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Tips for Disaster Responders: 

UNDERSTANDING COMPASSION FATIGUE

Disaster behavioral health response work can be 

very satisfying, but it can also take its toll on you. 

In this tip sheet, you will learn about the causes 

and signs of compassion fatigue (CF) and tips for 

how to prevent it from happening to you. 

Research indicates that CF is made up of two 

main components: burnout and secondary 

traumatic stress.1

 When experiencing burnout, 

you may feel exhausted and overwhelmed, like 

nothing you do will help make the situation better. 

For some responders, the negative effects of this 

work can make them feel like the trauma of the 

people they are helping is happening to them or 

the people they love. This is called secondary 

traumatic stress. When these feelings go on 

for a long time, they can develop into “vicarious 

trauma.” This type of trauma is rare but can be 

so distressing that the way a person views the 

world changes for the worse.

The Risks of Being a Disaster 

Behavioral Health Responder

Willingness to be in the trenches when 

responding to a disaster is one of the things that 

makes you credible and trustworthy to survivors. 

This usually means you live in conditions similar 

to those of disaster survivors. For example, you 

may have trouble finding enough food, let alone 

nutritious food. You may struggle with lack of 

personal space and privacy. You are likely to 

experience disruptions in sleep due to hectic work 

schedules or surrounding noise. These things 

can wear you down behaviorally, cognitively,

physically, spiritually, and emotionally. You may

also become more vulnerable to feeling the acute 

traumatic stress, sorrow, and anger of the people 

you help. You may even experience feelings 

of guilt for surviving the disaster. When this 

happens, you may have trouble understanding 

the risks to your own health and safety.

Signs of Burnout and Secondary

Traumatic Stress 

It is important to acknowledge the limitations 

of your skills and your own personal risks (such 

as a history of trauma) and other negative 

aspects of the disaster response experience 

(e.g., gruesome scenes or intense grieving) so 

that you recognize how they may be affecting 

your feelings as well as your behavior. Some 

responders may experience several of the 

following signs of burnout and the more serious 

component of CF, secondary traumatic stress. 

Remember, not all disaster behavioral health 

responders will experience every symptom. 

Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov 1

1 Huggard, P., Stamm, B.H. & Pearlman, P.A. (in press). Physician stress: Compassion satisfaction, compassion fatigue and vicarious traumatization. In C.R. 

Figley & P. Huggard (Eds.), First do no self-harm: Understanding and promoting physician stress resilience. USA: Oxford University Press.
TIPS FOR DISASTER RESPONDERS: 

UNDERSTANDING COMPASSION FATIGUE

2

When you experience burnout, a symptom of 

CF, you may have some of the following feelings: 



















As if nothing you can do will help

Tired—even exhausted—and overwhelmed

Like a failure

As though you are not doing your job well

Frustrated

Cynical

Disconnected from others, lacking 

feelings, indifferent

Depressed

As if you need to use alcohol or other 

mind-altering substances to cope 

Signs of secondary traumatic stress, a more serious 

component of CF, may include the following:















Fear in situations that others would not think 

were frightening

Excessive worry that something bad will happen 

to you, your loved ones, or colleagues

Easily startled, feeling “jumpy” or “on guard” all 

of the time

Wary of every situation, expecting a 

traumatic outcome

Physical signs like a racing heart, shortness of 

breath, and increased tension headaches

Sense of being haunted by the troubles you see

and hear from others and not being able to 

make them go away

The feeling that others’ trauma is yours

If you are experiencing any of these signs of 

stress, talk with a friend or colleague, seek wise 

counsel from a trusted mentor, or ask your 

supervisor to help you determine a course of 

action. You may also consider seeking help 

from a qualified mental health professional. 

Tips for Coping With Compassion Fatigue

Traditionally, disaster workers have been trained 

to screen survivors for negative behavioral 

health effects. More recently, the field is also 

focusing on identifying survivor resilience, 

fostering strengths, and encouraging self-care. 

Just as you assist survivors in this process, 

you can apply this approach to yourself on a 

routine basis—even when not on a disaster 

assignment—to avoid CF. By focusing on 

building your strengths and carrying out 

self-care activities, you are contributing to

your behavioral, cognitive, physical, spiritual, 

and emotional resilience. The following 

strategies can help you do just that: 











Focus on the four core components of 

resilience: adequate sleep, good nutrition, 

regular physical activity, and active relaxation 

(e.g., yoga or meditation).

Get enough sleep or at least rest. This is of 

great importance, as it affects all other aspects 

of your work—your physical strength, your 

decision making, your temperament. 

Drink enough fluids to stay hydrated, and eat 

the best quality food that you can access.

Complete basic hygiene tasks like combing 

your hair, brushing your teeth, and changing 

clothes when possible. Wearing clean clothes 

can make you feel better.

Try to wash up, even just your hands and face, 

after you leave your work shift. Think of it 

as a symbolic “washing away” of the hardness 

of the day.

Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov
TIPS FOR DISASTER RESPONDERS: 

UNDERSTANDING COMPASSION FATIGUE

Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov 3

















Make time to learn about the people with whom 

you work. Taking time for conversations will 

help foster feelings of positive regard toward 

yourself and others. 

Engage with your fellow workers to celebrate 

successes and mourn sorrows as a group.

Take time to be alone so you can think, 

meditate, and rest.

Practice your spiritual beliefs or reach out to a 

faith leader for support.

Take time away from the work when 

possible. Removing yourself from the 

disaster area can help you remember that 

not every place is so troubled.

Try to find things to look forward to.

Communicate with friends and family as best you 

can. If you do not have Internet or cell phone 

access or ways to mail letters, write to loved ones 

anyway and send the letters later.

Create individual ceremonies or rituals. For 

example, write down something that bothers 

you and then burn it as a symbolic goodbye. 

Focus your thoughts on letting go of stress or 

anger or on honoring the memory, depending 

on the situation.

Prevention

When combined, the self-care practices 

mentioned above can help prevent the 

development of CF. Once you begin to routinely 

practice these healthy habits, they become part 

of your overall prevention plan. Not only do 

healthy habits strengthen your ability to cope 

while in the moment, they can help your body 

remember how to bounce back to a healthier 

state. Remember, prevention is part of a good 

preparedness plan. 

Compassion Satisfaction 

Compassion satisfaction (CS) refers to the sense 

of fulfillment you feel for the work you do. It can 

be a source of hope, strength, and ultimately 

resilience. This satisfaction with your work 

is also what allows you to face another day, 

another disaster, another tragedy. It is the quiet 

knowledge that what you do makes a difference, 

and that you possess the same strengths you 

see and support in the survivors with whom 

you work. Appreciating each encounter with 

a disaster survivor can add to your CS and 

help protect you from CF. Even when things 

do not go as well as you had hoped, you can 

try to appreciate these encounters, knowing 

that you took action and extended yourself 

to others. In these ways, CS can serve as a 

natural, protective tool against the negative 

aspects of disaster response work. By noticing, 

acknowledging, and appreciating the work you 

do, you can build CS in yourself and encourage 

it in your colleagues.

When To Get Help

Regular meetings with your supervisor and 

peer support group during and after a disaster 

assignment can be a significant help in managing 

stress and CF. But when signs and symptoms 

continue for more than 2 weeks or are truly 
TIPS FOR DISASTER RESPONDERS: 

UNDERSTANDING COMPASSION FATIGUE

4

bothersome at any point, seek out professional 

help. You can start by contacting your employee 

assistance program or a primary care physician, 

who may be able to rule out any physical 

concerns and recommend a counselor or 

therapist familiar with traumatic stress. You can 

also download the SAMHSA Behavioral Health 

Disaster Response Mobile App and access a 

directory of behavioral health service providers in 

your area. Additional information is provided in 

the Helpful Resources section below.

Helpful Resources 

Substance Abuse and Mental Health Services 

Administration Disaster Technical Assistance 

Center (SAMHSA DTAC)

Toll-Free: 1-800-308-3515

Website: http://www.samhsa.gov/dtac

SAMHSA’s National Recovery Month

Website: http://www.recoverymonth.gov 

SAMHSA Behavioral Health Disaster Response Mobile App

Website: http://store.samhsa.gov/product/PEP13-DKAPP-1

Federal Employee Assistance Program

Toll-Free: 1-800-222-0364 

TTY: 1-888-262-7848 

Website: http://foh.hhs.gov/services/EAP/EAP.asp

National Institute on Drug Abuse 

Website: http://www.drugabuse.gov/publications/seekingdrug-abuse-treatment

U.S. Department of Homeland Security: FirstResponder.gov*

Website: http://www.firstresponder.gov

U.S. Department of Veterans Affairs*

National Center for Posttraumatic Stress Disorder (PTSD)

PTSD Information Voicemail: 1-802-296-6300

Website: http://www.ptsd.va.gov

Treatment Locators

Mental Health Treatment Facility Locator

Toll-Free: 1-800-789-2647 (English and español) 

TDD: 1-866-889-2647

Website: http://findtreatment.samhsa.gov/MHTreatmentLocator

MentalHealth.gov

Website: http://www.mentalhealth.gov

MentalHealth.gov provides U.S. government information and 

resources on mental health. 

Substance Abuse Treatment Facility Locator

Toll-Free: 1-800-662-HELP (1-800-662-4357) 

(24/7 English and español); TDD: 1-800-487-4889

Website: http://www.findtreatment.samhsa.gov

Hotlines

SAMHSA Disaster Distress Helpline

Toll-Free: 1-800-985-5990 Text “TalkWithUs” to 66746

Website: http://disasterdistress.samhsa.gov

National Suicide Prevention Lifeline

Toll-Free: 1-800-273-TALK (1-800-273-8255) 

TTY: 1-800-799-4TTY (1-800-799-4889)

Website: http://www.samhsa.gov

This resource can be found by accessing the Suicide Prevention 

Lifeline box once on the SAMHSA website.

Workplace Helpline

Toll-Free: 1-800-WORKPLACE (1-800-967-5752)

Website: http://workplace.samhsa.gov

*

Note: Inclusion of a resource in this fact sheet does not imply endorsement by 

the Center for Mental Health Services, the Substance Abuse and Mental Health 

Services Administration, or the U.S. Department of Health and Human Services.

·

HHS Publication No. SMA-14-4869

(2014)

Toll-Free: 1-877-SAMHSA-7 (1-877-726-4727) | Info@samhsa.hhs.gov | http://store.samhsa.gov