Summary: When their teen is in mental health treatment, what helps parents manage compassion fatigue the most is first recognizing that compassion fatigue is a real psychological and emotional phenomenon that’s well-documented among professional caregivers.
Key Points:
- Compassion fatigue is real.
- Compassion fatigue was first identified in the early 1990s in nurses.
- Anyone in a caregiving role – from parents, to teachers, to mental health professionals, to ER doctors, to nurses – can develop compassion fatigue.
- Parents who develop compassion fatigue when their teenager is in mental health treatment should not feel bad about it: it’s a natural consequence of caring.
- Evidence shows there’s a set of specific, practical steps that helps parents manage compassion fatigue.
What is Compassion Fatigue?
A nurse named Carla Johnson coined the term compassion fatigue in an essay published in 1992 called “Coping With Compassion Fatigue.” In that essay, she identified the following symptoms in colleagues and coworkers:
- Feeling of detachment
- Irritability
- Anger
- Depression
- Lack of joy
- Dread of going to work
- Fatigue
- Frequent headaches, stomachaches
Johnson observed that this group of symptoms and set of characteristics led to decreasing and ineffective job performance. And although we’re jumping forward, here, one thing that helps parents manage compassion fatigue is understanding that in the long run, compassion fatigue will impair their effectiveness as a parent.
The analogy between compassion fatigue in professional caregiving and compassion fatigue in parenting teens in mental health treatment is not perfect – no analogy is – but it’s a powerful tool that can help us understand why it develops and helps us understand how parents can manage compassion fatigue.
Dr. Charles Figley, an expert in mental health and trauma at Tulane University expanded on the concept of compassion fatigue described by Johnson in the 2002 article “Compassion Fatigue: Psychotherapists’ Chronic Lack of Self Care.” Here’s how he defined compassion fatigue:
“A state of tension and preoccupation with traumatized patients by re-experiencing the traumatic events, avoidance/numbing of reminders and persistent arousal associated with the patient.”
If we insert “teenager in treatment” for “traumatized patients” the accuracy of the analogy strengthens. When a child is in pain, in trouble, or having difficulty, most parents are one hundred percent preoccupied with what’s going on, stressed out about it – or in a state of tension about it – and experienced a state of heightened awareness about their child.
That’s natural. But it can also lead parents to a feeling that very few are willing to verbalize. We’ll attempt to verbalize it for them:
“I am sick and tired of caring so much.”
If you’re the parent of a teen in treatment, the first thing that can help you manage compassion fatigue is recognizing this feeling, accepting that it’s valid, and most importantly, understanding this:
Having that thought or feeling those feelings does not make you a bad person or a bad parent.
Now let’s get a better understanding of how compassion fatigue develops.
Learning How It Develops Helps Parents Manage Compassion Fatigue
In the article “Compassion Fatigue: An Application of the Concept to Informal Caregivers of Family Members with Dementia,” a group of researchers apply the concepts of compassion fatigue defined by Dr. Figley to caregiving at home. The following description of how compassion fatigue can develop when caring for older family members with dementia applies well to how compassion fatigue can develop among parents with teens in mental health treatment.
Here’s a basic, 3-step description of how compassion fatigue develops when caring for a loved one, which we extrapolate to parenting.
How Compassion Fatigue Develops: Three Steps
- An empathetic, concerned family member is exposed to the suffering of a loved one and develops an empathetic response. For example, when a parent sees their child suffering, and feels strong emotions for them.
- If a caregiver is unwilling or unable to detach – literally or figuratively – from the caregiving situation, they can develop compassion stress. For instance, when a parent is unable to separate or detach emotion from the support and care they offer, they can develop psychological and emotional discomfort, called compassion stress.
- When the situation continues without change, a caregiver can develop traumatic memories associated with caregiving. These memories can combine with existing life demands aside from caregiving and lead to compassion fatigue. For example, the steady accumulation of negative or difficult experiences associated with parenting a child in mental health treatment can lead to traumatic memories of parenting. These memories, when combined with competing factors from the rest of life – i.e. life demands – can lead to what we call compassion fatigue.
When a parent reaches stage 3, compassion fatigue, they may show the following signs:
- Helplessness
- Hopelessness
- Apathy
- Disengagement
- Withdrawal
The consequences of reaching this stage, as a parent, may include five negative outcomes:
- Depression, including anger, irritability, and frustration.
- Increased sense of burden, including escalating feeling of resentment.
- Increased sense of strain, including loss of meaning and purpose related to caregiving.
- Decreased quality of relationship, which may include reduced communication, superficial communication, viewing the relationship only in terms of task and effort, and an increasingly dispassionate approach to offering support and care.
- Termination of caregiving, which in the case of parenting would mean a withdrawal from supportive engagement with the teenager in treatment.
When depression, burden, and strain lead to a deterioration of the parent-child relationship, the parent may pull back from the situation entirely and withdraw or terminate their compassionate support.
That’s the last thing parents or teenagers want or need when a teenager is in mental health treatment. However, if we accept the validity of the analogy, we can also accept that if the early stages of compassion fatigue go unrecognized, unaddressed, and unresolved, then disconnection – i.e. termination of compassionate support – from the situation is a real possibility.
How to Prevent or Bounce Back from Compassion Fatigue
We included the detailed information above for parents of teens in mental health treatment to get a clear idea that if they begin to experience negative emotions related to their ongoing efforts to offer compassionate support to their teen, those negative emotions are a natural response to their situation. They’re well-documented and thoroughly described in peer-reviewed studies about similar, if not perfectly analogous, caregiving circumstances.
That means at least two things for parents who want to learn how they can manage compassion fatigue. Here’s what we want parents to know:
- You’re not alone.
- You can take practical steps to manage compassion fatigue.
In the publication “Building Compassion Fatigue Resilience: Awareness, Prevention, and Intervention for Pre-Professionals and Current Practitioners,” mental health researchers examine evidence on compassion fatigue and offer a template for increasing resilience to and managing the consequences of compassion fatigue. We’ll offer what the authors call key clinical considerations for mental health professionals concerning compassion fatigue, which we’ll adapt for parents seeking to manage compassion fatigue.
Five Key Considerations for Understanding How to Deal With Compassion Fatigue
- Prevention is the best first line of defense against compassion fatigue. Parents with teens in treatment need to know compassion fatigue can happen, what the signs and symptoms are, and how to identify them in themselves.
- Absence of awareness of compassion fatigue is one of the primary reasons compassion fatigue can escalate toward a wide range or negative consequences.
- New parents, younger parents, and parents unfamiliar with mental health disorders and treatment may be at higher risk of compassion fatigue.
- Parents can help their children by addressing and resolving compassion fatigue. This may seem obvious, but it’s worth emphasizing. Ignoring the symptoms of compassion fatigue, or hoping they’ll go away on their own, will most likely result in an increase in compassion fatigue, which can lead to negative outcomes for everyone, parents and teens alike.
- Resolve resistance to self-care. There’s a phenomenon among professional caregivers that’s also present in parents, related to self-care. It includes a mental script which, at its most basic level, reads like this:
”I feel guilty and selfish when I take care of myself, because taking care of others is more important.”
In order to manage compassion fatigue, it’s critical to first resolve any ambiguity about the value of self-care and guilt about time spent taking care of oneself rather than others.
Helping Parents Find Balance While Supporting Their Teen
The first step for parents is learning the Five Key Considerations above. We encourage parents to take note of #5, because it really is essential, and it’s something we’ll keep repeating: to better help your child you will need to take some time away from your child and focus on yourself.
How Parents Can Manage Compassion Fatigue: Three Tips
- Identify your current level of social support. Think of the people in your life you can talk to about what you’re going through. They may be old friends, people you know from work with kids who’ve had mental health issues, new friends, or parents from parenting groups your teen’s therapist connects you with. Once you identify who they are, make arrangements to spend time with them. Ask if they have time to listen, and if they say yes, then go and talk to them. Sometimes real healing starts with a simple, open, honest conversation between friends.
- Identify your current level of self-care. Think about your daily and weekly schedule. If you spend every waking hour outside of work thinking about, taking care of, or making plans to take care of your teen in mental health treatment, it’s time to adjust your schedule. Make time for yourself. Your self-care can be anything you want it to be. Walking, gardening, shopping, whatever gets you away from stressing about your teenager, and takes you toward things that relax and restore you count as self-care. Identify your level, and if your level is zero, make plans to elevate the time you spend on yourself to a nonzero number.
- Professional Therapy and Support. You may feel you’ve backed yourself into a psychological and emotional corner. All you think about is supporting your child, but all the thinking about and supporting your child is causing harm to your personal mental health. Professional therapists can help you work your way out of this corner.
Those are our three top tips for helping parents manage compassion fatigue. We’ll close this article by expanding on tip #3, and discussing two type of therapy that can help: cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT).
Cognitive Behavioral Therapy (CBT):
A therapist experienced in CBT can help you understand how your thoughts, feelings, and behaviors are related, with a specific focus on resolving false beliefs and cognitive distortions that may contribute to compassion fatigue. For instance, if you’ve arrived at the idea that taking care of yourself while your teenager is in treatment makes you a bad parent, a CBT therapist can help you reframe that idea, and help you realize the opposite is true: taking care of yourself while your teen is in treatment is more likely to make you a better parent.
Acceptance and Commitment Therapy (ACT):
A therapist trained in acceptance and commitment therapy (ACT) can guide you through a six-step process that helps you identify your personal values and create a plan to take action to live by those values. An ACT therapist helps you accept your situation – including validating the thoughts and feelings you have about it – and create distance between you and negative thoughts about yourself and your circumstances. Next, they help you become fully present in the moment, in order to manage worry about what might happen or what has happened. Finally, they help you take practical steps to bring your behavior in line with your beliefs.
In parenting a teen in mental health treatment, this ACT approach would most likely involve taking action to take care of yourself, so that you can become balanced, whole, and achieve your goal of supporting your child in a way that benefits you both, and benefit your entire family.
Our final thought on this topic is one we share with parents frequently about their teens, but this time it’s for the parents:
The earlier you identify the signs of compassion fatigue and take proactive steps to manage it – whether through social support, self-care, or professional support – the better the outcome.
