Module 4: Handler Self-care & Peer Support

Developed by:
M. D. Daschuk, PhD, Department of Sociology; University of Saskatchewan
Colleen A. Dell, PhD, Department of Sociology; University of Saskatchewan
Janelle Jackiw, MA, MEd, Department of Justice Studies, University of Regina

Maryellen Gibson, MPH, Department of Sociology; University of Saskatchewan
Grace Rath, BA, Department of Sociology; University of Saskatchewan

Therapy Dog Handler Reviewer:
Jane Smith, B.Trad., B.Ed, MStJ; St. John Ambulance Therapy Dog Program


In this module you will have the opportunity to increase your awareness and skills about mental health self-care and peer support, why they are important, and how therapy dog handlers can practice them. You will learn about some of the ‘costs of caring’ that service providers commonly experience as they learn about the traumatic experiences of their clients. This can be similar to situations therapy dog volunteers find themselves in with program participants. You will also become familiar with the differences between secondary stress, compassion fatigue, and vicarious trauma, and the symptoms related to each. By the end of this module, you will have an understanding of holistic perspectives on wellness and introduced to strategies to help you maintain balance in your emotional, spiritual, social, physical, and cognitive health as a therapy dog handler.

Figure 4-1: Permission: Courtesy of Janelle Jakiw, Department of Justice Studies, University of Regina.

EXPERT SPEAKER: About Janelle Jackiw

Janelle Jackiw holds a Master’s degree in both Criminology and Educational Psychology. This background informs her current work as a lecturer in the Justice Studies program at the University of Regina. She is also a Certified Clinical Counselor. Janelle’s work focuses on mental health and wellness, stress management, and trauma. She believes that positive change can happen when people build meaningful connections with each other and have a sense of passion and purpose. Janelle resides in Regina, Saskatchewan, which has long been rumored to be the birthplace of professional wrestling legend Macho Man Randy Savage (this rumor is not true).

Learning Objectives

When you have finished this module, you should be able to: 

  1. Define the mental health continuum.
  2. Identify the importance of mental health self-care for therapy dog handlers.
  3. Describe secondary stress, compassion fatigue, and vicarious trauma.
  4. Discuss peer support strategies at the organizational, group, and individual levels.
  5. Outline strategies for self-care.

Key Terms

  • Critical Incident Stress Management
  • Self-Care
  • Secondary Stress
  • Compassion Fatigue
  • Vicarious trauma
  • Peer Support
  • Mindfulness


Essential Information for Therapy Dog Handlers

Click to expand each section.

Maintaining Mental Health and Wellbeing

Maintaining Mental Health and Wellbeing

To this point in the course, you have considered various ways that therapy dog handlers can help program participants feel accepted and safe, as well as a variety of ways that trauma may be experienced and expressed by participants. While therapy dog programs take great care to ensure participants have a PAWSitive (positive) experience, we need to also recognize that providing therapy dog services in the community can influence the mental health of the therapy dog handlers.

Providing services to people in crisis from traumatic experiences can be emotionally draining. Negative health outcomes are commonly reported by service providers doing this type of work, including hospital staff (Fox, 2019), Registered Nurses (Delaney, 2018; Coetzee and Laschinger, 2017), public healthcare professionals (Rossi et al., 2012), psychiatric service providers (Roberts et al., 2022, Hernandez-Wolf, et al. 2015), researchers (Nikisher, 2018), and veterinarians (Harrison, 2021). In some cases, service providers can feel overwhelmed learning about the significant hardships people experience in their lives while building relationships with them, or by repeatedly being entrusted with descriptions of clients’ traumatic encounters. In other cases, service providers can experience feelings of emotional or mental exhaustion that coincide with the inadequacy or under-funding of programs and services that could improve the wellbeing and quality of life of individuals in need of assistance. As the following story from Stephanie Peachey shows, volunteer therapy dog handlers may also experience profound sadness overwhelmingly from situations they find themselves in, such as the passing of a program participant they developed a close relationship with.

Handler Story (Dude and Stephanie Peachy, featuring therapy dog in training Chewy)

Handler Story (Dude and Stephanie Peachy, featuring therapy dog in training Chewy)

Please watch the following video.

Written content and video by Stephanie Peachey

Who are you?

My name is Stephanie Peachy and I am a Provincial evaluator with the St. John Ambulance Therapy Dog Program. I have been involved with the program for about 10 years.  I am also a First Aid instructor with St. John Ambulance.

Who is your therapy dog?

I had a 17-year-old Shih Tzu dog named Dude who was a therapy dog. He passed away in 2020. I have with me today, Chewbacca or Chewy for short. He is a therapy dog in training. He is 18 months old.

What are you going to share?

I would like to share a story about one time that Dude and I visited an ill child in the hospital. This story will tell you how a dog can not only visit the child but also the extended family. As a handler, I was emotionally affected by this situation.

This story took place several years ago on the children’s ward at the Royal University Hospital. I had been asked by a nurse if Dude and I could please visit with a young five-year-old girl who had just returned from brain surgery. I was apprehensive but gladly went. I was not prepared for what I was getting myself into.

As Dude and I stepped into this girl’s hospital room, I noticed that there was a little girl in a great big bed. Mom and Dad were sitting beside the bed with arms around each other, crying. Grandma and Grandpa times two were there as well. Each of them was trying to support each other while crying. Big brother was playing with a truck on the floor in the corner. Nobody noticed as we entered. Dude immediately went to the big brother who was six. Instantly, the brother started talking to Dude. Dude climbed onto his lap, and they cuddled and hugged. Grandma noticed this and came over to talk to me. She said that this girl had a huge dog at home, and she was always with her furry pal. I said that Dude (being a little dog) could be put on the bed beside the girl. Grandma smiled and I lifted Dude onto the bed. There were many monitors and some of them were beeping. Dude cuddled up to the side of the girl, Mom moved the girl’s hand over Dude’s back and the rest of the people (including the nurse) held our breath. As the girl’s hand went over Dude’s fur, the monitors stopped beeping, the heart rate and breathing rate stabilized and everyone in the room relaxed a little.

After this first visit, Dude and I consistently returned to visit three times a week and spent time with the entire family. Dude would come onto the children’s ward and would head all the way down the hall to the far room to visit. Both sets of Grandma and Grandpas, Mom and Dad, big brother, and of course the girl all received cuddles and hugs from Dude. Sometimes there was little talking and at other times there was lots of reminiscing and visiting. Sometimes Dude just snuggled beside the girl on the bed and slept. Dude provided a distraction and a few minutes of escape from the stress of the day. Many times, the nurses would come in to see how the monitors would change when Dude was on the bed. Dude and I became part of the hospital team who supported this family.

Sadly, this young girl never gained consciousness. She was transferred to a smaller hospital near her home. Dude and I made a trip to this other hospital to bring the therapy dog program to this little girl and her family. We also introduced another therapy dog team who visited regularly. The family greeted us with open arms when we came to the smaller hospital. They were so very glad that we were able to visit and able to arrange for another team to visit as well.

I remember the day that I found out that this young girl who had turned six two days before, passed away. Tears came flowing, Dude got many hugs, and I was able to reflect on how much of an impact Dude and I had on the family at an incredibly difficult time. Grandma called to ask Dude and I to attend the celebration of this young girl’s life. Wow, I was overcome with joy and yet sadness. Dude and I made the trip and arrived at a packed building. When we walked into the building, I thought we would sit at the back. However, the family wanted to see us, hug Dude, and we walked into the service with the family. Big brother got to hold onto a second leash on Dude while I held the other one. What an honor for Dude and I. What a loving time. What a sad time. I still get tears and choked up when I recall this experience. It was very hard to leave the family and make the long drive home. Thankfully, Dude cuddled beside me on the front seat with his head on my knee.

When I got home, I surrounded myself with my family, other therapy dog teams, and the St. John Ambulance staff. I needed to look after myself and Dude. We both took some time off from volunteering and did some tender loving care for us. Hugs, cuddling, long walks, playing in the doggie park, and some quiet reflection time were a part of our days.

What do you wish you knew at the time?

At the time of the first visit, I did not know what to expect when we walked into that hospital room. I had no idea that the entire extended family would be there. I thought that the little girl would wake up. I also never expected to see how Dude would change the dynamics of the room, and support the girl which also supporting the family. Dude seemed to know what was expected of him. Even at the service of celebration, Dude knew who needed the support. I felt like I just followed Dude and he did all the work. I was the inexperienced one when it came to identifying who needed support. As a therapy dog handler I need to trust my dog and follow along. I also need to know best I can, where he is leading me, so I can be prepared.

Providing Care for Care Providers

Providing Care for Care Providers

Stephanie’s story demonstrates that assisting therapy dog program participants can be immensely rewarding. At the same time hearing the difficult stories of therapy dog program participants has the potential to be immensely challenging. Some therapy dog organizations recognize this, and have policies and programs in place to provide therapy dog handlers with the necessary care and assistance. The Saskatchewan St. John Ambulance Therapy Dog Program learned about the importance of this first-hand in 2018 when its handlers offered front-line comfort and support to the victims and families of a large-scale provincial tragedy with a bus crash involving the Humboldt Broncos hockey team (handler Wendi shared about this in the prior module). Afterward, representatives from the Saskatchewan Society for the Prevention of Cruelty to Animals, Saskatchewan Health Authority Mental Health and Addiction Services, the University of Regina Faculty of Social Work, and the University of Saskatchewan did interviews with individuals who were part of the response, from emergency room personnel to therapy dog handlers. Six ‘essential actions’ were recommended to effectively integrate therapy dogs into a coordinated provincial trauma response (Dell et al., 2019).

Recommending that the wellbeing of individuals providing support be safeguarded is consistent with critical incident stress management opportunities provided by many organizations to its staff. The International Critical Incident Stress Foundation of Canada describes critical incident stress management as “a comprehensive, integrated, systematic, and multicomponent psychosocial support program [designed] to provide a sense of normalization, foster a sense of affiliation, as well as assist an impacted individual to re-establish their disrupted natural coping strategies” (ICISFC, 2020). Following the fatal Humboldt Broncos bus crash, the primary hospital involved systematically reviewed its critical incident stress management opportunities for staff and volunteers, including therapy dog handlers.

While critical incident stress management opportunities help organizations respond to particularly troubling incidents, being aware of day-to-day strategies for maintaining health and a positive outlook in the wake of more mundane negative experiences is just as important. The commonplace situations you get involved with as a therapy dog handler have the potential to ‘pile up’ and have an accumulative negative effect on your health over time. Think of it this way. If we approach a ‘critical incident’ as an extreme weather event like a blizzard, and your daily interactions with therapy dog program participants as single snowflakes, we can appreciate how small measures toward peer-support and self-care are just as meaningful as mandated emergency policies.

In the event of a blizzard, the sudden accumulation of snow can lead us to a situation where we depend on our city or town administration to get snow removal crews out to clear our streets and help get our lives back to normal. A typical visiting day as a therapy dog handler, on the other hand, may be more akin to the thin blanket of snow we often find covering our walkways throughout the winter months. Each snowflake could be equivalent to a troubling story a client has shared, an emotionally taxing institutional visit, or an empathetic response you felt because of the challenging circumstances an individual finds themselves in. It is not necessary to call city crews in to remove this thin blanket of snow, but it would be worthwhile to have the tools on hand to quickly clear the walkway yourself. Otherwise, neglecting to clear the walk over a series of days could contribute to weeks, and even months, of snow accumulation. Inevitably, you may find the snow that gathered over time to be as deep and troublesome as the downfall of a blizzard.

In Janelle Jakiw’s first video, she provides an overview of the tools you can use to clear your walkway after a day of light snow, discusses the benefits of coordinating snow removal plans with your neighbors, and shares information on how to plan your own snow removal routine. (By the way, if you don’t want to think about snow removal right now, we get it. Think instead about gathering grass clippings in the summer or accumulating leaves in Autumn!)

Program Participant Perspectives (Speaker – Janelle Jackiw)

Program Participant Perspectives (Speaker – Janelle Jackiw)

Janelle Jakiw’s presentation will increase your awareness of strategies to assess and maintain your mental health by establishing peer support networks and developing your own self-care strategies. Janelle discusses the interconnected dimensions of health and how to maintain balance among them, elaborates on ways that therapy dog handlers can recognize feelings associated with secondary stress, compassion fatigue, and vicarious trauma, and provides insight into methods for maintaining balance at the emotional, physical, cognitive, social, and spiritual levels of health.

Please watch the following video.

Indigenous Perspectives on Health and the Medicine Wheel

Janelle’s description of the mental health continuum and the importance of maintaining balance between emotional, physical, cognitive, social, and spiritual domains of health aligns well with traditional Indigenous perspectives on health and wellness. Indigenous perspectives take a holistic approach to health and associate the wellbeing of human populations with that of the natural environment, including the land and animals. The medicine wheel illustrates how Indigenous worldviews associate good health with maintaining balance between spiritual, emotional, mental, and physical health. While different Indigenous cultures conceptualize the medicine wheel in unique ways, they commonly illustrate the interconnections between the four domains of health and other elements of the natural world (such as the four cardinal directions, the four seasons, and the four stages of the life cycle).

According to now passed Saskatchewan Elder Campbell Papequash, all types of experiences contribute to an individual’s experiences within the Circle of Life:

All of our experiences in life have meaning and purpose and connect together with the Medicine Wheel. The healing journey includes all of creation and is about seeking within ourselves and beyond our own existence. This can be understood in the story of the Sundance Pole. A Sundance ceremony is commonly summoned by traditional Elders to honour a scared event or person to call upon the Creator. A circular Lodge is built with the Sundance pole in the centre. The top of the hole has two large branches reaching up to the sky, representing the positive and negative forces of the sun and rain. The base of the pole is grounded in mother earth. The relationship between the sacred pole and mother earth symbolizes creation and life, with the force of sun and rain together producing renewed, healthy growth on earth. Similar in our own lives, both cheerful and difficult experiences together create our balanced existence. Seeing the journey of healing…is a process that values all of our experiences within the Circle of Life.

Note how Figure 4-2 depicts the role of animals in this medicine wheel, circle of life teachings, as shared by the late Elder Campbell Papequash (2012), which identifies the buffalo, bear, eagle, and thunderbird.

Figure 4-2: The medicine wheel (circle of life teachings) by Elder Campbell Papequash. Permission: Courtesy of course author Colleen Anne Dell, Department of Sociology, University of Saskatchewan.

(Re)discovering cultural identity and engaging with traditional heritage can serve as important forms of self-care for Indigenous populations. As described by Elder Jim Dumont of the Thunderbird Partnership Foundation (2014):

Wellness from an Indigenous perspective is a whole and healthy person expressed through a sense of balance of spirit, emotion, mind and body. Central to wellness is belief in one’s connection to language, land, beings of creation, and ancestry, supported by a caring family and environment.

Take specific note of how connection to ‘beings of creation’ is a part of this definition of wellness. Now think about the therapy dog you work alongside and how they are likely considered a part of your own wellness, as might be your relationship to the land, environment and other animals around you, in addition to humans.

The Costs of Caring

Next, Janelle discusses concepts related to the ‘cost of caring too much’ that can be experienced by service providers, and likewise therapy dog handlers. We will review some of the important connections and differences between the four most common ‘costs of caring’ prior to moving on to our first module activity.

Please watch the following video:

We should take an additional minute here to consider several of the concepts Janelle discussed. While secondary stress, compassion fatigue, and vicarious trauma are interrelated, the ways in which they can have a negative influence on specific domains of mental health is important to recognize. Burnout can also have a negative impact.

According to the Canadian Medical Association (2020), burnout is “a psychological syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment [that] typically emerges over time as a result of prolonged stress”.  In this sense, burnout refers to negative consequences related to a service provider dedicating too much time and focus to work, for example, and not enough time and focus to self-care.

Secondary stress (or, secondary traumatic stress) and compassion fatigue are both related to the practice where service providers strive to make emotional connections with clients by ‘considering others’ experiences’ and building bonds through empathy. Secondary stress occurs specifically when a service provider has a negative emotional reaction when learning about another persons’ traumatic experience or becoming informed about a traumatic event (NTCSN, 2022). Secondary stress for a therapy dog handler, then, is connected to what a handler feels given the empathetic bond they develop with therapy dog participants.

Compassion fatigue is more closely linked with experiences of emotional exhaustion related to service providers empathizing with many clients who share traumatic experiences (Psychology Today, 2022). Compassion fatigue is more directly related to the quantity of connections a service provider builds with clients. It occurs when an individual absorbs more stories than their emotional circuitry can handle, leading to overload and a lack of capacity to feel much of anything. Compassion fatigue is oftentimes associated with the ‘emotional residue’ service providers accumulate over a long span of time working with clients – small blankets of snowfall that go unattended – and contributes to the cost of caring affecting their capacity for emotional empathy. This is applicable to therapy dog handlers too.

Finally, vicarious trauma can be approached as the outcome associated with experiencing secondary stress and/or compassion fatigue to such an extent as to have an accumulative negative influence on several domains of the continuum of mental health. Vicarious trauma is reflected in the presence of symptoms across the domains of emotional, physical, cognitive, social, and spiritual health. Vicarious trauma can be understood as the unfortunate outcome of having neglected to tend to a series of light snowfalls, and now being faced with a looming snow pile equivalent to the outcome of a sudden, heavy blizzard.

Based on these definitions and recalling Janelle’s presentation, the following activity will help you distinguish between instances of burnout, secondary stress, compassion fatigue, and vicarious trauma.

Learning Activity 4-1: Identifying Secondary Stress, Compassion Fatigue and Vicarious Trauma

In this activity, consider the given scenarios and note whether the information provided indicates that the person is experiencing burnout, secondary stress, compassion fatigue, or vicarious trauma. How can you recognize each of these? After considering your answer, you can click to reveal the suggested response.

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The Significance of Support Networks

In Janelle’s next video she touches on the important role peer support networks can play in helping to maintain the health of therapy dog handlers. Given that your fellow therapy dog handlers may experience the ‘costs of caring’, including burn out, secondary stress, compassion fatigue, and vicarious trauma, establishing networks of mutual support can be a crucial resource for peer therapy dog handlers.

Please watch the following video:

Here, Janelle touches on the important concept of peer support. According to the Mental Health Commission of Canada (2013: 7), “[p]eer support is a supportive relationship between people who have lived experience in common…the experience that individuals or groups have in common is in relation to a mental health challenge or illness. This common experience might be related to their own mental health or that of a loved one”.

Learning Activity 4-2: Offering Peer Support at the Organizational, Group and Individual Level

Given Janelle’s discussion of the importance for therapy dog handlers to develop peer support networks – and noting that this can take place at an organizational, group, or individual level – it will be worthwhile to revisit three of the scenarios featured in our last activity. You have already worked on telling the difference between the various ‘costs of caring’ to get a sense of the potential needs of a fellow therapy dog handler. Now you have the opportunity to reflect on the types of peer support strategies that may be useful to improve therapy dog handlers’ mental health and wellness.

It is important to keep in mind, when considering your answers, that your role as part of a peer support network is to listen from a place of shared experience or understanding, suggest resources if you are aware of any, and access external support if required. It is not to replace professional support.

As an aside, Dr. Brené Brown has a popular 2-minute video outlining the differences between sympathy and empathy – have a quick watch of it here Her main point is that “empathy fuels connection. Sympathy drives disconnection”. Empathy requires that you consider others’ experiences (as discussed in Module 2: Participant Diversity & Inclusion).

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Strategies for Maintaining Self-Care

Janelle’s final video introduces strategies you can use to practice self-care, which centres around activities, relaxation techniques, and how to maintain positive thinking to ensure balance in your emotional, spiritual, social, physical, and cognitive health. It would be worthwhile – and useful for the activity that follows – to consider the types of activities you may want to include as part of your own self-care routine.

Please watch the following video:

Learning Activity 4-3: Setting Up Your Self-Care Routine

Now that Janelle has touched on several different ways you can maintain balance and personal wellness, the following activity should help you plan a personal care routine to attend to your emotional, spiritual, physical, social, and cognitive health. It also includes a few prompts to help you keep some of the strategies Janelle suggests in mind.

[Direct link]


Looking Back, Looking Forward

As a therapy dog handler, the relationships you develop with program participants you meet can be spiritually enriching and emotionally rewarding. However, it is important to recognize that engaging with individuals who have experienced trauma or find themselves facing challenging and sometimes tragic circumstances can negatively influence your own mental health. Early on, these influences may be experienced as secondary stress or compassion fatigue based on the sheer number of people you connect with. Over time, with an accumulation of stressful encounters, you may experience vicarious trauma.

To help avoid experiencing secondary stress, compassion fatigue, or vicarious trauma, it is critical for therapy dog handlers to maintain balance in their emotional, spiritual, physical, social, and cognitive health domains. It is also helpful that organizations have complementary policies and peer support networks in place to help attend to these needs. It is likewise important for you to be aware of ways you can engage in self-care practices, and develop skills to maintain your mental health by planning activities, engaging with relaxation techniques, and developing ways of thinking that promote a positive outlook and avoid negative thinking. Doing so will help you maintain balance in your health, and better enable you to offer comfort and support to individuals in their pursuit of similar positive health outcomes.

To this point, we have touched on ways that therapy dog programs and handlers can respect the needs of the program participants you visit with as well as attend to maintaining your own health. Our final module centres around ways of ensuring the welfare of the third partici-PANT (participant) in your visits. And that is your therapy dog! We turn next to a consideration of animal ethics, discuss ways to ‘read’ canine body language, and help you to organize a therapy dog care RUFFtine (routine).

Discussion/Self-Reflection Questions

  1. Are you able to define the mental health continuum?
  2. Are you able to identify the importance of mental health self-care for therapy dog handlers?
  3. Are you able to describe secondary stress, compassion fatigue, and vicarious trauma?
  4. Are you able to explain the role of mental health peer support in self-care?
  5. Are you able to outline strategies for self-care as a therapy dog handler?


Supplementary Resources

Mental Health and Stress Reduction Tools & Tips

Vicarious Trauma

Peer Support Resources




Compassion fatigue: a feeling of being emotionally exhausted and unable to empathize due to connecting with a large numbers of individuals and learning about their traumatic experiences.

Critical Incident Stress Management: A process where organizations implement pre-developed policies in the wake of a particularly traumatic or emotionally troubling incident.

Mindfulness: A practice related to maintaining emotional and cognitive health that involves situating one’s thoughts ‘in the moment’ while avoiding self-judgement and negative thinking.

Peer support: An informal practice where people who share similar roles and experiences provide mutual support and assistance to one another to help minimize burnout, secondary stress, compassion fatigue and vicarious trauma.

Secondary stress: A feeling of experiencing trauma due to empathetically reacting to the traumatic experiences and situations of others.

Self-care: The practice of maintaining balance in health through scheduled activity, relaxation techniques, and positive thinking strategies.

Vicarious trauma: Negative health outcomes that can be experienced in multiple domains of health due to the accumulation of unattended to secondary stress and/or compassion fatigue.



Coetzee, S. and H. Laschinger. 2018. “Toward a comprehensive, theoretical model of compassion fatigue: An integrative literature review”. Nursing & Health Sciences, 20: 4-15. DOI: 10.1111/nhs.12387

Delaney, M. 2018. “Caring for the caregivers: Evaluation of the effect of an eight-week pilot mindful self-compassion (MSC) training program on nurses’ fatigue and resilience”. PLoS ONE 13 (11): 1-20.

Dell, C. A., C. Petryk, D. Chalmers and L. Sillers. 2019. “Integrating therapy dogs into Saskatchewan’s co-ordinated trauma response: Essential actions”. The Humanitarian, Winter 2019.

Fox. M. 2019. “Compassion fatigue and vicarious trauma in everyday hospital social work: A personal narrative of practitioner-researcher identity transition”. Social Sciences, 8: 313. doi:10.3390/socsci8110313

Harrison, K. 2021. “Compassion fatigue: Understanding empathy”. Vet Clin Small Anim 51: 1041-1051.

Hernandez-Wolfe, K. Killian, D. Engstrom and D. Gangsei. 2015. “Vicarious resilience, vicarious trauma, and awareness of equity in trauma work”. Journal of Humanistic Psychology, 55(2): 153-172. DOI: 10.1177/0022167814534322

International Critical Incident Stress Foundation Canada. 2020. “The ICISF-CISM Model of Peer Support”, ICISF Canada Online,

National Child Traumatic Stress Network. 2022. “Secondary traumatic stress”. NCTSN Website,,disasters%2C%20and%20other%20adverse%20events

Elder Jim Dumont, National Native Addictions Partnership Foundation, Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment Project – University of Saskatchewan. 2014. Definition of Wellness ©. Bothwell, Ontario: Author. Canadian Institutes of Health Research, Funding Reference Number AHI-120535.

Nikischer, A. 2019. “Vicarious trauma inside the academe: Understanding the impact of teaching, researching and writing violence”. Higher Education, 77: 905-916.

Psychology Today. 2022. “Compassion Fatigue”. Psychology Today Online

Roberts, C., F. Darroch, A. Giles and R. van Bruggen. 2022. “You’re carrying so many people’s stories: Vicarious trauma among fly-in fly-out mental health service providers in Canada”. International Journal of Qualitative Studies on Health and Well-being, 17: 1. , DOI: 10.1080/17482631.2022.2040089

Rossi, A., G. Cetrano, R. Pertile, L. Rabbi, V. Donisi, L. Grigoletti, C. Curtolo, M. Tansella, G. Thornicroft and F. Amaddeo. 2012. “Burnout, compassion fatigue, and compassion satisfaction among staff in community-based mental health services”. Psychiatry research 200: 933-938.

Sunderland, K., W. Mishkin, Peer Leadership Group, Mental Health Commission of Canada. (2013). Guidelines for the Practice and Training of Peer Support. Mental Health Commission of Canada Website,