"Empathic Discernment " by Dr. Charles Figley

Empathic Discernment: The Key to Preventing Compassion Fatigue
Charles R. Figley, Ph.D.
Professor and the Henry Kurzweg, MD Chair in Disaster Mental Health
Tulane University School of Social Work, New Orleans, USA

Purpose:
Recognize and avoid the Compassion Fatigue and promote resilience
Caring as much for ourselves as we care for the traumatized
Appreciate the importance of empathic discernment for both.

Objectives:
Appreciate the various sources of stress among counselors including the demand to be compassionate with suffering clients – especially fellow survivors of Katrina.
Define the critical concepts, including empathic discernment.
Describe two useful models for predicting compassion fatigue and the role of empathic discernment.
Note the various ways counselors cope with these demands – effectively and ineffectively.
Be better prepared to prevent and be resilient in a post-Katrina work environment.

Working with the suffering requires compassion
Compassion requires empathy, interest, and contact
Exposure to clients’ distress can be distressing for the caregiver, particularly if the distress is associated with the counselor’s own experiences.
4
Basic Caregiver Resilience Assumptions

Basic Assumptions (cont.)
Exposure can also be inspiring. The services provided generate a sense of pride and satisfaction.
Most counselors have the ability to survive, be resilient, and thrive
Resilience is the antidote to compassion fatigue.
5

Definitions of Critical Concepts
Work-related stress: The demands of one’s job that are applied in the work setting but affect other settings as well.
Caregiver Resilience: The tendency to cope with the work-related stress naturally or through the help of others (organization and or colleagues, friends, and family

Psychological Burnout:
the experience of long-term exhaustion and diminished interest in one’s work that is most often corrected by changing work settings or clients (Altman & Jackson, 2005).

Compassion stress
The perceived demands derived from experiencing the suffering of others and wanting to help relieve their suffering in some way (Figley, 1995; 2002)

Compassion Satisfaction
The perceived joys derived from experiencing the suffering of others and succeeding in helping to relieve their suffering in some way (Figley, 2002)

Empathic Discernment
Effectiveness in accurately selecting and using the best empathic response for both client and self (Radey & Figley, 2007)

Compassion Fatigue (CF) is
the experience of short-term exhaustion and traumatic stress reactions associated with exposure to the suffering one’s clients(Boscarino, Figley & Adams, 2004).

Plain old job burnout stems from dissatisfaction with the work environment
Vs
compassion fatigue stems from absorbing the suffering of clients

Empathic Discernmentis the key ingredient for
Avoiding both burnout and compassion fatigue
A case example: Animal caregivers

Humane Society of the US
Organization dedicated to helping and managing abused, neglected, and abandoned animals
Members of the animal care community include those who rescue animals, care for their medical and psychological needs, or who must euthanize them.
Here is a short film about compassion fatigue

Compassion Fatigue Research
Example of the Animal Care Community research (2003-2006)
Resulting in a book
and a short film

National sample of animal care workers (Roop & Figley, 2006) (cont.)
Compassion Fatigue risk
53.1% extremely high risk
12.4% high risk
11.9 %moderate risk
Burnout risk
45.6% extremely low
35.9% moderate risk
Compassion Satisfaction
43.0% good
21.4% high
3.9% extremely high

CF Theory: Based on more than 10 years of research
The following 11-factor model identifies the major factors contributing to compassion stress, fatigue, and management.

The Compassion Fatigue Process:

Implications
1. Compassion fatigue hurts counselors of the suffering
2. Compassion fatigue blues can be avoided or stopped
3. The way to do it is focusing on EMPATHIC DISCERNMENT

Figure 1: Transformation to compassion fatigue or compassion satisfaction: ROLE OF POSITIVE AFFECT (Radey & Figley, 2007)

(Positive) Affect
Provides essential foundation in meeting client needs (e.g., empathic response, therapeutic alliance)
as well as the caregiver needs (e.g., joy of service and its appreciation by all).

Figure 2: Transformation to compassion fatigue or compassion satisfaction: SELF CARE!

Self-care
Self-care involves
Self-monitoring
Social supportive monitoring
Utilizing an individually-designed and updated self-care plan
Following recognized standards of self-care

Self-care (cont.)
The negative consequences of poor self-care:
Harm to clients
Lowered compassion satisfaction
Harm to the caregiver’s health and relationships

Figure 2: Transformation to compassion fatigue or compassion satisfaction: Increasing RESOURCES (Radey & Figley, 2007)

Resources ARE IMPORTANT
They include Intellectual, unit morale, effective leadership, and physical resources
Intellectual resources includes helping and other practice skills

Resources (cont.)
Physical Resources from
Enhanced recreational resources
Opportunities to exercise
Good nutrition through the cafeteria
Contact with nature
Personal space and opportunities to use it

Figure 2: Transformation to compassion fatigue or compassion satisfaction: EMPATHIC DISCERNMENT (Radey & Figley, 2007)

Empathic Discernment
Helps in balancing and increasing three independent factors in the process of human services with the suffering: Resources, Affect, and Self-care (RAS)
It is the gateway to determining how much fatigue and satisfaction can be derived from the work of caregiving
Thus, empathic discernment ultimate is a measure of caregiver resilience

Stress Management Strategies for Enhancing Empathic Discernment

Stress Management Resiliency
In vivo (working with clients)
Breath-work
Self-talk
Physical movement (walking, bikes, basketball, etc.)

Stress Management Resiliency (cont.)
Between Clients at Work
Breathing Meditation
Prayer and Meditation
Visualization (e.g., safe place)
Dance and Other Kinesthetic Treatments

Stress Management Resiliency (cont.)
Journaling
Art Therapy
Music Therapy
Poetry Therapy
All hobbies and absorbing activities
Music and Other Creative Therapies

Treating Compassion Fatigue
Caregivers deserve as good a treatment as they are providing.
Most treatments of anxiety disorders are relevant for CF
The challenge is establishing and maintaining a strong therapeutic alliance with the caregiver client

September 2008
35
Treatment Implications
Focusing on Desensitization of the traumatized worker
Assessment of currently available approaches

Conclusions
1. You deserve as good a treatment as you provide the traumatized
2. Caring for yourself results in being a more effective
counselor,
Family member and friend, and
Human being

Questions, Answers, Discussion
Contact information:
CharlesFigley.Com
Figley@tulane.edu

"Empathic Discernment " by Dr. Charles Figley

by Tulane School of Social Work on Jun 22, 2009

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