Stress and Grief Reactions among Rehabilitation Professionals: Dealing Effectively with Empathy Fatigue

Abstract

Many rehabilitation counselors are exposed to counseling-related activities in which they must be empathically available to individuals and family members who are survivors of a variety of chronic illnesses, traumatic, and life-threatening disabilities. Professional rehabilitation counselors are compelled by ethical obligation to sometimes sacrifice their needs for needs of their clients. The nature of beneficent actions by rehabilitation counselors are clearly pronounced in Code of Professional Ethics for Counselors (1987) which reads: Rehabilitation counselors shall endeavor at all times to place their clients' interest above their own (p. 27). Regardless of how beneficent rehabilitation professionals may appear, lack of empathy, when working with persons with disabilities, will greatly diminish counselor's ability and obligation to act in a manner that promotes well-being of others (Rubin & Roessler, 1995). Consequently, as rehabilitation counselors are compassionate and in their service to others, there appears to be a state of emotional, mental and physical exhaustion that may occur as counselors' wounds are revisited by issues raised concerning their client's life stories and experience of disability. The concept and phenomenon of was first introduced by Joinson (1992) in nursing literature. This concept, which was expanded in psychology and trauma stress literature by Figley (1995), may assist rehabilitation counselors in describing state of emotional, mental, physical exhaustion, and secondary stress reaction that occurs during therapeutic interactions with persons who have experienced traumatic life events. Figley's (1995) wellspring of research illustrates how compassion fatigue among professional counselors is identical to secondary traumatic stress disorder (STSD) and is equivalent to post-traumatic stress disorder (PTSD) in terms of its symptomatology. Because compassion fatigue has been recognized as a form of professional burnout, this condition may manifest itself within helping relationship as a pattern of secondary traumatic stress (STS; Figley, 1993). To date, rehabilitation literature has not addressed issues related to compassion fatigue. Rather, this concept, as it relates to rehabilitation counseling and administration, has been discussed in terms of phenomenon of Burnout has been described as a syndrome of cumulative physical and emotional stress that is observed among rehabilitation professionals who work in organizations that serve persons with chronic and several disabilities (Blankertz & Robinson, 1996; Cranswick, 1997; Gomez & Michaelis, 1995; Riggar, Godley, & Hafer, 1984; Vash, 1980). The term will be used in this article because historically, considerable attention has been given to developing skills of empathy as a fundamental tool and resource for preparation of masters-level rehabilitation counselors-in-training (Stebnicki, 1998). As Rogers (1980) emphasizes, the ideal therapist is, first of all, empathic (p. 146). Empathy as a way of being is foundation for establishing and building working alliance within client-center models of counseling and is necessary for working with psychosocial aspects of adjustment and adaptation to disability. Empathy fatigue transcends experience of professional burnout. The experience of burnout emerges gradually within individual and results in cumulative emotional and physical exhaustion. Compassion fatigue (Figley, 1995) or empathy fatigue, as described here, can emerge suddenly with little warning as an unhealthy form of countertransference or STS. If professional helpers are not empathically available to persons they serve, then there should be little concern for influences of STS reactions or compassion fatigue (Figley, 1995). …

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