Provider Self-care

Compared to their civilian counterparts, military mental health providers are at higher risk of burnout and compassion fatigue.[ Reference 1 ] Recognizing the early warning signs of compassion fatigue and burnout and implementing self-care strategies are key to maintaining wellness and providing sound patient care.

Compassion Fatigue

Compassion fatigue, also called the “cost for caring,” refers to physical and mental exhaustion and emotional withdrawal that is sometimes experienced by those who care for individuals in distress.[ Reference 2 ]

Signs and Symptoms [ Reference 2 ], [ Reference 3 ]

  • Reduced empathy
  • Intrusive imagery or dissociation
  • Increased use of drugs and alcohol
  • Difficulty sleeping
  • Impaired decision-making
  • Headaches
  • Hypersensitivity to emotional material
  • Increased irritability, anger, or anxiety
  • Emotional and/or physical exhaustion
  • Symptoms of depression
  • Strained relationships

Risk Factors for Compassion Fatigue[ Reference 2 ], [ Reference 4 ], [ Reference 5 ]

  • Personal life circumstances
  • Inadequate self-care
  • Work environment
  • High empathy
  • Gender (women are at higher risk)
  • Personal history of trauma
  • Lack of supportive social network
  • Clients with posttraumatic stress disorder
  • Early career status

Burnout

Burnout is a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress.[ Reference 2 ]Providers with large, high-severity caseloads are at particularly high risk for burnout. [ Reference 6 ], [ Reference 7 ] Additional provider risk factors include having excessively high expectations of oneself, feeling inadequate or incompetent, feeling unappreciated for one’s work efforts, and believing that one is expected to do more than is reasonable.[ Reference 8 ], [ Reference 9 ]

Signs and Symptoms [ Reference 2 ], [ Reference 10 ], [ Reference 11 ]

Physical

  • Constantly feeling tired and drained
  • Lowered immunity, increased illness
  • Reduced efficiency and energy
  • Frequent headaches or muscle pain
  • Changes in appetite or sleep habits
  • Irritability

Emotional

  • Sense of failure and self-doubt
  • Feeling helpless, trapped, and defeated
  • Feeling detached
  • Increasingly cynical and negative outlook
  • Decreased satisfaction and sense of accomplishment

Behavioral

  • Withdrawing from responsibilities
  • Isolating oneself from others
  • Procrastinating, taking longer to get things done
  • Using food, drugs, or alcohol to cope
  • Taking out frustrations on others
  • Increased work absenteeism

Work-related

  • Feeling like one has little or no control over one’s work
  • Lack of recognition for good work
  • Working too much, without enough time for socializing or relaxing
  • Increased errors
  • Decreased motivation

Self-care Strategies

Practicing self-care, which can help to alleviate the effects of workplace stressors, can potentially protect against compassion fatigue and burnout. The ability to recover from stressful experiences is a skill that can be learned and cultivated and implementing effective self-care strategies can help providers return to their pre-stressor state, often even stronger than before.[ Reference 12 ], [ Reference 13 ], [ Reference 14 ]

Self-care practices should be tailored to each individual’s needs and preferences. Providers can focus efforts according to these broad themes and implement strategies to protect themselves from burnout and compassion fatigue.[ Reference 2 ], [ Reference 4 ], [ Reference 11 ], [ Reference 15 ]

Focus on Physical Wellness

  • Eat a balanced and nutritious diet
  • Engage in relaxation (meditation, listening to music, etc.)
  • Exercise regularly
  • Avoid alcohol and drugs
  • Establish restful sleeping habits
  • Practice mindfullness and self-awareness

Maintain and Cultivate Supportive Relationships

  • Invest in relationships outside of work
  • Nurture social support networks
  • Cultivate strong working relationships with co-workers

Establish Work-life Balance

  • Make time for leisure activities
  • Keep work at work
  • Take a break/vacation

Set Emotional Boundaries

  • Establish protective/firm emotional boundaries
  • Remain compassionate without taking on patients’ pain
  • Honor your emotional needs

Seek Professional Support

Resources

The following resources can support leaders and providers in addressing compassion fatigue and burnout.

  • Burnout Self-Assessment Tool This self-assessment tool for providers from the American Psychological Association also provides a list of resources.
  • Colleague Assistance and Self-care This page on the American Psychological Association website offers discussion and resources on stressors faced by psychologists might face and provides ideas on how to talk to a colleague who might need help.
  • Compassion Fatigue Awareness This website from the Compassion Fatigue Awareness Project provides information and resources on compassion fatigue.