Keeping Up with the Cost of Caring: Compassion Fatigue in Dispute Resolution & Healthcare Work
- Shiv Martin
- 1 day ago
- 9 min read
Understanding the impact of compassion fatigue on caring professionals and conflict resolution practitioners
Starting close to home
I have known compassion fatigue. Not from a journal, or a research paper, but from living through it. It hit me hardest during stretches of full-time complaints work, or weeks of ten, twelve, fifteen back-to-back conciliations. Every session asked me to show up switched on, curious, open, unbiased and genuinely caring.
Compassion takes energy, and it is this energy that is essential to any form of human services work. This energy is a finite resource that gets drawn down and needs replenishing. The constant absorption of stories, emotions and distress draws on our single reserve, and the ordinary load of being a person (with their own needs and relationships) draws on the same one. There were seasons when generating compassion at work became measurably harder for me. I know the well had grown shallower. And it wasn’t just the work that drew my reserves, it was my identity as a carer outside of work, as a mother and as a daughter.
What protected me in these times, and supported me to carry on was my team, our workplace culture and flexible work supports. I’m talking about colleagues who noticed when I'd gone quiet, and workplaces that treated reflective practice as part of the job. The turning points in my career have been the moments I realised those protective conditions were no longer there. So I'm not writing as someone who has solved compassion fatigue. I'm writing as someone who has met it, lost ground to it, recovered from it, and is paying close attention to how it's showing up now in our field.
A starting reflection....
When did you last name compassion fatigue, in yourself or in a colleague, before it had really started affecting the work? What made the naming possible, or what made it hard?
What we are actually talking about
Compassion fatigue is the emotional and physical depletion that builds up from sustained empathic engagement with other people's distress. It comes from the trauma research and literature of the 1990s, and it was always meant to describe something specific: the strain that gathers in the helper through prolonged closeness to the struggle and distress of others. It's generally understood as the convergence of two things:
Secondary traumatic stress (STS): trauma-like symptoms picked up through indirect exposure to other people's traumatic material.
Cumulative burnout: the physical and mental exhaustion that comes from a depleted capacity to meet everyday demands (Cocker & Joss, 2016; Stamm, 2010).
The Blue Knot Foundation, Australia's National Centre of Excellence for Complex Trauma, frames the related concept of vicarious trauma as basically an "occupational hazard" of working in health, legal, complaints, family services and similar sectors (Blue Knot Foundation, 2024). That framing matters. It's a foreseeable consequence of the work, not a defect in the worker. When we frame it as weakness or a lack of resilience, we mislocate the problem and let the institution off the hook.
A reflection. Which of these constructs best names what you, or someone you work alongside, might be experiencing right now? What changes if you re-locate it from "personal struggle" to "occupational hazard"?
How it shows up in conflict and complaints work
The signs are usually subtle, and almost always more obvious to others than to us, but here’s what I’ve noticed:
In how we engage with parties, curiosity and positive intent quietly fades.
We assess files before we've properly read them, because we are sure we’ve seen it before.
The "high-conflict complainant" hardens from a person into a category.
We cut people off sooner, managing expectations and shortening the time we allow to simply listen.
We reach for the same interventions regardless of fit, because they get us through the day.
Cocker and Joss (2016) describe these patterns as signs of exhaustion, irritability, reduced empathy, less enjoyment of work, and impaired decision-making for the people in front of us.
In our internal narrative, cynicism creeps in. A growing sense that we've seen it all, which usually means we've stopped seeing what's in front of us. In our bodies, attention drifts during sessions and sleep stops restoring. In our craft, matters close faster, the slow parts of process get skipped, agreements get thinner, and we lean evaluative because facilitative takes longer.
When it comes to the impact on us, there's a reason we're so often the last to notice. The work trains us to manage our affect with real skill, which is also training in masking, including from ourselves. It's identity-protective too: most of us hold "I help people through hard things" close to who we are, which makes it hard to look squarely at evidence our capacity has degraded.
Why it's intensifying right now
Three patterns deserve attention at this time:
Volume and complexity. A global scoping review found prevalence of compassion fatigue among healthcare workers ranging from twenty to eighty-seven percent depending on role and context (Garnett et al., 2023). Australian work even shows measurable compassion fatigue in secondary school Year Coordinators, with caseload, gender identity and years of experience correlating with severity (Berger & Reupert, 2025). For us in complaints, conflict and dispute resolution, matters are more legally complex, more emotionally charged, and more entangled with mental health and systemic issues. Time per matter rarely grows to match.
Remote and hybrid work. Remote work has expanded access for practitioners and parties, and on those terms it's a genuine gain. It has also stripped out the small recovery moments that used to be built into the day: the walk to a meeting room, the corridor debrief, the colleague who could read your face after a hard call. We're now doing harder conversations, back-to-back, alone in a room, with the next one starting in two minutes. Emerging research is documenting blurred work-life boundaries and amplified emotional exhaustion as features of the model, not side-effects (Chatham et al., 2024).
Thinner cultures. The protective layer of team and culture is harder to access through a screen and overwhelmed workloads. Connection takes deliberate effort where it once happened by adjacency. Informal supervision has eroded. Practitioners can travel a long way without anyone really seeing how they're travelling.
Recent work on public sector employees has found that the mindset that the work is failing the people it's meant to help predicts both burnout and compassion fatigue, especially where organisational supports are weak (Sciepura & Linos, 2024).
What actually helps
Sustainable practice is cumulative, and the evidence points to consistent patterns. And no, it’s not just about individuals accessing EAP and taking some time off.
External mirrors. Because we're so often the last to notice, the noticing has to come from elsewhere. A 2025 scoping review of compassion fatigue among social workers found peer support and access to reflective supervision among the strongest protective factors (Lin et al., 2025). The Blue Knot Foundation similarly identifies trauma-informed supervision as a precondition for the work being done safely, not a discretionary extra (Blue Knot Foundation, 2024).
Reflective practice as routine, not crisis response. Structured reflection is different from venting. It helps us metabolise what we've witnessed before it accumulates. A meta-analysis of psychological interventions for compassion fatigue found them effective overall, with online options showing real promise for distributed practitioners (Owusu-Addo et al., 2024). The form matters less than the consistency.
Variety in caseload, where it's structurally possible. A diet of only the heaviest matters is rarely sustainable. Systematic review evidence consistently identifies high caseload and trauma exposure intensity as primary risk factors (Garnett et al., 2023).
Recovery built into the day, not added on after. Buffers between sessions. Genuine breaks. Movement. Laughter with peers. The small physiological practices that down-regulate an activated nervous system. These aren't luxuries; they're conditions of sustainable practice.
Honest reckoning with role fit and conditions. Sometimes the answer is more support. Sometimes it's fewer matters. Sometimes it's leaving a role where the conditions make sustainable practice impossible. I've made the last decision when the other measures have failed and I’m glad I made that choice.
Individual self-care, however valuable, isn't enough on its own. A scoping review of vicarious trauma interventions concluded that organisational-level interventions remain underdeveloped (Sutton et al., 2022). The conditions that produce compassion fatigue have to be addressed at the level of the conditions.
A reflection. Of the five strategies above, which is most embedded in your practice? Which is most absent? What would it take to bring the absent one in?
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Where teams and culture come in
Compassion fatigue is shaped powerfully by the environment we work in. Teams that protect their people tend to share certain features:
Leaders who model recovery, not martyrdom.
Workloads honestly resourced, not aspirationally allocated.
Reflective practice treated as core and cultural, not optional.
Psychological safety enough that "this matter is getting to me" can be said without personal cost.
Cultures where vicarious trauma is named and normalised, not whispered about or simply discussed in yearly e-learning modules.
Where these are present, practitioners last longer and work better. Where they're absent, even highly skilled and committed people will struggle. It's often the most committed who struggle hardest, because they keep absorbing for longer before they recognise the cost.
A closing thought
Compassion fatigue is best understood as evidence that we've been doing the work, not as evidence that we're bad at it. The real question isn't whether it'll visit us. It's how we, and the systems we work in, respond when it does.
For us as practitioners: notice what you'd notice in a colleague. Ask the people you trust to tell you what they're seeing. Treat reflective practice and supervision as part of the work.
For the organisations employing us: the most expensive thing isn't the supervision or reflective practice budget. It's the steady, quiet attrition of skilled practitioners who walk away because the conditions made staying impossible.
I'll come back to teams and culture in a follow-up. For now, the message I most want to leave is this. The cost of caring is real. It's researched. It has a name. And it gets a lot more workable the moment we stop treating it as a private problem and start treating it as the structural condition it is.
Supporting Sustainable Dispute Resolution Practice
If your organisation is navigating increasing emotional load, high-conflict matters, burnout risk or staff fatigue within complaints, conciliation or dispute resolution teams, I provide practical support through peer supervision, reflective practice and tailored facilitation. My work with Ombudsman offices, regulators, tribunals and workplace teams focuses on building sustainable, psychologically safe dispute resolution cultures that protect both service quality and practitioner wellbeing.
This includes:
Core dispute resolution and conciliation training
Managing challenging and unreasonable interactions training and policy support
Reflective practice and Communities of Practice
Team facilitation and system design support
You can learn more about my training and workshop services here: Training & Speaking
Or contact me for a free confidential conversation about tailored support for your team: Contact Shiv Martin Consulting
References
Berger, E., & Reupert, A. (2025). Caring for the carers: Compassion fatigue among secondary school Year Coordinators. The Australian Educational Researcher. https://doi.org/10.1007/s13384-025-00885-7
Blue Knot Foundation. (2024). Professional wellbeing: Vicarious trauma and trauma-informed supervision. National Centre of Excellence for Complex Trauma. https://professionals.blueknot.org.au/professional-wellbeing/
Chatham, A. A., Petruzzi, L. J., Patel, S., Brode, W. M., Cook, R., Garza, B., Garay, R., Mercer, T., & Valdez, C. R. (2024). Structural factors contributing to compassion fatigue, burnout, and secondary traumatic stress among hospital-based healthcare professionals during the COVID-19 pandemic. Sage Open.
Cocker, F., & Joss, N. (2016). Compassion fatigue among healthcare, emergency and community service workers: A systematic review. International Journal of Environmental Research and Public Health, 13(6), 618. https://doi.org/10.3390/ijerph13060618
Garnett, A., Hui, L., Oleynikov, C., & Boamah, S. (2023). Compassion fatigue in healthcare providers: A scoping review. BMC Health Services Research, 23(1), 1336. https://doi.org/10.1186/s12913-023-10356-3
Lin, X., et al. (2025). Understanding compassion fatigue among social workers: A scoping review. Frontiers in Psychology, 16, 1500305. https://doi.org/10.3389/fpsyg.2025.1500305
Rauvola, R. S., Vega, D. M., & Lavigne, K. N. (2019). Compassion fatigue, secondary traumatic stress, and vicarious traumatization: A qualitative review and research agenda. Occupational Health Science, 3, 297-336. https://doi.org/10.1007/s41542-019-00045-1
Sciepura, B., & Linos, E. (2024). When perceptions of public service harms the public servant: Predictors of burnout and compassion fatigue in government. Public Administration Review.
Sutton, L., Rowe, S., Hammerton, G., & Billings, J. (2022). The contribution of organisational factors to vicarious trauma in mental health professionals: A systematic review and narrative synthesis. European Journal of Psychotraumatology, 13(1). https://doi.org/10.1080/20008198.2021.2022278
Hi, I’m Shiv Martin. I’m a nationally accredited mediator, lawyer, conciliator, and conflict management specialist with over a decade of experience working across government, business, and community settings. I support teams to navigate complex and emotionally charged situations through mediation and conciliation, conflict skills training, facilitation, and practical advice on policies and processes. My approach is grounded in law, psychology, and real-world dispute resolution, with a strong focus on clarity, fairness, and workable outcomes.
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