Written by: Dana Rexrode, LPC, LCMHC; Regional Director, Eastern Child Welfare Programs and National Director of Clinical Operations.
Working in mental health is more than a job for those who are called to it. However, there is no denying that the emotional intensity can be both fulfilling and exhausting. The stories we hold, the crises we manage, and the systems we navigate aren’t just challenging—they can be profoundly draining. Over time, without intentional care, that weight can lead to compassion fatigue.
Compassion fatigue—also referred to as the “cost of caring”—is not the same as burnout, though the two are related. Burnout tends to stem from external factors like overwhelming caseloads or lack of support. Compassion fatigue, on the other hand, arises from the emotional residue of exposure to the trauma of others. It can sneak up subtly, masked by our dedication and desire to help, until one day we find ourselves emotionally depleted.
Why It Hits Harder with High-Acuity Youth
Children and adolescents with severe mental health needs like many of those we serve at Rite of Passage require constant vigilance, high levels of emotional attunement, and quick thinking in moments of crisis. These young people may be navigating intense trauma, suicidality, self-injury, aggression, or disconnection from caregivers and systems. The stakes are high, and the emotional labor is relentless.
Mental health professionals working in this space are often empathetic — drawn to the work out of a deep desire to heal and protect. But when we pour from an empty cup, even our best intentions can fall short. Worse, unaddressed compassion fatigue can lead to clinical errors, ruptures in therapeutic relationships, and ultimately, our own departure from the field.
How do we combat the challenges of this type of work? We have to use intentional and mindful strategies to support ourselves and our partners in this process.
Strategies to Sustain the Work
1. Prioritize connection-with yourself and others: We encourage our clients to regulate their emotions, build secure attachments, and develop self-awareness. We must do the same as staff. Supervision, consultation groups, and peer debriefing provide crucial space to process the emotional impact of the work. These aren’t luxuries—they’re lifelines.
2. Establish boundaries that honor your capacity: High-acuity work often demands flexibility, but that doesn’t mean we have to be endlessly
available. Protect time for taking a breath and set realistic expectations about what you can hold in a day. Boundaries are a form of professional sustainability and modeling those for our coworkers and our clients is important.
3. Engage in regular reflective practice: Whether through journaling, therapy, or mindfulness, carve out space to notice what you’re carrying. Ask: What did I take home today that wasn’t mine? Naming the emotional load helps you consciously release it.
4. Reaffirm your “why”: When the work gets hard, revisit what brought you here. Was it a belief in the power of healing? A mentor who inspired you? A personal journey with mental health? Let your purpose be a steadying force. Here at Rite of Passage, our mission is “Improving the lives of youth.” That is our central why – and centering ourselves on the youth we serve and the reasons we entered this field can be critical.
5. Nurture joy and play outside of work: Working with youth can be heavy—but it also reminds us of the importance of play, curiosity, and hope. Reclaim those qualities in your own life. Make time for the people, hobbies, and experiences that refill your emotional reserves.
You are Not Alone
Helping others heal is sacred work—but so is taking care of yourself. Compassion fatigue is not a sign you’re in the wrong profession; it’s a signal that you’re human. In fact, the very empathy that makes you effective also makes you vulnerable. You can’t eliminate that risk—but you can meet it with intention, support, and self-compassion.
Remember: one of the most powerful things you can model for the young people you serve is what it looks like to care for yourself while caring for others.
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