Frontline Initiative: Self-Care for DSPs

When Caring Too Much Can Hurt
Compassion Fatigue in Direct Support Professionals


Patricia Smith is a certified Compassion Fatigue Specialist and founder of the Compassion Fatigue Awareness Project. Patricia can be reached at

Mixed media drawing titled "Elma"

Morgan Brooke, “Elma”, oil pastel on paper, 11x14, 2019

With 20 years of experience working with caregivers in all the helping professions, I now recognize that caring too much can hurt. When Direct Support Professionals (DSPs) provide support to others without taking care of yourselves in a way that is meaningful to you, you can experience a secondary traumatic stress syndrome when you neglect your own needs over time. This is known as compassion fatigue. Compassion fatigue can affect all areas of a support provider’s life.

Each day DSPs face intense and emotional situations on the job. It is almost a given that you will experience some trauma. The American Psychological Association (APA) defines trauma as “an emotional response to a severe situation (Rowell & Thomley, 2013).” Immediately after or during the event, shock and denial are typical. Some people experience long-term reactions that may include unpredictable emotions or flashbacks. Relationships may become strained. Some caregivers are affected physically with symptoms like headache or nausea. While these feelings are normal, some have difficulty moving on with their lives.

As empathetic and compassionate DSPs, the work you do supporting and advocating for others touches your body, mind, and soul. It is important to foster an awareness of compassion fatigue. It is important to be aware of the symptoms and causes. With this knowledge, you can begin a healing journey that can literally save your life. Taking care of yourself, can allow you and your colleagues to continue to do your chosen work for years to come.

Compassion fatigue is a set of symptoms. It is not a disease. To be healthy professionals, you must learn to manage the symptoms. The symptoms can include: isolation from others, emotional outbursts, persistent physical ailments, substance abuse, lack of interest in personal hygiene, sadness, apathy, and recurring nightmares or flashbacks. These symptoms are red flags. Your overstressed, overworked body is signaling an SOS that self-care is badly needed.

The causes of compassion fatigue are complex. DSPs experiencing high levels of compassion fatigue are most likely “other-directed.” This means somewhere in the early development and formative years you learned that caring for others was more important than caring for yourself. You likely understand that it is good for you to do self-care daily. However, when you do, you may feel guilty or selfish. Letting go of these harmful thought patterns is the best thing you can do for yourself. You do need to fill up with actions, behaviors, and practices that promote self-care and wellness, so that you have something to give others.

Create a Self-Care Plan

You may see some behaviors or thought patterns in yourself that signal compassion fatigue. If you do, the first step to getting better is to create a self-care plan. Take the time to identify your needs. This will be time well spent. Plan time to practice self-care and release stress. You may do this in a manner that works for you, such as walking, riding a bike, hugging an animal or someone you love, enjoying a hobby, reading, journaling, or belting out a favorite song. Try to stay away from self-medicating with food, alcohol, drugs, video games, internet searching, or gambling.

The rhythm of a healthy DSP is to “fill up, empty out, fill up, and empty out” daily. Be sure to fill up with activities, thoughts, and behaviors that satisfy and nurture you. As difficult as it may be to ask for help, you may need to reach out to others for support. It is a part of healthy living and the healing process. None of us were meant to manage the work-life balance by ourselves. We all need others to help us integrate our lives. It is imperative that you create a strong, supportive system and surround yourself with others who understand the stresses inherent in professional caregiving.

Begin a self-care plan that works for you. After that you will need a toolbox of new skills and approaches to keep your self-care plan going. Activities such as mindfulness meditation, yoga, good nutrition, regular exercise, and “letting go” exercises are some of the tried-and-true long-terms approaches that do work.

You Are Not Expected to Take on the Challenges of Others

Perhaps the most important thing to remember is this: you are not expected to take on the challenges of others. Your job as a DSP is to be present to those in your care, and to complete your caregiving in the easiest, simplest, and most gentle way possible. Providing support to others is one of life’s most challenging and at times heart-wrenching tasks. As a professional, you are called to provide respectful, kind, and compassionate care, to bear witness to the challenges of others with strength and courage. You share your time and talents with those you support. At times you may be asked to bear witness to difficult situations or events of those your support. As part of your work you may be asked to help improve the situation.

Day-to-day professional caregiving can be a roller coaster ride of emotions. This is normal. Learning not to allow your emotions to overwhelm you is first and foremost in keeping high levels of compassion fatigue at bay. With a focus on practicing authentic, sustainable self-care daily, you can learn to manage the symptoms of compassion fatigue and experience a new level of happiness, good health, and well-being.


Learn more about compassion fatigue at ; and follow . Take the Professional Quality of Life Self-Test measuring compassion, satisfaction, burnout and secondary traumatic stress levels at .

“Elma” is currently part of a Avivo Artworks installation for Art for All: The Stephanie Evelo Fund for Art Inclusion at the Institute on Community Integration at the University of Minnesota.


  • Rowell, K., & Thomley, R. (2013). Recovering emotionally from disaster. American Psychological Association Help Center. Retrieved from