home » compassion & empathy » compassion
Compassion Resources for Therapists & Counselors
Kenneth S. Pope, Ph.D., ABPP
PLEASE NOTE: I created this site to be fully accessible for people with disabilities:
—Please follow this link to change text size, color, or contrast
—Please follow this link for other accessibility functions for those with visual, mobility, and other disabilities.
I gathered following references to help therapists, counselors, and other clinicians who wish to keep abreast of the research, theory, and related literature on compassion.
Although there is a massive literature on compassion, I've focused mainly on works concerned with compassion in clinical training and practice. This literature addresses such issues as:
- methods to nurture clinicians' compassion
- preventing or coping with compassion fatigue
- increasing compassion in clinical decision-making
- the role of self-compassion in clinicians, clients, & treatment
- compassion-focused therapy
- compassion training's effects on neural plasticity, inflammation, etc.
- effects of compassion meditation
For those interested, I also maintain a web page on this site focusing on empathy resources.
75 Articles on Compassion in Clinical Contexts:
Au, T. M., et al. (2017). "Compassion-based therapy for trauma-related shame and posttraumatic stress: Initial evaluation using a multiple baseline design." Behavior Therapy 48(2): 207-221.
Excerpt: "The aim of this study was to develop a brief compassion-based therapy and assess its efficacy for reducing trauma-related shame and PTSD symptoms. Using a multiple baseline experimental design, the intervention was evaluated in a community sample of trauma-exposed adults (N = 10) with elevated trauma-related shame and PTSD symptoms. Participants completed weekly assessments during a 2-, 4-, or 6-week baseline phase and a 6-week treatment phase, and at 2 and 4 weeks after the intervention. By the end of treatment, 9 of 10 participants demonstrated reliable decreases in PTSD symptom severity, while 8 of 10 participants showed reliable reductions in shame. These improvements were maintained at 2- and 4-week follow-up. The intervention was also associated with improvements in self-compassion and self-blame. Participants reported high levels of satisfaction with the intervention."
Bell, T., et al. (2016). "Developing a compassionate internal supervisor: Compassion-focused therapy for trainee therapists." Clinical Psychology & Psychotherapy[in press].
Excerpt: " A training programme was developed for trainee cognitive-behavioural therapists using adapted versions of compassion-focused therapy interventions. The training focused on guided imagery exercises and reflective practices undertaken for a 4-week period. Seven trainee cognitive-behavioural therapists were interviewed, utilizing a semi-structured format, regarding their experience of the training programme. The resulting transcriptions were analysed using Interpretative Phenomenological Analysis (IPA). The analysis identified six super-ordinate themes: (1) the varied nature of the supervisor image, (2) blocks and their overcoming, (3) increased compassion and regulation of emotion, (4) impact on cognitive processes, (5) internalization and integration, and (6) professional and personal benefit. The themes describe the varied ways in which participants created and experienced their compassionate supervisor imagery. Working with the personal blocks encountered in the process provided participants with a deeper understanding of the nature of compassion and its potential to support them in their training, practice and personal lives. The process and impact of 'internalizing' a compassionate supervisory relationship is described by participants and then discussed for potential implications for psychotherapy training and self-practice."
Bibeau, M., et al. (2016). "Can compassion meditation contribute to the development of psychotherapists' empathy? A review." Mindfulness, 7(1): 255-263.
Excerpt: "Studies in neuroscience have shown that loving-kindness and compassion meditation actually change the brain in areas associated with positive emotions and empathy. Loving-kindness and compassion meditation training studies have shown positive impacts on a number of empathy-related variables such as altruism, positive regard, prosocial behavior, interpersonal relationships, as well as affective empathy and empathic accuracy. Moreover, loving-kindness and compassion meditation actually reduce negative affects associated to empathy for pain, thus reducing the risk of psychotherapists' burnout and enhancing their self-care.... Loving-kindness and compassion meditation would constitute an important and useful addition to every counselling or psychotherapy training curriculum."
Boellinghaus, I., et al. (2013). "Cultivating self-care and compassion in psychological therapists in training: The experience of practicing loving-kindness meditation." Training and Education in Professional Psychology 7(4): 267-277.
Excerpt: "Five master themes were identified: (a) engaging with the practice, (b) impact on self, (c) impact on relationships, (d) bringing compassion into the therapy room, and (e) integrating LKM into life. Participants perceived LKM to have led to increased self-awareness, compassion for self and others, and therapeutic presence and skills. At the same time, LKM was experienced as emotionally challenging. The findings suggest that it may be useful to offer LKM to TT as an approach to enhancing self-care and compassion, but that it should be taught with care, given its potential emotional impact."
Braehler, C., et al. (2013). "Exploring change processes in compassion focused therapy in psychosis: Results of a feasibility randomized controlled trial." British Journal of Clinical Psychology 52(2): 199-214.
Excerpt: "Findings support the feasibility of group CFT in psychosis and suggest that changes in compassion can be achieved, which appear to reduce depression in particular. This is the first randomized controlled evaluation of CFT.... Compassion focused therapy appears as a safe, acceptable, promising, and evolving intervention for promoting emotional recovery from psychosis."
Brill, M. and N. Nahmani (2017). "The presence of compassion in therapy." Clinical Social Work Journal 45(1): 10-21.
Excerpt: " The article examines the uniqueness of compassion as a healing element in current therapeutic processes. It aims to distinguish compassion from concepts such as pity, consolation, sympathy, and empathy, which have been attributed to it in the past. Despite their linkage, the emotional component in compassion is perceived as dominant in contrast to the applied cognitive ingredient in empathy. The essence of compassion in this article has been examined along three major directions: the definitions of compassion in therapy, in a concrete and applicable manner; the perception of compassion as an intersubjective concept of therapist–client relationships, and the absence of compassion components from therapeutic relationships, known as a 'compassion fatigue' process, and its implications. The implementation of compassion in therapy is illustrated through two case studies, each from a different life stage—a male in his seventies and a young woman in her thirties—each being treated according to a different theoretical approach: narrative and psychosocial. The essential presence of compassion and self-compassion in the fabric of the therapeutic relationship, as reflected in both illustrations, turns a spotlight onto the innovative dynamics of therapist–client relationships. The reciprocal component that evolves produces legitimacy to experience self-compassion, and the discovery of compassion on the part of the therapist enables the client to develop self-compassion."
Breines & Chen (2013). "Activating the inner caregiver: The role of support-giving schemas in increasing state self-compassion." Journal of Experimental Social Psychology 49(1): 58-64.
Excerpt: "In four experiments we examined the hypothesis that activating support-giving schemas can increase state self-compassion. In Experiments 1 and 2, participants first recalled a negative event (Experiment 1) or experienced a lab-based test failure (Experiment 2), then were randomly assigned to recall an experience of giving support to versus having fun with another person, and finally completed a measure of state self-compassion. Experiments 3 and 4 examined the effects of actually giving support to another person (via written advice), compared to not giving support or simply reading about another's problem, and assessed effort invested in writing a self-comforting statement, operationalized as statement length (Experiment 3), and self-reported self-compassion (Experiment 4). As predicted, both forms of support-giving schema activation increased self-compassion. Alternative explanations involving affect, self-esteem, and awareness of others' problems were addressed. These results suggest that one way to increase compassion for the self is to give it to others."
Brumley, D. (2012). "An island of compassion." J Pain Palliat Care Pharmacother 26(3): 271-273.
Excerpt: "This narrative describes the experience of a palliative care physician from Australia visiting the palliative care service at a cancer hospital in India."
Butler, L. D., et al. (2017). "Trauma, stress, and self-care in clinical training: Predictors of burnout, decline in health status, secondary traumatic stress symptoms, and compassion satisfaction." Psychological Trauma: Theory, Research, Practice, and Policy 9(4): 416-424.
Excerpt: " All students reported trauma exposures in their field placements and/or coursework, including retraumatization experiences that were associated with higher STSS and BO. Field stress and SC effort were both consistent predictors across outcomes. Higher field stress levels predicted higher BO and STSS, a greater likelihood of decline in HS, and lower CS. Lower SC effort was also associated with higher BO and STSS, and a greater likelihood of decline in HS, while higher SC effort predicted higher CS. Older students, those with traumatized field clients, and those whose field work addressed trauma, also reported higher CS.... These findings suggest that clinical training involving trauma content can be both rewarding and stressful, and may evoke distress in some trainees. Given that learning about and working with trauma are essential to adequate clinical training, the authors suggest adopting a trauma-informed approach within clinical training programs.
Caldwell, J. G. and P. R. Shaver (2015). "Promoting attachment-related mindfulness and compassion: A wait-list-controlled study of women who were mistreated during childhood." Mindfulness 6(3): 624-636.
Excerpt: "Taken together, the results suggest that the intervention led to increases in mindfulness, primarily due to decreased rumination and increased emotional clarity, and these treatment-related changes were specifically related to participants' thoughts and emotions regarding attachment."
Corso, V. M. (2012). "Oncology nurse as wounded healer: developing a compassion identity." Clin J Oncol Nurs 16(5): 448-450.
Excerpt: "Awareness of one's own fragility and the need to understand the connections between body, mind, and spirit can assist the clinician in developing a compassion identity that nurses and other clinicians can use to insulate themselves from the stressors of their difficult and rewarding environment."
Crawford, P., et al. (2013). "The language of compassion in acute mental health care." Qualitative Health Research 23(6): 719-727.
Excerpt: "We report on a corpus-assisted discourse analysis of 20 acute mental health practitioner interview narratives about compassion and find a striking depletion in the use of 'compassionate mentality' words, despite the topic focus. The language used by these practitioners placed more emphasis on time pressures, care processes, and organizational tensions in a way that might compromise best practice and point to the emergence of a 'production-line mentality.'"
Decker, J. T., et al. (2015). "Mindfulness, compassion fatigue, and compassion satisfaction among social work interns." Social Work & Christianity 42(1): 28-42.
Excerpt: "Data revealed that greater levels of mindfulness positively correlated with greater potential for compassion satisfaction (r = .46, p < .00) while lower levels of mindfulness increased a student's risk for compassion fatigue (r = -.53, p < .00). Results suggest that mindfulness may be an important variable in mitigating compassion fatigue and increasing compassion satisfaction for helping professionals."
Fernando, A. T., et al. (2017). "Increasing compassion in medical decision-making: Can a brief mindfulness intervention help?" Mindfulness 8(2): 276-285.
Excerpt: "ANCOVAs showed that mindfulness predicted greater patient "liking" and "caring" but only among persons lower in self-compassion. The mindfulness intervention predicted greater helping behaviour, but primarily among those with higher self-compassion. A brief mindfulness induction showed some promise in enhancing compassionate responses and behaviour among medical students. Mindfulness training may offer a means of sustaining and enhancing compassion among some medical professionals but further research is needed."
Fetter, K. L. (2012). "We Grieve Too: One Inpatient Oncology Unit's Interventions for Recognizing and Combating Compassion Fatigue." Clin J Oncol Nurs 16(6): 559-561.
Excerpt: "[The unit helped] the staff in the fight against compassion fatigue by implementing bereavement interventions in a community hospital's oncology unit."
Fulton, C. L. and C. S. Cashwell (2015). "Mindfulness-based awareness and compassion: Predictors of counselor empathy and anxiety." Counselor Education and Supervision 54(2): 122-133.
Excerpt: "Mindfulness-based awareness and compassion differentially contributed to explaining the variance in counselor empathy and anxiety. Implications for counselor education are discussed."
Gale et al. (2012). "An Evaluation of the Impact of Introducing Compassion Focused Therapy to a Standard Treatment Programme for People with Eating Disorders." Clin Psychol Psychother.
Excerpt: "This study demonstrates the potential benefits of using CFT with people with eating disorders and highlights the need for further research on this new approach.... CFT can be combined with standard therapies especially cognitive behavioural therapy. CFT can be especially useful in a group context where the relationships between members can become increasingly compassionate, validating, supportive and encouraging."
Gard et al. (2012). "Effects of a yoga-based intervention for young adults on quality of life and perceived stress: The potential mediating roles of mindfulness and self-compassion." The Journal of Positive Psychology 7(3): 165-175.
Excerpt: "Participation in the program predicted increases in quality of life and decreases in perceived stress, mediated by mindfulness and self-compassion. Multiple mediator models revealed that the effect of group on quality of life was simultaneously mediated by mindfulness and self-compassion, while the effect of group on perceived stress was only mediated by self-compassion."
Germer, C. K. and K. D. Neff (2013). "Self-compassion in clinical practice." Journal of Clinical Psychology 69(8): 856-867.
Excerpt: "Self-compassion is conceptualized as containing 3 core components: self-kindness versus self-judgment, common humanity versus isolation, and mindfulness versus overidentification, when relating to painful experiences. Research evidence demonstrates that self-compassion is related to psychological flourishing and reduced psychopathology. Mindful Self-Compassion (MSC) is an 8-week training program, meeting 2.5 hours each week, designed to help participants cultivate self-compassion. MSC contains a variety of meditations (e.g., loving-kindness, affectionate breathing) as well as informal practices for use in daily life (e.g., soothing touch, self-compassionate letter writing)."
Gilbert, P. (2014). "Compassion-focused therapy: Preface and introduction for special section." British Journal of Clinical Psychology 53(1): 1-5.
Excerpt: "The first article in this special edition on compassion-focused therapy (CFT) provides an overview of the basic psychological science that underpins the CFT model, including an exploration of social mentality theory and the significance of different evolved emotion regulation systems, especially those underpinning affiliation (Gilbert, 2014). The second article is by Gumley, Braehler, and Macbeth (2014) who explore the roles of affiliation in psychosis. People with these experiences can be especially vulnerable to feelings of isolation and internal states of hostility. Increasing interest is focused on one of the core hormones that underpin affiliation (oxytocin), and they offer an extensive review of this work. The article highlights the importance of thinking about and promoting affiliative processes in people with these difficulties."
Gilbert, P. (2014). "The origins and nature of compassion focused therapy." British Journal of Clinical Psychology 53(1): 6-41.
Excerpt: "CFT therefore highlights the importance of developing people's capacity to (mindfully) access, tolerate, and direct affiliative motives and emotions, for themselves and others, and cultivate inner compassion as a way for organizing our human 'tricky brain' in prosocial and mentally healthy ways."
Gleichgerrcht, E. and J. Decety (2014). "The relationships between different facets of empathy, pain perception and compassion fatigue among physicians." Frontiers in Behavioral Neuroscience.
Excerpt: "The effect of dispositional empathy on pain perception and induced personal distress was different for each sub-component, with perspective taking and empathic concern (EC) being predictive of the behavioral outcomes. Physicians who experience both compassion satisfaction and fatigue perceive more pain and suffer more personal distress from it than those who only suffer the negative aspects of professional quality of life. Conclusions: Professional experience seems to desensitize physicians to the pain of others without necessarily helping them down-regulate their own personal distress. Pain perception is also related with specific aspects of empathy and varies depending on context, as is the case with the gender of their patients. Minimum levels of empathy appear necessary to benefit from the positive aspects of professional quality of life in medicine."
Goss, K. and S. Allan (2014). "The development and application of compassion-focused therapy for eating disorders (CFT-E)." British Journal of Clinical Psychology 53(1): 62-77.
Excerpt: "CFT-E offers a promising treatment for adult outpatients who present to specialist eating disorder services with restricting and binge/purging eating disorders. Recent developments include treatment protocols for patients who are low weight and have an eating disorder and for those presenting with obesity."
Greenberg, J., et al. (2018). "Compassionate hearts protect against wandering minds: Self-compassion moderates the effect of mind-wandering on depression." Spirituality in Clinical Practice 5(3): 155-169.
Excerpt: "At baseline, mind-wandering was associated with higher depressive symptoms only among individuals with low self-compassion. Self-compassion additionally predicted depressive improvement. As expected, MBCT increased self-compassion and reduced mind-wandering compared with a treatment-as-usual control group. Overall, longitudinal changes in self-compassion produced a moderation effect similar to the one at baseline so that increases in mind-wandering were associated with increases in depressive symptoms only among those who decreased in self-compassion. Results provide the first evidence that self-compassion can protect against the deleterious effects of mind-wandering among depressed participants, both at baseline and longitudinally. Findings also suggest that self-compassion is an effective predictor of depressive improvement. Finally, MBCT is effective not only at reducing depressive symptoms, but also at targeting protective and risk factors associated with depression."
Howard, M. (2012). "The incidence of burnout or compassion fatigue in medical dosimetrists as a function of various stress and psychologic factors." Med Dosim.
Excerpt: "Results obtained indicated an incidence rates of burnout or CF for medical dosimetrists were less than the rates previously measured for radiation therapists (53% vs 11% for emotional exhaustion [EE] and 45% vs 27% for depersonalization [DP]).... Although not as prevalent among medical dosimetrists as a variety of additional radiation oncology professionals, a significant portion of the population demonstrated signs of burnout or CF."
Hunter, S. V. (2012). "Walking in sacred spaces in the therapeutic bond: therapists' experiences of compassion satisfaction coupled with the potential for vicarious traumatization." Fam Process 51(2): 179-192.
Excerpt: "Therapists described the importance of the 3 component parts of the therapeutic bond: the empathic connection between therapist and client; the role investment of the client; and the mutual affirmation experienced by both therapist and client in the therapeutic process. Walking in sacred spaces with the client was seen as both enriching and challenging for the therapist. The therapeutic bond gave therapists intense satisfaction and posed risks for them, especially when working with traumatic client experiences. However, the findings suggest that the experience of compassion satisfaction and the development of vicarious resilience counter-balanced the intense difficulty of bearing witness to clients' traumatic experiences and the potential for vicarious traumatization."
Jacobson, J. M. (2012). "Risk of compassion fatigue and burnout and potential for compassion satisfaction among employee assistance professionals: Protecting the workforce." Traumatology 18(3): 64-72.
Excerpt: "Results suggest EAP professionals are at moderate risk for compassion fatigue, low risk for burnout, and have high potential for compassion satisfaction."
Karnieli-Miller et al. (2013). "Cloak of compassion, or evidence of elitism? An empirical analysis of white coat ceremonies." Med Educ 47(1): 97-108.
Excerpt: "The WCCs studied did not celebrate the status of an elite class, but marked the beginning of educational, personal and professional formation processes and urged matriculants to develop into doctors 'worthy of trust'. The ceremonies centred on the persons entering the vocation, who were invited to affirm its calling and obligations by donning a symbolic garb, and to join an ancient and modern tradition of healing and immersion in their community. The schools' articulated construct of the white coat situated it as a symbol of humanism."
Kelly et al. (2012). "Self-compassion and fear of self-compassion interact to predict response to eating disorders treatment: A preliminary investigation." Psychother Res.
Excerpt: "At baseline, lower self-compassion and higher fear of self-compassion were associated with more shame and eating disorder pathology. Multilevel modeling also revealed that patients with combinations of low self-compassion and high fear of self-compassion at baseline had significantly poorer treatment responses, showing no significant change in shame or eating disorder symptoms over 12 weeks."
Keng et al. (2012). "Mechanisms of change in mindfulness-based stress reduction: Self-compassion and mindfulness as mediators of intervention outcomes." Journal of Cognitive Psychotherapy 26(3): 270-280.
Excerpt: "MBSR [mindfulness-based stress reduction] participants demonstrated significantly greater improvements in worry, fear of emotion, difficulties in emotion regulation, suppression of anger, and aggressive anger expression. Mediation analysis using bootstrap resampling indicated that increases in self-compassion mediated MBSR's effects on worry, controlling for change in mindfulness. Increases in mindfulness mediated the intervention's effects on difficulties in emotion regulation, controlling for change in self-compassion. Both variables mediated MBSR's effects on fear of emotion. These findings highlight the importance of mindfulness and self-compassion as key processes of change that underlie MBSR's outcomes."
Klimecki et al. (2012). "Functional Neural Plasticity and Associated Changes in Positive Affect After Compassion Training." Cereb Cortex.
Excerpt: "Whereas participants reacted with negative affect before training, compassion training increased positive affective experiences, even in response to witnessing others in distress. On the neural level, we observed that, compared with a memory control group, compassion training elicited activity in a neural network including the medial orbitofrontal cortex, putamen, pallidum, and ventral tegmental area-brain regions previously associated with positive affect and affiliation. Taken together, these findings suggest that the deliberate cultivation of compassion offers a new coping strategy that fosters positive affect even when confronted with the distress of others."
Krawitz, R. (2012). "Behavioural treatment of severe chronic self-loathing in people with borderline personality disorder. Part 2: self-compassion and other interventions." Australasian Psychiatry 20(6): 501-506.
Excerpt: "Self-compassion has promise as an intervention in the behavioural treatment of severe chronic self-loathing in people with BPD. Due to the challenges faced, it is useful for behavioural clinicians to have a range of flexible treatment approaches embedded into a coherent principled treatment in treating severe chronic self-loathing in people with BPD."
Krieger, T., et al. (2013). "Self-compassion in depression: Associations with depressive symptoms, rumination, and avoidance in depressed outpatients." Behavior Therapy 44(3): 501-513.
Excerpt: "Results indicate that depressed patients showed lower levels of self-compassion than never-depressed individuals, even when controlled for depressive symptoms. In depressed outpatients, self-compassion was negatively related to depressive symptoms, symptom-focused rumination, as well as cognitive and behavioral avoidance. Additionally, symptom-focused rumination and cognitive and behavioral avoidance mediated the relationship between self-compassion and depressive symptoms. These findings extend previous research on self-compassion, its relation to depression, as well as processes mediating this relationship, and highlight the importance of self-compassion in clinically depressed patients. Since depressed patients seem to have difficulties adopting a self-compassionate attitude, psychotherapists are well advised to explore and address how depressed patients treat themselves."
Lawrence, V. A. and D. Lee (2014). "An exploration of people's experiences of compassion-focused therapy for trauma, using interpretative phenomenological analysis." Clinical Psychology & Psychotherapy 21(6): 495-507.
Excerpt: "Five superordinate themes emerged from the data including: (1) the battle to give up the inner critic: who am I if I am not self-critical?; (2) an aversive and alien experience: how it feels to develop self-compassion; (3) the emotional experience of therapy; (4) self-compassion as a positive emotional experience; and (5) amore positive outlook in the present and for the future. Self-criticism formed an important part of the participants' self-identity, and they experienced an initially aversive emotional response to self-compassion, describing it as a completely new experience and one to be feared. Despite this, they were able to persist with therapy and subsequently experience positive emotional responses to self-compassion. They reported the therapeutic relationship as an important factor making this possible. Participants reflected on several reasons for the aversive nature of developing self-compassion, which are discussed. A process model of the journey from self-criticism to self-compassion is proposed."
Leaviss, J. and L. Uttley (2015). "Psychotherapeutic benefits of compassion-focused therapy: An early systematic review." Psychological Medicine 45(5): 927-945.
Excerpt: "The findings from the included studies were, in the most part, favourable to CFT, and in particular seemed to be effective for people who were high in self-criticism.... CFT shows promise as an intervention for mood disorders, particularly those high in self-criticism."
Liddell, A. E., et al. (2016). "Therapist competencies necessary for the delivery of compassion-focused therapy: A delphi study." Psychology and Psychotherapy: Theory, Research and Practice [in press]
Excerpt: "The CFT competency framework (CFT-CF) that was produced comprised 25 main competencies within six key areas of competence. The areas were as follows: competencies in creating safeness, meta-skills, non-phase-specific skills, phase-specific skills, knowledge and understanding and use of supervision. The main competencies included several subcompetencies specifying knowledge, skills and attributes needed to demonstrate the main competence. Overall, there was consensus on 14 competencies and 20 competencies exceeded an 80% agreement level."
Litz, B. and J. R. Carney (2018). "Employing loving-kindness meditation to promote self- and other-compassion among war veterans with posttraumatic stress disorder." Spirituality in Clinical Practice 5(3): 201-211.
Excerpt: "We described how we have recently incorporated compassion training in the form of Loving Kindness Meditation into an existing psychotherapy for war-related PTSD called Adaptive Disclosure. We provided background to support the assumption that targeting compassion deficits in war-related trauma may improve mental and behavioral health by helping patients engage in adaptive and potentially reparative behaviors, particularly improving social connections. We also described how compassion training may help veterans suffering from traumatic loss and moral injury, specifically. Throughout, we provide clinical heuristics that may help care providers who work with veterans who have experienced diverse war traumas."
Lolak, S. (2013). "Compassion cultivation: A missing piece in medical education." Academic Psychiatry 37(4): 285.
Excerpt: "Although there have been efforts to promote humanism, empathy and communication training in medicine, it is notable that little attention is paid to formally teaching physicians to cultivate compassion, a quality so central to our profession's identity. Scholars in the fields of psychology, social science, and contemplative neuroscience now have a better idea of how to measure compassion and its neurological underpinnings. To this end, systematic training programs for compassion cultivation, including compassion for oneself and others, should be integrated to the overall medical student curricula. More importantly, it should be maintained throughout clinical years by way of regularly scheduled classes that include a combination of reflection exercises, experiential practice, and interactive discussion."
Lown, B. A. (2016). "A social neuroscience-informed model for teaching and practising compassion in health care." Medical Education 50(3): 332-342.
Excerpt: " Empathy and compassion are important catalysts for the healing process, but some research suggests their decline during training and practice. Compassion involves recognition, understanding, emotional resonance and empathic concern for another's concerns, distress, pain and suffering, coupled with their acknowledgement, and motivation and relational action to ameliorate these conditions. Compassion, Altruism and Reward: Neuroscientists have identified neural networks that generate shared representations of directly experienced and observed feelings, sensations and actions. When shared representations evoke empathic concern or compassion for another's painful situation, humans experience altruistic motivation to help. The resulting behaviours are associated with activation of areas in the brain associated with affiliation and reward. Compassion Modulators: Activation of these neural networks is sensitive to multiple inter- and intrapersonal influences. These include the ability to focus one's attention, the ability to receive and accurately interpret input about distress, the perspective one adopts in order to understand another's experience, self-other boundary awareness, the degree to which one values another's welfare, the ability to recognise and regulate one's own emotions, the ability to attend to one's own wellbeing through self-care and self-compassion, effective communication skills, reflection and meta-cognition.... Current research suggests that compassion can be modulated through education and training and is associated with positive emotions, a sense of affiliation, reward and prosocial behaviours.... Education must be aligned with changes in clinical practice to sustain compassionate care."
Lucre, K. M. and N. Corten (2013). "An exploration of group compassion-focused therapy for personality disorder." Psychology and Psychotherapy: Theory, Research and Practice 86(4): 387-400.
Excerpt: "This 16-week group therapy was associated with significant reductions in shame measured by the Others as Shamer Scale (OAS), social comparison on the Social Comparison Scale (SCS) feelings of hating oneself, and an increase in abilities to be self-reassuring on the Self-Attacking and Self-Reassuring Scale (FSCRS), depression and stress measured by the Depression Anxiety and Stress Scale (DASS). There were significant changes on all CORE variables, well-being, risk, functioning, and problems. Also interesting was that all variables showed a trend for continued improvement at 1- year follow-up, albeit statistically non-significant. A content analysis revealed that patients had found it a moving and very significant process in their efforts to develop emotional regulation and self-understanding.... CFT, delivered in a routine psychotherapy department for personality disorders, revealed a beneficial impact on a range of outcome measures. These improvements were maintained and further changes noted at 1-year follow-up."
MacBeth & Gumley (2012). "Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology." Clin Psychol Rev 32(6): 545-552.
Excerpt: "We found a large effect size for the relationship between compassion and psychopathology of r=-0.54 (95% CI=-0.57 to -0.51; Z=-34.02; p<.0001).... Compassion is an important explanatory variable in understanding mental health and resilience."
Mascaro et al. (2013). "Compassion meditation enhances empathic accuracy and related neural activity." Soc Cogn Affect Neurosci 8(1): 48-55.
Excerpt: "Upon completion of the study interventions, participants randomized to CBCT and were significantly more likely than control subjects to have increased scores on the RMET [Reading the Mind in the Eyes Test] and increased neural activity in the inferior frontal gyrus (IFG) and dorsomedial prefrontal cortex (dmPFC). Moreover, changes in dmPFC and IFG activity from baseline to the post-intervention assessment were associated with changes in empathic accuracy. These findings suggest that CBCT may hold promise as a behavioral intervention for enhancing empathic accuracy and the neurobiology supporting it."
Merriman, J. (2015). "Enhancing counselor supervision through compassion fatigue education." Journal of Counseling & Development 93(3): 370-378.
Excerpt: "Providing education to interns on compassion fatigue and protective factors, such as self-care, can normalize struggles experienced by interns. Supervision provides a relationship to build skills to help prevent compassion fatigue. Interns should understand counselor developmental phases and the necessity of self-care plans.... Supervisors should focus on the purpose of supervision, activities of supervision, counselor developmental phases, and compassion fatigue education."
Miller, B. and G. Sprang (2017). "A components-based practice and supervision model for reducing compassion fatigue by affecting clinician experience." Traumatology 23(2): 153-164.
Excerpt: "Published approaches to compassion fatigue in psychotherapists typically emphasize clinician self-care strategies. Implicit in the self-care emphasis is the assumption that trauma therapy encounters are inherently fatiguing, and that recovery occurs during the clinician’s off-duty time. In contrast, the components for enhancing clinician engagement and reducing trauma (CE-CERT) model addresses the experience of the clinician concurrent with the treatment encounter. The clinical skill components are synthesized from evidence within the psychological treatment and neurophysiology literature relating to the management of difficult emotional states. The 5 proposed components are synthesized into an integrated model for the purpose of positively affecting the experience of clinicians during trauma treatment. We propose that effective use of these evidence informed strategies will allow the clinician to remain emotionally regulated during treatment and, will, therefore, reduce compassion fatigue. The 5 skill categories comprising the components of the CE-CERT model are experiential engagement, managing rumination, intentional narrative, reducing emotional labor, and parasympathetic recovery strategies. These skills are defined and evidence is provided to support their use within the model. The model has immediate application for clinical training and supervision and can be used as a basis for operational definitions for use in effectiveness trials."
Molinsky et al. (2012). "The bedside manner of homo economicus: How and why priming an economic schema reduces compassion." Organizational Behavior and Human Decision Processes 119(1): 27-37.
Excerpt: "Across three experiments, we show that unobtrusively priming economic schemas decreases the compassion that individuals express to others in need, that this effect is mediated by dampened feelings of empathy and heightened perceptions of unprofessionalism, and that it is circumscribed to bad news that has economic implications."
Montross-Thomas, L. P., et al. (2016). "Personally meaningful rituals: A way to increase compassion and decrease burnout among hospice staff and volunteers." Journal of Palliative Medicine 19(10): 1043-1050.
Excerpt: "Three hundred ninety hospice staff and volunteers from across 38 states completed the online survey.... The majority of hospice staff and volunteers used personally meaningful rituals after the death of their patients to help them cope (71%). Those who used rituals demonstrated significantly higher Compassion Satisfaction and significantly lower Burnout as measured by the ProQOL, with professional support, social support, and age playing significant roles as well."
Neff & Germer (2013). "A pilot study and randomized controlled trial of the mindful self-compassion program." J Clin Psychol 69(1): 28-44.
Excerpt: "Study 1 found significant pre/post gains in self-compassion, mindfulness, and various wellbeing outcomes. Study 2 found that compared with the control group, intervention participants reported significantly larger increases in self-compassion, mindfulness, and wellbeing. Gains were maintained at 6-month and 1-year follow-ups."
Newsome et al. (2012). "Mindfulness group work: Preventing stress and increasing self-compassion among helping professionals in training." Journal for Specialists in Group Work 37(4): 297-311.
Excerpt: "Perceived stress significantly decreased, and mindfulness and self-compassion significantly increased in response to the group."
O'Brien, J. L. and D. A. F. Haaga (2015). "Empathic accuracy and compassion fatigue among therapist trainees." Professional Psychology: Research and Practice 46(6): 414-420.
Excerpt: "Psychotherapists are in the challenging position of needing to (a) listen to traumatic self-disclosures well enough to form empathically accurate responses to clients and (b) keep such self-disclosures and their own emotional reactions to them private, without (c) becoming burned out or suffering excessively from compassion fatigue. To shed light on these phenomena, we compared trait empathy as well as empathic accuracy and compassion fatigue in response to a standard videotaped trauma self-disclosure among advanced (fourth-/fifth-year graduate students, n = 18) and novice (first-year graduate students, n = 18) therapist trainees and age- and gender-matched nontherapists (n = 36). As expected, therapist trainees reported substantially (d = .77) less compassion fatigue than did nontherapists, and the trainees were substantially (d = .81) more accurate on a multiple-choice empathic accuracy test. However, therapist trainees did not differ from nontherapists in trait empathy or on a free-response measure of empathic accuracy. Advanced trainees did not differ from novice trainees on any measure. These results tentatively suggest that therapist trainee resilience in managing the stress of receiving traumatic self-disclosure stems more from selection, than retention or training/experience effects."
Pace et al. (2012). "Engagement with Cognitively-Based Compassion Training is associated with reduced salivary C-reactive protein from before to after training in foster care program adolescents." Psychoneuroendocrinology.
Excerpt: "Engagement with CBCT may positively impact inflammatory measures relevant to health in adolescents at high risk for poor adult functioning as a result of significant ELA, including individuals placed in foster care."
Pirelli, G., et al. (2020). "Preventing vicarious trauma (VT), compassion fatigue (CF), and burnout (BO) in forensic mental health: Forensic psychology as exemplar." Professional Psychology: Research and Practice. Published online in advance of print publication.
Excerpt: "In this article, we address the concepts of vicarious trauma (VT), compassion fatigue (CF), and burnout (BO) within the context of forensic mental health. These are related, albeit distinct, concepts that have been used to describe patterns of negative emotional outcomes in various employment contexts. We begin with a general review and delineation of VT, CF, and BO before discussing these outcomes across professions. Then, we discuss these concepts in the specific context of forensic mental health to include how such issues can impact students, trainees, early career professionals (ECPs), supervisors and instructors, and practitioners. We then use the subfield of forensic psychology as exemplar, whereby we outline relevant research and address VT, CF, and BO within the context of criminal, civil, and administrative matters as well as treatment, teaching, and research contexts. Subsequently, we outline four areas of consideration for those working in the forensic arena, specifically, (a) identifying potential risk factors; (b) recognizing, developing, and strengthening protective factors; (c) overcoming self-care and treatment barriers; and (d) identifying and engaging in therapeutic interventions. Lastly, we set forth a formal call for research, which we believe is essential to the development of a more meaningful understanding of the connection between VT, CF, and BO in forensic mental health."
Potter, P., et al. (2015). "Compassion fatigue resiliency training: The experience of facilitators." The Journal of Continuing Education in Nursing 46(2): 83-88.
Excerpt: "All of the participants described one or more self-improvements as a result of the program, particularly in regard to emotional health. All of the participants also described how they regularly applied one or more of the resiliency skills taught in the class to improve their ability to manage stress and prevent compassion fatigue. This program shows promise in ameliorating compassion fatigue and burnout in health care providers."
Ray, S. L., et al. (2013). "Compassion satisfaction, compassion fatigue, work life conditions, and burnout among frontline mental health care professionals." Traumatology 19(4): 255-267.
Excerpt: "The aim of this nonexperimental, cross sectional study was to determine the relationships among compassion satisfaction (CS), compassion fatigue (CF), work life conditions and burnout among FMHPs.... Consistent with our hypothesis, higher levels of compassion satisfaction, lower levels of compassion fatigue, and higher overall degree of fit in the six areas of work life were predictive of lower burnout in FMHPs."
Reddy, S. D., et al. (2013). "Cognitive-Based Compassion Training: A promising prevention strategy for at-risk adolescents." Journal of Child and Family Studies 22(2): 219-230.
Excerpt: "Compared to the general population, youth in foster care experience multiple psychosocial difficulties due to exceptionally high rates of maltreatment. Many youth in care receive psychological and/or psychotropic treatment but not all require or are willing to accept that level of intervention. For many, a 'mental health' approach feels pathologizing. Nevertheless, these youth have suffered maltreatment and interventions to improve their ability to cope with past trauma and their often uncertain present are clearly needed. Cognitively-Based Compassion Training (CBCT) provides an alternative perspective on suffering and can be framed as a wellness intervention that is appropriate for all humans.... Seventy adolescents were randomized to CBCT (twice weekly) or a wait-list condition. Youth were assessed at baseline and after 6 weeks. Groups did not differ on measures of psychosocial functioning following training; however practice frequency was associated with increased hopefulness and a trend for a decrease in generalized anxiety. Qualitative results indicated that participants found CBCT useful for dealing with daily life stressors. Adolescents in care were willing to engage in CBCT. The majority reported CBCT was very helpful and almost all reported they would recommend CBCT to a friend. Participants reported specific instances of using CBCT strategies to regulate emotion, manage stress, or to respond more compassionately towards others. Standardized self-report measures were not sensitive to qualitative reports of improved functioning, suggesting the need for measures more sensitive to the positive changes noted or longer training periods to demonstrate effects."
Reid, J. (2012). "Respect, compassion and dignity: the foundations of ethical and professional caring." J Perioper Pract 22(7): 216-219.
Excerpt: "Throughout 2011, and for much of this year, the national and professional press have been dominated by reports of failures in health and social care. Stories have focussed on the avoidable harm and disturbing cruelty suffered by individuals and the distress of distraught families seeking answers in the light of systemic organisational failure on an incredible scale."
Rohlf, V. I. (2018). "Interventions for occupational stress and compassion fatigue in animal care professionals—A systematic review." Traumatology 24(3): 186-192.
Excerpt: "The review found that although occupational stress is highly prevalent in the animal care profession, only 4 articles evaluating therapeutic interventions in this population were identified. This small number, combined with the variability in design and outcome measures of the articles, made best practice recommendations on the basis of this review difficult. The author recommends that administrators and/or managers within the animal care profession and mental health professionals wishing to implement therapeutic interventions borrow from research conducted in other areas until a strong research base in the animal care profession is established. A review of occupational stress interventions in the human care profession revealed that cognitive–behavioral techniques, including mindfulness-based approaches, are the most frequently cited approaches for therapeutic interventions in this population. Programs incorporating psychoeducation, coping skills training, and relaxation within a cognitive–behavioral framework with possible mindfulness-based approaches may, therefore, offer mental health professionals, administrators, and/or managers in the animal care profession a useful starting point with which to base future interventions."
Rossi et al. (2012). "Burnout, compassion fatigue, and compassion satisfaction among staff in community-based mental health services." Psychiatry Res 200(2-3): 933-938.
Excerpt: "Psychiatrists and social workers were the professionals with the highest levels of BO [burnout] and CF [compassion fatigue]. Workers with psychological distress reported both higher BO and CF scores, and lower levels of CS [compassion satisfaction]. A significant increase in the BO and CF scores was also detected for each extra year spent working in a CMHS. A higher level of CF was associated with female and having been experienced one negative life event in the previous year."
Sansó, N., et al. (2015). "Palliative care professionals' inner life: Exploring the relationships among awareness, self-care, and compassion satisfaction and fatigue, burnout, and coping with death." Journal of Pain and Symptom Management 50(2): 200-207.
Excerpt: "The awareness-based model of self-care was successfully tested in a multidisciplinary sample of Spanish palliative care professionals. This research applies a quantitative evaluation of the model, providing evidence of a constellation of key variables for health professionals' quality of life, such as specific training, self-care, awareness and coping with death competency."
Scheid, D. and F. Singh (2019). "Can compassion focused therapy enhance dual recovery for veterans?" Psychiatric Rehabilitation Journal 42(3): 329-329.
Excerpt: "For a program development project at our Veterans Affairs Psychosocial Rehabilitation and Recovery Center, we designed and implemented a group therapy program based on Compassion Focused Therapy (CFT), a therapeutic model that directly addresses the aforementioned challenges (Gilbert, 2009b). Results from pre- and post-intervention measures suggested veterans gained compassion and mindfulness skills and experienced reduced depressive symptoms."
Shih et al. (2012). "Effect of a Compassion-Focused Training Program in Palliative Care Education for Medical Students." American Journal of Hospice & Palliative Medicine 30(2): 114-120.
Excerpt: "Experience with caring for patients with terminal cancer was positively related to improvement in the decision of 'truth telling is helpful to a good death.' In addition, improvement in the perception of 'compassionate care' was correlated with higher improvement in the decision of 'discharge planning and home care'.... Compassion-focused training program can be helpful to improve medical students' competence in making more appropriate ethical decisions in end-of-life care."
Shonin, E., et al. (2015). "Buddhist-derived loving-kindness and compassion meditation for the treatment of psychopathology: A systematic review." Mindfulness 6(5): 1161-1180.
Excerpt: "Participants demonstrated significant improvements across five psychopathology-relevant outcome domains: (i) positive and negative affect, (ii) psychological distress, (iii) positive thinking, (iv) interpersonal relations, and (v) empathic accuracy. It is concluded that LKM and CM interventions may have utility for treating a variety of psychopathologies. However, to overcome obstacles to clinical integration, a lessons-learned approach is recommended whereby issues encountered during the (ongoing) operationalization of mindfulness interventions are duly considered."
Sinclair, S., et al. (2017). "Can self-compassion promote healthcare provider well-being and compassionate care to others? Results of a systematic review." Applied Psychology: Health and Well-Being [in press].
Excerpt: " The construct of self-compassion in healthcare has significant limitations. Self-compassion has been related to the definition of compassion, but includes limited facets of compassion and adds elements of uncompassionate behavior. Empirical studies use the Self-Compassion Scale, which is criticised for its psychometric and theoretical validity. Therapeutic interventions purported to cultivate self-compassion may have a broader effect on general affective states. An alleged outcome of self-compassion is compassionate care; however, we found no studies that included patient reports on this primary outcome."
Sommers-Spijkerman, M. P. J., et al. (2018). "Compassion-focused therapy as guided self-help for enhancing public mental health: A randomized controlled trial." J Consult Clin Psychol 86(2): 101-115.
Excerpt: "Compared with the waitlist control group, the CFT group showed superior improvement on well-being at postintervention, d = .51, 95% CI [.25, .77], p < .001, and 3-month follow-up, d = .39, 95% CI [.13, .65], p < .001. No significant moderators were found. On all secondary outcome measures but positive affect, the intervention group showed significantly greater improvements up to 3-month follow-up. At 9-month follow-up, improvements on all measures were retained or amplified among CFT participants."
Straughair, C. (2012). "Exploring compassion: implications for contemporary nursing. Part 1." Br J Nurs 21(3): 160-164.
Excerpt: "as the profession of nursing advanced to develop evidence-based practice, some of the ethos of the compassionate nursing character was seemingly lost in favour of technical skills. This is supported by evidence suggesting that nurses have a decreased affinity with the ethos of altruism. Recent reports have highlighted negative patient experiences which reflect a clear lack of compassionate nursing care. This has led to a variety of documents re-endorsing the concept of compassion as a core and fundamental nursing value. This has raised several issues for nursing practice which require due consideration if the profession is to restore the image of the compassionate nurse, technically skilled and clinically effective, equipped with the appropriate skills, knowledge, values and attitudes to fulfil the pledges to respond to patients with humanity and kindness and to deliver high-quality compassionate care."
Straughair, C. (2012). "Exploring compassion: implications for contemporary nursing. Part 2." Br J Nurs 21(4): 239-240, 242-234.
Excerpt: "Effective student nurse recruitment is essential to ensure that the most appropriate individuals are selected. Contemporary marketing campaigns must be implemented, and recruitment strategies developed, which consider specific values and attitudes. Service user involvement in recruitment and selection, curriculum planning and learning and teaching strategies, and post-qualification education, can enhance nurses' understanding of the patient perspective and make headway in embedding compassion as a core nursing value. Additionally, effective role modelling in practice which demonstrates high-quality compassionate nursing care is essential. Nurses must be adequately supported in the clinical environment to facilitate compassionate behaviours and clinical leadership at all levels must uphold political and professional pledges to achieve this."
Thomas, J. (2013). "Association of personal distress with burnout, compassion fatigue, and compassion satisfaction among clinical social workers." Journal of Social Service Research 39(3): 365-379.
Excerpt: "Studies of empathy and empathy-related responding show that while some people respond to observing the suffering of another with a prosocial concern and urge to help the suffering person, others have an aversive, avoidant response that is primarily self-focused and aimed toward relieving their own distress rather than helping the other person. This self-focused response, labeled...personal distress, is associated with various social and psychological problems.... Results..indicate that the model of empathy components and control variables explain 20% to 23% of the variance in the dependent variables. Personal distress is the only component of the empathy construct with significant associations with the dependent variables. Higher personal distress is associated with higher compassion fatigue and burnout and lower compassion satisfaction among clinical social workers.")
Trueland, J. (2012). "Compassion for keeps." Nurs Stand 27(2): 20-22.
Excerpt: "A three-year programme in Scotland to encourage compassion in every aspect of nursing care drew to a close this summer. However, senior nurses are still involved in the Leadership in Compassionate Care programme, and are determined that its influence will continue to spread across the country.
Way & Tracy (2012). "Conceptualizing compassion as recognizing, relating and (re)acting: A qualitative study of compassionate communication at hospice." Communication Monographs 79(3): 292-315.
Excerpt: "Using qualitative data gathered among hospice employees, this study explores the communication of compassion at work, providing an in-depth understanding of one of the most quickly growing healthcare contexts and offering a new conceptualization of compassion. The analysis is framed with emotional labor, burnout, and compassion literature, and shows how communicating compassion emerged as a central theme."
Weidlich, C. P. and D. N. Ugarriza (2015). "A pilot study examining the impact of care provider support program on resiliency, coping, and compassion fatigue in military health care providers." Military Medicine 180(3): 290-295.
Excerpt: "CPSP training was effective in reducing burnout, which often leads to decreased compassion fatigue in a group of military and civilian registered nurses, LPNs, and medics."
West, A. L. (2015). "Associations among attachment style, burnout, and compassion fatigue in health and human service workers: A systematic review." Journal of Human Behavior in the Social Environment 25(6): 571-590.
Excerpt: "The findings demonstrated consistent results for secure and anxious attachment, suggesting that attachment security is associated with lower levels of burnout, whereas attachment anxiety is associated with higher levels of burnout. Some studies found an association between avoidant attachment and burnout, whereas others did not."
Wiklund & Wagner (2012). "The butterfly effect of caring - clinical nursing teachers' understanding of self-compassion as a source to compassionate care." Scand J Caring Sci.
Excerpt: "This study has its roots in a clinical application project, focusing on the development of a teaching-learning model enabling participants to understand compassion. During that project four clinical nursing teachers met for a total of 12 hours of experiential and reflective work. This study aimed at exploring participants' understanding of self-compassion as a source to compassionate care....Five themes were identified: Being there, with self and others; respect for human vulnerability; being nonjudgmental; giving voice to things needed to be said and heard; and being able to accept the gift of compassion from others. A main metaphorical theme, 'the Butterfly effect of Caring', was identified, addressing interdependency and the ethics of the face and hand when caring for Other - the ethical stance where the Other's vulnerable face elicits a call for compassionate actions. The findings reveal that the development of a compassionate self and the ability to be sensitive, nonjudgmental and respectful towards oneself contributes to a compassionate approach towards others.... compassionate care is not only something the caregiver does, nor is compassion reduced to a way of being with another person or a feeling. Rather, it is a way of becoming and belonging together with another person where both are mutually engaged and where the caregiver compassionately is able to acknowledge both self and Other's vulnerability and dignity."
Wolf, A. W., Goldfried, M. R., & Muran, J. C. (Eds.). (2013). Transforming negative reactions to clients: From frustration to compassion. Washington, DC: American Psychological Association.
Excerpt: "In addition to tracking their clients' affective states, therapists need to monitor and regulate their own affective reactions. If therapists fail to recognize such emotional reactions, or perceive them only as noise in the therapeutic process, they risk missing an important source of data that may directly or indirectly affect the therapeutic alliance and negatively influence treatment outcomes."
Wong & Mak (2012). "Differentiating the Role of Three Self-Compassion Components in Buffering Cognitive-Personality Vulnerability to Depression Among Chinese in Hong Kong." Journal of Counseling Psychology.
Excerpt: "The results of the present study show that when the effect of gender and the 2 other self-compassion components were controlled, self-kindness and mindfulness could moderate the association between autonomy and depression, and the association between self-criticism and depression, while common humanity could moderate the association between self-criticism and depression. Unexpectedly, interaction between sociotropy and mindfulness was found, with the association between sociotropy and depression being stronger among individuals with high mindfulness than it was with individuals with low mindfulness. These results suggest the differentiating role of the 3 self-compassion components in buffering autonomous and self-critical individuals from depression."
Youngblut & Brooten (2012). "Perinatal and pediatric issues in palliative and end-of-life care from the 2011 Summit on the Science of Compassion." Nursing Outlook 60(6): 343-350.
Excerpt: " More than 25,000 infants and children die in US hospitals annually; 86% occur in the NICU or PICU. Parents see the child's pain and suffering and, near the point of death, must decide whether to resuscitate, limit medical treatment, and/or withdraw life support. Immediately after the death, parents must decide whether to see and/or hold the infant/child, donate organs, agree to an autopsy, make funeral arrangements, and somehow maintain functioning. Few children and their families receive pediatric palliative care services, especially those from minority groups. Barriers to these programs include lack of services, difficulty identifying the dying point, discomfort in withholding or withdrawing treatments, communication problems, conflicts in care among providers and between parents and providers, and differences in cultural beliefs about end-of-life care. The 2011 NIH Summit on the Science of Compassion provided recommendations in family involvement, end-of-life care, communication, health care delivery, and transdisciplinary participation."
Yu, H., et al. (2016). "Prevalence and predictors of compassion fatigue, burnout and compassion satisfaction among oncology nurses: A cross-sectional survey." International Journal of Nursing Studies 57: 28-38.
Excerpt: "Higher compassion fatigue and burnout were found among oncology nurses who had more years of nursing experience, worked in secondary hospitals and adopted passive coping styles. Cognitive empathy, training and support from organizations were identified as significant protectors, and 'perspective taking' was the strongest predictor of compassion satisfaction, explaining 23.0% of the variance. Personality traits of openness and conscientiousness were positively associated with compassion satisfaction, while neuroticism was a negative predictor, accounting for 24.2% and 19.8% of the variance in compassion fatigue and burnout, respectively."