Compassion fatigue and burnout are unique risk factors faced by the helping professions. Compassion fatigue occurs when therapists experience reduced empathy and compassion for others due to physical and emotional exhaustion. This can be distressing for therapists, as high levels of empathy are often a factor that leads individuals to the helping profession in the first place. Compassion fatigue is also referred to as secondary or vicarious trauma, as it is common in trauma therapists who may be especially vulnerable due to assisting with trauma processing or desensitization frequently over long periods of time. Therapists experiencing compassion fatigue will experience negative emotions about their clients.

Burnout refers to general exhaustion and a lack of interest or motivation in one’s work. Therapists experiencing burnout may avoid work, arrive late, leave early, and are much more likely to break ethical boundaries in their profession (Simionata and Simpson, 2018). When it comes to psychiatry, a 2020 study by Summers and associates at the University of Pennsylvania found that 78% of psychiatrists in their sample met criteria for burnout, and 16% met criteria for major depressive disorder. In this particular study, full time scheduling, younger age, lack of control over scheduling and non-academic work settings were all associated with higher levels of burnout.

The research is clear: therapists and psychiatrists alike are highly susceptible to burnout and compassion fatigue. This comes at a great cost, as both are associated with poorer client outcomes. Clients working with a therapist who is experiencing burnout of compassion fatigue have poorer treatment outcomes than those working with healthy therapists (Delgadillo, Saxon & Barkham, 2018) Burnout and compassion fatigue are ethical issues facing the profession. In addition to reduced clinical effectiveness, Delgaadillo, Saxon and Barkham also associated burnout and compassion fatigue with poorer physical and mental health outcomes for therapists as well as to reports of therapist misconduct.

Psychedelic medicines place clients in a highly vulnerable state. Changes to their perception, time orientation and consciousness all occur. It could be argued that self-care is even more important among psychedelic therapists given the vulnerability of their client population during plant medicine journeys. Transference and counter transference issues can also occur during ceremonial treatments, so therapist wellness is of the utmost importance. Ethically, therapists who are considering this type of work must ensure they are taking the time to “help the helper” not only in the interest of their own mental and physical health outcomes, but also for the safety of their clients and the clinical effectiveness of their work.

ATMA is developing self care programs, workshops and activities for healthcare professionals, so that you can continue to provide effective care to your clients.