Experiences of Empathy-Based Stress Among Care Staff Supporting Children and Adolescents With Intellectual Disabilities and/or Autism in Residential and Respite Services: A Qualitative Exploration

Abstract

Background: Care staff in the disability sector experience high levels of work-related stress and burnout, which contribute to high staff turnover and limited residential service capacity and affect both staff well-being and the quality of care provided. Little is currently known about the impact that exposure to secondary trauma has on care staff, which could put them at risk of experiencing empathy-based stress. This qualitative study aimed to explore how empathy-based stress is experienced by care staff supporting children and adolescents with intellectual disabilities and/or autism in residential and respite services, and the factors they perceive as contributing towards or protecting them from experiencing empathy-based stress.

Methods: Twelve care staff from four different community-based organisations in Ireland (two residential care and two overnight respite) took part in online semistructured interviews, which were recorded and transcribed verbatim. Reflexive thematic analysis was used to analyse the data.

Results: Four themes were identified, which had two to three subthemes each: (i) Challenging Periods (exposure to distress and trauma, empathy and feeling powerless), (ii) Organisational Factors (lack of support from management, training and staff cohesion), (iii) Personal Resilience (awareness, focussing on the positives) and (iv) Impact of Empathy-Based Stress (negative work affect, adverse impact on health and well-being).

Conclusion: Staff were exposed to service user distress or trauma, which at times initiated an empathy-based stress process. A build-up of factors, both individual and contextual, led to adverse physical and psychological outcomes and negative work affect. These findings have implications for policy and practice within disability care settings and suggest that interventions at a personal and organisational level and the adoption of a trauma-informed approach may help to reduce empathy-based stress in care staff and improve quality of care for service users.