Stress, Burnout, and Compassion Fatigue Among Mental Health Professionals
As mental health professionals, we play a crucial role in supporting the well-being of others, yet the emotional demands of our work can often take a toll on our own mental health. The rewards of helping others are significant, but so too are the risks of experiencing stress, burnout, and compassion fatigue. Recognising the signs of therapist burnout in mental health professionals is essential to maintaining our own well-being and continuing to provide effective care.
Nevertheless, levels and predictors of burnout in mental health professionals, particularly therapists within “Adult and Children Improving Access to Psychological Therapies” (CYP/IAPT) services seem to be thus far unknown.
The Unseen Struggles of Mental Health Professionals
It might not come as a surprise, but many mental health professionals face significant challenges with their own mental health. In their study, Tai et al. (2018) assessed the prevalence of personal experiences of mental health problems among clinical psychologists, concluding that such experiences are common, with two-thirds of participants reporting mental health issues themselves.
Another study by Westwood et al. (2017) highlighted the significant prevalence of burnout in mental health professionals, particularly within the Improving Access to Psychological Therapies (IAPT) program. The study found that nearly 69% of Psychological Wellbeing Practitioners (PWPs) and 50% of high-intensity (HI) therapists experience burnout. Factors such as overtime hours were linked to higher burnout rates among PWPs, while increased clinical supervision appeared to reduce burnout risk.
It is hypothesised that emotional labour involved in empathising with clients can drain a therapist’s mental and emotional resources, leaving us vulnerable to these mental health challenges. For example, Gilroy, Carroll, and Murra (2002) found that nearly half of the psychotherapists they surveyed reported experiencing symptoms of depression at some point in their careers.
Understanding Stress, Burnout, and Compassion Fatigue: Is It All the Same?
While often used interchangeably in colloquial language, compassion fatigue, burnout, and stress appear to remain separate constructs in the literature and can affect mental health professionals in different ways:
- Stress is the body’s response to demands or pressures, and it’s usually temporary. While stress can sometimes drive us to accomplish tasks (being associated with heightened emotions), ongoing stress without relief can lead to burnout or compassion fatigue.
- Burnout develops over time as a result of prolonged stress. It’s marked by feelings of exhaustion, detachment, and a decline in personal achievement. Burnout can leave professionals feeling drained and disconnected from the work they once found fulfilling.
- Compassion Fatigue is a type of burnout that stems specifically from the emotional impact of caring for others who are suffering. As Figley (2002a) explains, constantly empathising with others can lead to emotional exhaustion and a reduced ability to feel compassion.
Why are we not seeking help?
According to a survey by the American Psychological Association (APA, 2000), almost half of those experiencing mental health issues do not reach out for support.
A study by Edwards and Crisp (2016) highlights several significant barriers (e.g. confidentiality, stigma and career implications) that prevent mental health professionals from seeking help for their own psychological distress. Despite having good mental health literacy and personal experience with mental illness, many professionals prefer to handle their issues independently. The study concludes that barriers to seeking support are significant and require further attention, suggesting that future research should focus on understanding them and the attitudes that contribute to them.
In the mental health field, there seems to be a paradox: those who dedicate their lives to supporting others often struggle to seek support for their own mental health challenges. Despite advances in mental health awareness, stigma remains pervasive within professional circles.
There seems to be an unspoken expectation that those in the profession should have it all together, creating a divide between the “helpers” and the “helped.” This mindset can make it difficult for professionals to admit when they are struggling, for fear of being seen as professionally weak or incapable.
Additionally, many therapists worry that discussing their own mental health challenges could negatively impact their practice. They may feel that disclosing these issues could undermine their credibility or disrupt the therapeutic relationship with their clients.
Is There Anything I Can Do?
Striking a balance between caring for ourselves and others can be challenging, but as practitioners, we have a responsibility to prioritise our own well-being. It’s crucial to invest the same dedication in self-care that we advocate for our clients.
Creating an open dialogue about mental health challenges among professionals requires collective effort. The culture within health and mental health professions often equates mental health problems with weakness, fostering the belief that professionals should be mentally resilient and capable of managing on their own (Tai et al., 2018).
While some of the issues contributing to burnout among mental health professionals need to be addressed at a systemic level—such as workload management and the availability of adequate supervision—practitioners can and should take proactive steps to safeguard our own mental health.
Research suggests that self-compassion plays a vital role in reducing burnout and improving overall well-being (Beaumont, 2015; Zessin et al., 2015). By treating ourselves with the same kindness and understanding that we offer our clients, practitioners can mitigate the negative effects of stress and compassion fatigue (Neff, 2003; Beaumont et al., 2016).
Developing Self-Compassion as a Practitioner
- Engage in Therapy: For some, learning self-compassion might start with seeking therapy themselves. Just as we encourage clients to engage in therapy to explore emotions and develop coping strategies, practitioners can benefit from working with a therapist to address their own needs.
- Mindful Self-Compassion Programmes: Participating in a structured programme like Mindful Self-Compassion (MSC) could be beneficial. These programmes, often available as workshops or online courses, teach techniques such as guided meditations, self-compassion exercises, and reflective journaling that help integrate self-compassion into daily life.
- Read and Reflect: Reading books on self-compassion is another practical way to develop this skill. For example, in his book The Compassionate Mind, Professor Paul Gilbert outlines research findings on the value of compassion and proposes basic mind training exercises to enhance the capacity for, and use of, compassion.
Additionally, to create a healthier work environment, it’s vital to challenge the stigma surrounding mental health within the profession. By fostering open conversations and encouraging mental health professionals to seek the support they need, we can ensure that those who care for others are also cared for themselves. Prioritising self-care is not just important—it’s essential for sustaining the ability to help others effectively.
References
- American Psychological Association. (2000). Professional health and well-being for psychologists. Retrieved from https://www.psychpage.com/ethics/wellness.pdf
- Beaumont, E., Durkin, M., Hollins Martin, C. J., & Carson, J. (2016). Measuring relationships between self-compassion, compassion fatigue, burnout, and well-being in trainee counsellors and trainee cognitive behavioural psychotherapists: A quantitative survey.Counselling and Psychotherapy Research, 16(1), 15-23.
- Edwards, J. L., & Crisp, D. A. (2016). Seeking help for psychological distress: Barriers for mental health professionals. Australian Psychologist, 51(3), 218-225. https://doi.org/10.1111/ap.12174
- Figley, C. R. (2002a). Compassion fatigue: Psychotherapists’ chronic lack of self-care. Journal of Clinical Psychology, 58(11), 1433–1441. https://doi.org/10.1002/jclp.10090
- Gilroy, P. J., Carroll, L., & Murra, J. (2002). A preliminary survey of counseling psychologists’ personal experiences with depression and treatment. Professional Psychology: Research and Practice, 33(4), 402–407. https://doi.org/10.1037/0735-7028.33.4.402
- McCann, I. L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3(1), 131-149. https://doi.org/10.1007/BF00975140
- Pope, K. S., & Tabachnick, B. G. (1994). Therapists as survivors of client suicide. Professional Psychology: Research and Practice, 25(4), 338–344. https://doi.org/10.1037/0735-7028.25.4.338
- Rupert, P. A., & Morgan, D. J. (2005). Work setting and burnout among professional psychologists. Professional Psychology: Research and Practice, 36(5), 544-550. https://doi.org/10.1037/0735-7028.36.5.544
- Sherman, M. D., & Thelen, M. H. (1998). Distress and professional impairment due to substance abuse among rural and urban psychologists. Professional Psychology: Research and Practice, 29(1), 63-68. https://doi.org/10.1037/0735-7028.29.1.63
- Tai, S., Alcock, K., & Scior, K. (2018). Mental health problems among clinical psychologists: Stigma and its impact on disclosure and help-seeking. Journal of Clinical Psychology, 74(9), 1545–1555. https://doi.org/10.1002/jclp.22614
- Westwood, S., Morison, L., Allt, J., & Holmes, N. (2017). Predictors of emotional exhaustion, disengagement, and burnout among improving access to psychological therapies (IAPT) practitioners. Journal of Mental Health, 26(2), 172-180. https://doi.org/10.1080/09638237.2016.1276540
- Zessin, U., Dickhäuser, O., & Garbade, S. (2015). The relationship between self-compassion and well-being: A meta-analysis. Applied Psychology: Health and Well-Being, 7(3), 340–364. https://doi.org/10.1111/aphw.12051