G287(P) Compassion fatigue and compassion satisfaction in volunteer counsellors in one stop child sexual abuse centres in malawi: a descriptive qualitative study

Abstract

Aims Approximately 1 in 5 Malawian women experiences sexual abuse, mostly as children. Until recently, child survivors seeking help had to make numerous trips to police stations, social welfare and emergency rooms to report the crime and seek treatment, a drawn out and difficult process. One-stop child sexual assault (‘Chikwanekwane’) centres were introduced in urban areas in 2012 to assist survivors as part of the Malawi government’s response to child sexual abuse. Social welfare, police, paralegal, medical and counselling staff work together with the child and family. All children meet with a trained volunteer counsellor at least once; many have several sessions of supportive and trauma-focused counselling. It is known that burnout (associated with compassion fatigue) is common amongst those providing child-sexual-abuse services in industrialised countries but it is not known if similar problems exist in low-income settings where such services are in their infancy. We set out to determine the experience of compassion fatigue and compassion satisfaction amongst volunteer counsellors (VCs) in Chikwanekwane centres in Malawi. Methods In this descriptive phenomenological qualitative study, 10 VCs in 2 Chikwanekwane centres were interviewed to understand how compassion satisfaction and compassion fatigue affected them. Data collection and analysis occurred iteratively until data saturation (no new information) was achieved. Ethical approval was granted, and psychological support offered to participants if requested. Results Both compassion fatigue and compassion satisfaction were common amongst VCs. Factors contributing to compassion fatigue included systematic failures (e.g. police corruption), cultural norms, personal financial expense, the nature of the abuse and personal feelings of inadequacy. Personal religious belief, survivor empowerment, involvement in community education to raise awareness of abuse contributed to compassion satisfaction. VCs used a range of coping strategies and especially valued discussions with colleagues. Conclusion VCs in Chikwanekwane centres are at risk of burnout as a result of excessive compassion fatigue. Education about compassion fatigue and satisfaction, how to recognise them and effectively cope with them may be helpful, along with reimbursing VC expenses. Regular debriefs with colleagues as individuals (‘buddy scheme’) or in groups are recommended to support VC providing this important service.