Compassion Fatigue Test
The Compassion Fatigue Test is a self-report screener, based on the structure of the ProQOL (Professional Quality of Life) scale, that measures compassion satisfaction, burnout and secondary traumatic stress over the past month in nurses, therapists and caregivers. It is an educational tool, not a diagnosis.
For professional reference, research, and education only. Not for diagnosis or medical advice.
The Compassion Fatigue Test is a self-report screener for people in helping roles, built on the structure of the ProQOL (Professional Quality of Life) scale. It measures compassion satisfaction, burnout and secondary traumatic stress over the past month [1].
What does the Compassion Fatigue Test measure?
The cost of caring is real. If you work with people in pain, as a nurse, therapist, social worker, teacher, or family caregiver, you may be absorbing more of that pain than you realize.
What is compassion fatigue?
Compassion fatigue is the emotional and physical exhaustion that results from caring for others who are suffering. It's sometimes called the "cost of caring" [3], the price you pay for showing up, feeling the weight of others' pain, and giving yourself to the work of helping.
Compassion fatigue is distinct from burnout [2]. Burnout is rooted in cumulative workplace stress, workload, poor management, lack of recognition.
Compassion fatigue is more specific: it emerges from the repeated exposure to others' trauma and suffering, from the empathic engagement that is, paradoxically, the very thing that makes you good at what you do. For burnout on its own, see the Burnout Inventory (MBI).
The Professional Quality of Life (ProQOL) scale, developed by Beth Hudnall Stamm, is one of the most widely used measures of compassion satisfaction and fatigue [1]. It captures three dimensions:
- Compassion Satisfaction: the meaning and reward you derive from the work.
- Burnout: feelings of hopelessness, ineffectiveness, and depletion from the job itself.
- Secondary Traumatic Stress: the intrusive, hypervigilant, avoidant symptoms that emerge from indirect trauma exposure.
If you've ever gone to your car and cried before your shift starts, you already know what this feels like. If you've noticed that you feel less moved by clients' stories than you used to, or that the suffering doesn't register the way it did at the beginning, that's not hardening. That's a warning sign.
The antidote to compassion fatigue isn't less caring. It's compassion satisfaction, reconnecting to the meaning of the work, building the conditions that allow you to keep giving without being hollowed out by it. This screener measures both.
How do you give the Compassion Fatigue Test?
Rate each statement based on how often you've experienced it over the past month in your caregiving or professional role. The screener is completed by the respondent; results are for self-awareness and for conversation with a supervisor, occupational health professional, or mental health clinician.
How do you score and interpret the Compassion Fatigue Test?
This screener is based on the structure of the Professional Quality of Life (ProQOL) scale. The ProQOL yields three subscale scores, each derived from 10 items rated on a 5-point frequency scale (1 = Never to 5 = Very Often), so each subscale ranges from 10 to 50.
The subscales are interpreted separately, not combined into a single total.
| Subscale | What it measures | Score range | High score means |
|---|---|---|---|
| Compassion Satisfaction | Reward, meaning, and positive energy from the caregiving role | 10–50 | Positive — you are sustaining motivation and fulfillment |
| Burnout | Hopelessness, ineffectiveness, and depletion from the work environment | 10–50 | Concerning — systemic exhaustion is accumulating |
| Secondary Traumatic Stress | Intrusive, hypervigilant, or avoidant symptoms from indirect trauma exposure | 10–50 | Concerning — trauma content from clients is affecting you |
The ProQOL scoring manual places each subscale score into low, average, and high bands based on normative percentile data. These bands are descriptive guides rather than validated diagnostic cutoffs, and individual context always matters.
Directionality differs across subscales:
- High Compassion Satisfaction is a protective sign.
- High Burnout or Secondary Traumatic Stress is a warning signal that warrants attention, ideally with a supervisor, peer, or mental health professional.
Burnout and secondary traumatic stress are substantially correlated (pooled r ≈ .69 across professions) [5], so elevated scores on both subscales at once are common and reinforce the need for support. Secondary traumatic stress shares symptoms with PTSD; where symptoms are marked, the PCL-5 gives a fuller picture.
Psychometric properties
- Factor structure: In 310 child protection workers, confirmatory factor analysis did not confirm Stamm's three-factor structure; a bifactor model with a general factor plus the three subscales fitted, supporting use of each subscale separately and suggesting a single overall score can also be computed [1].
- Convergent and discriminant validity: The ProQOL correlated with a PTSD checklist (r = −.427), well-being at work (r = .694) and psychological distress at work (r = −.666), and showed no association with the Life Event Checklist [1].
- Subscale overlap: Across 41 studies of 8,256 workers, burnout and secondary traumatic stress were strongly associated (weighted r = .69), and more so with measures developed within the compassion fatigue framework (weighted r = .74) [5].
Limitations
- Screening, not diagnosis. An elevated Burnout or Secondary Traumatic Stress score prompts a conversation; it is not a diagnosis.
- Limited validity evidence. The ProQOL is widely used despite little publicly available evidence for its validity, and its three-factor structure has not always replicated [1].
- Descriptive bands. The low/average/high bands are descriptive guides from normative data, not validated diagnostic cutoffs.
- Self-report. Scores depend on honest, reflective responding about a demanding role, and can shift with recent events.
Who gets compassion fatigue?
Compassion fatigue can affect anyone who regularly bears witness to others' pain: a review of 71 studies found it across all the practitioner groups studied [2]. Some roles carry a higher structural risk, not because of individual weakness, but because of the nature of the exposure and the systems that surround the work.
Burnout vs compassion fatigue: what's the difference?
They often co-occur, and the distinction matters for how you approach recovery. Treating compassion fatigue like burnout, or vice versa, can mean targeting the wrong root cause.
Burnout
- Rooted in systemic and organizational stress
- Develops gradually over months or years
- Less tied to empathy, more to workload and systems
- Core feeling: "This job is crushing me"
- Improves with organizational change and recovery time
Compassion fatigue
- Rooted in the relationship with suffering clients or loved ones
- Can develop suddenly after acute trauma exposure
- Empathy is the entry point, caring too deeply, too often
- Core feeling: "Their pain has become part of me"
- Improves with supervision, boundaries, and reconnection to meaning
How do you recover from compassion fatigue?
Recovery from compassion fatigue is possible, but it requires more than a vacation. It requires addressing the structural conditions that create it, alongside personal replenishment.
Approaches cluster into three levels:
Individual: Mindfulness-based practices, regular clinical supervision, boundary-setting, and protected recovery time outside of caregiving contexts. A 2015 meta-analysis found that both workplace support (r = −.17) and social support (r = −.26) were protective factors against secondary traumatic stress, meaning connection itself is an intervention [4].
Team and organizational: Peer support programmes, reduced trauma caseload ratios, and psychological safety within teams are structural levers. A survey of emergency department nurses found that low manager support was a significant predictor of higher burnout and compassion fatigue, while high manager support contributed to greater compassion satisfaction [6].
Scheduling practices that prevent serial high-acuity exposure without decompression time matter, particularly in emergency, oncology, and palliative settings.
Clinical supervision and reflective practice: Regular supervision, especially restorative supervision, is distinct from administrative oversight; it is a dedicated space to process the emotional weight of the work, notice early warning signs, and reconnect to meaning. Where supervision is unavailable or inaccessible, peer consultation and structured debriefing serve a similar function.
For individuals: This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.
Related
Billing
In the US, the Compassion Fatigue Test is usually billed under these CPT codes. Payer rules vary.
Assessments
- Burnout Assessment
- Burnout Inventory (MBI)
- Burnout Test
- Beck Anxiety Inventory (BAI) Scoring & Interpretation
- DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure, Adult
- Epworth Sleepiness Scale (ESS)
Dot size shows how strongly each scale's condition is linked to this one in HiBoop's co-occurrence map.
FAQ
Is the ProQOL a single score or multiple scores?
The ProQOL yields three separate subscale scores — Compassion Satisfaction, Burnout, and Secondary Traumatic Stress — which are interpreted independently. There is no single total score; the subscales measure different constructs and cannot meaningfully be summed.
What is a high Compassion Satisfaction score?
On the ProQOL, higher Compassion Satisfaction scores indicate greater reward and meaning derived from the caregiving role. A high score is a positive sign, suggesting you are sustaining the motivation and fulfillment that makes sustained helping possible.
Can this test diagnose compassion fatigue?
No. Screeners like this one are educational tools designed to raise self-awareness. A clinically elevated score on the Burnout or Secondary Traumatic Stress subscale should prompt conversation with a supervisor, occupational health professional, or mental health clinician — it does not constitute a diagnosis.
Who is most at risk for compassion fatigue?
Research shows compassion fatigue occurs across all helping professions. A 2015 meta-analysis found that higher caseload volume and frequency of trauma exposure, personal trauma history, and lower levels of workplace and social support were the strongest predictors of secondary traumatic stress in therapeutic workers.
References
- 1.Geoffrion S, Lamothe J, Morizot J, Giguère CÉ. Construct Validity of the Professional Quality of Life (ProQoL) Scale in a Sample of Child Protection Workers. J Trauma Stress. 2019;32(4):566-576.
- 2.Cavanagh N, Cockett G, Heinrich C, et al. Compassion fatigue in healthcare providers: A systematic review and meta-analysis. Nurs Ethics. 2020;27(3):639-665.
- 3.Sinclair S, Raffin-Bouchal S, Venturato L, Mijovic-Kondejewski J, Smith-MacDonald L. Compassion fatigue: A meta-narrative review of the healthcare literature. Int J Nurs Stud. 2017;69:9-24.
- 4.Hensel JM, Ruiz C, Finney C, Dewa CS. Meta-analysis of risk factors for secondary traumatic stress in therapeutic work with trauma victims. J Trauma Stress. 2015;28(2):83-91.
- 5.Cieslak R, Shoji K, Douglas A, Melville E, Luszczynska A, Benight CC. A meta-analysis of the relationship between job burnout and secondary traumatic stress among workers with indirect exposure to trauma. Psychol Serv. 2014;11(1):75-86.
- 6.Hunsaker S, Chen HC, Maughan D, Heaston S. Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses. J Nurs Scholarsh. 2015;47(2):186-94.
HiBoop does not offer this scale. This page is reference material.This library is an academic and clinical reference. A scale described here is not necessarily offered in HiBoop; each page says whether it is.