Professional Quality of Life Scale
Professional Quality of Life (ProQOL) is a free tool for any helper to assess their current levels of compassion satisfaction and compassion fatigue.
Professional Quality of Life Scale
Compassion Satisfaction and Fatigue · Version 5
A validated 30-question self-assessment for helping professionals.
Before You Begin
When you help people, you have direct contact with their lives. Your compassion for those you help can affect you in both positive and negative ways.
Consider each question about you and your current work situation. Think about your experiences over the last 30 days.
How to Rate Each Statement
Move the slider to the number that honestly reflects how frequently you experienced each thing in the last 30 days.
What You'll Receive
After completing all 30 statements, you'll receive scores in three areas:
Compassion Satisfaction — the fulfillment you get from helping others
Burnout — feelings of hopelessness and ineffectiveness
Secondary Traumatic Stress — the impact of others' trauma on your wellbeing
Your Results
Based on your responses over the last 30 days
This measure may be freely copied as long as (i) the author is credited, (ii) no changes are made, and (iii) it is not sold.
Ownership of the ProQOL measures transferred to the Center for Victims of Torture (CVT) in 2016.
Burnout & Compassion Fatigue
Two distinct conditions that affect helping professionals. Understanding the difference is the first step toward meaningful support and sustainable practice.
Burnout
Long-term occupational stress that depletes your energy and erodes your sense of effectiveness.
Explore →Compassion Fatigue
The cost of caring. Secondary trauma combined with burnout can diminish your capacity to help.
Explore →How do they relate?
See the key differences and the connection between these two conditions.
🔥 Burnout
Emotional depletion resulting from prolonged work-related stress — and a signal that something in your environment needs to change.
Burnout results from long-term, work-related stress and is characterized by feeling emotionally depleted or drained. It develops gradually and involves three interconnected dimensions.
Burnout shows up across multiple domains. Select a category to explore the signs.
- Fatigue and exhaustion
- Headaches
- Sleep disturbances — difficulty falling or staying asleep, increased or decreased sleep
- Digestive problems
- Increased physical complaints
- Emotional distress, including feelings of sadness and depression
- Anger and irritability
- Inwardly directed criticism
- Difficulty concentrating
- Increased cynicism or negativity
- Increased doubts and uncertainty
- Excessive use of substances — nicotine, alcohol, illicit drugs
- Risk-taking
- Avoidance or dread of working with certain patients or colleagues
- Withdrawing from colleagues
- Decreased job performance
- Negative attitude toward the job, organization, and/or patients
- Depersonalization and absenteeism
- Lack of satisfaction from achievements
- Decreased sense of personal accomplishment
- Feeling unable to help
- Disillusionment and reduced job commitment
- Low career satisfaction
- Feeling overworked and over-extended
- Increased medical errors
Work-related and organizational factors increase vulnerability to burnout. These are conditions — not personal weaknesses.
- Long working hours and difficult work environment
- Too much challenge or too little control over working conditions
- Chronic work-related stress and intense work demands
- Lack of clear boundaries between work and rest
- Limited opportunity for rest and recovery
- Continual boredom (which can be both a cause and a symptom)
- Unclear or non-existent job description
- A persistent gap between job expectations and one's skills or knowledge
- Poor match between the job and the person
- Responsibility for things you cannot control
- Inconsistent or inadequate supervision
- Lack of fairness or feedback
- Limited autonomy and high degree of interference
- Efforts not being acknowledged or appreciated
- Feeling devalued and unrewarded
- Lack of engagement in the workplace
Prevention requires both individual self-care and organizational change. Neither alone is sufficient.
- Ensure adequate sleep (6–8 hours per night)
- Seek help from colleagues or supervisors when needed
- Develop competence and confidence in your role
- Assess the fit between your interests, talents, and job description
- Reorganize your workday to create more self-care time
- Assess how well your personal values align with your organization's
- Look for commonalities where your values do match
- Consider advocating for values you believe are important in your workplace
- Engage in regular physical exercise
- Maintain a healthy diet — fruits, vegetables, reduced sugar, salt, and caffeine
- Make time for your spiritual practice — prayer, meditation, time in nature
- Find meaning or purpose in daily activities
- Use reminders to reconnect with your sense of meaning (notes, photos at your desk)
- Practice gratitude — set time aside each day to reflect on a few things you are thankful for
- Build and maintain a strong social support network
- Connect with your support network regularly, both personally and professionally
- Maintain reasonable working hours
- Balance intensity of work and ensure there is downtime
- Encourage rest breaks and employee vacations
- Foster an organizational culture where self-care is valued and seen as necessary for quality work
- Provide clear job descriptions and role clarity
- Ensure employees are appropriately trained for their responsibilities
- Establish regular check-ins and encourage help-seeking
- Create peer support or buddy systems
- Implement systems that celebrate success and show appreciation
- Promote the importance of wellbeing through regular team meetings
- Provide information about stress and healthy coping strategies
References: Castelo-Branco et al. (2007); Lacy & Chan (2018); Pearlman (2012, 2013)
💧 Compassion Fatigue
The cost of caring deeply. A state of exhaustion that can emerge when helpers absorb the weight of others' suffering without adequate support or recovery.
Compassion fatigue (CF) results in a decreased ability to cope with the everyday environment. It is defined as a state of emotional distress, exhaustion, and biological, psychological, and social dysfunction resulting from three overlapping sources.
Compassion fatigue presents across five domains, including a spiritual dimension not present in burnout alone.
- Headaches and digestive problems (diarrhea, constipation, upset stomach)
- Muscle tension
- Sleep disturbances — difficulty falling or staying asleep, nightmares
- Tiredness and fatigue
- Cardiac symptoms — chest pain, palpitations, elevated heart rate
- Increased incidents of illness or accidental injury
- Mood swings, restlessness, depression
- Anger, resentment, and irritability
- Loss of objectivity and impaired judgment
- Memory issues and poor concentration
- Reduced empathy and difficulty separating personal from professional life
- Hyperarousal, hypervigilance, increased startle response
- Pessimism and moodiness
- Difficulty with decision making
- Excessive use of substances — nicotine, alcohol, illicit drugs
- Isolation and introversion
- Increased interpersonal conflict
- Pessimism and moodiness
- Increased startle response and hypervigilance
- Avoidance or dread of working with certain patients or colleagues
- Reduced ability to feel empathy toward patients or families
- Frequent sick days and absenteeism
- Loss of joy and satisfaction in work
- Decreased ability to care for patients
- Loss of productivity and reduced standards of care
- Clinical mistakes in patient care
- Feelings of incompetence and inefficiency
- Questioning the meaning of life and loss of purpose
- Anger at God or questioning religious beliefs
- Loss of faith and skepticism
- Lack of self-satisfaction
Empathy is essential to helping work — but empathy combined with insufficient protective boundaries is the primary vulnerability factor for compassion fatigue. Empathy requires understanding both the emotional and cognitive experience of those you help. This closeness, without adequate self-protection, can cause helpers to absorb the distress of those they serve.
- High intensity workload and physically demanding assignments
- Task repetitiveness and additional workdays
- Perceived lack of control in the workplace
- Low job satisfaction and unclear outcomes
- Inadequate rest time during the workday
- Insufficient leave from work
- Lack of meaningful recognition
- Poor managerial support
- Poor personal resilience and limited coping capacities
Building resilience across five domains strengthens your ability to prevent and recover from compassion fatigue. Self-care practices, engaged with intentionality, help your body and mind remember how to restore themselves.
- Focus on the four core components of resilience: adequate sleep, good nutrition, regular physical activity, and active relaxation (yoga, meditation)
- Engage in practices that build team cohesiveness — celebrate successes together
- Reduce workload intensity and integrate variety where possible
- Seek a mentor or experienced colleague for support and perspective
- Take time away from work when possible and nurture positive relationships
- Seek professional support when needed
- Take time alone to think, reflect, and practice grounding
- Challenge negative internal dialogue
- Work toward shifting negative automatic thoughts toward a more balanced outlook
- Prioritize sleep — it affects physical strength, decision-making, and temperament
- Stay hydrated throughout the day
- Maintain a balanced, healthy diet
- Spend time in nature regularly
- Build self-awareness through mindfulness and reflection practices
- Practice your spiritual beliefs or connect with a faith leader for support
- Find meaning or purpose in your daily activities
- Make time to learn about the people you work with — connection is protective
- Create personal rituals that separate work from home (changing clothes, a specific song, a walk)
- Practice self-compassion consistently
References: Cocker & Joss (2016); Lombardo & Eyre (2011); SAMHSA (2014)
⇄ How They Relate
Burnout and compassion fatigue are distinct conditions — but they can occur together, and one can contribute to the other.
Compassion fatigue is understood as a combination of:
| Feature | Burnout | Compassion Fatigue |
|---|---|---|
| Onset | Gradual — builds over time | Can be rapid — tied to specific events |
| Primary cause | Cumulative work-related stress | Exposure to others' trauma + burnout |
| Core experience | Depletion, inefficacy, cynicism | Absorbed distress, empathic exhaustion |
| Spiritual symptoms | Not typical | Common — loss of meaning, faith, purpose |
| Who is affected | Any worker under sustained stress | Helpers with empathic exposure to trauma |
| Relationship to trauma | Not trauma-specific | Directly tied to secondary traumatic stress |
| Protective factor | Organizational support, recovery time | Compassion satisfaction, strong boundaries |
