.
Wagaman et al. / The Role of Empathy in Burnout, Compassion Satisfaction, and Secondary Traumatic Stress 205
with STS as the dependent variable, 14 percent tect social workers from decision-making patterns
(R2=.19, adjusted R2=.14) of the variance was that reflect poor boundary setting and maintenance.
accounted for [F(8, 145)=4.34, p<.01) with self Affective response, which was found to have sig-
other awareness [=.26, t(145)=2.65, p<.01] and nificant predictive value for higher levels of compas-
emotion regulation [=.21, t(145)=2.31, p<.05] sion satisfaction, is thought to work in concert with
as individually significant predictors. The model for the cognitive component of emotion regulation.
STS varied significantly by the type of work done. Unregulated affective response is seen as having the
Those in supervisory- or administrative-only posi- potential to create distress in an individual. The find-
tions had lower levels of STS than those in direct ings of this study suggest that affective response has
practice positions, all else being held constant. a positive relationship with compassion satisfaction.
The findings of this study indicate a significant Social workers may need to be able to share emotion
relationship between empathy and both compassion with clients. This process of affect sharing, while
satisfaction and compassion fatigue among social often contextualized in terms of trauma and pain,
work practitioners. Selfother awareness and emo- would also include sharing in a clients joy and suc-
tion regulation, which are cognitive components of cesses. Such affect sharing may be important to the
empathy, appear to be significant contributors to maintenance of a feeling of satisfaction in ones work,
components of compassion fatigue as compared with which is linked to a lower risk of compassion fatigue.
the other components of empathy. In contrast, af- Emotion regulation, a cognitive component of
fective response, which is a physiological component empathy, and its association in this study with burn-
of empathy, was identified as a significant contribu- out and STS suggest that the ability to regulate the
tor to compassion satisfaction. These findings do not emotional responses to clients that are physiological
vary significantly by time in the current position. in nature equips social workers to protect themselves
from repeated exposure to those who have experi-
DISCUSSION enced pain and trauma. Emotion regulation is a skill
The findings of this study suggest that there is a that can be learned and honed through training.
significant opportunity to use empathy in the prep- The identified relationship between the type of
aration of social work practitioners to cope with the work (direct versus administrative or supervisory
factors related to burnout and STS. The study find- practice) and STS is an important reminder that
ings also suggest that empathy may be a factor con- supervisors who move out of engagement in direct
tributing to the maintenance of the well-being and client contact need to remain aware and sensitive to
longevity of social workers in the field. the vulnerability of their supervisees to developing
It is important to explore the specific components STS. From an organizational perspective, this may
of empathy for which there was a significant predic- suggest a need for supervisors to maintain some di-
tive value, to understand the relationships that they rect client work or engage in empathy-related train-
suggest. Selfother awareness is a cognitive compo- ing to better understand the experiences of their
nent of empathy that emphasizes the ability to sep- supervisees.
arate oneself from others, including ones thoughts Finally, the fact that the relationships identified
and feelings, which is the process of setting and between empathy and burnout and compassion sat-
maintaining boundaries. The results of this study isfaction varied significantly by time in the profes-
suggest that attention to specifically training social sion is an important finding, particularly given that
workers in selfother awareness, both before enter- more years in the profession overall was associated
ing the field and while in the field, could serve as a with lower levels of burnout and higher levels of
protective factor against STS. Similarly, the relation- compassion satisfaction. This finding suggests that
ship between selfother awareness and compassion social work professionals can learn from strategies
satisfaction, as indicated by the findings, suggests used by long-term social workers that prevent burn-
that selfother awareness training may help to pre- out and maintain compassion satisfaction. Clearly,
vent burnout and STS by increasing compassion burnout can be prevented and managed across ones
satisfaction. Empathy can help social workers main- professional career. Given that issues of retention
tain professional boundaries by training them to be are important in the profession, this finding has
mindful of selfother awareness and emotion regula- important implications for intervention with social
tion in their everyday practice, which may also pro- workers, particularly in those areas of the profession
Wagaman et al. / The Role of Empathy in Burnout, Compassion Satisfaction, and Secondary Traumatic Stress 207
Decety, J., & Moriguchi, Y. (2007). The empathic brain Maslach, C. (2003). Burnout: The cost of caring. Los Alto:
and its dysfunction in psychiatric populations: ISHK.
Implications for intervention across different clinical Maslach, C., & Leiter, M. P. (1997). The truth about burnout.
conditions. BioPsychoSocial Medicine, 1(22), 121. San Francisco: Jossey-Bass.
Eisenberg, N., & Eggum, N. D. (2009). Empathic Maslach, C., & Schaufeli, W. B. (1993). Historical and
responding: Sympathy and personal distress. In conceptual development of burnout. In
J.Decety & W. Ickes (Eds.), The social neuroscience of W.B.Schaufeli, C. Maslach, & T. Marek (Eds.),
empathy (pp. 7183). Cambridge, MA: MIT Press. Professional burnout: Recent developments in theory and
Elliott, R., Bohart, A. C., Watson, J. C., & Greenberg, research (pp. 116). Washington, DC: Taylor & Francis.
L.S. (2011). Empathy. Psychotherapy, 48(1), 4349. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001).
Figley, C. R. (2002). Compassion fatigue: Psychotherapists Jobburnout. Annual Review of Psychology, 52(1),
chronic lack of self care. Journal of Clinical Psychology, 397422.
58, 14331441. McCarthy, W. C., & Frieze, I. H. (1999). Negative aspects
Gerdes, K. E., Geiger, J. M., Lietz, C. A., Wagaman, of therapy: Client perceptions of therapists social
M.A., & Segal, E. A. (2012). Examination of influence, burnout, and quality of care. Journal of
known-groups validity for the Empathy Assessment Social Issues, 55(1), 3350.
Index (EAI): Differences in EAI scores between social McMahon, S. D., Wernsman, J., & Parnes, A. L. (2006).
service providers and recipients at community Understanding prosocial behavior: The impact of
treatment agencies. Journal of the Society for Social Work empathy and gender among African American
and Research, 3(2), 94112. adolescents. Journal of Adolescent Health, 39,
Gerdes, K. E., Lietz, C. A., & Segal, E. A. (2011). 135137.
Measuring empathy in the 21st century: Develop National Institute of Mental Health. (2014). Symptoms of
ment of an empathy index rooted in social cognitive traumatic stress (NIH Publication No. 086388).
neuroscience and social justice. Social Work Research, Washington, DC: U.S. Government Printing Office.
35, 8393. Neumann, M., Bensing, J., Mercer, S., Ernstmann, N.,
Gerdes, K. E., & Segal, E. (2011). Importance of empathy Ommen, O., & Pfaff, H. (2009). Analyzing the
for social work practice: Integrating new science. nature and specific effectiveness of clinical
Social Work, 56, 141148. empathy: A theoretical overview and contribution
Gibbons, S. B. (2011). Understanding empathy as a towards a theory-based research agenda. Patient
complex construct: A review of the literature. Clinical Education and Counseling, 74(3), 339346.
Social Work Journal, 39, 243252. Newell, J. M., & MacNeil, G. A. (2010). Professional
Jacobson, J. M., Rothschild, A., Mirza, F., & Shapiro, M. burnout, vicarious trauma, secondary traumatic stress,
(2013). Risk for burnout and compassion fatigue and and compassion fatigue: A review of theoretical
potential for compassion satisfaction among clergy: terms, risk factors, and preventive methods for
Implications for social work and religious clinicians and researchers. Best Practice in Mental
organizations. Journal of Social Service Research, 39, Health, 6(2), 5768.
455468. OHalloran, M. S., & OHalloran, T. (2001). Secondary
Kahill, S. (1988). Symptoms of professional burnout: A traumatic stress in the classroom: Ameliorating stress
review of the empirical evidence. Canadian in graduate students. Teaching in Psychology, 28(2),
Psychology/Psychologie Canadienne, 29(3), 284297. 9297.
Killen, M., & Smetana, J. (2008). Moral judgment and Perkins, E., & Sprang, G. (2013). Results from the Pro-
moral neuroscience: Intersections, definitions, and QOL-IV for substance abuse counselors working
issues. Child Development Perspectives, 2(1), 16. with offenders. International Journal of Mental Health &
Kulkarni, S., Bell, H., & Hartman, J. L. (2013). Exploring Addiction, 11(2), 199213.
individual and organizational factors contributing to Pooler, D. K., Wolfer, T. A., & Freeman, M. L. (2014).
compassion satisfaction, secondary traumatic stress, Finding joy in social work: Interpersonal sources.
and burnout in domestic violence service providers. Families in Society, 95(1), 3442.
Journal of the Society for Social Work and Research, 4(2), Pryce, J. G., Shackelford, K. K., & Pryce, D. H. (2007).
114130. Secondary traumatic stress and the child welfare professional.
Laible, D. J., Carlo, G., & Roesch, S. C. (2004). Pathways Chicago: Lyceum Books.
to self-esteem in late adolescence: The role of parent Qualtrics Online Survey Software. (2014). Provo, UT:
and peer attachment, empathy, and social behaviours. Qualtrics, LLC. Retrieved from http://www
Journal of Adolescence, 27, 703716. .qualtrics.com
Lakey, B., & Cohen, S. (2000). Social support theory and Schaufeli, W., & Enzmann, D. (1998). The burnout
measurement. In S. Cohen, L. G. Underwood, & companion to study and practice: A critical analysis.
B.H. Gottlieb (Eds.), Social support measurement and Philadelphia: Taylor & Francis.
intervention: A guide for health and social scientists Sprang, G., Craig, C., & Clark, J. (2011). Secondary
(pp.2952). New York: Oxford University Press. traumatic stress and burnout in child welfare workers:
Lee, R. T., & Ashforth, B. E. (1996). A meta-analytic A comparative analysis of occupational distress across
examination of the correlates of the three dimensions professional groups. Child Welfare, 90(6), 149168.
of job burnout. Journal of Applied Psychology, 81(2), Stamm, B. H. (Ed.). (1999). Secondary traumatic stress:
123133. Self-care issues for clinicians, researchers, & educators (2nd
Lietz, C. A., Gerdes, K. E., Sun, F., Geiger, J. M., ed.). Lutherville, MD: Sidran Press.
Wagaman, M. A., & Segal, E. A. (2011). The Stamm, B. H. (2010). The concise ProQOL manual (2nd ed.).
Empathy Assessment Index (EAI): A confirmatory Pocatello, ID: ProQOL.org.
factor analysis of a multidimensional model of Toussaint, L., & Webb, J. R. (2005). Gender differences in
empathy. Journal of the Society for Social Work and the relationship between empathy and forgiveness.
Research, 2(2), 104124. doi:10.5243/jsswr.2011.6 Journal of Social Psychology, 145, 673685.
Lloyd, C., King, R., & Chenoweth, L. (2002). Social van Heugten, K. (2011). Social work under pressure: How to
work, stress and burnout: A review. Journal of Mental overcome stress, fatigue and burnout in the workplace.
Health, 11(3), 255265. London: Jessica Kingsley.
Wagaman et al. / The Role of Empathy in Burnout, Compassion Satisfaction, and Secondary Traumatic Stress 209