Understanding Vicarious Trauma and Compassion Fatigue versus Burnout
Understanding the difference between vicarious trauma, compassion fatigue, and burnout is essential for mental health professionals working in high-empathy roles. While these terms are often used interchangeably, they have distinct causes, symptoms, and impacts on clinical effectiveness. This guide breaks down the 10 key differences between vicarious trauma, compassion fatigue, and burnout, helping therapists recognize early warning signs, understand how each condition develops, and apply targeted prevention and recovery strategies. By clarifying these distinctions, clinicians can protect their well-being, maintain ethical and effective care, and build a more sustainable long-term practice.
Bea Sanders, LCSW
Last Updated: December 12, 2025
What You'll Learn
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The defining differences between vicarious trauma, compassion fatigue, and burnout, and why they’re not interchangeable terms
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How each condition develops, including common triggers, emotional responses, and physical symptoms
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Warning signs that help you identify which form of stress you’re experiencing—or if multiple are occurring at once
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How these conditions uniquely affect clinical effectiveness, empathy, and job satisfaction
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Practical insights into prevention and recovery strategies tailored to each experience
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Why understanding these distinctions matters for ethical practice, sustainability, and long-term clinician well-being
Contents
- What is Vicarious Trauma?
- What is Compassion Fatigue?
- What is Burnout?
- The 10 Key Differences Between Vicarious Trauma, Compassion Fatigue and Burnout
- Can You Experience Vicarious Trauma and Compassion Fatigue Simultaneously?
- How Common are Compassion Fatigue, Vicarious Trauma, and Burnout Among Mental Health Professionals?
- Other Impacting Factors
- Self-Care and Burnout Management, Ethical Considerations
- How to Treat, Prevent, and Manage Burnout, Compassion Fatigue and Vicarious Trauma
- Six Essential Self-Care Domains for Mental Health Professionals
As a mental health provider, you may find yourself drawn to the profession because of your innate desire to help others. You provide a safe space for clients to share personal experiences and emotions, no matter how uncomfortable they may be. However, the emotional toll of this kind of “helping” can be overwhelming and lead to feelings of exhaustion, detachment, and cynicism. The Institute for Public Health (2012) reports between 40 and 85% of helping professionals have developed vicarious trauma and compassion fatigue and/or high rates of traumatic symptoms at least one point in their career.
The mental health community has also experienced incredible change since the COVID-19 pandemic, SAMHSA reporting in 2022 that over 50% of Behavioral Health Providers reported experiencing burnout in the last year. The 2024 HRSA “State of the Behavioral Health Workforce” report notes that elevated burnout remains a key barrier to behavioral health providers practicing at full capacity and staying in the workforce, citing high workloads, reimbursement challenges, and limited support. Three terms commonly used to describe this emotional state are vicarious trauma, compassion fatigue, and burnout. While often used interchangeably, they describe different experiences that require unique strategies for prevention and treatment. Let’s explore the differences between vicarious trauma, compassion fatigue, and burnout, and discuss strategies to mitigate the risks of experiencing them.
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What is Vicarious Trauma?
Vicarious trauma is a psychological response that occurs when providers are repeatedly exposed to the traumatic experiences and stories of their patients. Vicarious trauma specifically involves experiencing symptoms similar to post-traumatic stress disorder (PTSD) as a result of empathetic absorption of their patients' trauma. This can include intrusive thoughts, nightmares, emotional numbness, avoidance, heightened anxiety/hyperarousal, and disrupted belief systems.
What is Compassion Fatigue?
Compassion fatigue, often called “the high cost of caring,” refers to the emotional and physical exhaustion that mental health professionals may experience due to continuous exposure to their clients' suffering and trauma, leading to a reduced capacity for empathy. It is a state of emotional numbness and decreased ability to connect with clients' emotions, due to the cumulative stress of providing care and support to individuals facing mental health challenges. Compassion fatigue occurs when mental health professionals become overwhelmed by the emotional demands of their work, leading to feelings of hopelessness, sadness, and a loss of satisfaction in their roles. This state is characterized by a sense of helplessness and a diminished sense of purpose in providing care. Compassion fatigue can manifest as physical symptoms such as headaches, fatigue, and sleep disturbances.
What is Burnout?
Burnout is a psychological syndrome marked by emotional exhaustion, depersonalization (a lack of empathy and detachment from clients), and reduced personal accomplishment. It occurs when providers are persistently overwhelmed by high levels of stress, workload, and demands, leading to a sense of emptiness and cynicism in their work. Burnout can result in feelings of emotional depletion, as providers struggle to manage the emotional intensity of their clients' issues and maintain their well-being. It is often characterized by a loss of motivation and a decline in the quality of care provided, as professionals become disengaged from their clients and their job satisfaction diminishes. 21-67% of mental health workers may be experiencing high levels of burnout. In a study of 151 community mental health workers in California, Webster, and Hackett found that 54% had high emotional exhaustion, and 38% reported high depersonalization rates, but most reported high levels of personal accomplishment as well.
The 10 Key Differences Between Vicarious Trauma, Compassion Fatigue and Burnout
| Key difference | Vicarious trauma | Compassion fatigue | Burnout |
|---|---|---|---|
| 1. Nature of emotional response | Involves symptoms similar to PTSD due to exposure to clients’ trauma. | Results from empathetic over-absorption of clients’ suffering and may reduce empathy. | A general state of emotional exhaustion and detachment, not necessarily tied to clients’ suffering. |
| 2. Emotional exhaustion | Primarily stems from the emotional demands of absorbing clients’ traumatic experiences. | Arises from sustained empathizing with clients and their distress. | Results from a broader mix of stressors, including workplace demands and personal factors. |
| 3. Relationship with clients | Impacts the clinician’s emotional well-being and ability to provide effective support. | Affects emotional connection and can lead to decreased empathy. | Influences overall engagement and motivation at work, including interactions with clients. |
| 4. Specific triggers | Triggered by exposure to clients’ traumatic experiences and stories. | Triggered by empathetic engagement with clients’ suffering. | Triggered by chronic workplace stress, overwhelming demands, and broader life factors. |
| 5. Physical symptoms | May include physical symptoms associated with emotional distress. | Can lead to emotional and physical symptoms from the toll of empathic caregiving. | Often includes physical symptoms that resemble depression and chronic stress. |
| 6. Onset and recovery time | Can develop quickly after intense trauma exposure; recovery often requires time away from traumatic content. | Develops over time and benefits from breaks and self-care. | Typically develops gradually due to chronic stress and may require longer time off and a comprehensive recovery approach. |
| 7. Work satisfaction | Mostly affects satisfaction with the emotional aspects of the job. | Impacts satisfaction tied to emotional engagement with clients. | Affects overall satisfaction, including motivation and sense of purpose. |
| 8. Preventive measures | Focuses on managing exposure to traumatic content plus strong self-care practices. | Centers on managing empathic caregiving and promoting self-care. | Addresses workload and workplace stressors alongside holistic self-care. |
| 9. Perceived purpose | Purpose may remain intact, but the emotional toll becomes difficult to carry. | May prompt doubts about one’s ability to make a difference due to emotional fatigue. | Often leads to hopelessness and loss of purpose in work and life. |
| 10. Scope of impact | More specific—focused on the response to traumatic content. | Emotionally focused but also reduces the ability to provide effective care. | Broader—impacts overall well-being and functioning professionally and personally. |
Can You Experience Vicarious Trauma and Compassion Fatigue Simultaneously?
Absolutely. Mental health providers facing any combination of these conditions may require more comprehensive support, including therapy, self-care strategies, and potential adjustments to their work environments to regain emotional wellness, job satisfaction, and the ability to provide effective care. Recognizing the complex interplay of these is crucial for mental health providers and their organizations to implement effective interventions and support systems to help them cope and recover.
Three things to know about mental health professionals experiencing compassion fatigue, vicarious trauma, and burnout simultaneously:
1. Complex Interplay: Compassion fatigue, vicarious trauma, and burnout can be experienced simultaneously, as these conditions often interact and exacerbate each other due to the intense emotional demands of their work.
2. Intense Emotional Toll: When these conditions co-occur, providers may face an overwhelming emotional toll due to the demands of their work, the emotional intensity of their clients' issues, and their exposure to traumatic content. The symptoms of these can impact a provider's life outside of work, leading to a diminished capacity for care in their personal lives as well.
3. Higher Risk for Mental Health Issues: The co-occurrence of compassion fatigue, vicarious trauma, and burnout increases the risk of mental health professionals developing mental health problems, such as anxiety, depression, and symptoms resembling post-traumatic stress disorder (PTSD).
How Common are Compassion Fatigue, Vicarious Trauma, and Burnout Among Mental Health Professionals?
Prevalance
- The American Psychological Association reports studies estimating 21-61% of mental health professionals report symptoms of Burnout at some point in their careers. SAMHSA (2012) reports one study showing 78% of psychiatrists reporting burnout in 2017.
- The National Association of Social Workers reports up to 70% of social workers will experience Compassion Fatigue.
- Vicarious Trauma was observed at high frequencies among mental health providers who had prolonged exposure to traumatic client stories, especially in roles dealing with trauma survivors. The National Child Traumatic Stress Network reports that studies show up to 26% of therapists working with traumatized populations and up to 50% of child welfare workers report secondary traumatic stress.
High-Stress Environments
Mental health professionals working in high-stress environments, such as crisis intervention or trauma therapy, were more likely to experience burnout, compassion fatigue, and vicarious trauma. SAMHSA (2012) reports a study in which prevalence rates of burnout among substance abuse counselors were 33%, and 65% of opioid treatment program counselors reported symptoms of burnout.
Years of Experience
Mental health professionals with more years of experience in the field were sometimes found to have a higher risk of experiencing burnout, possibly due to cumulative stress. This can also apply to vicarious trauma. A 2000’s study showed that of 29 directors of community mental health centers in Iowa, over two-thirds reported high emotional exhaustion and low personal accomplishment. Almost half reported high levels of depersonalization. (SAMHSA, 2012)
Influence of Caseload
The size and complexity of caseloads could impact the prevalence of all three conditions, with professionals dealing with larger caseloads at greater risk of injury experiencing these symptoms. The Institute for Public Health reports that professionals with client bases consisting of 60% or more clients with a significant trauma history are at an increased risk for experiencing secondary trauma.
Risk of Secondary Traumatic Stress
Mental health professionals working with clients who have experienced trauma may have a higher risk of developing secondary traumatic stress, a component of compassion fatigue and vicarious trauma.
Other Impacting Factors
- Greater shortages of behavioral health providers (especially in rural settings); SAMSHA (2012) reports that about 13 percent of rural counties have no access to psychologists, psychiatrists, psychiatric nurse practitioners, social workers, or counselors.
- Increased mental health needs; The American Psychological Association reports that over 50 percent of psychologists reported seeing more clients for anxiety, depression, and trauma/stress-related disorders compared to before the COVID-19 pandemic.
- SAMHSA (2012) continues by identifying the top 5 reported organizational factors impacting burnout as; unfair treatment at work, unmanageable workload, lack of role clarity, lack of communication/support from leadership, and unreasonable time pressure.
Self-Care and Burnout Management, Ethical Considerations
The impacts of burnout, vicarious trauma and compassion fatigue affect more than just the provider. These conditions and their symptoms ripple in impact to clients, organizations, and even communities. SAMHSA (2022) highlights these issues within various Codes of Ethics and Conduct. The APA Code of Conduct requires clinicians to take steps to stop working if their ability to provide is impeded. The Social Work Code of Ethics states that social workers address and confront symptoms of burnout individually but also directly with their coworkers. In 2021 they amended their code to include Professional Self-Care as an ethical social work practice.
How to Treat, Prevent, and Manage Burnout, Compassion Fatigue and Vicarious Trauma
Prevention and Treatment
- Set Boundaries: Establish clear boundaries between work and personal life to prevent overextension. Be mindful of your caseload and workload, and don't hesitate to ask for help or delegate when necessary to prevent the onset of compassion fatigue, vicarious trauma, and burnout. Evaluate structuring stronger boundaries surrounding your emotional and physical energy and mental wellness needs.
- Supervision and Consultation: Regularly engage in supervision or consultation with colleagues to process challenging cases and seek guidance for managing emerging symptoms.
- Self-Care Routine: Develop and invest in a true self-care routine that prioritizes your emotional and mental well-being and provides support in managing the emotional toll of your work. Brene Brown cites “non-doing play” as an anecdote for feelings of being overwhelmed.
Management
- Self-Compassion: Cultivate self-compassion and remind yourself that it's okay to have limitations and seek help when needed.
- Delegate and Collaborate: Collaborate with colleagues and delegate tasks to avoid taking on too much responsibility
- Variety in Work: If possible, vary your caseload to include a mix of challenging and less emotionally taxing cases.
- Switching Roles/Placement/Population: Consider switching roles, placements, or client populations periodically to prevent emotional burnout.
Prevention, treatment, and management strategies can vary from person to person, so it's important to find what works best for you. Mental health providers must be aware and practice ongoing mindfulness regarding their self-care and coping while working such an emotionally taxing job. Here are some free and accessible resources to help you identify the strategies that will serve you in your personal and professional life.
Six Essential Self-Care Domains for Mental Health Professionals
In “Dear Mental Health Practitioners, Take Care of Yourselves: a Literature Review on Self-Care,” authors Kirsten Posluns and Terry Lynn Gall identify six self-care domains with associated strategies that the literature shows to be effective for mental health professionals.
- Awareness: Acceptance and commitment therapy, mindfulness and meditation training, self-reflection, creative writing.
- Balance: Leisure activities, varied work activities (e.g., teaching), non-work related passions, non-work related relationships, holistic approach to health, professional and personal boundaries, time management, taking breaks, flexible work hours and locations, realistic work goals.
- Flexibility: Effective coping strategies, attitude of openness, adaptability, realistic self-expectations, cognitive reappraisal, self-compassion and acceptance, setting and reappraising goals, expressive writing and journaling, acceptance and commitment therapy, professional development.
- Physical Health: Sleep hygiene, balanced diet and hydration, exercise.
- Social Support: (Individual) family, friends, personal therapy (professional) individual or group supervision, professional associations, colleague assistance programs, peer consultation.
- Spirituality: Spiritual connection, prayer, mindfulness, spending time in nature, practicing gratitude, meaning-making, engaging in meaningful work, setting goals with life purpose.
How ICANotes Helps Clinicians Reduce Burnout and Documentation Stress
While vicarious trauma and compassion fatigue stem largely from emotional labor, burnout is often driven by systemic stressors — especially documentation burden, inefficient workflows, and administrative overload. For many mental health clinicians, time spent charting after hours or struggling with rigid EHR systems significantly contributes to exhaustion and disengagement.
ICANotes is designed specifically to reduce these stressors for behavioral health professionals. Structured, specialty-specific templates guide clinicians through progress notes, assessments, and treatment plans efficiently, minimizing decision fatigue and repetitive typing. Built-in clinical prompts help ensure required elements are captured without overdocumentation, supporting both compliance and clarity.
By streamlining documentation and reducing time spent on administrative tasks, ICANotes helps clinicians reclaim time for rest, reflection, and meaningful client work — key protective factors against burnout. When documentation feels manageable and purposeful, clinicians are better positioned to sustain empathy, maintain professional satisfaction, and support their own well-being.
Try ICANotes free for 30 days to experience how streamlined documentation, behavioral-health–specific templates, and intuitive workflows can help you spend less time charting and more time on care, recovery, and balance.
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Complete Notes in Minutes – Purpose-built for behavioral health charting
Always Audit-Ready – Structured documentation that meets payer requirements
Keep Your Schedule Full – Automated reminders reduce costly no-shows
Engage Clients Seamlessly – Secure portal for forms, messages, and payments
HIPAA-Compliant Telehealth built into your workflow
Frequently Asked Questions
Conclusion: Protecting Clinician Well-Being Starts With Understanding—and Support
Vicarious trauma, compassion fatigue, and burnout are distinct experiences, but they often overlap in the lives of mental health professionals working in high-demand environments. Understanding the differences between them is a critical first step toward early recognition, appropriate intervention, and long-term sustainability in clinical practice.
Equally important is addressing the systems that contribute to chronic stress. By combining self-awareness, ethical self-care, and tools that reduce unnecessary burden, clinicians can protect both their well-being and the quality of care they provide.
ICANotes supports clinicians by simplifying documentation, reducing cognitive load, and allowing more time for what matters most — clients and clinician health.
Start your free trial of ICANotes today to streamline documentation, reduce burnout risk, and build a more sustainable clinical practice.
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Bea Sanders
LCSW