Understanding Empathy-Based Stress and Trauma in Non-Profit and (I)NGO Contexts

by Kimberley Ducimo

In human services work—whether in child, youth, or adult services, humanitarian aid, or development—professionals frequently encounter the traumatic stories and experiences of the individuals they serve. Whether supporting children or adults who have experienced abuse or violence, human trafficking, conflict, or natural disasters, these professionals are regularly exposed to the emotional and psychological toll of others’ suffering. This exposure can lead to what is known as empathy-based stress (EBS), a combination of trauma exposure and the emotional response of empathy. EBS includes burnout, secondary traumatic stress (STS), compassion fatigue (CF), and vicarious trauma (VT). While these terms are sometimes used interchangeably, each refers to distinct forms of trauma exposure that can affect professionals in different ways. Understanding the differences between secondary trauma and vicarious trauma, as well as the broader impact of empathy-based stress, is critical for developing effective strategies to support non-profit and NGO professionals and protect their mental health. Over time, sustained emotional engagement with persons who have experienced trauma can lead professionals to experience stress, burnout, and even trauma themselves.

This article explores empathy-based stress in the context of STS and VT, highlighting their differences and the profound effects they can have on the mental health and professional effectiveness of those in helping professions.

Defining Empathy-Based Stress
Empathy-based stress refers to the emotional and psychological strain that arises when professionals are exposed to the trauma of others and respond with empathy. This concept encompasses a range of responses, from short-term effects like secondary traumatic stress (STS) to long-term, more profound shifts in worldview and identity, as seen with vicarious trauma (VT). According to May et al. (2024), empathy-based stress is a process that involves trauma exposure combined with a person’s emotional engagement with the suffering of others. This engagement can result in strain, negative health outcomes, and diminished professional efficacy.

In practice, this means that professionals who work with persons who have experienced trauma are not just exposed to those experiences, but also feel an emotional connection to those experiences, which can take an emotional toll over time. As awareness grows about trauma exposure in various professions, including the prevalence of workplace stressors such as sexual harassment and assault, the persons indirectly and directly affected by these experiences face increasing challenges to their well-being.

Empathy-based stress is a particularly significant concern in fields where professionals are regularly exposed to traumatic events or stories. As the demand for mental health services increases globally, understanding and addressing empathy-based stress becomes more critical. For example, a scoping review by May et al. (2024) identifies the need for targeted interventions to mitigate EBS and emphasizes that, while many interventions focus on addressing EBS at the individual level, a lack of organizational support and systemic issues can exacerbate the emotional toll on professionals, particularly those experiencing VT. This points to the importance of addressing not only individual coping mechanisms but also the broader organizational factors that contribute to EBS, such as workload, caseloads (e.g., investigators and case managers), workplace culture, and access to supervision and support.

Empathy and the Helping, Humanitarian, and Development Professional
Empathy is a core skill for professionals working in human services. It allows individuals to identify with or understand another person’s emotions and experiences. When engaging with people who have experienced trauma empathy is not merely a tool – it is a necessary part of their work. However, constant empathic engagement can lead to significant emotional challenges, particularly when the trauma stories are especially distressing or when the professional lacks adequate support systems.

Professionals working in human services, the non-profit sector, humanitarian crisis, and global development are particularly at risk for developing vicarious trauma (VT). Vicarious trauma occurs through prolonged or repeated exposure to traumatic events through empathic engagement with those who have directly experienced the trauma. These professionals become highly sensitized to the suffering they witness, and over time, the impact of this continuous exposure can cause changes in their mental, emotional, and even physical health (Figley, 1995)[1].

Secondary Trauma (STS): A One-Time Impact
Secondary trauma (STS), also referred to as secondary traumatic stress, occurs after hearing or witnessing another person’s trauma, which can be in a single instance or event. Unlike primary trauma, which directly affects an individual, STS occurs indirectly, usually as a result of empathic engagement with persons who have experienced trauma. The emotional response to these experiences can mimic the symptoms of post-traumatic stress disorder (PTSD) in the professional, even though they have not personally experienced the trauma. Symptoms of STS include intrusive thoughts, nightmares, irritability, hypervigilance, and avoidance of persons or traumatic situations (Figley, 1995; Jenkins & Baird, 2002).

For example, humanitarian aid workers responding to a crisis, such as providing relief to refugees fleeing conflict, or global development professionals working in areas of poverty and displacement, may hear distressing and traumatic stories. These workers might encounter children and adults who have endured violence, loss, or severe hardship. As a result, they could experience Secondary Traumatic Stress (STS) symptoms like anxiety, nightmares, or difficulty concentrating. Similarly, non-profit or human services workers, such as those in shelters or community centers, may be exposed to emotional and traumatic situations while helping individuals in crisis. Although this type of trauma is often acute and may diminish with time or once the immediate crisis is resolved, it can still have a significant impact on the emotional and psychological well-being of the professionals involved.

In some cases, STS can develop into other trauma-related responses, such as compassion fatigue (CF). As defined by Figley (1995), CF is a combination of STS symptoms and professional burnout. While burnout typically involves feelings of emotional exhaustion, disengagement from one’s work, and a lack of enthusiasm, CF is more specific to professionals who struggle to maintain empathy and compassion due to the emotional toll of their work. For safeguarding investigators and case managers, for instance, this could mean experiencing emotional depletion that makes it harder to approach cases with the same level of care and concern. Similarly, global development professionals or non-profit workers may find it increasingly difficult to maintain the emotional stamina necessary for effective engagement with vulnerable populations, leading to diminished effectiveness in their roles. In these cases, the toll of ongoing exposure to trauma, coupled with professional challenges, can severely impact their ability to provide support and make critical decisions.

Vicarious Trauma (VT): The Cumulative Effect
Vicarious trauma, on the other hand, is the result of prolonged or repeated exposure to the trauma of others over time. Pearlman and Saakvitne (1995) defined VT as a profound shift in a person’s cognitive schemas resulting from consistent empathic engagement with persons who have experienced trauma. The trauma stories and emotional experiences of others gradually alter the way professionals perceive themselves, others, and the world. Unlike STS, which can occur from a single traumatic event, VT is a cumulative experience that unfolds over time.

Symptoms of VT extend beyond the emotional to include deep, lasting shifts in worldview and personal identity. Professionals experiencing VT may begin to view the world as unsafe, others as untrustworthy, and themselves as incapable or inadequate in their professional roles (Cohen & Collens, 2013). The cumulative exposure to trauma and its effects can cause emotional numbness, detachment, hopelessness, and even a loss of meaning in one's work. For example, a child protection specialist working with unaccompanied children in the aftermath of displacement due to conflict might gradually begin to internalize the pervasive sense of helplessness and despair conveyed by the children. Over time, this could result in the professional feeling increasingly overwhelmed, unable to continue their work effectively, or even questioning their career choice.

As described by Newell & MacNeil (2010), VT is not only an emotional response but also involves a cognitive shift that can significantly impact a person’s professional identity and sense of self. The professional may begin to feel unqualified or inadequate, experiencing doubts about their ability to continue providing help to others. This loss of confidence and sense of competence is one of the distinguishing features of VT compared to other forms of empathy-based stress.

The Overlap: Secondary Trauma, Vicarious Trauma, and Compassion Fatigue
Though secondary trauma, vicarious trauma, and compassion fatigue (CF) are often used interchangeably, it is important to recognize the distinctions between them. Secondary trauma refers to the immediate, short-term symptoms that arise after witnessing or hearing about trauma. Vicarious trauma, on the other hand, is a long-term, cumulative process that leads to profound changes in the professional’s worldview. Compassion fatigue includes the symptoms of STS combined with professional burnout, resulting in emotional exhaustion, disengagement, and a diminished capacity for empathy (Figley, 1995; Newell & MacNeil, 2010).

While the terms overlap, the distinctions are critical for understanding how professionals may experience these effects differently. Some may experience short-term distress after a traumatic event (STS), while others may develop a deeper, long-term transformation of their worldview through repeated exposure (VT). Additionally, professionals with limited support or high workloads may be more vulnerable to compassion fatigue, a condition that can affect their ability to perform their job effectively and compassionately.

Mitigating the Impact: Prevention and Support
Given the significant impact that empathy-based stress, secondary trauma, and vicarious trauma can have on professionals, it is essential that organizations take proactive steps to mitigate these effects. Strategies for prevention and support include:

 1.     Regular Supervision and Debriefing: Offering regular opportunities for supervision and debriefing can provide professionals with a space to process emotional responses to their work and receive emotional support.
2.     Training, Awareness, and Engagement: Training staff to recognize the signs of STS, VT, and CF is crucial. Professionals should be aware of their emotional responses and know when to seek help before symptoms escalate.
3.     Self-Care and Boundaries: Encouraging self-care and promoting boundaries can help professionals manage their emotional engagement with clients. This includes ensuring regular breaks, opportunities for rest, and a work-life balance.
4.     Organizational Support: Organizations can create supportive environments by offering mental health resources, reducing workload and caseloads when necessary, and fostering a workplace culture that prioritizes employee well-being.

Key Takeaways
Empathy-based trauma, in the form of secondary trauma and vicarious trauma, is a critical concern for professionals in the helping fields. These professionals, whether working in humanitarian aid, global development, non-profit services, or safeguarding, are often exposed to the profound suffering of others. However, they cannot be expected to manage the emotional toll of this work in environments or cultures that fail to acknowledge or address the impacts of trauma. For organizations to effectively support their staff and prevent burnout, it is essential that they become trauma-informed. This means developing policies, practices, and workplace cultures that recognize the effects of trauma on both the individuals they serve and their own employees.

Trauma-informed organizations create environments where professionals can thrive, supported by training, resources, and a workplace culture that prioritizes wellbeing and emotional health. At Safe Organizations, we specialize in helping organizations build these trauma-informed practices, ensuring that both staff and the communities they serve are supported in a sustainable, compassionate manner. By focusing on internal culture and providing the tools for self-care and resilience, organizations can better equip their teams to continue their important work with persons who have experienced trauma, while safeguarding their own mental and emotional health.

If you or a colleague are experiencing empathy-based stress, it is essential to seek support as soon as possible through your Employee Assistance Program (EAP) or local and online mental health services. Ignoring the signs of emotional or psychological strain can lead to more serious consequences, including burnout, compassion fatigue, or vicarious trauma. Reaching out for help allows you to address these challenges early, preserving both your well-being and your ability to continue providing effective support to others. Remember, seeking assistance is not a sign of weakness but a proactive step towards maintaining a healthy balance between caring for others and caring for yourself. Your mental health is just as important as the work you do, and there are resources available to support you.

[1] NOTE: the article focuses on mental health clinicians, therapists, and others in helping roles but this applies equally to professionals in any human services focused work.