Compassion Fatigue Therapy in Ontario
Online support for healthcare workers, therapists, educators, clergy, and caregivers who feel depleted and disconnected from the work they once valued.
By Erika Mills, RP, Registered Psychotherapist, Certified Spiritual Health Practitioner, and Certified Supervisor-Educator in Spiritual Care.
When you feel like you don’t care anymore
You chose your work because helping people mattered to you. Now you feel irritated when someone needs more, disconnected from the people you support, or impatient with concerns you once had room to hear.
The change can be frightening. You may wonder why the reason you entered your profession feels so distant, or feel ashamed that you seem colder or less compassionate.
I am Erika Mills, RP, a compassion fatigue therapist providing online psychotherapy to adults across Ontario. We explore what is draining your capacity, what makes it difficult to ask for help or set limits, and how to begin making decisions that support your health and reflect what matters to you.
What is compassion fatigue?
Compassion fatigue describes emotional and physical depletion associated with repeated exposure to other people’s suffering and the demands of caring for them. It can involve reduced empathy, distress, and loss of satisfaction in helping work. Definitions vary; the Professional Quality of Life framework considers burnout and secondary traumatic stress as components of compassion fatigue.
The term can help us understand the cost of care. In therapy, we also explore your particular symptoms, experiences, and circumstances so we can identify the support you need.
What can compassion fatigue feel like?
In my practice, people describe feeling alarmed by changes in their patience, concern for others, and connection to their work. You may recognize thoughts such as:
- “I don’t care anymore, and it scares me.”
- “The reason I chose this work feels far away.”
- “Other people’s needs annoy me, and I feel ashamed of that.”
- “I feel disconnected and mean.”
These reactions deserve attention. We can explore the circumstances around them and what your current capacity allows.
You may also notice tiredness, difficulty switching off after work, or less emotional availability at home. These signs can have several explanations. Understanding what has changed helps us decide what to address.
What is draining your capacity to care?
When we begin working together, I ask where your energy and emotional capacity are going. Patterns that commonly come up in my work include:
- Difficulty asking for help. You continue carrying tasks because involving someone else feels like burdening them.
- Missing breaks. Your own needs keep getting postponed as other demands take priority.
- Taking work home. This may mean unfinished tasks, continued availability, or thinking about situations long after the workday ends.
- Doing too much outside work. Caregiving, household responsibilities, and commitments leave little time to recover.
We also examine workplace conditions: the workload, support available, expectations, and how much control you have. Some demands require changes in staffing, supervision, or organizational practice. Your circumstances shape which actions are realistic.
Why can setting limits feel so difficult?
People often know they need a break or more support and still find it hard to act. In my work, common barriers include guilt, fear of burdening others, reluctance to say no, and concern about getting in trouble.
We explore the beliefs beneath those fears. You may believe that a reliable professional should always manage, that your needs create problems for others, or that declining a request will have consequences.
Some concerns reflect real workplace conditions. Others may be connected to longstanding expectations about responsibility, approval, or being useful. Understanding both helps us choose a workable next step.
How does therapy for compassion fatigue help?
My approach begins with understanding your depletion and the patterns that maintain it. We work through four connected areas.
1. Identify where depletion is happening
We look at your workday, recovery time, relationships, and responsibilities outside work. Together, we identify the demands that consume your capacity and the support currently available to you.
2. Explore what makes limits difficult
We examine what happens when you consider asking for help, taking a break, or declining a request. This can include guilt, fear of disapproval, and concern about workplace consequences.
3. Examine the beliefs that keep patterns going
We explore the expectations you hold about caring, responsibility, and your own needs. Understanding these beliefs gives you more room to consider how you want to respond.
4. Set priorities around what matters to you
We clarify what is most important in your work and life, then use those priorities to guide decisions. Depending on your circumstances, this might mean asking for support, protecting a break, renegotiating a commitment, or changing how available you are outside work.
This work informs my practice framework, The Cost of Care. It helps organize conversations about depletion, identity, and rebuilding a sustainable relationship with responsibility.
What might change as therapy begins?
One early change I see in my work is relief when clients can understand their depletion in context. Feeling understood can ease shame and help them recognize a path forward.
We then work toward changes in thinking and behaviour: noticing limits sooner, making room to ask for help, considering priorities before agreeing to more, and creating opportunities to recover. Your goals and pace depend on your circumstances.
Compassion fatigue, burnout, secondary traumatic stress, and moral injury
These terms describe related experiences that can occur together.
| Experience | What the term describes |
|---|---|
| Compassion fatigue | Depletion associated with caring for people who are suffering. Some frameworks include burnout and secondary traumatic stress within this term. [1] |
| Burnout | The effects of chronic workplace stress, including exhaustion, greater distance or cynicism toward work, and reduced professional effectiveness. WHO classifies it as an occupational phenomenon. [2] |
| Secondary traumatic stress | Trauma-related distress associated with exposure to other people’s traumatic experiences through helping work. [1] |
| Moral injury | Psychological, social, or spiritual distress following experiences that violate deeply held moral beliefs, including things someone did, witnessed, or could not prevent. [3] |
We can explore which experiences fit what you are carrying and how they affect your daily life. You can also read about online burnout therapy and therapy for moral injury.
Your compassion fatigue therapist in Ontario
I am Erika Mills, a Registered Psychotherapist, Certified Spiritual Health Practitioner, and Certified Supervisor-Educator in Spiritual Care. My professional experience includes hospitals, palliative care, community settings, and leadership education.
That experience informs how I work with the emotional demands of caring roles, ethical strain, grief, and questions about meaning and identity. You can read more about my background and approach.
I work with adults across Ontario through online psychotherapy, including people in Kitchener-Waterloo, Cambridge, Hamilton, Ottawa, Toronto, and other Ontario communities. For support specific to healthcare roles, visit therapy for nurses and healthcare professionals.
Questions about compassion fatigue therapy
Can I experience compassion fatigue while still doing my job well?
Yes. In my practice, some people continue meeting their responsibilities while feeling increasingly irritated, disconnected, or depleted. We consider the personal cost of maintaining that level of functioning.
Does feeling less compassionate mean I have become a bad person?
Changes in your reactions deserve understanding. In therapy, we explore your capacity, the demands you are carrying, and the circumstances affecting your responses. There is room to talk honestly about reactions you feel ashamed of and consider how you want to act going forward.
Can therapy help if my workplace stays demanding?
Therapy can help you examine expectations, clarify priorities, ask for support, and consider workable limits. We also discuss what your environment makes possible and whether additional workplace support or changes are needed.
How long does recovery from compassion fatigue take?
The pace varies with your symptoms, ongoing demands, and available support. During therapy, we agree on goals and review how the work is helping. An initial consultation can help clarify what kind of support may fit your situation.
Do you offer online compassion fatigue therapy across Ontario?
Yes. I provide online psychotherapy to adults across Ontario, including healthcare workers, therapists, social workers, educators, clergy, and caregivers.
Can I see a compassion fatigue therapist in Toronto?
Yes. I offer online compassion fatigue therapy to adults in Toronto and throughout Ontario. We meet by video, so you can access support from a private space that works for you.
Is therapy covered by insurance?
Coverage depends on your plan. Check whether your benefits cover a Registered Psychotherapist, along with reimbursement limits and any documentation requirements.
Book a free consultation
A free 20-minute consultation gives us time to discuss what has changed, what you are carrying, and whether my approach fits your needs. You can ask questions and consider your next step afterward.
Book a free 20-minute consult with Erika
Sources
National Center for PTSD: Moral Injury.
Professional Quality of Life: Compassion Fatigue. The linked handout discusses definitions, symptoms, and contributors to compassion fatigue.
World Health Organization: Burn-out as an occupational phenomenon.
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