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Compassion fatigue among social work students: a gap analysis

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Compassion Fatigue Among Social Work Students: A Gap Analysis
by
Sarah Caliboso-Soto

Rossier School of Education
University of Southern California
A dissertation submitted to the faculty
in partial fulfillment of the requirements for the degree of
Doctor of Education

May 2022

© Copyright by Sarah Caliboso-Soto 2022
All Rights Reserved

The Committee for Sarah Caliboso-Soto certifies the approval of this Dissertation

Ruth Supranovich
Mary Andres
Kim Ferrario, Committee Chair

Rossier School of Education
University of Southern California
2022

iv
Abstract
This dissertation study explores Master of Social Work students’ experience of compassion
fatigue and secondary traumatic stress while placed in an internship. The organizational context
for this study was a large, private research university. The aim of the study was to examine the
knowledge and motivation factors related to Master of Social Work students’ experiences of
compassion fatigue and secondary traumatic stress. The study employed a mixed methodology,
utilizing a survey, interviews, and document analysis. Specifically, the Professional Quality of
Life scale was administered to assess experiences of compassion fatigue and secondary traumatic
stress. Survey findings reveal that Master of Social Work students experience moderate levels of
compassion fatigue and high levels of compassion satisfaction. Interview findings suggest that
students possess myriad self-care strategies to manage and cope with experiences of compassion
fatigue and secondary traumatic stress. A document analysis showed only four courses discuss
topics of compassion fatigue, secondary traumatic stress, and self-care. Based on these findings,
it is recommended that a curriculum be developed that includes instruction, discussion,
assignments, and activities that teach the signs and symptoms of compassion fatigue and
secondary traumatic stress and strategies of self-care to manage, cope with, and mitigate
experiences of compassion fatigue and secondary traumatic stress.

v
Dedication
To my incredibly supportive husband, Jeff Soto, thanks for always providing support and
encouragement during this journey. Thank you for making me laugh when I wanted to cry. I
appreciate all that you do for us. I could not have done this without you.

To my son, Vinny, I love you so much and am so proud to be your Mommy. You inspire me to
be the best at everything I do. I hope one day I make you as proud as you make me.

To my sister, Gina, thanks for our self-care days and the help and guidance you gave me during
this process—it’s your turn now.

To my dad, who always encouraged education and reaching for the stars.

To my mom—I wish you could be here to hear people call me “Dr. Caliboso-Soto.”

vi
Acknowledgments
To my dissertation committee, Dr. Kimberly Ferrario, Dr. Mary Andres, and Dr. Ruth
Supranovich thank you so much for your guidance and expertise. I learned so much from you
during this journey.
To my study team TJFMQ—Ahmad, Gina, Jey, Julie, Liz, and MA—there were a few
moments in the program where I just wanted to quit, but the thought of disappointing any of you
was far worse than not finishing the program. Thanks for the giggles and fun times during class.
To my Telehealth Team, Carolina, Karla, and Elias, thanks for the support and words of
encouragement, I appreciate the time you let me vent during our meetings.
To my colleagues, Suh Chen, Melissa, Maria, and Betsy, thank you for your steadfast
support throughout my studies. I am honored to work alongside you. Thank you.
I would also like to acknowledge and thank Cari, for your assistance during this project, I
couldn’t have done it without you. To the many students who I have worked for in the past, you
inspired this work, and you inspire me to be a better social worker, educator, and mentor.

vii
Table of Contents
Abstract .......................................................................................................................................... iv
Dedication ....................................................................................................................................... v
Acknowledgments.......................................................................................................................... vi
List of Tables .................................................................................................................................. x
List of Figures ................................................................................................................................ xi
Chapter One: Introduction to the Study .......................................................................................... 1
Background of the Problem ................................................................................................ 1
Organization Context and Mission ..................................................................................... 2
Purpose of the Study and Research Questions .................................................................... 3
Importance of the Study ...................................................................................................... 4
Overview of Theoretical Framework and Methodology .................................................... 4
Definitions........................................................................................................................... 5
Organization of the Dissertation ......................................................................................... 6
Chapter Two: Review of the Literature ......................................................................................... 7
Compassion Fatigue ............................................................................................................ 7
Compassion Fatigue Among Social Workers ..................................................................... 9
Risk and Protective Factors in Developing Compassion Fatigue ..................................... 13
Knowledge, Motivation, and Organizational Influences Framework ............................... 17
Conceptual Framework: The Interaction of Stakeholders’ Knowledge and Motivation and
the Organizational Context ............................................................................................... 25
Conclusion ........................................................................................................................ 26
Chapter Three: Methodology ........................................................................................................ 28
Research Questions ........................................................................................................... 28
Overview of Design .......................................................................................................... 29

viii
Stakeholders and Research Setting ................................................................................... 30
The Researcher.................................................................................................................. 30
Data Sources ..................................................................................................................... 31
Chapter Four: Findings ................................................................................................................. 38
Participating Stakeholders ............................................................................................................ 39
Findings............................................................................................................................. 42
Research Question 1: How, if at All, Do Social Work Students Experience Compassion
Fatigue and Secondary Trauma during Their Field Internships?...................................... 42
Theme 1: MSW Students Experience Secondary Traumatic Stress ................................. 42
Theme 2: MSW Students Experience High Levels of Compassion Satisfaction ............. 46
Research Question 2: What Knowledge and Motivational Factors Affect Students’
Ability to Engage in Behaviors Known to Identify and Manage the Experiences of
Compassion Fatigue and Secondary Traumatic Stress? ................................................... 49
Theme 3: Students Possess Strategies to Manage, Cope With, and Mitigate the Impact of
Compassion Fatigue and Secondary Traumatic Stress ..................................................... 49
Research Question 3: What Is the Interaction Between the Organizational Context and
Student Knowledge and Motivation?................................................................................ 58
Theme 4: Education and Training on Compassion Fatigue, Secondary Traumatic Stress,
and Self-Care Is Important ................................................................................................ 58
Theme 5: Students Felt Supported by the Faculty ............................................................ 67
Summary ........................................................................................................................... 70
Chapter Five: Discussion and Recommendations......................................................................... 72
Discussion of Findings ...................................................................................................... 72
Recommendations for Practice ......................................................................................... 76
Integrated Recommendations............................................................................................ 83
Limitations and Delimitations ........................................................................................... 89
Recommendations for Future Research ............................................................................ 90
Conclusion ........................................................................................................................ 90

ix
References ..................................................................................................................................... 92
Appendix A: Survey Questions .................................................................................................. 108
Appendix B: Interview Protocol ................................................................................................. 113
Appendix C: Document Analysis Protocol ................................................................................. 116
Appendix D: Information Sheet for Research ............................................................................ 117

x
List of Tables
Table 1: Knowledge Influences, Types, and Assessments for Knowledge Gap Analysis ............19
Table 2: Motivational Influences and Assessments for Motivation Gap Analyses .......................21
Table 3: Organization Influences and Influence Assessments for Organization Gap Analysis ....24
Table 4: Data Sources ....................................................................................................................29
Table 5: Survey Participant Demographics (N = 46) .....................................................................40
Table 6: Interview Participants’ Demographics ............................................................................42
Table 7: ProQOL Subscale Scores (N = 46) ..................................................................................44
Table 8: ProQOL Subscale Scores by Level of Severity ...............................................................47
Table 9: Self-Care Activities Utilized by Survey Respondents .....................................................51
Table 10: Strategies to Avoid Compassion Fatigue and Secondary Traumatic Stress ..................54
Table 11: Validated Knowledge Influences ...................................................................................56
Table 12: Validated Motivational Influences ................................................................................57
Table 13: How Did the School Educate You on Compassion Fatigue and Secondary Traumatic
Stress? ............................................................................................................................................60
Table 14: Suggestions for the School ............................................................................................61
Table 15: Department and Courses Analyzed ...............................................................................64
Table 16: Field Courses and Compassion Fatigue, Secondary Traumatic Stress, or Self-Care
Discussion Topics or Course Readings..........................................................................................66
Table 17: Validated Organizational Influences .............................................................................69
Table 18: Knowledge, Motivational, and Organizational Needs as Determined by the Data .......70
Table 19: Applying Kotter’s Eight-Step Framework to Successfully Recommendations ............87
Table A1: Professional Quality of Life Scale (PROQOL) Compassion Satisfaction and
Compassion Fatigue (PROQOL) Version 5 (2009)…………………………………………….108
Table B1: Interview Protocol…………………………………………………………………...113

xi
List of Figures
Figure 1: Conceptual Framework ..................................................................................................26
Figure 2: Survey Participants Who Engage in Managing Experiences of Compassion Fatigue and
Secondary Traumatic Stress ...........................................................................................................50
Figure 3: Importance That the School Provide Training on Compassion Fatigue and Secondary
Traumatic Stress.............................................................................................................................59

1

Chapter One: Introduction to the Study
Individuals are drawn to helping professions like social work because of a genuine desire
to help others improve the quality of their lives (Stevens et al., 2010). Social workers interact
with individuals who may have suffered trauma. Empathy and compassion are necessary skills to
be effective. However, social workers face a significant risk of what is known as compassion
fatigue (Beaumont et al., 2016; Decker et al., 2015). There is a need to understand the impact of
compassion fatigue and secondary trauma among social work students who are just beginning
their journey into the helping profession (Harr & Moore, 2011).
Background of the Problem
Compassion fatigue is a commonly acknowledged experience for individuals in the
helping professions such as nursing, counseling, and social work (Brown et al., 2017). Harr et al.
(2014) described compassion fatigue as the damaging outcomes of working with suffering and
vulnerable people and then experiencing the effects of the clients’ traumatic events. Compassion
fatigue is further defined as the debilitative consequences of chronic and intense interactions
with clients, exposure to client’s stressors, and use of self, which surpasses the social worker’s or
nurse’s tolerance (Figley, 1995). In addition to compassion fatigue, job-related stressors specific
to the helping field have also been called secondary trauma, vicarious trauma, or secondary
exposure (Cieslak et al., 2014). Continuous exposure to stressors inherent in social work
contributes to the development of high turnover and burnout (Zhang et al., 2018). Sartor (2010)
noted that if counselors continue to work with traumatized clients, they may experience vicarious
trauma, affecting their self-efficacy and perceived skills to treat their patients.
Poulin and Walter (1993) studied approximately 1,200 geriatric social workers and
discovered that about 60% of the sample reported high levels of burnout. In another study,
2

Siebert (2006) studied the prevalence of compassion fatigue in 751 social workers and found that
about 75% reported having experienced compassion fatigue. Bride (2007) examined social
workers who provided services to victims of trauma and found 15% of them suffered from work-
related stress. The evidence highlights the pervasiveness of compassion fatigue in the social
work profession. Sartor (2010) conducted a study of 83 mental health professionals and found
that those with high levels of vicarious trauma also had low self-efficacy levels. This problem is
important to address because compassion fatigue among social work interns can lead to physical
and psychological distress and adversely affect the quality of care (Brown et al., 2017; Kim et
al., 2011).
Organization Context and Mission
The organizational context of this study is Western University, a large private research
university in the United States. Western University (WU) is a pseudonym used throughout this
discussion to protect the privacy of the institution. WU is considered an epicenter of the arts,
technology, and international business. WU is composed of more than 20 outstanding academic
schools, programs, and departments. WU’s total enrollment for the 2020–2021 academic year
was about 46,000, including graduate and undergraduate students. The focus of this study is the
WU School of Social Work (WUSSW). According to WUSSW, representation of the following
ethnic groups has been steady over the past few years. The average age of students enrolled in
WUSSW is 30. Their gender and ethnic breakdown are 85% female to 15% male, with 35%
Caucasian, 27% Latina/o, 18% Asian American or Pacific Islander, 11% African American,
5.5% unknown, and 2–3% Native American (WU, 2020).
WUSSW has two on-campus locations and one virtual campus. One on-campus location
is located at the main university site, and the other is located about 3 miles away in the city’s
3

downtown district. Students can use a shuttle between the campuses to attend classes. WUSSW
offers master’s degrees in social work (MSW) and nursing (MSN), a doctorate in social work
(DSW), and a PhD in social work.
WUSSW’s mission is to advance knowledge, inspire innovation, and advocate for social
justice in the service of marginalized populations. The school seeks to prevent and alleviate
social challenges and build resilience among individuals, families, and communities.
Purpose of the Study and Research Questions
The aim of this study is to explore the knowledge, motivation, and organizational factors
related to MSW students’ experiences of compassion fatigue and secondary trauma at WUSSW.
In addition, this study seeks to evaluate the degree to which WUSSW is meeting its
organizational goals. Finally, this project seeks to identify strategies to assist students to manage
or mitigate experiences of compassion fatigue and secondary traumatic stress.
The study focuses on four research questions:
1. How, if at all, do social work students experience compassion fatigue and secondary
trauma during their field internship?
2. What knowledge and motivation factors affect the ability of students to engage in
behaviors known to identify and manage the experiences of compassion fatigue and
secondary trauma?
3. What is the interaction between the organizational context and student knowledge and
motivation?
4. What are the recommendations for organizational practice in the areas of knowledge,
motivation, and organizational factors?
4

Importance of the Study
Research highlights the pervasiveness of compassion fatigue, secondary traumatic stress,
and burnout (Cieslak et al., 2014). Individuals who want to enter social work should be aware,
educated, trained, and prepared to deal with compassion fatigue to have a long career in social
work (Harr & Moore, 2011). Health care professionals are expected to be compassionate and
empathic. Without adequate understanding and knowledge about the possible experience of
compassion fatigue and secondary traumatic stress, burnout and poor client care are certain
(Marciel et al., 2013). Addressing this issue could result in improvement in several areas,
including student satisfaction, student engagement, social work job satisfaction, retention, and
organizational efficiency.
Overview of Theoretical Framework and Methodology
Clark and Estes’ (2008) gap analysis, a systemic, analytical method that clarifies
organizational goals and identifies gaps between an actual performance level and the desired
performance level in an organization, was adopted for this study. Gap analysis is an appropriate
lens to assess this problem of practice because it permits examination of the social work intern’s
knowledge, motivation, and organizational influencers based on a general literature review and
utilizing data from surveys and one-on-one interviews. Recommendations will be made based on
data analysis.
This study utilized an explanatory sequential mixed methodology. Creswell and Creswell
(2018) defined mixed methods as involving qualitative and quantitative data, rigorous data
collection, analysis, and interpretation and integration of both datasets. Explanatory sequential
methods include utilizing survey data in the first phase, followed by engaging in a qualitative
interview to further explain and provide more detail to the quantitative data (Creswell &
5

Creswell, 2018). The specific strategy was a phenomenology case study, which is an exploration
of the human experience in a specific setting (Creswell & Creswell, 2018). This is an appropriate
design because this study seeks to describe and make meaning of the experience of compassion
fatigue among MSW students enrolled at WUSSW. Validity using this approach is based on
demonstrating both qualitative credibility and quantitative validity (Creswell & Creswell, 2018).
A valid and reliable survey instrument (for quantitative data) and triangulation and member
checks (qualitative data) were also used. Internal reliability, the degree of consistency that
researchers collect, analyze, and interpret data (Lincoln & Guba, 1985), was addressed by using
the Professional Quality of Life scale (ProQOL), a standardized tool to measure compassion
fatigue that has a Cronbach’s alpha of .88 (Stamm, 2010). This test dependability, or trackability
and logic of the research design and process (Lincoln & Guba, 1985), was addressed in this study
by recording accurately and utilizing interrater coding and checks during data collection and
interpretation.
Definitions
The following terms key concepts appear throughout this study. Although some terms
may have alternate definitions, the meanings presented are relevant to the understanding of this
study.
Compassion fatigue is the result of continuous exposure to patients experiencing trauma.
It is a syndrome whereby providing compassion and empathy to others extends beyond the
professional’s limits to the point that the professional displays both emotional and physical
symptoms (Figley, 2002).
Secondary traumatic stress is similar to posttraumatic stress disorder and is a
consequence among service providers whose clients suffer from a traumatic event (Figley, 2002).
6

Compassion satisfaction is the enjoyment obtained from work (Decker et al., 2015).
Burnout is a term usually addressed in conjunction with compassion fatigue and
secondary traumatic stress (Harr et al., 2014). Maslach et al. (2001) defined burnout as a
response to emotional and interpersonal job stress, including exhaustion, pessimism, and
inefficacy.
Organization of the Dissertation
This dissertation is organized into five chapters. This chapter presents key concepts and
definitions commonly found in discussing compassion fatigue, burnout, and self-efficacy of
social workers and social work students. Background on compassion fatigue, the purpose and
importance of the study, the organization’s mission and goals, stakeholders, theoretical
framework, and methodology are introduced. Chapter Two provides a review of the current
literature relevant to the scope of this study. Topics of compassion satisfaction, burnout,
secondary trauma, and compassion fatigue are addressed. Chapter Three details the knowledge,
motivation, and organizational elements to be examined, along with the methodology, sampling,
data collection, and analysis. In Chapter Four, the data and results are assessed and analyzed.
Chapter Five provides recommendations based on the data and literature for closing the gaps and
an implementation and evaluation plan for solutions.

7

Chapter Two: Review of the Literature
The literature review begins with a general examination of compassion fatigue research
and related terms and topics. Further research explores the prevalence of compassion fatigue and
risk and protective factors, including individual and organizational aspects. Finally, the chapter
examines Clark and Estes’ (2008) knowledge, motivational and organizational influences that are
assumed to contribute to or protect social work students from developing compassion fatigue.
Compassion Fatigue
Compassion fatigue has been studied in health care research because of its link to
providers’ burnout and leaving the profession (Sorensen et al., 2017). Compassion fatigue is
considered a consequence of working with victims of illness or trauma (Figley, 2002). Many
helping professionals are at risk of compassion fatigue. These include hospice workers (Slocum-
Gori, 2011), child protection workers (Geoffion et al., 2016; Salloum et al., 2015), adult
protective workers (Bourassa, 2012), community service workers (Cocker & Joss, 2016), clergy
(Jacobson et al., 2013), mental health workers (Ray et al., 2013; Rossi et al., 2012; Samios, 2017;
Singh et al., 2020), substance abuse workers (Tartakovsky & Kovardinsky, 2013), and
firefighters (Kim et al., 2020). Secondary traumatic stress and compassion fatigue have been
studied broadly in nurses, physicians, and police officers.
Nurses
Joinson (1992) first conceived the term compassion fatigue to describe hospital nurses
losing their ability to nurture their patients as a consequence of consistent exposure to patient
trauma and emergencies. Coetzee and Klopper (2010) utilized concept analysis to define
compassion fatigue in nursing further. This seminal study provided more profound knowledge of
the phenomenon, identifying categories of compassion fatigue and developing a theoretical
8

definition revealing risk factors, causes, processes, and manifestations of compassion fatigue in
nursing practice (Coetzee & Klopper, 2010). In another concept analysis study, Peters (2018)
found that compassion fatigue occurs in fields of practice, and nurses are at risk because of their
constant contact with suffering patients and stressful work settings. Peters (2018) further
concluded that overall, nurses are at risk of compassion fatigue and prevention is critical to
mitigating its impact.
Yoder’s (2010) study of nurses found 15% of nurses were at risk of compassion fatigue
and that caring for patients was the most common trigger of those at risk. Zhang et al. (2018)
conducted a meta-analysis of the nursing literature and compassion fatigue and found that stress,
stressful factors, and negative effects were strongly correlated with compassion fatigue and
burnout. In another study that looked at the contributing factors to the development of
compassion fatigue, burnout, and compassion satisfaction among emergency room nurses,
researchers found that low levels of compassion fatigue were related to high levels of
compassion satisfaction (Hunsaker et al., 2015). Similarly, Wu et al. (2016) found that positive
and healthy work settings were important for oncology nurses and helped protect against
compassion fatigue and burnout.
Physicians
Physicians are another group that experiences compassion fatigue. One study aimed to
identify indicators and pervasiveness of compassion fatigue, burnout, and compassion
satisfaction among pediatric emergency doctors (Gribben et al., 2019). The researchers found
that pediatric emergency doctors are at risk of developing compassion fatigue and burnout and
have low experience of compassion satisfaction. Gribben et al. (2018) also found that proactive
awareness of the experience of compassion fatigue and burnout leads to better self-care
9

management of it and related emotional stressors to enhance overall well-being. In another study,
researchers examined self-perceived experiences of compassion fatigue and compassion
satisfaction among family physicians (Račić et al., 2019). They discovered that family physicians
with several years of practice, large practices, and large caseloads of chronically ill patients are
at risk of compassion fatigue.
Police Officers
Law enforcement personnel are also impacted by compassion fatigue (Burnett et al.,
2020). Although law enforcement and police officers are exposed to violence and trauma, they
have not been subject to examination concerning compassion fatigue (Papazoglou et al., 2019).
Burnett et al. (2020) found that 20% of police personnel experienced secondary traumatic stress
and compassion fatigue. This study also identified that personality, self-care, and mental
toughness serve as protective factors in developing compassion fatigue. In a related study that
aimed to explore if police officers who worked with sexual assault victims experienced
compassion fatigue, secondary stress, and burnout, the researchers discovered that veteran
officers had increased levels of compassion fatigue, secondary traumatic stress, and burnout than
those who had not served as long in the field (Turgoose & Maddox, 2017).
Compassion Fatigue Among Social Workers
The U.S. Bureau of Labor Statistics (2020) reported that the field of social work is
predicted to expand 13% from 2019 to 2029, with the growth varying depending on
specialization. Overall, the growth is quicker than the average for all other professions. Although
the social work field is anticipated to grow, social worker turnover is increasing at a troubling
rate (Scales & Brown, 2020). These struggles in retention and high turnover have been a constant
challenge in the profession, and for years, researchers have studied this phenomenon from
10

different views (Schweitzer et al., 2013). Social workers spend an average of only 8 years in the
field, much less time compared to other helping professionals. For example, the average working
life is 25 years for a doctor and 15 years for a nurse (Curtis et al., 2010; Webb & Carpenter,
2012). Evidence highlights the annual turnover rate among social workers in child welfare is
15% to 30%, and job vacancies remaining unfilled for 2 to 3 months (Evans & Huxley, 2009;
Hwang & Hopkins, 2015; Mor Barak et al., 2006; National Child Welfare Workforce Institute,
2011). Poor retention not only affects the organization with higher caseloads for continuing staff
and poor continuity of care but can also lead to more communitywide economic and social costs
for vulnerable populations because their needs are not being met (Webb & Carpenter, 2012).
Those who enter the field of social work have a genuine desire to help others. An
essential skill in social work is the ability to demonstrate empathy for clients. Empathy is needed
to develop rapport and trust for an effective social work–client relationship. Demonstrating
empathy may also contribute to the development of compassion fatigue among seasoned
practitioners. Social workers can be exposed to incredibly emotional and traumatic experiences,
and these experiences can be both rewarding and very stressful (Lewis & King, 2019).
Although some information regarding compassion fatigue among social workers is
available, limited research has focused on this issue among social work students (Harr & Moore,
2011). As schools of social work continually update and innovate their curricula to address ever-
changing needs, it would prove advantageous to understand students’ compassion fatigue
experiences.
Figley (1995) defined secondary trauma as the feelings, behaviors, and stress associated
with helping traumatized individuals or learning about trauma. Symptoms of secondary trauma
include flashbacks, intrusive thoughts, and numbing (Figley, 1995). Secondary trauma stress is
11

the instinctive behaviors and emotions that occur after hearing or learning about another person’s
traumatizing event. In other words, it is stress related to helping or caring for a suffering person
(Figley, 2002). Secondary traumatic stress resembles posttraumatic stress disorder, except that
exposure to the trauma is experienced by the clients and is associated with secondary traumatic
stress symptoms among providers (Figley, 1995). Secondary traumatic stress is an expression
that is commonly used interchangeably with the term compassion fatigue (Cavanaugh et al.,
2020). Figley (2002) coined the term compassion fatigue instead of secondary trauma stress as a
friendlier and less stigmatizing term. Compassion fatigue and secondary traumatic stress are
equivalent in their meaning (Figley, 1995; Sorensen et al., 2017).
Figley (1995, 2002) referred to compassion fatigue as the ‘cost of caring’ and noted that
helping professionals like nurses, doctors, police officers, and social workers experience it as a
consequence of their work. The term is used to describe feelings and behaviors experienced by
social workers who serve those who have experienced trauma that are naturally related to the
client contact and influenced by the social worker’s compassion and empathy (Figley, 2002).
Compassion fatigue symptoms include depression, anxiety, difficulty sleeping, increased startle
response, and intrusive thoughts about traumatic events (Alkema, 2008; Harr & Moore, 2011).
These may have a swift onset and can be associated with a specific or continuous exposure to
traumatic situation (Alkema, 2008). Compassion fatigue is further defined by poor work
performance, evidenced by a reduced capacity to be empathetic toward their clients (Coetzee &
Klopper, 2010; Harr & Moore, 2011). Compassion fatigue can also affect personal relationships.
Individuals may self-isolate and experience distrust of others (Harr & Moore, 2011). Compassion
fatigue is a multidimensional construct consisting of secondary traumatic stress and burnout
(Stamm, 2010; Thieleman & Cacciatore, 2014).
12

Another term related to compassion fatigue and secondary traumatic stress is vicarious
trauma. Vicarious trauma develops through working with clients over time and is a disrupted
frame of reference that permanently affects clinicians’ or social workers’ world view, beliefs
about others, sense of self, and interpersonal relationships (McCann & Pearlman, 1990). This
long-lasting, pervasive shift in social workers’ beliefs about themselves and the world is what
distinguishes it from compassion fatigue and secondary traumatic stress (Rauvola et al., 2019).
Finally, burnout is another term that is used interchangeably with secondary traumatic
stress and compassion fatigue. Burnout is not limited to those working in the helping professions
but is a reaction to a job’s demands (Harr, 2013; Sodeke-Gregson et al., 2013). Burnout is
defined as the subsequent state of emotional and physical exhaustion from engagement in
mentally draining situations (Maslach & Leiter, 2008). High caseloads and poor organizational
support can lead to burnout, contributing to the harmful effects of compassion fatigue (Harr,
2014).
Prevalence of Compassion Fatigue Among Social Workers
According to Cavanaugh (2020), compassion fatigue can be seen across many different
health care-related practices, including nursing, social work, medicine, hospice work, and mental
health work. Compassion fatigue is strongly positively correlated with burnout, and compassion
satisfaction has an inverse association with burnout (Zhang et al., 2018).
Beder (2012a, 2012b) explored the prevalence of compassion fatigue, compassion
satisfaction, and burnout among social workers employed by the Department of Defense hospital
system and found the sample reported compassion satisfaction about their work, with more than
59% feeling strongly positive. Forty-five percent of the sample reported high levels of
compassion fatigue. With respect to burnout, social workers were well above the norm; 66.2% of
13

the sample reported burnout experiences. Maternity and gynecological professionals were at high
risk of compassion fatigue and burnout, and low levels of compassion satisfaction (Katsantoni et
al., 2019).
Risk and Protective Factors in Developing Compassion Fatigue
Risk factors that contribute to a social worker developing compassion fatigue can occur
at the client, individual, and organizational levels (Newell & Nelson-Gardell, 2014). The most
significant risk factor for developing compassion fatigue is the work itself (Newell & Garner,
2014). Hearing clients’ stories of abuse, neglect, oppression, pain, and trauma is a social
worker’s daily routine. Listening to these stories and providing empathy and compassion can
contribute to secondary stress and compassion fatigue (Figley, 1995). Ray et al. (2013) suggested
that those entering the helping professions with a personal trauma background tend to have
higher compassion fatigue levels. Tarshis and Baird (2019) found that students with a history of
trauma are at risk of experiencing compassion fatigue and are often not ready to deal with the
indirect exposure to trauma from their clients’ stories.
Bourassa’s (2012) qualitative study explored adult protective social workers’ experiences
that developing appropriate boundaries between them and their clients helped protect them
against developing compassion fatigue. Boundary setting assisted the social workers to
disengage from their work and prevented job responsibilities from seeping into their personal life
(Bourassa, 2012). Research on compassion fatigue also has focused on compassion satisfaction
and preventive-based interventions to reduce the risk of negative effects. Interventions include
self-care and mindfulness. Compassion satisfaction has been defined as the pleasure received
from work (Harr, 2014; Stamm, 2008). Compassion satisfaction is also associated with the
perception of helpfulness, effectiveness, a connection with clients, and career fulfillment
14

(Cuartero & Campos-Vidal, 2018). Compassion satisfaction can mitigate the adverse effects of
compassion fatigue and burnout and serves as a safeguard for those in the helping profession
(Harr et al, 2014). Bae et al. (2020) conducted a quantitative study with 120 social workers to
examine organizational and individual elements linked to compassion satisfaction and found that
higher levels of perceived autonomy at work, work-life balance, and emotional intelligence
increased compassion satisfaction among veteran social workers. Harr’s (2013) study found
social work students who had lower compassion fatigue levels experienced higher compassion
satisfaction levels. Conversely, students who had higher levels of compassion fatigue had lower
levels of compassion satisfaction.
Individual Factors
Self-Care
Self-care is an essential charge of a social worker’s professionalism and a core
competency in social work education (Grise-Owens & Miller, 2021). Self-care is critical in
moderating professional compassion fatigue, secondary trauma, and burnout (Miller et al., 2020;
Newell & Nelson-Gardell, 2014). Self-care activities can include physical or behavioral
strategies (exercise), relational strategies, and cognitive strategies (Diaconescu, 2015). Cuartero
and Campos-Vidal (2019) determined that self-care practices decrease the experience of
compassion fatigue and promote compassion satisfaction; engaging in self-care produces benefits
to social workers and the organization and clients they serve. Alkema (2008) studied the
relationship between self-care, compassion fatigue, and compassion satisfaction and found that
those who participated in more self-care activities showed lower levels of burnout and
compassion fatigue and higher compassion satisfaction. Lewis and King (2019) found that
15

students could better manage stress in both personal and professional situations when provided
education and training in self-care.
Mindfulness
Mindfulness practice is defined as an enhanced sense of awareness of somatic and
emotional feelings and thoughts and serves as a protective factor for the social worker and client
(Decker et al., 2015). The practice of mindfulness is related to overall emotional and physical
health. Research has shown an inverse relationship between mindfulness and compassion fatigue
(Brown et al., 2017; Thieleman & Caccitore, 2014). Social workers who engage in mindfulness
have a greater ability to manage work-related stressors and greater professional satisfaction
(Decker, 2015).
Self-Compassion
Beaumont et al. (2015) found that student midwives could benefit by practicing self-
kindness and self-compassionate, thus decreasing compassion fatigue and burnout. High
caseloads and low levels of compassion satisfaction were the clearest indicators of burnout
(Baugerud, 2016). Sense of mastery in job performance, organization commitment, and positive
challenges at work were associated with higher compassion satisfaction levels (Baugerud, 2016).
Kinman and Grant (2020) suggested that interventions that enhance compassion satisfaction and
self-compassion can reduce compassion fatigue.
Organizational Factors
Research also has pointed to organizational activities that can assist in addressing
compassion fatigue in the workplace. A supportive institutional environment, quality clinical
supervision, and continuing education can protect care providers from compassion fatigue
(Katsantoni et al., 2019; Kapoulitsas & Corcoran, 2015; Kinman & Grant, 2020).
16

Supervision
Kapoulitsas and Corcoran (2015) indicated that access to consistent and quality
supervision was crucial for social workers in guarding against compassion fatigue by developing
a supportive work environment. Quality supervision not only included regular, weekly, formal,
and structured time to discuss cases, debrief, and brainstorm interventions, but also informal
supervision, which are times outside of formal supervision when social workers could reach out
and consult with a supervisor (Kapoulitsas & Corcoran, 2015). Dehlin and Lundh (2018)
proposed that supervision was significantly associated with lower levels of compassion fatigue.
Thornberry et al. (2014) found similar findings such as lower compassion fatigue levels,
increased job satisfaction, and better team cohesion and retention.
Education
According to Yi (2019), social work education should include training on the role of
empathy, mindfulness (focusing on cognitive distancing and metacognition), and personal stress,
which can lead to compassion fatigue. Butler et al. (2017) suggested that a curriculum focused
on using self-care techniques can help students be better prepared when facing work-related
stressors that they will undoubtedly encounter throughout their career. In addition, these
researchers found the need to implement a trauma-informed approach in the curriculum. Flarity
et al. (2013) showed that nurses who participated in a multifaceted training program had
increased compassion satisfaction and decreased compassion fatigue.
Peer Support
Caringi et al. (2017) examined how peer support, which is the mutual assistance between
coworkers or others with similar experiences, affects compassion fatigue, burnout, and secondary
traumatic stress among social workers. Peer support played a significant role in mitigating
17

secondary traumatic stress (Caringi et al., 2017; Kapoulitsas & Corcoran, 2015). Researchers
found that coworkers could validate and understand the complexities of the job responsibilities
and offer humor as a way to lighten the impact of the stress social workers were feeling (Caringi
et al., 2017).
Knowledge, Motivation, and Organizational Influences Framework
Clark and Estes’ (2008) gap analysis provided a framework to methodically analyze and
clarify performance gaps related to knowledge, motivational, or organizational concerns.
Stakeholders must possess proper knowledge to achieve a task, appropriate motivation to persist
in a task, and access to organization supports to complete a task (Clark & Estes, 2008). Social
work students’ development of compassion fatigue is greatly affected by knowledge, motivation
and organizational factors.
Stakeholder Knowledge, Motivation, and Organizational Influences
Knowledge and Skills
Knowledge and skills are required for job performance and to prepare for resolution as
challenges arise (Clark & Estes, 2008). In addition, Krathwohl’s (2002) taxonomy of educational
objectives outlines three knowledge types: declarative, procedural, and metacognitive.
Declarative knowledge includes factual knowledge and conceptual knowledge. Factual
knowledge refers to basic elements, terminology, and details about a subject needed to solve a
problem or complete a task; conceptual knowledge is the interrelationships among the elements
and also refers to schemas, categorical information, generalizations, and theories (Krathwohl,
2002; Rueda, 2011). Procedural knowledge is the process of knowing how to do something or
the process associated with a task (Krathwohl, 2002). Metacognitive knowledge is the
knowledge and awareness of one’s cognition (Krathwohl, 2001).
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Knowledge Influences
Declarative Knowledge Influences
Once placed in an internship during their social work education, social work students
must possess knowledge of their internship role and responsibilities and the expectations of the
specific position. Knowledge of the values and ethics of the social work profession (National
Association of Social Workers, 2020) are important as the foundation of this knowledge. In
addition to knowledge of their role as social worker, students need to have knowledge of
compassion fatigue, secondary trauma, and burnout. If students lack this knowledge about their
social work role and compassion fatigue, they inevitably will develop compassion fatigue or
secondary trauma and not know how to manage it.
Procedural Knowledge Influences
Once declarative knowledge is ascertained, social work students need knowledge of the
processes to prevent compassion fatigue or manage symptoms associated with compassion
fatigue. Social work students should learn how to access and utilize self-care practices to to cope
with compassion fatigue (Cuartero & Campos-Vidal, 2019).
Metacognitive Knowledge Influences
Finally, students need knowledge of how to evaluate and monitor themselves and their
development of compassion fatigue. Metacognition is instrumental in performance and must be
deliberately cultivated (Ambrose et al., 2010). Metacognition is knowledge of learning and self-
regulation. As mentioned previously, self-awareness is a key component of guarding against
compassion fatigue. Social work interns’ self-awareness is equivalent to metacognition. Table 1
summarizes the knowledge influences and knowledge type.

19

Table 1
Knowledge Influences, Types, and Assessments for Knowledge Gap Analysis
Organizational mission
The mission of the WUSSW is to promote social justice and well-being at every social level
through advanced education, community engagement, interdisciplinary scientific activity,
advocacy, and professional leadership
Organizational performance goal
By June 2022, 95% of WUSSW students will be aware of compassion fatigue and secondary
traumatic stress.
Stakeholder goal
By August 2020, 100% of WUSSW students, will understand and develop coping skills or
management skills to manage compassion fatigue.
Knowledge influence Knowledge type
Social work students will have the knowledge of
compassion fatigue and secondary traumatic stress
and ways to manage it.
Factual
Social work students will understand the processes
involved in managing compassion fatigue and
secondary traumatic stress.
Procedural
Social work students need the knowledge of how to
evaluate and monitor themselves and their own
development of compassion fatigue.
Conceptual

Motivation Influences
Motivation refers to the reasons why people behave in a certain way and is composed of
three types of processes: active choice, persistence, and mental effort (Clark & Estes, 2008).
Active choice is the decision to pursue a goal; persistence is continuing in the face of challenges
once action toward the goal begins, and mental effort is continued effort to develop and improve
performance (Clark & Estes, 2008).
Expectancy Value Theory
Expectancy value theory suggests that motivation is a function of an individual’s
expectancy for success in a given task and the value that individual places on the task (Eccles &
20

Wigfield, 2002). Outcome expectancy is perceptions about the expected consequences of
engaging in a task. Efficacy expectancy is belief of personal ability to execute the task that will
result in a desired outcome. Task value can be broken down into several different types of values
an individual might assign a task (Eccles & Wigfield, 2002). Attainment value is defined as the
importance of thriving in one’s work or job (Appianing & Van Eck, 2018). Expectancy value
theory allows for exploration of the value students place on recognizing, preventing, and
managing compassion fatigue. Employing these principles can activate the students’ value and
improve their overall performance.
Self-Efficacy Theory
The cornerstone of social cognitive theory is that self-efficacy influences how individuals
manage tasks, set goals, and deal with challenges. Individuals who possess high self-efficacy
believe they can accomplish many goals. Conversely, those with low self-efficacy do not believe
they can accomplish goals or be successful with tasks or challenges (Bandura, 2002). Social
work students who possess high self-efficacy believe they can cope with, manage, and mitigate
the compassion fatigue and secondary traumatic stress if given the appropriate knowledge and
strategies to address the phenomena.
Emotions
Emotions are a multifaceted phenomenon involving affective, cognitive, and motivational
components (Elliot et al., 2017). Activating positive emotions promotes interest and intrinsic and
extrinsic motivation; on the other hand, negative deactivating emotions like hopelessness can
undermine intrinsic and extrinsic motivation (Elliot et al., 2017). Social work students who
possess positive activating emotions, similar to compassion satisfaction, will perform better.
With the added knowledge of the experience of compassion fatigue, they will be motivated to
21

cope with and manage the experience. Table 2 shows the assumed motivational influences of
social work students.

Table 2
Motivational Influences and Assessments for Motivation Gap Analyses
Assumed motivation influences Motivation theory
Social work students need to see the
anticipated value associated.
Expectancy value
Social work students need to possess
the confidence in their ability to
apply management and coping
techniques to manage compassion
fatigue and secondary traumatic
stress.
Self-efficacy
Social work students need to
experience positive activating
emotions similar to compassion
satisfaction to assist in managing
experiences of compassion fatigue.
Emotions

22

Organizational Influences
Developing and managing compassion fatigue and secondary traumatic stress is
influenced by motivational and knowledge factors. Organizational influences also contribute to
the social work student experience. Much of the literature on compassion fatigue and secondary
traumatic stress has involved individual risk factors, self-care, and mindfulness. However, there
is increasing research on how the organization has also influenced social work students’
experience of compassion fatigue, leading to burnout.
Organizational culture describes the core values, goals, and processes learned over time
in the work setting (Clark & Estes, 2008). Clark and Estes (2008) defined three approaches to
culture in organizations: environmental, group, and individual. Environmental culture refers to
the idea that to affect performance, the environment must be changed (Clark & Estes, 2008).
Group culture is the notion that to make changes, groups of people’s beliefs and knowledge must
change. The culture of individuals or a person’s work culture involves effective work processes
and motivation patterns that lead to successful performance. Shein and Shein (2017) proposed
that culture is composed of levels: artifacts (visible structures, processes, and behaviors), beliefs
and values (ideas, goals, and aspirations), and underlying assumptions (unconscious beliefs and
values). Cultural models are a shared schema and understanding of how the environment works
or should work and incorporate cognitive, behavioral, and affective mechanisms (Gallimore &
Goldenberg, 2001). Cultural settings refer to the visible activity and occasions where people
accomplish something of value (Gallimore & Goldenberg, 2001).
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Find the Value of Formally Teaching About Compassion Fatigue and Secondary Traumatic
Stress
The first cultural model that should be examined to achieve the school’s organizational
goal is to see the value in teaching about compassion fatigue and secondary traumatic stress and
strategies to prevent and manage them. Newell and Nelson-Gardell (2014) speculated that theory
and practice’s important curriculum requirements take precedence over teaching about
compassion fatigue. Students should be taught what compassion fatigue and secondary traumatic
stress are, including signs and symptoms. They need to be taught ways to prevent and cope with
compassion fatigue should they experience it. This could help create longevity and avoid
burnout. Faculty members have limited time available to process traumatic experiences related to
their field experiences (Newell & Nelson-Gardell, 2014). Interview questions were created to
gain insight into whether the faculty sees value in teaching students about these concepts.
Develop a Curriculum Focused on Compassion Fatigue and Secondary Traumatic Stress
The second cultural model that should be addressed to achieve the school’s
organizational goal is to develop a curriculum on compassion fatigue, secondary traumatic stress,
prevention, and management. Newell and Nelson-Gardell (2014) suggested that social work
schools are responsible for providing instruction on this content in a formal teaching setting. The
constructs of compassion fatigue, secondary traumatic stress, burnout, and prevention should be
infused into social work courses, experiential exercises, and assignments practically and
purposefully (Newell & Nelson-Gardell, 2014). To evaluate the school’s organizational culture,
interview questions were created to determine if students would benefit from learning about
compassion fatigue in the classroom.
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Provide Resources and Activities for Students to Assist in Fostering Mindfulness and Wellness
A cultural setting that should be explored to achieve the organization’s goal to determine
if the school needs to develop and provide resources and activities for students to foster self-care,
mindfulness, and wellness to help students combat compassion fatigue and secondary traumatic
stress. Lewis and King (2019) recommended that knowledge and consistent support from agency
management and other staff members will improve self-care utilization and consistent practice.
Lewis and King (2019) further noted the significance of modeling and teaching self-care in real-
world situations. Interview questions were established to assess the school environment. Table 3
shows the assumed organizational influences and cultural model or setting.

Table 3
Organization Influences and Influence Assessments for Organization Gap Analysis
Assumed organizational influences

Cultural model or setting
Find the value of formally teaching
about compassion fatigue and
secondary traumatic stress

Cultural model
Develop a curriculum on compassion
fatigue and secondary traumatic
stress

Cultural model
Provide resources and activities for
students to foster mindfulness and
wellness

Cultural setting

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Conceptual Framework: The Interaction of Stakeholders’ Knowledge and Motivation and
the Organizational Context
The conceptual framework depicts the interactions and relationships between the
different concepts presented in this study (Maxwell, 2013). The conceptual framework is
paramount to situating the study. Furthermore, it grounds the study in the pertinent literature. It
frames the foundation and importance of the problem of practice (Rocco & Plakhotnik, 2009).
Figure 1 presents the concept that social work students’ experiences of compassion fatigue or
secondary traumatic stress are affected by knowledge, motivation, and organizational influences.
The knowledge and motivation influences were derived from the literature review. The
organizational influences were selected based on the researcher’s experience with the
organization. These influences align with work by Shein and Shein (2016) and Clark and Estes
(2008) on organizational influences affecting organizational performance goal achievement.

26

Figure 1
Conceptual Framework

Conclusion
The purpose of this dissertation in practice is to identify the knowledge, motivation, and
organizational factors related to compassion fatigue among social work students at WU. This
research sought to inform the WUSSW and country about the experiences of social work
students and the development and prevention of compassion fatigue. Evaluating this issue can
decrease social work compassion fatigue and burnout, increase student satisfaction, improve
27

retention, and contribute to the current literature on social work students’ experiences. Chapter
Three presents the methodology of the present study and the rationale for the assumed
knowledge, motivational, and organizational influences presented in this chapter.

28

Chapter Three: Methodology
The purpose of this study is to identify the knowledge, motivational, and organizational
factors that contribute to or mitigate the experience of compassion fatigue and secondary
traumatic stress among social work students enrolled at WUSSW. This study determined
strategies that could be used by the school faculty to assist students in identifying, managing,
coping with, and mitigating experiences of compassion fatigue. Chapter Three discusses the
research methods used in this study, including the sampling criteria and rationale for the survey
and interviews with participants. It further discusses the methodology, instruments, and interview
protocols used in this study and the validity and reliability of the protocols. Finally, this chapter
ends by exploring ethical considerations for the completion of this study at WUSSW.
Research Questions
The following questions guided the gap analysis that addressed the knowledge and skills,
motivational, and organization influences and solutions at WUSSW.
1. How, if at all, do social work students experience compassion fatigue and secondary
trauma during their field internship?
2. What knowledge and motivational factors affect students’ ability to engage in
behaviors known to identify and manage the experiences of compassion fatigue and
secondary trauma?
3. What is the interaction between the organizational context and student knowledge and
motivation?
4. What are the recommendations for organizational practice in the areas of knowledge,
motivational, and organizational factors?
29

Overview of Design
This study aimed to explore social work students’ experience of compassion fatigue and
secondary traumatic stress; identify performance gaps related to knowledge, motivation, and
organizational influences; and make recommendations as to how the school can improve
teaching and training students to manage this experience. See Table 4.

Table 4
Data Sources
Research questions Survey Interviews Document
analysis
RQ1: How, if at all, do social work students
experience compassion fatigue and
secondary trauma during their field
internship?
X X
RQ2: What knowledge and motivation factors
affect students’ ability to engage in
behaviors known to identify and manage the
experiences of compassion fatigue and
secondary trauma?
X X X
RQ 3: What is the interaction between the
organizational context and student
knowledge and motivation?
X X
RQ4: What are the recommendations for
organizational practice in the areas of
knowledge, motivation, and organizational
factors?
X X

30

Stakeholders and Research Setting
The stakeholders of focus in this study are MSW students enrolled at WUSSW.
Stakeholders need to understand compassion fatigue and secondary traumatic stress, how to
recognize their symptoms, and how to cope, manage and mitigate the experience. WUSSW is
one of the country’s top-ranked accredited social work graduate programs. The school was
founded in 1920 and has approximately 114 faculty members, 3,200 MSW students, and 38 PhD
students. The school offers both programs on-campus and online. WUSSW is known for its
academic innovation, research, and experiential learning. Students must complete 60 units in
generalist social work, research, policy, and practice. Courses emphasize critical thinking,
analysis, complex problem solving, data-informed decision making, creativity, and leadership. In
addition to coursework, students are required to complete 1,000 hours of hands-on experience
during which they apply evidence-based interventions.
The Researcher
I am a woman of color, clinic director, and faculty member can influence participant
participation, responses, data collection, and data analysis. As a clinic director and faculty
member, I had an automatic power differential. Did students participate in this study because
they know the researcher? Were they honest and open? Merriam and Tisdell (2016) voiced that
both respondent and interviewer bring biases, predispositions, and attitudes that will affect the
interaction and the data gathered; however, a competent interviewer will balance these dynamics
to appraise the data obtained.
The most important approach is to be aware and mindful throughout the whole process of
the researcher’s positionality and how it may influence every step of the study. Another strategy
31

offered by Merriam and Tisdell (2016) is to take a nonjudgmental, sensitive, and respectful
stance during the interview as part of the process.
Data Sources
This study utilized an explanatory sequential mixed methodology. Creswell and Creswell
(2018) defined mixed methods as involving qualitative and quantitative data, including rigorous
data collection, analysis, interpretation, and integration of both datasets. The specific strategy
was a phenomenology case study, which explores the human experience of phenomena in a
particular setting or program (Creswell & Creswell, 2018). This is an appropriate design because
this study seeks to describe and make meaning of the experience of compassion fatigue among
MSW students who are enrolled at WUSSW.
Method: Surveys
Participating Stakeholders
The participants in this study were MSW students and recent graduates of WUSSW. A
nonprobability purposive sampling strategy was used for this research. This type of approach
assumes that the researcher seeks to gain the most robust information and therefore, a sample is
selected from which the most knowledge can be learned (Merriam & Tisdell, 2016). In this case,
the study focused on social work students. A sample is the representative portion of the
population (Malloy, 2020).
Instrumentation
A survey is an instrument used to collect data. It is composed of questions and aims to
gather data from a whole population (Robinson & Leonard, 2019). Advantages to surveys
include capturing necessary information with limited resources; obtaining a large dataset;
generalizing findings to a larger population; comparing responses with subgroups; and collecting
32

data across several sites (Robinson & Leonard, 2019). The goal will be 320 students. According
to the Raosoft Sample Size Calculator, with a population size of 1,800 (number of students
enrolled in the school), a 5% margin of error, a 95% confidence level, and a 50% response
distribution, the recommended sample size is 317. The ProQOL is the most commonly used
measure of the positive and negative affect of those in the helping professions. The ProQOL
contains subscales for compassion fatigue, compassion satisfaction, and burnout. The ProQOL is
composed of 30 questions. Responses are on a 5-point Likert scale: 1 = never, 2 = rarely, 3 =
sometimes, 4 = often, and 5 = very often (Stamm, 2010).
Data Collection Procedures
Qualtrics was utilized to administer the survey to sample. The researcher recreated the
ProQOL survey on the Qualtrics platform. Once the survey was created, an anonymous link was
generated to send to the sample. Participants could access the survey via their computer or
smartphone and answer the survey. Responses were recorded and stored on the Qualtrics
platform for analysis.
Data Analysis
Scoring of the ProQOL is composed of summing the items by subscale (Stamm, 2010).
Scores above 42 indicate high levels for each subscale (Stamm, 2010).
Validity and Reliability
According to Salkind and Frey (2021), validity refers to the property of the assessment
that indicates the tool measures what it is intended to measure. Stamm (2010) found that the
ProQOL had good construct validity in more than 200 published papers. Reliability, according to
Salkind and Frey (2021), refers to the measurement’s consistency. Stamm (2010) reported that
the ProQOL demonstrated scale reliability at an alpha of .88.
33

Merriam and Tisdell (2016) said research should be focused on producing reliable and
valid results thorough investigation in an ethical manner. Validity and reliability can be achieved
through the study’s conceptualization of data collection, analysis, and interpretations (Merriam
& Tisdell, 2016). Credibility, transferability, dependability, and confirmability are terms utilized
to define and assess qualitative research trustworthiness (Merriam & Tisdell, 2016).
Method: Interviews
Interview Sampling Criteria, Recruitment, and Rationale
Interview participants were recruited by asking for volunteers to participate in an
interview with the researcher in the email sent to all currently enrolled and recently graduated
MSW students who meet the criteria for the sample. A question in the survey asked if
participants would be interested in participating in an interview. If participants were interested,
they were directed to provide their name, phone number, and email so that the researcher could
contact them. The goal was to recruit 10 to 12 students until achieving saturation. Merriam and
Tisdell (2016) recommended including six to eight interviewees in a group and using
unstructured, open-ended questions that focus on generating the perspectives and opinions of the
participants. Once the survey was created, the researcher emailed participants and requested
volunteers to participate in the study’s interview portion.
Interview Protocol
This researcher utilized a semistructured approach. Semistructured interviews consist of
an interview guide that includes a mix of more or less structured interview questions (Merriam &
Tisdell, 2016). The interview was guided by a list of questions to be explored. This format
allows the interviewer to explore further the interviewee’s emerging perspectives and personal
experiences (Merriam & Tisdell, 2016). The protocol included 14 questions, and depending on
34

responses, there were follow-up probing questions. These questions addressed key concepts of
the study and explored knowledge and motivations related to students and their experience with
compassion fatigue. The questions also addressed students’ perceptions of the school’s
knowledge and motivations related to compassion fatigue.
Qualitative Data Collection
This researcher employed a reciprocity approach, which assumed the researcher could
find a reason for participants to participate in the interview (Merriam & Tisdell, 2016).
Volunteers were recruited and scheduled to participate in the interview; interviewees received a
brief introduction to the study and researcher. The researcher obtained consent to be recorded via
Zoom. Field notes also were taken during the interview, along with the recording. The interviews
were estimated to take about 45 to 60 minutes, and the researcher intended to complete eight to
10 interviews. The researcher projected that it will take 2 to 3 weeks to complete the interviews
and another 2 to 3 weeks to transcribe recordings and notes. Interviews were conducted virtually
through Zoom and recorded to preserve interview data. Notes also were taken during the
interview to capture participant responses and note the researcher’s thoughts or feelings during
the interview. Notes and recordings were secured on the researcher’s password-protected
computer to ensure the security of data.
Credibility and Trustworthiness
The researcher employed the following strategies to ensure credibility and
trustworthiness during the interviews. Triangulation is the best-known strategy for improving
internal validity and uses several data sources, data collection, or investigators to confirm
findings and interpretations (Merriam & Tisdell, 2016). Triangulation increases credibility and
quantity by addressing the concern that a study’s findings result from a single method (Merriam
35

& Tisdell, 2016). Next, the researcher utilized researcher position or reflexivity, which involves
engaging in critical self-reflection about biases or theoretical orientation and relationship to the
study that could affect the research data (Merriam & Tisdell, 2016). A final strategy was peer
examination or review. This entailed engaging colleagues in discussions regarding the study,
congruency of the findings, and possible explanations or interpretations (Merriam & Tisdell,
2016).
Method: Document Analysis
Documents and artifacts are typically a natural aspect of the research setting and are
sources of data in qualitative research (Merriam & Tisdell, 2016.) For this study, WUSSW
course syllabi was reviewed to collect additional data that could further identify the school’s
influence on MSW students’ knowledge about compassion fatigue and secondary trauma and
ways to manage the experience.
Data Collection Procedures
Course syllabi are an appropriate source in understanding if students learn about
compassion fatigue and how to address it. A request of the most recent course syllabi except
electives was made to the MSW program chair. Once all course syllabi were received from the
MSW program chair, this researcher used a data collection protocol to analyze the syllabi.
Data Analysis
The document analysis protocol consisted of 5 questions. This researcher employed the
use of a spreadsheet to collect the answers to questions on the protocol (Appendix C).
Annotations were taken during the review noting any ideas, patterns or themes were noted by
this researcher.
36

Ethics
The researcher provided informed consent to all potential participants in advance of any
data collection. The informed consent process outlined the study’s fundamental purpose and
included a section explaining how social workers experience compassion fatigue and secondary
traumatic stress. The consent form also discussed the research design and that their participation
would be voluntary, and if they chose, they could withdraw from the study at any time. Finally,
there was an explanation of how the researcher would maintain confidentiality throughout the
study. The researcher stated that no identifying information would be kept with survey or
interview data and that all data gathered would be kept in a secure location. Participation was
voluntary, and no compensation or incentives were provided for participation. Issues of power
dynamics may have occurred because the researcher is a faculty member at the WUSSW and a
community mental health program director. The sample was students enrolled in the same
school. The researcher addressed this issue by stating clearly why this study is relevant and how
the knowledge gained will assist in curriculum development and creating supportive resources
for MSW students,
This research can benefit and serve the interests of social work students, faculty
members, researchers, and WUSSW as an institution. There was the possibility that the
participants could be harmed during the interview. Questions regarding compassion fatigue and
secondary trauma could have triggered retraumatization and proved harmful. The researcher
reminded participants of this potential and exercised caution and was mindful of providing
appropriate care and concern during this process. The researcher designed this study, framed its
scope, and generated these perspectives on benefits and interests. Knowledge gleaned from this
study will be shared with the WUSSW faculty and students to provide the basis for ongoing
37

curriculum improvement and development. Knowledge also could be shared at conferences like
the annual meeting of the Council on Social Work Education.

38

Chapter Four: Findings
The purpose of this study was to identify the knowledge, motivational, and organizational
factors that contribute to or mitigate the experience of compassion fatigue and secondary
traumatic stress among social work students enrolled at WUSSW. This study determined
strategies that could be used by the school faculty to assist students in identifying experiences of
compassion fatigue and manage, cope with, and mitigate those experiences. This chapter
presents the data generated from the survey, participant interviews, and document analysis to
understand the knowledge, motivational, and organizational influences.
The following research questions guided this study:
1. How, if at all, do social work students experience compassion fatigue and secondary
trauma during their field internships?
2. What knowledge and motivational factors affect students’ ability to engage in
behaviors known to identify and manage the experiences of compassion fatigue and
secondary trauma?
3. What is the interaction between the organizational context and student knowledge and
motivation?
4. What are the recommendations for organizational practice in the areas of knowledge,
motivation, and organizational factors?
Chapter Four focuses on Research Questions 1 to 3, and Research Question 4 is
addressed in Chapter Five. Data derived from the survey validated whether students experience
compassion fatigue or secondary traumatic stress. The data from surveys and interviews either
validated or invalidated assumed knowledge and motivation influences. Interviews and
document analysis validated the organizational influences.
39

Participating Stakeholders
Survey Participants
The sample consisted of current students and graduates from the WUSSW graduate
program. Forty-six participants completed the survey; 29 were current students and 17 were
graduates. Approximately 76% of participants identified as female and 20% identified as male,
with about 4% identifying as nonbinary or preferring not to answer. Approximately 96% of the
sample came from the school’s online program. Fifty percent of the sample identified as
Caucasian. Most of the sample (47%) was placed in a mental health setting; about 10% of the
sample was placed in a school or educational environment. About 22 participants came from the
Adult Mental Health and Wellness Department, 16 were in the Children, Youth and Family
Department, and eight were associated with the Social Change and Innovation Department. The
survey was administered utilizing Qualtrics. See Table 5 for participant demographic
information. At the end of the survey, those who wished to participate in the study’s interview
portion were asked to provide their contact information.

40

Table 5
Survey Participant Demographics (N = 46)
n %
Current student 29 63.0
Graduate 17 37.0
Ethnicity
American Indian or Alaska Native 4 8.7
Asian 1 2.2
Black or African American 8 17.4
Native Hawaiian or other Pacific Islander 1 2.2
White 23 50.0
Other 9 19.5
Age group
18–25 9 19.6
26–34 22 48.8
35–44 11 23.9
45–54 4 8.7
Gender
Female 35 76.1
Male 9 19.6
Nonbinary 1 2.2
Prefer not to answer 1 2.2
Program
Online 44 95.6
On campus 2 43.5
Department
Children, Youth, and Families 16 34.8
Adult Mental Health and Wellness 22 47.8
Social Change and Innovation 8 17.4
Placement setting
Hospital or health care 6 13.0
School or education 10 21.7
Mental health 21 45.6
Child welfare 1 2.2
Human services 4 8.7
Other 4 8.7

41

Interview Participants
Semistructured interviews were conducted with eight participants to further elaborate on
the students’ knowledge and experience of compassion fatigue. A proxy was used to interview
students, and the researcher interviewed graduates. The proxy was employed at the study site but
did not have a supervisory relationship with potential participants. The proxy conducted all
student interviews and was responsible for stripping all identifying information before providing
interview data to the investigator for analysis. The interview included 14 questions, and
depending on responses, there were follow-up probing questions. These questions addressed vital
concepts of the study and explored knowledge and motivations related to students and their
experience with compassion fatigue. The questions also addressed students’ perceptions of the
school’s knowledge and motivations related to compassion fatigue.
Eight interviewees participated in the interview: three graduates and five current students.
All interviews were conducted via Zoom, and all students were enrolled in or had completed the
online program. The interview duration ranged from 25 to 60 minutes. There was at least one
interviewee for each of the school’s departments. See Table 6 for a summary of interview
participant information.

42

Table 6
Interview Participants’ Demographics
Participant Campus Current student
or graduate
Interview
duration (min)
Department
P1 Online Graduate 29 Adult Mental Health and Wellness
P2 Online Graduate 35 Children, Youth, and Families
P3 Online Graduate 27 Adult Mental Health and Wellness
P4 Online Student 25 Adult Mental Health and Wellness
P5 Online Student 38 Adult Mental Health and Wellness
P6 Online Student 60 Social Change and Innovation
P7 Online Student 32 Children, Youth, and Families
P8 Online Student 44 Children, Youth, and Families

Findings
The following section presents the survey findings, interview findings, and document
analysis and organizes them according to key themes. Themes were determined based on
concepts reported by four or more interview participants. Results are grouped by related research
questions.
Research Question 1: How, if at All, Do Social Work Students Experience Compassion
Fatigue and Secondary Trauma during Their Field Internships?
This research question intended to determine whether MSW students experience
compassion fatigue or secondary traumatic stress. The survey instrument contained both items
for an existing scale and items developed by the researcher. According to Stamm (2009), both
positive and negative aspects affect a social worker’s quality of life. The ProQOL is the most
commonly used measure of the positive and negative effects of those in the helping professions.
Theme 1: MSW Students Experience Secondary Traumatic Stress
Stamm (2009) described secondary traumatic stress as negative feelings brought on by
work-related trauma or working with individuals who experienced trauma. This study explored if
43

MSW students experience secondary traumatic stress. Items 31 to 35 were composed of nominal
and ordinal questions to measure the student’s or graduate’s emerging knowledge, motivation,
and organizational concepts regarding compassion fatigue, secondary traumatic stress, or self-
care. The ProQOL consists of 30 questions and contains subscales for secondary traumatic stress,
compassion satisfaction, and burnout. Responses are on a Likert scale: 1 = never, 2 = rarely, 3 =
sometimes, 4 = often, and 5 = very often (Stamm, 2009). The cutoff scores for each subscale are
22 or less for low, between 23 and 41 for moderate, and 42 or more for high levels of secondary
traumatic stress, compassion satisfaction, or burnout. The ProQOL has good construct validity
with more than 200 published papers. Stamm (2009) reported that the ProQOL demonstrated
scale reliability at an alpha of .88.
Survey Findings
The secondary traumatic stress subscale consisted of 10 questions. Examples of these
statements are “I am preoccupied with more than one person,” “I feel as though I am
experiencing the traumatic experiences of the people I help,” and “I can’t recall important parts
of my work with trauma victims.” Ratings are added for a total subscale score. Based on survey
data, participants scored a mean of 23.65 (SD = 9.65), indicating a moderate level of secondary
traumatic stress. Looking closer at the data, 28 respondents scored low, 15 respondents scored
moderate, and three respondents scored high for secondary traumatic stress (Table 7). Table 7
shows the scores of each subscale along with the minimum, maximum, and standard deviation.

44

Table 7
ProQOL Subscale Scores (N = 46)
Subscales Min Max M SD
Compassion satisfaction 27 50 41.57 6.12
Burnout 10 37 21.33 7.21
Secondary traumatic stress 11 50 23.65 9.65

Based on survey data, participants experienced moderate to high levels of compassion
satisfaction, low levels of burnout, and low to moderate levels of secondary traumatic stress.
According to Salkind and Frey (2021), the standard deviation is a calculation used to quantify the
amount of variation throughout data. The smaller the standard deviation, the higher the level of
agreement among group members. There was a moderate level of variation regarding secondary
traumatic stress compared to compassion satisfaction and burnout (Salkind & Frey, 2021).
Interview Findings
All interview participants affirmed experiences of compassion fatigue and secondary
traumatic stress during their field placement. P3 reported experiencing bodily issues, which
included digestive problems and fatigue. She stated the need to “pause” and “remove” herself
from facilitating a few groups. She also expressed feeling extremely angry and helpless. In
addition to providing empathy to her clients, she reported stress trying to assist them, especially
when they needed more than what she was trained to provide.
P1 stated she experienced compassion fatigue during her internship, where she worked as
a hospice social worker. P1 recalled working with a family that just had a family member pass
away. The family had several questions about their family member. P1 tried to redirect the
family to the medical team because their questions were out of her scope of practice. The family
was unhappy to hear this and began to yell profanities at her. P1 said:
45

It went bad, and it made me a question like, is this really for me? Like, am I in the right
field? So yeah, I think I gave up on social work for like a month. I was still in school,
though, so I was. Practically it was in my last semester, and I think I needed like two
more one or two more semesters or quarters.
P8 described her experience with compassion fatigue as follows:
Some days you just don’t want to go in because you know something terrible is going to
happen. You know, you’re going to have to. You don’t know what’s going to happen, but
you know you’re going to have to work hard.
P2 reported that experiencing compassion fatigue led to him resigning from the Department of
Children and Family Services:
There was a lot of stuff going on in my life at the time that I was kind of pushing aside
because I felt like I needed to give myself to my clients and to my work, to my
supervisors. So, it was a lot of just not being able to turn off my brain. It was a lot. It was
a lot to deal with those sorts of experiences. I got to the point that Sunday nights,
especially, were very rough because I was already thinking about the kind of what was
going to be waiting for me. Then the guilt that I think comes with being a social worker
or somebody in a helping profession of when something bad would happen on a case.
There’s always that thought of, could I have done more? What did I miss? Should I have
done something else? And you know, going through therapy, because that’s what
ultimately led me to quitting my job as well, is sort of realizing that in a lot of instances,
there wasn’t much more that I could have done.
P4 shared how rewarding it is to serve others who have experienced much trauma in their
lives and that caring for herself has protected her so she can be present for her clients.
46

I’m working in a housing project with individuals that have chronic homelessness and
have pretty horrific stories. Even though I can compartmentalize, some of the stories can
be horrific and some of the things that these individuals have had to endure over their
life. So luckily, since I’m only working Monday through Friday, now I’m able to provide
myself with lots of self-care. I feel like now that these individuals are getting a little bit of
help, so they’re not falling through the cracks, at least so had lots of things that have
happened in the prior. But now, at this point, going forward, I can kind of assist them
with transforming their life into a better way.
Based on interview findings, compassion fatigue can manifest itself in many ways.
Compassion fatigue can lead social workers to question their ability to do the work or even
consider resigning. It is crucial to understand if social work students experience compassion
fatigue and secondary traumatic stress to address whether this phenomenon needs to be
addressed in schools of social work.
Theme 2: MSW Students Experience High Levels of Compassion Satisfaction
Stamm (2010) described compassion satisfaction as a positive aspect for those working in
a helping profession. Compassion satisfaction serves as a protective factor and can guard against
experiencing compassion fatigue. Research has shown that individuals who have low levels of
compassion satisfaction are at a higher risk of compassion fatigue, secondary traumatic stress,
and burnout (Dehlin & Lundh, 2018).
Survey Findings
Similar to the subscale for secondary traumatic stress, the compassion satisfaction
subscale consisted of 10 questions. Examples of questions include: “I get satisfaction from being
able to help people,” “I have happy thoughts and feelings about those I help and how I and how I
47

can help them,” and “I am happy that I chose to do this work.” Compassionate satisfaction serves
as a protective factor and guards against experiencing compassion fatigue. Compassion
satisfaction is the joy and pleasure experienced from work or helping others (Stamm, 2009).
Based on survey data, survey participants scored a mean of 41.57, indicating an overall high
level of compassion satisfaction. Survey respondents were split evenly: 50% of the sample
scored at a moderate level and 50% scored at a high level of compassion satisfaction. Students
reported overall positive experiences from their work. Table 8 shows subscales and the level of
severity for compassion satisfaction, burnout, and secondary traumatic stress.

Table 8
ProQOL Subscale Scores by Level of Severity
Level of severity
Low
(10–22)
Moderate
(23–41)
High
(42–50)
Subscale n % n % n %
Compassion satisfaction 0 0.00 23 50.00 23 50.00
Burnout 25 54.35 21 45.65 0 0.00
Secondary traumatic stress 28 60.87 15 32.61 3 6.52

48

The table shows that survey respondents overall had a moderate to a high level of
compassion satisfaction and a low to moderate level of burnout. Secondary traumatic stress
scores were more spread throughout the levels of severity. According to the ProQOL (Stamm,
2010), moderate levels of secondary traumatic stress and moderate to low levels of compassion
fatigue are considered positive. Individuals who score in this range receive a fair amount of
positive reinforcement from their work; they do not experience significant disturbance from their
work.
Interview Findings
Five of the eight interview participants report experiencing compassion satisfaction in
their work. P5 said that being a social worker provided her with “the opportunity to help to
transform lives.” P7 noted that not only was there “versatility” in the field, but there was also an
opportunity to learn different skills “to be able to help people in general, just being able to
empower people and improve their quality of life,” which the participant viewed as significant
benefits to being in the social work field. Similarly, P4 said, “We have the ability to, on the
ground level, to help individuals at an individual level. I want to work with individuals and
hopefully better their well-being.”
P2 reported that even working with individuals who have committed awful crimes can be
fulfilling:
So right now, I’m working with parolees who are out, who’ve committed sex offenses of
all types, which is not the easiest population to work with, necessarily. But again, having
that sort of compassion and talking to people and seeing like, well, yes, you did a bad
thing, but that doesn’t necessarily make you a bad person. I think just getting that sort of
perspective and realizing that there’s more than just my lived experience that is out there
49

in the world has been the biggest benefit and the biggest change that I’ve seen in my
attitude over the last five years or so.
P6 reported that what she enjoys most about being a social worker is that “my working
has an impact, like a positive impact and sometimes an immediate or direct positive impact on
the people that I’m working with.” P8 said that social workers could make a difference and affect
those they serve. Studies have shown that although stressful situations promote negative work
experiences, positive work experiences can lead to compassion satisfaction, which aids in
mitigating the effects of compassion fatigue (Zhang et al., 2018).
Research Question 2: What Knowledge and Motivational Factors Affect Students’ Ability
to Engage in Behaviors Known to Identify and Manage the Experiences of Compassion
Fatigue and Secondary Traumatic Stress?
This section explores knowledge and motivational factors that affect students’
engagement in behaviors known to manage compassion fatigue and secondary traumatic stress.
Survey and interview findings indicate that students know the importance of learning to cope
with compassion fatigue and secondary traumatic stress. Findings also demonstrate that students
possess various strategies and engage in many self-care activities to protect against compassion
fatigue and secondary traumatic stress. Firm professional boundaries were an overall strategy
utilized among interview participants.
Theme 3: Students Possess Strategies to Manage, Cope With, and Mitigate the Impact of
Compassion Fatigue and Secondary Traumatic Stress
Survey Findings
Survey data reveal that almost 70% of respondents engaged in managing, coping with, or
mitigating experiences of compassion fatigue (Figure 2). Similarly, 70% of survey respondents
50

reported that learning to cope with, manage, and mitigate compassion fatigue and secondary
traumatic stress is imperative. Interestingly, 16% of the respondents thought it was moderately
unimportant. Figure 2 depicts the number of survey participants who engaged in managing,
coping with, or mitigating experiences of compassion fatigue or secondary traumatic stress.

Figure 2
Survey Participants Who Engage in Managing Experiences of Compassion Fatigue and
Secondary Traumatic Stress

0
10
20
30
40
Yes No
Do you engage in managing, coping, or
mitigating experiences of campssion
fatigue or secodanry traumatic stress?
(n=46)
51

Survey participants who indicated that they do engage in self-care to manage, cope with,
and mitigate experiences of compassion fatigue described various activities. The most-reported
self-care activity was to engage in physical activity. Sixteen survey respondents reported
engaging in this activity for self-care. Physical activity included specific activities—for example,
exercise, gardening, walking, hiking, and yoga. Fourteen survey respondents engaged in
mindfulness, meditation, and breathing exercises. Other activities reported were reading,
meditation, and engaging in an artistic expression like music, poetry, or arts and crafts. Table 9
shows self-care activities and the number of survey respondents who reported utilizing a specific
activity to engage in self-care.

Table 9
Self-Care Activities Utilized by Survey Respondents
Self-care activity n
Physical activity (e.g., exercise, sports, hiking in nature) 16
Mindfulness, meditation, and breathing 14
Socializing with friends and family 11
Therapy and counseling 9
Hobbies and reading 9
Creative outlets (e.g., crafts, art) 6
Supervision and consultation 3
Boundary setting 2

52

Overall, social work students possessed knowledge of myriad strategies and activities to
combat compassion fatigue. Most survey respondents reported engaging in more than one self-
care activity. Maintaining multiple strategies may contribute to more protection against
experiencing compassion fatigue.
Interview Findings
Five interviewees emphasized the importance of learning to cope with compassion
fatigue and secondary traumatic stress and practice self-care. P2 said, “I think it is as important
as anything else that we learn here at school. We need to take better care of ourselves so that we
can do better work.” P1 said that students must learn to cope with compassion fatigue and
secondary traumatic stress, “especially knowing how to cope with it because we why people
burn out so quickly. I also see many social workers not care about their patients, which
consequently the effects on the patient.” P8 said, “It is really important because this is the
foundation of what your professional work is going to look like. So, if you can learn it now, the
easy way, you don’t have to learn it the hard way later.” P3 also said it was very important that
students clearly understand how to identify and handle it. P5 shared that social work students
need to know about compassion fatigue and how to manage it because it affects all areas in life;
it can manifest itself in behavior or relationships.
I think it’s incredibly important for both working with the client and the service the client
is receiving, as well as the clinician’s health. It’s just, it’s much more difficult to fully
serve those clients when you don’t feel your best. Especially, like I said, when you have
something like I did where it was giving me actual migraines. Being also a trauma
survivor myself and seeing how it affects every single part of my life. The vicarious
trauma because it can cause symptoms that can be similar to primarily experiencing
53

trauma as well. It’s not just, oh well, it’s important for the clinician’s overall health—
like, it affects every part of your life when you develop those symptoms. I think it would
be a disservice to the clinicians, in addition to the clients, to not fully know what’s going
on with compassion, fatigue and how to handle it. (P7)
Knowing the importance of learning to cope with, manage, and mitigate the effects of
compassion fatigue and secondary traumatic stress served as a motivating factor for students
combating the experience. Interview participants noted how these experiences could affect their
ability to care for and serve their clients and how they affect them. Interview participants shared
how these experiences can affect their physical health and relationships with others. In addition
to the importance of learning to manage the effects of compassion fatigue and secondary
traumatic stress, interview participants noted that setting firm professional boundaries was a
common strategy to cope.
Setting Professional Boundaries Is a Common Strategy to Avoid Compassion Fatigue and
Secondary Traumatic Stress
Five of the eight interviewees reported that having strong professional boundaries is a
strategy to avoid compassion fatigue and secondary traumatic stress. Interviewees described
having limits in various ways. One example was not checking emails or turning on their cell
phone after work hours or not giving out their cell phone number to clients. Table 10 includes
participant quotes relevant to how social work students cope with compassion fatigue and
secondary traumatic stress.

54

Table 10
Strategies to Avoid Compassion Fatigue and Secondary Traumatic Stress
Strategy Quote
Strong
boundaries
That particular case really helped me because I was having a lot of trouble
with establishing boundaries. So, like now, I turn my phone off at 4:30. I
also keep my boundaries with coworkers. (P1)
If I’m off it right now, I’m off at 7 o’clock, not checking my emails after 7
o’clock. That’s self-care. Making sure that if I’m giving out my personal
number for a client that I’m OK with that client calling me at all hours of
the night and if not, setting those firm boundaries. That’s something that I
learned probably too late for DCFS [the Department of Children and
Family Services], but definitely something that I’ve taken and implemented
moving forward is just creating those professional boundaries for myself.
(P2)
As soon as I leave my work, I leave it there. I mean, once I get in my car, I
take my badge off, and it stays there, and lots of self-care. (P4)
I’ve just learned if it’s outside of office hours to be careful to pull back and
pause. (P5)
Caring for myself is like having boundaries, being able to say what’s OK and
what’s not OK for me, being able to do the things that I know are going to
help me like, continue to be effective in whatever it is I’m choosing to do.
And so, kind of like taking a step back from that, kind of like my boundary
that I’ve created for myself. (P6)
Being self-
aware
I think you have to really; it’s a push to be self-aware. When I feel like if
something is out of whack when I’m more tired, I have to really look at
more physical things that are happening in order for me to know when it’s
too much. (P3)
Other
methods
Having faith has been very helpful. (P3)
I think meditation is underrated at how well it is helping you start your day
and end it. Learning what self-care actually means. Self-care means going
to the dentist. Self-care means going to your therapist. It means going to
your doctor. (P8)
I see a therapist to understand my experiences. I go to the dentist regularly. I
keep up with those appointments that are for myself. I spend time with my
kids. (P8)

Survey and interview data reveal that MSW students possessed many strategies for self-
care. Having multiple strategies like setting solid boundaries, having a strong support system,
and engaging in physical activities may serve as extra protection from experiencing compassion
55

fatigue and secondary traumatic stress. Similar to survey respondents, interviewees had coping
strategies, including being self-aware, spirituality, meditation, and participating in therapy.
MSW Students Know That Compassion Fatigue and Secondary Traumatic Stress Affect Client
Care
Five interview participants reported that in many cases, they experienced compassion
fatigue that affected client care. P1 and P8 reported decline to serve certain clients. P1 said, “If it
was a tough case, I would just give it to my preceptor. I was like, here you can have it. I’m not
even dealing with this.”
P8 recollected a time when she declined to see a client because she was experiencing a
panic attack,
It wasn’t until I was in placement that I had a full-blown panic attack. I was working with
an individual, and I felt like I don’t even know how they were going to get through this?
How am I supposed to support them in this? I almost quit placement; what I found out is
it was because I hadn’t worked on my stuff yet. It’s just like a doctor, right? You can’t do
surgery if they’re bleeding out of their hands. You absolutely cannot do it if you haven’t
dealt with the trauma you have had.
P5 provided more detail on how compassion fatigue affected her ability to provide client care:
It highly affects my ability to engage successfully with my clients. I’m half-listening. I’m
trying not to come off as short and shitty. It definitely affects the engagement process,
which therefore reflects on the level of care for my clients.
P5 went further and stated, “When you’re burned out, you have few resources. It is hard
to bring your A game to the table, and [that] affects the care that we give for sure.” P7 remarked
that there were occasions when she couldn’t provide care due to her migraines. She disclosed
56

that the migraines were so severe she could not get out of bed. P2 made an interesting analogy:
“Make sure that you are taking care of yourself, because if you can’t put on your oxygen mask,
you’re not going to be able to help the other person next to you put on their oxygen mask.”
Knowing that compassion fatigue and secondary traumatic stress affect client care served as a
motivating factor to understand their impact clearly and develop strategies to manage them.
Knowledge and Motivational Influences
MSW students had factual and procedural knowledge of coping with compassion fatigue
and secondary traumatic stress by utilizing self-care strategies. Both survey and interview
participants understood the importance of managing compassion fatigue and secondary traumatic
stress. Survey and interview participants also reported various ways to manage these issues.
Among the interview participants, professional boundaries were the most reported strategy to
mitigate the effects of compassion fatigue and secondary traumatic stress. Table 11 illustrates the
assumed knowledge influences, evaluation method, and validated knowledge influences.

Table 11
Validated Knowledge Influences
Assumed knowledge influences Evaluation method Validation
Factual (declarative) knowledge: Social work
students will know ways to manage
compassion fatigue and secondary
traumatic stress
Survey and
interview
Partially validated
Procedural knowledge: Social work students
will understand the processes and strategies
involved in managing compassion fatigue
and secondary traumatic stress
Survey and
interview
Partially validated
Conceptual knowledge: Social work students
need the knowledge of evaluating and
monitoring themselves and their
development of compassion fatigue
Interviews Not validated

57

Participants recognized the benefit of learning to cope and manage compassion fatigue
and secondary traumatic stress. Participants noted that compassion fatigue can directly affect
client care and that engaging in coping strategies will lead to better client care. Interview
participants possessed confidence in their self-care strategies to assist in managing compassion
fatigue and secondary traumatic stress. Participants scored high in compassion satisfaction,
which is a protective factor for experiencing compassion fatigue. Table 12 shows the assumed
motivational influences, evaluation method, and validated motivational influences.

Table 12
Validated Motivational Influences
Assumed motivational influences Evaluation method Validation
Expectancy value: Social work students need to
see the anticipated value associated
Interviews Partially validated
Self-efficacy: Social work students need to
possess confidence in applying management
and coping techniques to manage compassion
fatigue and secondary traumatic stress
Interviews Validated
Emotions: Social work students need to
experience positive activating emotions
similar to compassion satisfaction to assist in
managing experiences of compassion fatigue
Survey and
interview
Validated

58

Interview participants place a value on recognizing and managing their experiences of
compassion fatigue by engaging in self-care. Survey and interview participants shared various
self-care methods, which demonstrates their belief in their ability to cope with their experiences.
Interview respondents shared their feelings of compassion, satisfaction, or pleasure in their work
as social workers. These feelings serve as activating positive emotions that promote intrinsic and
extrinsic motivation (Elliot et al., 2017).
Research Question 3: What Is the Interaction Between the Organizational Context and
Student Knowledge and Motivation?
Ineffective organization work processes and structure can prevent achievement of
organizational goals. According to Clark and Estes (2008), individuals with exceptional
knowledge and motivation will still perform below expectations if there are insufficient
organizational processes and resources. This section explores the organizational context and its
impact on students engaging in behaviors known to manage compassion fatigue and secondary
traumatic stress.
Theme 4: Education and Training on Compassion Fatigue, Secondary Traumatic Stress,
and Self-Care Is Important
Survey Findings
Thirty-five (76%) survey respondents recalled learning about compassion fatigue and
secondary traumatic stress as part of the school curriculum. Thirty participants thought it was
extremely important and eight participants thought it was very important that the school provides
training on compassion fatigue. Figure 3 shows survey results on the importance that the school
provide training on compassion fatigue, secondary traumatic stress, and self-care.

59

Figure 3
Importance That the School Provide Training on Compassion Fatigue and Secondary Traumatic
Stress

Interview Findings
Interviewees had varied recollections on learning about compassion fatigue and
secondary traumatic stress. Interviewees recalled discussing self-care but not directly related to
experiencing compassion fatigue and secondary traumatic stress. See Table 13 for a summary of
quotes from interview participants when asked if the school provided education on compassion
fatigue and secondary traumatic stress.

0
10
20
30
40
Not at all important Slightly important Moderately
important
Very important Extremely important
How important is it that the school provide
training? (N = 46)
60

Table 13
How Did the School Educate You on Compassion Fatigue and Secondary Traumatic Stress?
Participant Quote
P2 I would say close to nonexistent. I was in the [online program] during my whole
time. I remember reading about compassion fatigue in my asynchronous stuff.
I remember reading about self-care, transference, counter-transference, but I
don’t think we spent enough time on it. This conversation that I’m having
with you that I just had about boundaries; I was the one sort of bringing up
professional boundaries in all of our discussions. It wasn’t. It wasn’t instructor
led. It wasn’t curriculum led.
P3 So it was like every semester, there was every class. There was something on
self-care, right?
P5 They don’t talk about it in depth. They just offer a lot of resources for it. But in
terms of public awareness and education, no.
P6 So, there’s in the field class, what do I feel like we’ve got some of this in the
field, right? And the other classes that I’ve taken, not so much, and I don’t
know if that’s because I’m on the SCI [Social Change and Innovation] track
and not the direct client-work classes.
P7 That’s what most of the classes for that are is processing, not necessarily
compassion fatigue specifically but taking the time to process and talk about
things that are happening internship and as a class, as a team kind of help each
other. There’s definitely lots of opportunities to talk through those
experiences, even if they’re not specific to vicarious trauma. And the
professors were very heavy on self-care, though not necessarily specifically
vicarious trauma.
P8 I was going to say no initially, I think Professor X definitely talked to us about
it, so I can’t say zero percent. No, I do not feel like that came from [the
university], though I really think that was her.

Five of the eight interviewees suggested that a curriculum be created and taught at the
beginning of the program. Interviewees suggested a class on signs and symptoms of compassion
fatigue and secondary traumatic stress and how to manage them. Table 14 contains a summary of
participant quotes. Elements of the class would also include time set aside for processing
experiences related to compassion fatigue and secondary traumatic stress. Students at WUSSW
61

must take a field course that resembles this description. However, there seemed to be varying
student experiences.

Table 14
Suggestions for the School
Participant Quote
P1 A lecture, you know, like kind of a what to expect and like, what if you are
experiencing it? What are some of the things like symptoms you’ll see? OK,
because I feel like a lot of us were questioning social work, but we never really
said it, you know, until somebody started opening up in class. And then it was
like, oh yeah, I feel that way, too. So, I feel like it’s a little taboo for a social
worker, which your job is to help people to feel that so kind of making it more
accepting and more
P2 I think that it’s important enough and big enough to have its own class. I think
about the placement class; we would meet seven times a month to talk about
what was going on in our field placements and things like that. And I feel like
there needs to be something like that for compassion, fatigue, self-care. You
know, if it’s not a weekly thing, that may be a biweekly thing where that’s all
we discuss and like these other things from the placements are going to come
up, but it sort of gives people the opportunity to have a mandatory group
therapy session, which I think could be very useful because a lot of people, like
you were saying because of the stigma, they won’t necessarily seek out
therapeutic services on their own. They won’t do any of that. So having a
mandatory thing where it’s like, these are the things that you need to look out
for, these are the things that can help. I think would be really useful if not
again, the entire time that you’re there, then maybe the second year for sure
when you’re starting placement. Having that be part of the curriculum would be
super important and hopefully lead to less turnover rates and all of these jobs.
So I think if we can’t make it its own class, that it needs to be built into that
curriculum somewhere in the first foundation year where you’re learning the
basics and then sort of, you know, trying to build it into as much as you can
when you’re talking about, you know, when you’re talking about research or
when you’re talking about how to work with children, youth and families, like
setting aside that little bit of time during class if it’s an hour and a half class
setting aside that last half hour of 15 minutes being like, OK, so you know,
what can you kind of see as being barriers to your own compassion, fatigue,
self-care and starting a dialogue that way? So that way, it’s always fresh in
people’s minds.
P3 It would be closed. There was a program that was like even like a favor by like
pro bono, like group therapy. OK. I think that even if it were like a monthly
62

Participant Quote
thing so that students then maybe like a list of resources specific to those again
that are pro bono.
P4 If they really want to train individuals to be good social workers, you have to
train them to take care of themselves, and that starts with the school taking care
of us. They just need to do more as far as implementing, don’t just tell us to
self-care, provide us the opportunity to do some more training, I’d say them
and understanding what it could happen because, you know, sometimes these
stories of my can be, you know, traumatic. These individuals have been
through. I guess and explaining what they’re going to be in for. I think they
should probably implement that at the beginning. That way, people, students
can understand, especially if they’re going on the micro-level. You know what
they’re in store for, for sure.
P5 Oh, it would definitely be beneficial. You know, because it would, you know,
help those who may not be aware or are mindful of when they’re experiencing
it. You know, and then it more so can be beneficial because it offers solutions
as to what to do when this is when the fatigue is happening. You know, you
have a lot of students who I observed who aren’t as seasoned and may not
know what to do when you know fatigue occurs.
P6 And so, taking away one of the electives, sure, and having like a class on, you
know, managing like compassion, fatigue, and secondary trauma and stuff, I
think would be helpful because we are all going to experience it no matter what
our track is.

Although most survey respondents remember being taught compassion fatigue, secondary
traumatic stress, and self-care, interview respondents cited a different learning experience. Some
interviewees said that a relevant curriculum was not taught at all, and other interviewees recalled
that some discussions were explicitly covered in their field courses. Interviewees offered some
suggestions on teaching about compassion fatigue, secondary traumatic stress, and self-care.
Suggestions included teaching a class dedicated to these topics, and others suggested having a
process group. A document analysis was conducted to illuminate how the school influences
MSW students’ knowledge and motivation.
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Document Analysis Findings
Course syllabi are an appropriate source of determining whether students are taught about
compassion fatigue and how to address it. For this study, 29 course syllabi were reviewed to
collect additional data that could further identify the school’s influence on MSW students’
knowledge about compassion fatigue and secondary trauma and ways to manage the experience.
Only core and required courses were reviewed; no electives were included in this document
analysis. There were four foundation semester courses, six courses from each of the three
concentrations (Children, Youth, and Families; Adult Mental Health and Wellness; and Social
Change and Innovation), and seven field courses. Table 15 provides a summary of the class
syllabi reviewed. The document analysis protocol consisted of five prompts:
1. In how many units, if any, is compassion fatigue introduced or taught?
2. In how many units, if any, is secondary traumatic stress introduced or taught?
3. In how many units, if any, is self-care introduced or taught?
4. Does the syllabus include any assignments that reference compassion fatigue,
secondary traumatic stress, and self-care? If so, how many and which ones?
5. Does the syllabus include any readings that reference compassion fatigue, secondary
traumatic stress, and self-care? If so, how many and which ones?
Table 15 outlines the type of class or department and the title of the course. All students
were required to take foundation courses and field courses. The department in which students
were enrolled determined which classes they take; for example, if a student is enrolled in the
Children, Youth, and Families Department, that student enrolls in the department’s required
courses.

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Table 15
Department and Courses Analyzed
Class or
department
Course title
Foundation
course
SOWK 506 Human Behavior and the Social Environment
SOWK 536 Policy and Advocacy in Professional Social Work
SOWK 544 Social Work Practice with Individual, Families and Groups
SOWK 546 Science of Social Work
Children, Youth,
and Family
SOWK 608 Research and Critical Analysis for Social Work with Children
and Families
SOWK 609 Introduction to Social Work Practice with Children, Youth and
Families
SOWK 610 Social Work Practice with Children and Families Across
Settings
SOWK 613 Social Work Practice with Children and Families in Early and
Middle Childhood
SOWK 621 Social Practice with Adolescents, young Adults and Their
Families
SOWK 627 Policy and Macro Practice in Child, Youth, and Family
Services
Adult Mental
Health and
Wellness
SOWK 635 Research and Evaluation for Social Work with Adults and
Older Adults
SOWK 637 Assessing Wellness to Improve Recovery and Integrated Care
SOWK 638 Policy in Integrated Care
SOWK 643 Social Work Practice in Integrated Care Settings
SOWK 644 Explanatory Theories of Health and Mental Health
SOWK 647 Advanced Practice with Complex Social Work Cases
Social Change
and Innovation
SOWK 629 Research and Evaluation for Community, Organization, and
Business
SOWK 639 Policy Advocacy and Social Change
SOWK 648 Management and Organizational Development for Social
Workers
SOWK 665 Grant Writing and Program Development for Social Workers
SOWK 672 Social Work and Business Settings
SOWK 684 Community Practice for Social Innovation
Field course SOWK 588 Integrative Learning for Social Work Practice
SOWK 589a Applied Learning in Field Education
SOWK 589b Applied Learning in Field Education
SOWK 698a Integrative Learning for Advanced Social Work Practice
SOWK 698b Integrative Learning for Advanced Social Work Practice
SOWK 699a Advanced Applied Learning in Field Instruction
SOWK 699a Advanced Applied Learning in Field Instruction

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The analysis demonstrated that of the 29 documents reviewed, four courses mentioned
compassion fatigue, secondary traumatic stress, and self-care in the unit topics. These courses
were in the field department and required for all students. In SOWK 589a, self-care, stress
management, compassion fatigue, burnout, and compassion satisfaction were listed as topics
reviewed in the course’s practice lab. SOWK 589a also listed four readings that cover self-care.
In SOWK 698a, there were two required reading assignments, one on self-care and one on
mindfulness, and compassion fatigue. SOWK 699a and 699b are courses related to the third and
fourth semesters of the program. This course is the student’s internship and allows the student to
apply their learning in a fieldwork setting with clients. The topic of “review of self-care
strategies to maintain emotional and physical well-being and balance competing demands on
time inherent in the MSW program” was under the evaluation model of the course. There were
no assignments assigned related to compassion fatigue, secondary traumatic stress, or self-care.
Interviewees overwhelmingly thought there should be more training and education on these
topics. Table 16 summarizes the classes that include topics or readings related to compassion
fatigue, secondary traumatic stress, or self-care.

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Table 16
Field Courses and Compassion Fatigue, Secondary Traumatic Stress, or Self-Care Discussion
Topics or Course Readings
Course Discussion or reading
SOWK 589a Self-care, stress management, compassion fatigue, burnout, and
compassion satisfaction are topics discussed in Units 9–11
Three required readings
SOWK 698a Promoting self-resilience is a topic in Unit 5
Two required readings that cover self-care and compassion fatigue
SOWK 699a and 699b Review self-care strategies to maintain emotional and physical well-
being and balance competing demands on time inherent in the
MSW program

The topics of compassion fatigue, secondary traumatic stress, and self-care are covered in
field coursework, and there are readings to complement the discussions. As some interviewees
reported, this may not be enough to support students. The SOWK 699a and 699b sequence
involves classes associated with internships. Although the topics are identified in the syllabi,
there is no guarantee these topics are being reviewed in supervision times with the students.
Required readings and discussions in four courses are limited evidence that students are learning
how to identify compassion fatigue and secondary traumatic stress signs and symptoms and ways
to manage them through self-care. For learning to occur, topics that are important and should be
prioritized, supplemental class activities, and assessments on compassion fatigue, secondary
traumatic stress, and self-care need to be included with readings and discussions. In addition to
instruction on these topics, the school’s ability to provide resources or supports to students
experiencing compassion fatigue was explored with interview participants.
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Theme 5: Students Felt Supported by the Faculty
Seven interview participants reported feelings very supported and understood by their
professors, particularly their field course instructors. Support consisted of providing an
opportunity to talk about internship stressors; P1 remembers staying after class to meet with her
field liaison and feeling supported because of the instructor’s willingness to listen.
So, and then the professors were helpful, too, like they were. I had got really, really sick
one semester, and a professor was super understanding and allowed for me to turn in a
paper when I could because I literally like, there were days I couldn’t even have my
camera on because I had to lie down because I was so queasy. The professors themselves
showed a lot of compassion. (P2)
P3 said:
My professor for the field is extremely honest about doing self-care. Then all the
professors, pretty much, I think probably 95%, have like discussed self-care. And then
you know what to look out for when we’re getting, you know, secondary trauma.
P7 shared that her professors provided class time “to process and talk about things that
are happening internship. As a class, as a team, [we] kind of help each other.” P8 said that her
field seminar instructor was available to “talk to her about what I’m going through and have her
lend an ear and give me support; that helped.”
When interview participants were asked what school resources were available to students
to combat compassion fatigue, P1 recalled signing up for a mentoring program that served as a
support system, but other than that, she was not aware of any resources. P1 said that she was so
busy she could not access any resources, if any were available. Similarly, P4 stated, “I guess
there’s a counseling center or something, but you know, unless they’re going to add more hours
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to my days, kind of not.” Similarly, P6 noted that she knew resources were available, but she was
too overwhelmed to seek them out. P2 and P5 recalled receiving emails from the school about
wellness and self-care but not necessarily utilizing them as a source of support.
The school’s faculty overwhelmingly appeared to be a consistent and robust resource to
support students experiencing compassion fatigue. Based on interview responses, interviewees
thought there might be other resources and supports available to students; however, various
reasons for not accessing those resources, including time and lack of knowledge of the supports,
were cited by interviewees.
Organizational Influences
Organizational influences contribute to social work students’ experiences of compassion
fatigue and secondary traumatic stress. Most survey respondents reported having learned about
these topics in their curriculum, whereas the interview participants had varying reports of
learning about compassion fatigue, secondary traumatic stress, and self-care. One participant
described relevant education and training as “nonexistent.” Other students described having
opportunities to discuss and process field experiences in their field courses. Interview
participants revealed that the faculty was an essential source of support during their placement.
The document analysis shows that these topics were discussed in field courses. The curriculum
featured six readings on these topics. There were no written assignments or tests that covered
these topics. Most participants were not aware of or did not access the school’s resources. Table
17 shows the assumed organizational influences, evaluation method, and validation of
organizational results.

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Table 17
Validated Organizational Influences
Assumed organization influences Evaluation method Validation
The school is not teaching about
compassion fatigue and secondary
traumatic stress.
Survey and interview Partially validated
The curriculum does not contain
relevant activities, assignments, or
assessments.
Interview and
document analysis
Partially validated
The school provides resources and
activities for students to assist in
fostering mindfulness and wellness.
Interview Partially validated

The findings from this study indicate that MSW students had the knowledge and
motivation to engage in behaviors known to help them cope with and manage the symptoms of
compassion fatigue and secondary traumatic stress. The study also demonstrated gaps at the
organizational level that need to be addressed. Table 18 presents the knowledge, motivational,
and organization influences explored in this study and their determination as a need.

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Table 18
Knowledge, Motivational, and Organizational Needs as Determined by the Data

Summary
This chapter presented the findings from the survey, interviews, and document analysis.
Survey data revealed that MSW students did experience a moderate level of compassion fatigue
and secondary traumatic stress. MSW students also experienced a high level of compassion
satisfaction, which the research findings demonstrate. Interview findings indicate that MSW
Assumed influence Need
Knowledge influences
Social work students will know ways to manage
compassion fatigue and secondary traumatic
stress.
Develop curriculum and courses that
include self-care strategies
Social work students will understand the
processes and strategies involved in managing
compassion fatigue and secondary traumatic
stress.
Provide and promote mental health and
peer supportive services
Motivation influences
Social work students need to see the anticipated
value associated.
Provide relevant awareness program
activities during the semester
Social work students need to possess confidence
in applying management and coping techniques
to manage compassion fatigue and secondary
traumatic stress.
Develop assignments and classroom
activities that identify ways to cope with
and manage compassion fatigue and
secondary traumatic stress
Social work students need to experience positive
activating emotions similar to compassion
satisfaction to assist in managing experiences of
compassion fatigue.
Provide classroom time for discussion of
cases that identify experiences of
compassion satisfaction at students’
placements
Organizational influences
The school is not teaching about compassion
fatigue secondary traumatic stress.
Develop curriculum and courses that
include self-care strategies
The curriculum does not contain relevant
activities, assignments, or assessments.
Embed interactive activities and in-depth
discussion in courses to engage students
The school provides resources and activities for
students to assist in fostering mindfulness and
wellness.
Provide and promote mental health and
peer support services for students
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students possessed self-care strategies to guard against experiencing compassion fatigue and
secondary traumatic stress. Interview data also indicate that some students did not recall learning
about compassion fatigue, secondary traumatic stress, and self-care in their courses. Document
analysis demonstrated that these topics are only reviewed and discussed in courses. For these
topics to be prioritized and valued, more emphasis needs to be placed on compassion fatigue,
secondary traumatic stress, and self-care in coursework. These research findings are further
discussed further in Chapter Five, along with recommendations to improve student knowledge,
motivation, and organizational gaps.

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Chapter Five: Discussion and Recommendations
This chapter provides a discussion of the study findings and addresses Research Question
4: What are the recommendations for organizational practice in the areas of knowledge,
motivation, and organizational factors? It is organized into the following sections: discussion of
findings, recommendations for change, limitations of the study, recommendations for future
research, and conclusions. The discussion of findings section features themes that emerged from
the survey, interviews, and document analysis, along with a discussion how these themes align
with the literature review. Next, based on these findings and rooted in research,
recommendations for organizational practice are offered. Finally, an integrated approach
utilizing Kotter’s eight-step process for leading change for successful implementation of the
recommendations is presented.
Discussion of Findings
Utilizing Clarke and Estes’ (2008) gap analysis framework, the results reveal strengths
and gaps in MSW students’ knowledge and motivation and WSSSW’s organizational processes
for students to learn how to manage and cope with experiences of compassion fatigue and
secondary traumatic stress. The organizational recommendations for WUSSW are based on these
study results and reinforced by prior research. Research findings from this study are organized
by the five major themes discussed in Chapter Four.
Theme 1: MSW Students Experience Secondary Traumatic Stress
Survey respondents scored a mean of 23.65 on the ProQOL portion of the survey,
indicating a moderate level of compassion fatigue. In addition, all eight interview participants
reported various experiences of compassion fatigue and secondary traumatic stress. Situations
included experiences of somatic complaints and extreme feelings of anger and hopelessness.
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Interviews also revealed that some MSW students considered resigning from their field
placement or withdrawing from the MSW program due to these stressful experiences. This
finding aligns with the literature presented in Chapter Two and further emphasizes the need to
address the phenomenon while students are in school to better prepare them for life after they
graduate and are part of the workforce. In a related study, Ben-Porat et al. (2021) found 36%,
18%, and 18% of students suffered from mild, moderate, and extreme secondary traumatic stress,
respectively, further illustrating the importance of helping students manage this phenomenon.
Theme 2: MSW Students Experience High Levels of Compassion Satisfaction
Survey respondents scored a mean of 41.57, indicating an overall high level of
compassion fatigue, and 50% of the sample scored in the moderate level and the other 50% of
the sample scored in the high level. Interview participants reported compassion satisfaction from
working with individuals and helping them make a change in their lives. Interview participants
further explained that they understood their service affects individuals’ lives. As discussed in the
literature review, compassion satisfaction serves as a protective factor by mitigating the adverse
effects of compassion fatigue and burnout for social workers (Harr et al., 2014). Senreich et al.
(2020) found that although social workers are exposed to stressful and traumatic client
experiences, many experience a substantial level of compassion, satisfaction, and reward in their
work. Positive work experiences are associated with higher levels of compassion satisfaction
(Vagharsyyedin et al., 2018). Pelon (2017) suggested that compassion fatigue and compassion
satisfaction are negatively correlated, and that satisfaction guards against fatigue. Students’ high
level of compassion satisfaction protected them from experiencing compassion fatigue. Based on
this finding, it may be useful to consider interventions that enhance compassion satisfaction for
social workers and students.
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Theme 3: Students Possess Strategies to Manage, Cope With, and Mitigate the Impact of
Compassion Fatigue and Secondary Traumatic Stress
Survey data reveal that most respondents engaged in managing, coping, or mitigating
experiences of compassion fatigue. In addition, most survey respondents reported that it is
imperative to learn to cope with, manage, and mitigate compassion fatigue and secondary
traumatic stress. Survey participants reported various self-care activities and strategies that they
engage in, such as exercise, counseling, and interacting with friends and family. Students
appeared to be practicing this core social work competency. As presented in the literature review,
according to the Council on Social Work Education (2020), self-care is a prime responsibility of
a social worker’s professionalism and core competence in social work training. Practicing self-
care helps reduce compassion fatigue and improve compassion satisfaction among social
workers (Cuartero & Campos-Vidal, 2019). In addition to self-care, interview participants
recognized that setting firm boundaries was another key strategy for coping with compassion
fatigue and secondary traumatic stress. Peters (2018) concluded that in addition to teaching about
the signs and symptoms of compassion fatigue and secondary traumatic stress, training on
prevention and setting professional boundaries will help those in the helping professions manage
these challenges.
Theme 4: Education and Training on Compassion Fatigue, Secondary Traumatic Stress,
and Self-Care Is Important
Most survey respondents thought that training on compassion fatigue, secondary
traumatic stress, and self-care is important and recalled learning about these topics in the MSW
program. Interviewees had a varied recollection of being taught about these topics. Interviewees
thought students should be taught about signs and symptoms of compassion fatigue and
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secondary traumatic stress and how to manage them when students first enter the program.
Integrating knowledge of these risks in social work education and training will improve social
work skills and enhance work experience (Kapoulitsas & Corcoran, 2015). Aligned with the
literature review, the curriculum should also be focused on using self-care techniques to better
prepare to deal with work-related stressors in their career (Butler et al., 2016). Document
analysis revealed that of the 29 syllabi examined, four courses, specifically field courses,
contained topics or readings on compassion fatigue, secondary traumatic stress, and self-care.
Four courses are not enough for MSW students to adequately learn about and understand
compassion fatigue, secondary traumatic stress, and self-care. Complete student engagement in
this topic is necessary for students to be skilled in managing the damaging aspects of compassion
fatigue and secondary traumatic stress. Courses need to include structured class activities, written
assignments, breakout groups, self-reflection assignments, and self-assessment practices. This
will hold students accountable and demonstrate the importance of this topic. Researchers have
recommended that MSW students be trained in the possible impact of working with clients with
traumatic experiences (Staudt & Williams-Hayes, 2019). Training should also include the
symptoms of compassion fatigue and secondary traumatic stress and how to integrate self-care
into social work practice (Staudt & Williams-Hayes, 2019).
Theme 5: Students Felt Supported by the Faculty
Most interview participants reported feeling supported and understood by the faculty.
Interview participants shared that the faculty demonstrated support in a few ways, including
allowing students to debrief about clients, consultation, and encouraging self-care. Kapoulitsas
and Corcoran (2015) suggested that having a support system with which they could debrief about
work stresses is important for social workers to continue to perform well in their jobs. Barr
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(2017) found that having social support was a significant resource for nurses because it reduced
the chances of worsening secondary traumatic stress. Singh et al. (2020) found that emotional
support from an experienced professional can guard against compassion fatigue and secondary
traumatic stress. Peer support and mutual assistance between coworkers or others with similar
experiences can play a significant role in mitigating secondary traumatic stress (Caringi et al.,
2017; Kapoulitsas & Corcoran, 2015). Coworkers can validate and understand the complexities
of the job and offer humor to lighten the impact of stress (Caringi et al., 2017). Finally, some
interviewees recalled the school offering other resources like counseling, but interviewees did
not access resources. Interviewees cited various reasons, including lack of knowledge of the
resources and lack of time.
Recommendations for Practice
Through careful data analysis and examining the current research on compassion fatigue,
secondary traumatic stress, and self-care, three recommendations have been identified that will
significantly affect MSW students’ experience with these issues at WU. These recommendations
address this study’s findings and are supported by the literature: (a) create a curriculum that
teaches about compassion fatigue, secondary traumatic stress, and self-care; (b) provide
supportive resources to students; and (c) sponsor compassion fatigue, secondary traumatic stress,
and self-care awareness activities for students.
Recommendation 1: Create a Curriculum That Includes Compassion Fatigue, Secondary
Traumatic Stress, and Self-Care
Knowledge and awareness of compassion fatigue, secondary traumatic stress, and self-
care are essential and should be prioritized for the program at WUSSW. Document analysis
revealed that of the 29 courses studied, only four courses reviewed these topics. The first
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recommendation is to create a curriculum that includes direct instruction, discussions,
assignments, activities, reflective writing, and readings that teach the signs and symptoms of
compassion fatigue and secondary traumatic stress, strategies of self-care, and boundary setting.
Lewis and King (2019) created a self-care module that includes: (1) instruction on
compassion fatigue and secondary traumatic stress risk factors, signs, and symptoms; (2)
activities that identifying stress sources and stress reduction techniques; and (3) student
reflection through group discussion, self-assessment, and a self-care assessment. The
recommended curriculum would contain these aspects and be embedded throughout the MSW
students’ enrollment in the program. It is recommended that students be introduced to these
topics in a first-semester foundation class and a core course in the third or fourth semester.
Cuartero and Campos-Vidal (2019) suggested that promoting self-care helps increase
compassion satisfaction, decrease compassion fatigue, and bring benefits to social workers,
clients, and the organization. In addition, the faculty’s knowledge and skill to teach student-
centered practices should be assessed. Faculty training and support should be provided to the
faculty to support teaching effectiveness. This will demonstrate that is a priority for the school
and students.
Language in the syllabi and curriculum must be specific and explicit. Unit objectives
should be specific, measurable, and clearly state what students will be learning; for example,
“Risk factors, signs and symptoms of compassion fatigue will be presented and discussed.”
Furthermore, it is important to revisit compassion fatigue, secondary traumatic stress, and self-
care early in the program and throughout students’ coursework. This is important because
students may not recognize the phenomena during their stages in the program. Regular
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discussion and review will also help courses to be more consistent across the board and will
build the culture of self-awareness and self-care for social work students.
Field courses also should emphasize compassion fatigue, secondary traumatic stress, and
self-care in classroom discussions about MSW students’ field experiences. Field course
instructors should also include discussions that highlight experiences of compassion satisfaction
by having students share success stories and positive aspects of their work in the field. Harr et al.
(2014) recommend that field seminar instructors allow sufficient time to debrief and process
field experiences and assist students in developing a healthy work–life–school balance. Students
can complete a self-care plan assignment that identifies triggers and mechanisms for coping with
potential stressors, addresses safety needs, and develops support systems (Harr et al., 2014). In
addition, students can be assigned a reflection assignment describing self-care and coping
strategies most appropriate for them for current and future reference (Lewis & King, 2019).
According to Iacono (2017), including self-care in the social work curriculum demonstrates that
it is a shared responsibility for MSW students. Individuals should be committed to practicing
self-care. Similarly, organizations need to be committed in supporting and encouraging their
workers to engage in self-care.
Developing a more focused curriculum with clear, specific, and measurable objectives to
support curriculum changes will close the knowledge gap for MSW students by providing the
knowledge and skills necessary to be successful social workers (Clark & Estes, 2008). Courses
should be designed to provide: (a) information on compassion fatigue, secondary traumatic
stress, and self-care; (b) job aids (self-assessments), tools, and resources to assist in identifying
compassion fatigue and secondary traumatic stress for current and future use; (c) training on how
to manage these stressors; and (d) education, which is the acquisition of the conceptual and
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strategic knowledge and skills, to identify compassion fatigue and secondary traumatic stress and
use self-care to manage these issues (Clark & Estes, 2008).
Recommendation 2: Provide and Promote Supportive School Resources, Including Peer
Support and Mental Health Services
Seven of the eight interviewees felt supported by their faculty. According to interviewees,
the faculty provided a space for students to talk about internship cases and stressors, but this was
not enough. One student remarked that having the faculty listen and provide support was helpful.
Baugerud et al. (2018) found that supervision and social support were instrumental in buffering
against developing secondary traumatic stress and burnout. All MSW students are assigned to a
field instructor who must provide weekly supervision; it is apparent that students need more
support and opportunities to process their work. Reaching out to the faculty serves as additional
support resource to assist in processing the stressors associated with their work. Creating
additional supportive systems in the school is essential for student success and reducing
compassion fatigue and burnout (Benner & Curl, 2018).
One type of supportive system involves peer support services, so it is recommended that
the WUSSW provide peer support services for MSW students. This peer-led support group could
be implemented in the 698a/b course sequence. Students in the 698a/b course have already one
year of placement and have more field experience, making this an ideal time for students who
need support or can provide support to fellow students. MSW students would provide peer
support to help other MSW students. Research has shown the benefits of peer support to increase
compassion satisfaction and combat compassion fatigue and secondary traumatic stress (Wahl et
al., 2018). Peer support can decrease feelings of isolation and increase emotional support (Ben-
Porat et al., 2021). Peer support involves individuals who provide active listening, validating,
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normalizing, sharing stories, developing coping mechanisms, and self-care (Chambers, 2022).
The Resilience in Stressful Events program is an example of an effective peer support model. It
is based on the premise that support from a trained peer promotes emotional wellness and is
designed to provide peer support to others who encounter stressful work-related events and the
day-to-day stresses of providing care to others (Connors et al., 2020). Another model called the
Peer Support Network includes peer support, education, and resilience training that has
demonstrated improvement in compassion satisfaction and fatigue among nurses (Wahl et al.,
2018). This type of support, also described as collegial support, refers to the social workers’ need
for empathy and provides a framework for sharing case dilemmas, knowledge, and support,
assisting in the prevention of secondary traumatic stress (Ben-Porat et al., 2021).
It is further recommended that under the umbrella of providing supportive services,
WUSSW should provide mental health services to its online and on-campus students who may
be experiencing compassion fatigue and secondary traumatic stress. This study confirmed that
MSW students experience compassion fatigue and secondary traumatic stress. Interviewees
reported diverse experiences of these issues. Based on interview responses, students had varied
knowledge of available resources, and some did not utilize them because of their schedules.
Students experiencing severe compassion fatigue and secondary traumatic stress symptoms may
need to access professional interventions to cope. Barleycorn (2019) suggested that health care
providers experiencing secondary traumatic stress or compassion fatigue should know when and
where to seek support from trained professionals. Mental health resource information needs to be
widely and consistently promoted. All students should have awareness and knowledge of
counseling services available to them if they are experiencing compassion fatigue and secondary
traumatic stress to the degree that they cannot go to school or internships. Services should
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incorporate various interventions, including mindfulness and cognitive behavioral therapy, and
be flexible enough to accommodate MSW students’ schedules. Cognitive behavioral therapy has
been shown to decrease burnout and emotional exhaustion (Babineau et al., 2019).
This study revealed that students were not aware of or did not utilize counseling services
when needed. The school did not outwardly promote resources to help students cope with
stressors like compassion fatigue and secondary traumatic stress. Clark and Estes (2008)
maintain that to build motivation among students, the school needs foster a culture of positive
beliefs and practices. Promoting and providing these resources to MSW students would help
close the motivation gap. Adopting a motivational climate will increase student and
organizational trust, collaboration, positive emotions, and value regarding student work. In
addition, expectancy value theory suggest that motivation is a function of an individual’s
expectancy for success in a task (Eccles & Wigfield, 2002). Outcome expectancy is the
perception of the expected consequences of engaging in a task. Efficacy expectancy is belief in
the ability to execute the task to result in a desired outcome (Appianing & Van Eck, 2018).
MSW students will utilize these resources when appropriate because they understand that peer
support and counseling will help them to be better social workers.
Recommendation 3: Provide Compassion Fatigue, Secondary Traumatic Stress, and Self-
Care Awareness Program Activities for Students
Knowledge of compassion fatigue and secondary traumatic stress can increase awareness,
leading to the practice of prevention, boundary setting, and self-care (Mattioli et al., 2018).
Marshman et al. (2021) recommended interventions to increase awareness of compassion fatigue
and secondary traumatic stress and build personal resilience. The third recommendation is for
WUSSW to host compassion fatigue, secondary traumatic stress, and self-care awareness
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activities in the fall and spring semesters for both on-campus and online students. The purpose of
these activities would be to build awareness and knowledge of compassion satisfaction, signs and
symptoms of compassion fatigue and secondary traumatic stress, develop self-care strategies,
create a work–life balance, and promote school resources to help those who may be experiencing
compassion fatigue and secondary traumatic stress. Specific activities could also include
lectures, guest speakers, brown-bag lunches, and interactive practices on self-care. The school
should also promote self-assessments like the ProQOL and Life Stress Test so MSW students
can learn to be proactive in their awareness by providing them the necessary tools.
Awareness of compassion fatigue and secondary traumatic stress can inspire mindfulness,
prevention, and self-care, ultimately leading to overall healthier social workers (Mattioli et al.,
2018). One example of an awareness activity is an intervention conducted with certified nursing
assistants. The intervention included a presentation on compassion fatigue awareness and self-
care skills, like exercise, journaling, stress management, and muscle relaxation (Dreher et al.,
2019). Dreher et al. (2019) found that this intervention improved the nurses’ compassion
satisfaction, secondary traumatic stress, and compassion fatigue as measured by the ProQOL.
This study showed that WUSSW did not create a culture conducive to learning about
compassion fatigue and secondary traumatic stress, nor encourage coping with and managing
this experience. Clark and Estes (2008) described organizational culture as values, goals, and
processes learned over time. Clark and Estes (2008) stated that organizational culture is the most
important process in organizations because it sets the framework for overall successful
performance. Providing compassion fatigue, secondary traumatic stress, and self-care awareness
program activities not only would help build knowledge on these topics but also demonstrate to
students that the school understands the value of teaching about these issues. It would also show
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that the school places a value on the students’ health, well-being, and success. This
recommendation will help create a school environment and culture that emphasizes the
importance of self-care as a social worker.
Integrated Recommendations
In the long term, the expected outcomes of these recommendations would be less
compassion fatigue, secondary traumatic stress, and burnout; increased compassion satisfaction;
improved client care; fewer students taking leaves of absence due to stress; and improved
retention. In the short term, graduating students will have increased knowledge of the signs and
symptoms of compassion fatigue and self-care practices. Graduating students will have improved
motivation to manage and cope with compassion fatigue and secondary traumatic stress. These
recommendations will require changes both in the micro and macro levels of the school. To
ensure a successful transition, Kotter’s (1995) eight-step process for leading change is offered as
the framework for implementing recommendations.
Step 1: Act with Urgency
This first step is crucial because it requires cooperation from many players in the school
(Kotter, 1995). The researcher will present findings from this study with those in key leadership
positions, including the Associate Dean for Curriculum and Associate Director of Professional
Development of WUSSW, that current MSW students and recent graduates experience moderate
levels of compassion fatigue and secondary traumatic stress. This researcher intends to request a
meeting with the associate dean for curriculum and the associate director of professional
development to present a succinct presentation on the findings and recommendations of this
study. Leadership will need to be involved in the change process. Leadership commitment must
be demonstrated and communicated to the whole school to ensure success (Clark & Estes, 2008).
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Data will need to be presented to show how compassion fatigue and secondary traumatic stress
among students affect enrollment and graduation rates. The whole school will need to understand
that its responsibility is to respond to this problem. The faculty and leadership will need to listen
to student needs actively. Stakeholders will need to be involved in this conversation to
demonstrate the importance of addressing this issue. A discussion including the potential
opportunity for the school to focus on compassion fatigue, secondary traumatic stress, and self-
care can distinguish WUSSW from other schools of social work.
Step 2: Develop a Guiding Coalition
According to Kotter (1995), a successful guiding team features three to five members and
grows as the change effort continues. The guiding team should be five to seven faculty members,
students, and staff members to lead the change effort. These members should be passionate about
this initiative and invested in developing innovative solutions to address compassion fatigue and
secondary traumatic stress with students (Wheeler & Holmes, 2017).
Step 3: Create a Vision
The critical element for successful change is connecting a compelling vision, processes to
reach the vision, and precise work goals (Clark & Estes, 2008). Creating the vision directs the
change effort and develops strategies for meeting the vision (Kotter, 1995). The guiding team
should create a vision encompassing micro (student) and macro (organization) interventions. The
vision should include developing a curriculum covering compassion fatigue, secondary traumatic
stress, self-care, mental health resources, peer support resources, and awareness activities.
Step 4: Communicate the Vision
According to Kotter (1995), every vehicle possible should communicate the vision and
the strategies to stakeholders. Communication will be critical in this endeavor. To initiate
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effective communication, the need for this program should be tied to the school mission, values,
and beliefs. These efforts should be linked to data and evidence. It will be essential to
demonstrate the importance of this initiative and the prospective outcomes and provide updates
throughout the development and implementation phases. The guiding team should lead the
communication efforts at student and faculty meetings, department and committee meetings, and
student organization and caucus meetings. The team should provide quarterly updates on
progress. The team should also invite stakeholders to guide team meetings and provide monthly
updates about development and implementation. Clear and consistent communication instills
trust and helps stakeholders adjust performance. Trust increases commitment to goals (Clark &
Estes, 2008). Lewis (2011) noted that the following communication measures improve
organizational change effectiveness: stakeholder participation in change communication,
transparency, promoting an open style of communication, and frequent interaction.
Step 5: Enable Action by Removing Barriers
In addition to communication, it will be important to identify challenges and obstacles
(Wheeler & Holmes, 2017). The guiding team will need to identify ways to overcome and
resolve barriers. This will empower the school to maintain the work of the change effort (Kotter,
1995). Barriers can include lack of resources, financial limitations, or lack of leadership buy-in.
The coalition should resolve these challenges by creating funding and attaining leadership
investments. Understanding how the external environment may influence employee performance
issues and organizational changes is critical. Many external circumstances can threaten an
organization’s ability to survive. To survive these threats, organizations need to improve their
capacity to adapt. Costanza et al. (2016) suggested that the organization’s ability to adapt is
86

rooted in its organizational culture. This culture helps members recognize and manage these
threats to the organization (Costanza et al., 2016).
Step 6: Generate Short-Term Wins
This step involves recognizing and planning for improvements and changes (Kotter,
1995). Wins are apparent and provide acceleration for changes as the project advances. Short-
term successes can increase student knowledge of compassion fatigue, secondary traumatic
stress, and self-care or increase student participation in self-care activities and training (Wheeler
& Holmes, 2017). Outcome evaluations, which could include exit interviews, may need to be
conducted to see if students learned from the training and curriculum. These short-term wins will
demonstrate progress and help others realize the significance of this issue.
Step 7: Consolidate Improvements and Produce More Change
It is not good enough to have short-term wins, but it is vital to sustain and accelerate
change (Kotter, 1995). It will be important to build on small gains. Learning organizations
continuously innovate and modify their behaviors to mirror innovations and knowledge (Senge,
1990). The WUSSW will need to know and change as it moves toward this new instruction
change and focus on student wellness.
Step 8: Institutionalize New Approaches
According to Kotter (1995), this step occurs when connections are evident between
changes and school success. The difference will be clear when students utilize self-care resources
and are mentally and emotionally healthier. In addition, time and resources from executive
leadership will be invested in providing education and resources for students. It will be of utmost
importance to implement new approaches to renew the stakeholders’ energy to trigger innovative
thinking and continue pushing the school toward the pathway of change (Burke, 2018).
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Kotter’s (1995) eight steps provide a step-by-step framework for implementing
organizational change. Table 19 summarized these steps, recommendations, and research.

Table 19
Applying Kotter’s Eight-Step Framework to Successfully Recommendations
Kotter’s eight steps Recommendations Research
Create a sense of urgency Present findings to the
Associate Dean of
Curriculum and Associate
Director of Professional
Development.
Leadership commitment must
be clearly demonstrated and
communicated to the whole
school is critical for success
(Clark & Estes, 2008)
Build a guiding coalition Build a coalition composed of
stakeholders: faculty
members, students, alumni,
and partner organizations
The coalition will share a
sense of urgency and are
invested in developing
innovative solutions to
address compassion fatigue
and secondary traumatic
stress with students
(Wheeler & Holmes, 2017).
Create a vision for change The guiding team will create a
vision that encompasses
micro and macro
interventions.
The critical element for
successful change is having
a connection between
compelling vision,
processes to reach the
vision, and clear work goals
(Clark & Estes, 2008).
Communicate the vision The guiding team will lead the
communication efforts at all
student and faculty
meetings, department and
committee meetings,
student organization and
caucus meetings.
The guiding team will
communicate the need for
faculty to be trained in
delivering the specific
pedagogical practices.
The faculty will need some
recommendations for
The following communication
measures will improve
organizational change
effectiveness: stakeholder
participation in change
communication,
transparency, promoting an
open style of
communication, and
promoting frequent
interaction (Lewis, 2011).
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Kotter’s eight steps Recommendations Research
professional development in
this area.
The faculty will develop clear,
specific and measurable
objectives to support the
curriculum changes.
Enable action by removing
barriers
The guiding team will need to
identify ways to overcome
barriers and develop
resolutions.
Organizations need to improve
their capacity to adapt.
Costanza et al. (2016)
suggested that the
organization’s ability to
adapt is rooted in its
organizational culture. This
culture helps members
recognize and manage these
threats to the organization
(Costanza et al., 2016).
Generate short-term wins Short-term wins can increase
student knowledge of
compassion fatigue,
secondary traumatic stress,
and self-care or increase
student participation in self-
care activities and training.
Wins are highly visible and
provide acceleration for
changes going forward
(Wheeler & Holmes, 2017).
Build on change The school will need to build
on what it learns from
program and outcome
evaluations.
Learning organizations are
organizations that
continuously innovate and
modify their behaviors to
mirror the new innovations
and knowledge (Senge,
1990).
Institute change Change is successful when
students utilize self-care
resources and are mentally
and emotionally healthier.
Institutionalizing new
approaches when we can see
connections between
changes and school success
(Kotter, 1995).

89

Limitations and Delimitations
Limitations in any research study are related to the weakness of the research, which is out
of the researcher’s control. This can be a weakness inherent in the chosen research design or
other factors (Theofanidis & Fountouki, 2018). On the other hand, delimitations are deliberately
made by the researcher and arguably under the researcher’s control (Theofanidis & Fountouki,
2018).
Limitations
One limitation of this study is the sample size and lack of generalizability of the findings
to other MSW students. The survey respondents (N = 46) represented only a 5% overall response
rate. Of these survey respondents, 95% were from the online program, which provides an
inadequate understanding of MSW students enrolled in the campus-based program. All eight
interviewees were associated with the online program, so generalizability to campus-based
students is also limited.
Delimitations
The researcher chose only to review core program syllabi and not electives as part of this
study. Including more syllabi may have revealed other classes that included more education and
training regarding compassion fatigue, secondary traumatic stress, and self-care. In addition, this
research study did not involve students in their first semester of field placement. The researcher
chose to focus on students who had field experience. The researcher felt that inquiring about
compassion fatigue and secondary traumatic stress might confuse students who were
experiencing anxieties and worries about being in school and a field placement.
90

Recommendations for Future Research
MSW students’ education and support are important issues as the need for social workers
continues to grow. The purpose of this study was to explore MSW students’ experiences of
compassion fatigue and secondary trauma at WUSSW. In addition, this project’s objective was
to identify strategies that the WUSSW can provide to assist students in managing or mitigating
experiences of compassion fatigue and secondary traumatic stress.
This researcher identified a readily available stakeholder group to study, which may have
limited the size of the study. Future research should include MSW students across the country.
More extensive studies can produce data that can allow comparisons among regions, gender,
ethnicity and race, full- and part-time students, and online and campus-based programs. In
addition, it may be beneficial to include a document analysis of how other schools of social work
incorporate compassion fatigue, secondary traumatic stress, and self-care in their curricula.
Conclusion
Social workers play a critical role in providing services and care to individuals who have
experienced trauma in their lives. WUSSW is one of the country’s oldest and top-ranked schools
of social work. WUSSW is committed to preparing future social workers through its innovative
curriculum and cutting-edge research. This research study found that MSW students are
knowledgeable about and motivated to engage in self-care practices; however, some
organizational gaps need to be closed to ensure that students graduate from the program trained
in and aware of the experience of compassion fatigue and secondary traumatic stress and ways to
cope with these challenges. By implementing the evidence-based recommendations in this study,
WUSSW MSW students will be better able to cope with the challenges of the field of social
work. In addition, students will have an overall better educational experience at WUSSW.
91

Finally, if implemented, WUSSW will ultimately fulfill its mission of championing “social
justice for the well-being of individuals, families, and communities through innovative teaching
of evidences-based and practice-based skills.”

92

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Appendix A: Survey Questions
Target population: (currently enrolled and recently graduated MSW students)

Table A1
Professional Quality of Life Scale (PROQOL) Compassion Satisfaction and Compassion Fatigue
(PROQOL) Version 5 (2009)
Question Open
or
closed
Level of
measurement
(nominal,
ordinal,
interval,
ratio)
Response
options (if
closed)
RQ Concept
being
measured
(from
emerging
conceptual
framework)
1. I am happy. Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
2. I am preoccupied
with more than
one person I help.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
3. I get satisfaction
from being able to
help people.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
4. I feel connected to
others.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
5. I jump or am
startled by
unexpected
sounds.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
6. I feel invigorated
after working with
those I help.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
7. I find it difficult
to separate my
personal life from
my life as a social
worker.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
Motivation
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Question Open
or
closed
Level of
measurement
(nominal,
ordinal,
interval,
ratio)
Response
options (if
closed)
RQ Concept
being
measured
(from
emerging
conceptual
framework)
8. I am not as
productive at work
because I am
losing sleep over
traumatic
experiences of a
person I help.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
9. I think that I
might have been
affected by the
traumatic stress of
those I help.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
10. I feel trapped by
my job as a social
worker.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
11. Because of my
job I have felt “on
edge” about
various things.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
12. I like my work
as a social worker.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
13. I feel depressed
because of the
traumatic
experiences of the
people with whom
I work.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
14.I feel as though I
am experiencing
the trauma of
someone I have
helped.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
15. I have beliefs
that sustain me.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
110

Question Open
or
closed
Level of
measurement
(nominal,
ordinal,
interval,
ratio)
Response
options (if
closed)
RQ Concept
being
measured
(from
emerging
conceptual
framework)
16. I am pleased
with how I am
able to keep up
with [helping]
techniques and
protocols.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
17. I am the person I
always wanted to
be.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
18. My work makes
me feel satisfied.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
19. I feel worn out
because of my
work as a social
worker.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
20. I have happy
thoughts and
feelings about
those I help and
how I could help
them
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
21. I feel
overwhelmed
because my
caseload seems
endless.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
22. I believe I can
make a difference
through my work.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
Motivation
23. I avoid certain
activities or
situations because
they remind me of
frightening
experiences of the
people I help.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
111

Question Open
or
closed
Level of
measurement
(nominal,
ordinal,
interval,
ratio)
Response
options (if
closed)
RQ Concept
being
measured
(from
emerging
conceptual
framework)
24. I am proud of
what I can do to
help.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
25. As a result of my
work with clients,
I have intrusive,
frightening
thoughts.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
26. I feel “bogged
down” by the
system.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
27. I have thoughts
that I am a
“success” as a
helper.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
Motivation
28. I can’t recall
important parts of
my work with
trauma victims.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
29. I am a very
caring person.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
30. I am happy that I
chose to do this
work.
Closed Ordinal 5-point Likert
scale (1 = never
to 5 = very often)
1 Knowledge
Motivation
31. Do you engage
in managing,
coping, or
mitigating
experiences of
compassion
fatigue or
secondary
traumatic stress?
Closed Nominal Yes
No
2 Knowledge
32. If you answered
‘yes’ to the
previous question.
Please specify the
activities you do.
Open 2 Knowledge
Motivation
112

Question Open
or
closed
Level of
measurement
(nominal,
ordinal,
interval,
ratio)
Response
options (if
closed)
RQ Concept
being
measured
(from
emerging
conceptual
framework)
33 How important is
it to learn to cope,
manage, and
mitigate
compassion
fatigue and
secondary
traumatic stress?
Closed Ordinal 5-point Likert
scale (1 = not
at all to 5 =
extremely
2 Motivation
34.Does the school
offer instruction or
training on
compassion
fatigue and
secondary
traumatic stress?
Closed Nominal Yes
No
3 Knowledge
Organization
35. How important
is it to you that the
school provides
training on
compassion
fatigue and
managing it?
Closed Ordinal 5-point Likert
scale (1 = not
at all to 5 =
extremely
3 Organization
36. Would you be
interested in
participating in an
interview?
Closed 1 = Yes
2 = No

37. Please give me
your name, phone,
and email so that
the researcher can
contact you for the
qualitative portion
of this study
Open

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Appendix B: Interview Protocol
Respondent Type: Social Work Students
Introduction to the Interview:
Hello, my name is Sarah Caliboso-Soto, and I am a doctoral student in the Organizational
Change and Leadership program at the University of Southern California, Rossier School of
Education. Thank you for agreeing to meet with me to discuss some of your experiences as a
social work intern. This meeting should take no longer than an hour. My study examines Social
Work Interns’ perceptions of compassion fatigue and secondary trauma or vicarious trauma.
Your responses will be kept confidential. Do you have any questions before we get started? Do
you consent to be interviewed? May I record this session? I will be also be taking handwritten
notes throughout the interview. The recording will only be used for data analysis. I can share my
findings with you once I conclude the study and the write-up.

Table B1
Interview Protocol
Interview questions Potential probes RQ
addressed
Key concept
addressed
1.What inspired you to become a
social worker?
What are the good
things about being
a social worker?
What are the
negative things
about being a
social worker?
1 Motivation to be a
social worker
2. In your own words, tell me
what compassion fatigue is?
In your own words,
tell me what
secondary
traumatic stress is.
Have you ever
experienced it?
1 Knowledge
Compassion
Fatigue
114

Interview questions Potential probes RQ
addressed
Key concept
addressed
Describe to me your
experience.
Have you
experienced this at
your field
placement?
3.How does compassion fatigue
or secondary traumatic stress
affect your ability to care for
your clients?
1 Motivation
5.What strategies are you aware
of to avoid compassion fatigue
and secondary trauma?
Do you practice
them for yourself?
1 Knowledge
Motivation
6.How has the school educated or
trained you in compassion
fatigue and secondary traumatic
stress?
What benefits, if
any, are there for
social work
students for the
program to
include training in
compassion
fatigue?
2 Organization
7.How does the school encourage
you to manage your experience
with compassion fatigue or
secondary traumatic stress, if at
all?
What about your
internship?
Do you think the
school should do
more to prepare
you for the
possible
experience of
compassion
fatigue or
secondary
traumatic stress?
2 Organization
8.What school resources were
most supportive of you as a
student intern, if any were
available to you?
What are additional
resources needed
to support social
work interns to
help manage
compassion
fatigue and
secondary
traumatic stress?
3 Organization
9.What suggestions do you have
for school/faculty to support
3 Organization
115

The conclusion to the interview:
Thank you for taking time out of your busy schedule to meet with me to discuss your
experiences. I appreciate your honesty and openness. Should you have any questions or
concerns, please call or email me. Thanks again.

Interview questions Potential probes RQ
addressed
Key concept
addressed
students experiencing
compassion fatigue secondary
traumatic stress?
10.Does the school demonstrate
to you the importance of
understanding what
compassion fatigue and
secondary traumatic stress is
and ways to manage or cope
with it?
3 Organization
11.How important is it that
students should clearly
understand compassion fatigue
and how to identify it?
If it is essential at
all.
4 Knowledge
12. How important is it that
students should manage and
cope with compassion fatigue?
4 Motivation
13.What suggestions or advice
would you give to a new social
work student about managing
or coping with compassion
fatigue?
If any? 4 Organization
14.Is there anything I should have
asked but didn’t?
4 Organization
Knowledge
116

Appendix C: Document Analysis Protocol
The documents that will be analyzed for this study include the following:
1. Course syllabi for all MSW courses at the WUSSW, excluding electives
Course Syllabi Prompts
1. In how many units, if any, is compassion fatigue introduced or taught? (RQ 2 and 3)
2. In how many units, if any, is secondary traumatic stress introduced or taught? (RQ 2
and 3)
3. In how many units, if any, is self-care introduced or taught? (RQ 2 and 3)
4. Does the syllabus include any assignments that reference compassion fatigue,
secondary traumatic stress, and self-care? If so, how many and which ones?
5. Does the syllabus include any readings that reference compassion fatigue, secondary
traumatic stress, and self-care? If so, how many and which ones?

117

Appendix D: Information Sheet for Research
University of Southern California
Rossier School of Education
3470 Trousdale Parkway Los Angeles, CA 90089

INFORMATION SHEET FOR EXEMPT NON-MEDICAL RESEARCH

Compassion Fatigue among Social Work Students: A Gap Analysis
You are invited to participate in a research study conducted by Sarah Caliboso-Soto under the
supervision of Dr. Kimberly Ferrario at the University of Southern California (USC). Research
studies include only people who voluntarily choose to take part. This document explains
information about this study. You should ask questions about anything that is unclear to you.

PURPOSE OF THE STUDY
The purpose of this study is to explore the knowledge, motivation, and organizational factors
related to MSW students’ experiences of compassion fatigue and secondary trauma.

PARTICIPANT INVOLVEMENT - SURVEY
If you agree to take part in this study, you will be asked to complete an online questionnaire
comprised of 48 statements related to the experience of compassion fatigue and compassion
satisfaction. The questionnaire will take approximately 20-30 minutes of your time. Answering
survey questions indicates your consent to participate in the study. No potential risks to
participants have been identified; however, you may stop participating at any time with no
penalty or repercussions.

PARTICPANT INVOLVEMENT - INTERVIEW
If you agree to complete the questionnaire to follow, you will be invited to participate in an audio
recorded Zoom interview that will take approximately 30-45 minutes. You do not have to answer
any questions you do not want to and if you do not want to be audiotaped, handwritten notes will
be taken. Interview participants will be asked to give consent to participate in the interview
portion prior to being asked questions on the interview protocol. No potential risks to
participants have been identified; however, you may stop participating at any time with no
penalty or repercussions. If you participate in both the questionnaire and interview, the total time
commitment will range between 60-90 minutes.

PAYMENT/COMPENSATION FOR PARTICIPATION
You will not be compensated for your participation in completing the questionnaire and/or
interview.

CONFIDENTIALITY
The members of the research team, and the University of Southern California Institutional
Review Board (IRB) may access the data. The IRB reviews and monitors research studies to
protect the rights and welfare of research subjects.

118

Any identifiable information obtained in connection with this study will remain confidential.
Your responses will be coded with a false name (pseudonym) and maintained separately. The
recordings will be destroyed once they have been transcribed. Participants have the right to
review their own interview transcript one time for accuracy and provide feedback to the
researcher. In order to review an interview transcript, the participant must provide an email
address during the interview and the researcher will email a copy for review.

All data will be stored on a password-protected computer indefinitely after the study has been
completed with a maximum storage time of seven (7) years, after which time the data will be
destroyed.

The members of the research team and the University of Southern California’s Human Subjects
Protection Program (HSPP) may access the data. The HSPP reviews and monitors research
studies to protect the rights and welfare of research subjects.

When the results of the research are published or discussed in conferences, no identifiable
information will be used.

PARTICIPATION AND WITHDRAWAL
Your participation is voluntary. Your refusal to participate will involve no penalty or loss of benefits
to which you are otherwise entitled. You may withdraw your consent at any time and discontinue
participation without penalty. You are not waiving any legal claims, rights, or remedies because of
your participation in this research study.

INVESTIGATOR CONTACT INFORMATION
Principal Investigator: Sarah Caliboso-Soto via email at scalibos@usc.edu or phone at 310-403-
3365 or Faculty Advisor: Dr. Kimberly Ferrario via email at kferrari.usc.edu or phone at 213-
740-3471. Proxy: Cari Browing, cbrownin@usc.edu. This Principal Investigator will not be
receiving any identifiable information about current students and all data will be managed by
proxy.

IRB CONTACT INFORMATION
If you have questions, concerns, or complaints about your rights as a research participant or the
research in general and are unable to contact the research team, or if you want to talk to someone
independent of the research team, please contact the Social Behavioral Institutional Review
Board (SBIRB), 1640 Marengo St., Suite 700, Los Angeles, CA 90033, (213) 442-0114 or
upirb@usc.edu.

Abstract (if available)

Abstract This dissertation study explores Master of Social Work students’ experience of compassion fatigue and secondary traumatic stress while placed in an internship. The organizational context for this study was a large, private research university. The aim of the study was to examine the knowledge and motivation factors related to Master of Social Work students’ experiences of compassion fatigue and secondary traumatic stress. The study employed a mixed methodology, utilizing a survey, interviews, and document analysis. Specifically, the Professional Quality of Life scale was administered to assess experiences of compassion fatigue and secondary traumatic stress. Survey findings reveal that Master of Social Work students experience moderate levels of compassion fatigue and high levels of compassion satisfaction. Interview findings suggest that students possess myriad self-care strategies to manage and cope with experiences of compassion fatigue and secondary traumatic stress. A document analysis showed only four courses discuss topics of compassion fatigue, secondary traumatic stress, and self-care. Based on these findings, it is recommended that a curriculum be developed that includes instruction, discussion, assignments, and activities that teach the signs and symptoms of compassion fatigue and secondary traumatic stress and strategies of self-care to manage, cope with, and mitigate experiences of compassion fatigue and secondary traumatic stress.

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Asset Metadata

Creator Caliboso-Soto, Sarah (author)

Core Title Compassion fatigue among social work students: a gap analysis

School Rossier School of Education

Degree Doctor of Education

Degree Program Organizational Change and Leadership (On Line)

Degree Conferral Date 2022-05

Publication Date 04/19/2022

Defense Date 03/24/2022

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag compassion fatigue,MSW students,OAI-PMH Harvest,secondary traumatic stress,social work students

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Ferrario, Kim (committee chair), Andres, Mary (committee member), Supranovich, Ruth (committee member)

Creator Email scalibos@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC111022417

Unique identifier UC111022417

Document Type Dissertation

Format application/pdf (imt)

Rights Caliboso-Soto, Sarah

Type texts

Source 20220420-usctheses-batch-930 (batch), University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the author, as the original true and official version of the work, but does not grant the reader permission to use the work if the desired use is covered by copyright. It is the author, as rights holder, who must provide use permission if such use is covered by copyright. The original signature page accompanying the original submission of the work to the USC Libraries is retained by the USC Libraries and a copy of it may be obtained by authorized requesters contacting the repository e-mail address given.

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA

Repository Email cisadmin@lib.usc.edu