Compassion fatigue is treated with a mix of professional counseling, skills based therapy, rest, and support from people who understand your work. If the signs last more than two weeks or are hurting your daily life, SAMHSA advises seeking professional help. This guide covers how to tell what you are dealing with, which treatments have research behind them, how support groups differ from therapy groups, and how to check your PPO benefits if you live in California.
TL;DR
- Compassion fatigue combines burnout with secondary traumatic stress, which comes from hearing about or witnessing other people's trauma.
- Cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) have a strong evidence base for the stress related symptoms that come with it.
- A support group is not treatment. Group therapy is treatment led by a licensed mental health professional.
- Rest and self care help, but signs that last more than two weeks call for a conversation with a professional.
- Many California PPO plans include out of network mental health benefits. Check yours before you book.
Table of Contents
- What compassion fatigue is, and what it feels like
- When self care is enough and when to get treatment
- Treatment options with research behind them
- Support group or therapy group: which do you need?
- Our perspective
- What treatment can look like at Kin Wellness
- Preventing compassion fatigue at work and at home
- Using PPO benefits for counseling in California
- FAQ
- Sources
What compassion fatigue is, and what it feels like
SAMHSA describes compassion fatigue as a combination of burnout and secondary traumatic stress. Burnout brings exhaustion, a cynical attitude toward work, and a sense that you are not doing well. Secondary traumatic stress can follow when you hear about trauma that others lived through, especially from many people over time.
The concept comes from Charles Figley, PhD, who studied trauma workers and mental health professionals who seemed to take on the effects of trauma through their clients. That is why nurses, physicians, therapists, first responders, social workers, and caregivers at home are so often affected.
Common signs from SAMHSA's material include:
- Helplessness, extreme tiredness, feeling overwhelmed, frustration, cynicism, anger, and irritability
- Disorientation or confusion
- Physical effects such as headaches, heart palpitations, trouble falling asleep, and muscle tension
SAMHSA's guidance for healthcare professionals adds a stronger startle response, trouble making decisions, intrusive thoughts about patients, feeling cut off from colleagues, reduced empathy, avoiding reminders of upsetting events, and more alcohol or drug use. The APA notes that unusually intense feelings can be an early warning, such as feeling too close to a patient, stretching boundaries, or feeling apathetic.
How it differs from burnout
The two overlap, and people often use the words as if they were the same. WebMD explains that burnout is a cumulative sense of fatigue or dissatisfaction, while compassion fatigue is a more specific experience tied to stressful environments, limited resources, or long hours. If you want a closer comparison, our guide on compassion fatigue versus burnout walks through it for caregivers.
You may also hear about four stages. Verywell Mind describes Figley's four stage model: empathetic ability, empathetic response, compassion stress, and compassion fatigue. It is a useful way to picture how caring can slowly turn into depletion. It is not a diagnostic checklist, and you do not need to match a stage to deserve help.
When self care is enough and when to get treatment
Everyone has hard weeks. Treatment becomes the right step when the pattern does not lift. Consider reaching out to a licensed therapist or a prescriber when:
- The signs above have lasted more than two weeks, or they are affecting your quality of life, which is the threshold SAMHSA gives.
- Sleep is disrupted most nights, or you dread going to work in a way that feels physical.
- You avoid reminders of difficult cases, or intrusive thoughts about patients or clients keep returning.
- You are drinking or using other substances more to cope.
- Weekly rest, time off, and talking with friends are no longer enough.
If you are having thoughts of harming yourself, call or text 988, the Suicide and Crisis Lifeline, or call 911. Kin Wellness does not provide crisis services, so these lines are the right place for urgent help.
Treatment options with research behind them
No single protocol fits everyone. Most plans combine a few of the following, matched to what is driving the symptoms.
CBT and ACT
Paiva-Salisbury and Schwanz, writing in 2022, state that CBT and ACT have a strong evidence base for treating symptoms related to stress, posttraumatic stress, depression, anxiety, and occupational stress. They describe the aims of treating compassion fatigue as awareness, identifying current self care and unhelpful thinking and behavior patterns, building skills, addressing barriers, problem solving, and planning ahead.
In practice, that can mean learning to spot the thoughts that keep you working past your limits, practicing ways to step back from them, and clarifying what matters to you so your choices at work and home line up with it. Our article on CBT for burnout explains what sessions look like.
Resilience focused programs
A 2016 systematic review by Cocker and Joss found that the most promising trend was for interventions with an element that teaches or builds resilience. All of those showed improvement in burnout, and two also reduced secondary traumatic stress. The review also describes the Accelerated Recovery Program developed by Gentry and colleagues, a five session model built around resilience and self efficacy. Findings like these are about groups of studies, not promises for any one person.
Reflection and supervision
The APA reports that research points to reflection as an important first step: a deliberate, critical look at your own work experiences to gain insight and self awareness. Reflective journaling is one way to do it. The APA also describes peer consultation and supervision as a critical tool, including weekly 90 minute team meetings to discuss cases and seek support.
Trauma focused therapy
When the problem includes intrusive images, avoidance, or startle responses, trauma focused care may be part of the plan. EMDR is one such approach, and we offer it, by video or in person. You can read more on our EMDR therapy page, and our post on trauma therapy for clinicians covers how it fits into care for healthcare workers.
Medication management
There is no medication for compassion fatigue itself. But sleep problems, anxiety, or depression that travel with it may be worth discussing with a prescriber. Talk with your prescriber before starting, stopping, or changing any medication. Our medication management page describes how that works with us.
Self care that supports treatment
The U.S. Department of Defense's Psychological Health Center of Excellence recommends physical wellness habits, supportive relationships, work life balance, and firm emotional boundaries. SAMHSA lists four core parts of resilience: adequate sleep, healthy eating, regular physical activity, and active relaxation. These habits matter, but they work best alongside support rather than in place of it.
Self compassion deserves a mention too. American Nurse Journal reports that practices aimed at building self compassion may help prevent and reduce compassion fatigue. It involves mindfulness, self kindness, and a sense of common humanity. Unlike a spa day, it can be used in the middle of a shift. For more on prevention in clinical roles, this piece on how psychiatric nurses cope with burnout covers practices that support physical wellness and resilience.
Support group or therapy group: which do you need?
This is one of the most common questions, and the difference is real.
| Support group | Therapy group | |
|---|---|---|
| Purpose | Shared experience, belonging, practical tips | Mental health treatment |
| Led by | Peers or a clinician | A licensed mental health professional |
| Treatment? | No, though it can enhance treatment | Yes |
| Cost and coverage | Often free or low cost | Usually costs money and can often be covered by insurance |
| Best when | You want to feel less alone | Symptoms are affecting sleep, work, mood, or relationships |
The table follows the definitions from Marla Deibler, PsyD, for ADAA: support groups are not treatment but can enhance it and help people feel less alone, while group therapy is guided by a licensed provider for people with similar conditions. Mayo Clinic makes the same distinction, noting that support groups let people share stories, feelings, and coping approaches, whereas group therapy is treatment led by mental health professionals.
A third format shows up in hospitals. The Center for Advancing Practice in Care describes well being debriefings as informal, peer facilitated small group meetings that are not therapy. They help normalize the emotional reactions that come with draining work.
The same logic applies to grief. A grief support group offers company from people who have lost someone. Grief counseling is treatment with a clinician. Many people use both, and one does not replace the other. If grief is part of what you carry from your work, our page on burnout, grief, and life stress explains how we approach it.
A simple rule: if you mainly need to feel understood, a support group may be enough. If you have symptoms that persist and interfere with daily life, ask about group therapy or individual therapy. Our post on group therapy benefits for working adults goes into what the research on groups covers.
Our perspective
Compassion fatigue is rarely a character flaw. It tends to show up in people who care a great deal and who have been exposed to other people's pain for a long time, often without enough room to process it.
In our experience, weekly therapy fits some people well. Others need more structure than one hour a week can offer, especially when work keeps pulling them back into the same stress. That is why we built a virtual intensive outpatient program for adults in California. Groups meet by video for three hours, three to five days a week, in the morning or evening, so people can fit care around shifts and family life.
Our groups use DBT, CBT, and ACT skills. The program can include EMDR and medication management, and individual therapy can be added by video or in person in Fountain Valley. Care is provided by our clinical director (LCSW), our medical director (MD), and a team that includes a registered associate therapist working under clinical supervision.
We do not promise outcomes, because every person's path is different. What we can say is that you do not have to keep carrying this on willpower alone.
Kin Wellness Clinical Team
What treatment can look like at Kin Wellness
If weekly sessions have not been enough, or your schedule makes a standard clinic hard to reach, our virtual intensive outpatient program may be worth a look. It is for adults in California, including healthcare workers, executives, parents, and other working professionals. If you would rather start with one on one care, we also offer individual therapy by video or in person.
To see all of our services in one place, visit our services page. Kin Wellness does not treat eating disorders, a primary substance use disorder, or detox. If one of those is your main concern, a specialized program is the right fit. We do treat dual diagnosis when mental health is the main focus.
Preventing compassion fatigue at work and at home
Prevention is the first line of defense. Paiva-Salisbury and Schwanz note that prevention is the primary recommendation and that self care can lower secondary traumatic stress. A few habits stand out across the sources:
- Set emotional boundaries. Stay compassionate without taking on the other person's pain. Keep work at work when you can.
- Protect your relationships outside work. The health.mil guidance recommends investing in them and building strong ties with coworkers.
- Build regular contact with peers. Supervision, case consultation, or a staff support group gives hard experiences somewhere to go.
- Take real breaks. Time off and leisure are part of the work, not a reward for finishing it.
- Watch the stressors you carry in. Deborah Boyle, a nursing author, points out that problems like marital strain or caring for young children or aging parents can spill into work and may need counsel and support.
If you manage a team, Boyle also notes that work setting options include on site counseling and staff support groups, and that sessions in the evening, on weekends, or in retreat settings may draw better attendance. For a wider view of the workplace side, see our guide to healthcare worker burnout.
Using PPO benefits for counseling in California
Cost is often what stops people from starting. Here is a practical way to check coverage.
- Call the member services number on your insurance card. Ask whether your plan covers outpatient mental health services, including intensive outpatient programs and medication management.
- Ask about your network status. In plain terms: does the plan include out of network benefits, and what is the deductible and reimbursement percentage?
- Ask about prior authorization. Some services need approval before you start.
- Ask how claims work. Find out whether you pay up front and submit a claim, or whether the provider bills the plan.
- Ask the provider what billing support they offer. We provide insurance billing support and work with most PPO and HMO plans.
Kin Wellness does not accept Medi-Cal or Medicare. If you are covered by either, we are not the right fit, and your plan can point you to in network options.
FAQ
Can compassion fatigue be treated?
Yes. Counseling, skills based therapies such as CBT and ACT, peer consultation, rest, and healthy routines are all used. The best mix depends on your symptoms and your work. A licensed therapist can help you build a plan that fits.
How long does compassion fatigue last?
There is no standard timeline, and we cannot predict one for you. It depends on how long the exposure has gone on, what else is happening in your life, and what support you have. If signs persist beyond two weeks or affect your daily life, SAMHSA recommends professional help.
Is compassion fatigue the same as burnout?
Not exactly. Burnout is a broader sense of exhaustion and dissatisfaction with work. Compassion fatigue also includes secondary traumatic stress from exposure to others' trauma. They often occur together, and the same kinds of support can help with both.
What is the difference between a support group and group therapy?
A support group offers shared experience and belonging and may be led by peers. Group therapy is mental health treatment led by a licensed professional. Group therapy can often be covered by insurance, while support groups are typically not billed as treatment.
Should I see a therapist or a psychiatrist?
Most people start with a therapist. A prescriber can help if sleep, anxiety, or mood symptoms are severe. Talk with your prescriber before starting, stopping, or changing any medication.
If you would like to find out whether your plan covers care with us, you can check your insurance coverage and see your options.
Sources
- SAMHSA: Compassion Fatigue and Self-care Resources for Crisis Counselors
- SAMHSA: Tips for Healthcare Professionals
- APA: Addressing compassion fatigue
- WebMD: Compassion Fatigue Symptoms
- Verywell Mind: Compassion Fatigue
- Paiva-Salisbury and Schwanz: Building Compassion Fatigue Resilience
- Cocker and Joss: Compassion Fatigue among Healthcare, Emergency and Community Workers
- ADAA: Understanding Group Therapy and Support Groups
- Mayo Clinic: Support groups
- CAPC: Well Being Debriefings for Health Care Workers
- Psychological Health Center of Excellence: Understanding Burnout
- American Nurse Journal: Prevent compassion fatigue through self compassion
- OJIN: Countering Compassion Fatigue
- Nursing Science: PMHNP Burnout
Recommended
- Compassion Fatigue vs Burnout: What Caregivers Need to Know
- CBT for Burnout: How It Works and What to Expect
- Moral Injury Treatment: Therapies, Steps, and Support
- Healthcare Worker Burnout: A Guide for Clinicians & Managers
Clinically reviewed by Angelina DeSanto, LCSW, Clinical Director at Kin Wellness. This article is for general information only and is not medical or mental health advice. Kin Wellness serves adults in California. If you are in crisis, call or text 988, or call 911 in an emergency.