How Charities Prepare Volunteers for Intensely Emotional Work

Deborah Bender, a veteran volunteer and trainer of volunteers for the Make-a-Wish Foundation of Central New York, in Syracuse, remembers her first job for the charity a decade ago. She was assigned to grant the request of a teenage cancer patient, a horse lover who wished to receive a pregnant Arabian mare. Ms. Bender and another volunteer went to meet the girl and her family, having girded themselves for the likelihood that the client, who was undergoing chemotherapy, would be bald.

When they arrived at the girl’s house, they noticed a stack of boxes in one corner of a room. During their visit, a UPS truck arrived bearing more packages — all drugs. At one point, Ms. Bender says, the girl’s mother announced that it was time for her daughter’s medication. The mother lifted up her child’s shirt and revealed a shunt, a device inserted into the body to facilitate the delivery of injections. Ms. Bender, a mother of two, drops her voice into a saddened whisper as she recalls the sight’s emotional impact: “I thought, ‘OK. I guess this is what this is all about.’”

Since that day, Ms. Bender has worked with more than 30 ailing children and their families on behalf of Make-a-Wish. But while she has gotten used to seeing young clients’ suffering, she hasn’t grown hardened to it. With her organization’s support, she has learned to set personal boundaries — and continue doing the charity’s work. “I’ve lost 25 to 30 percent of the children I granted wishes to, but I don’t go to funerals,” she says. “If I had to bury the children, I couldn’t go on.”

Charities rely upon volunteers to handle some of the most emotionally stressful work they do, from caring for the terminally ill to assisting sexual-assault victims. How an organization prepares its volunteers for their work’s impact can affect not only those volunteers’ emotional state and commitment, but also the charity’s ability to deliver services.

At Rape Victim Advocates, in Chicago, more than 100 volunteers sign up for two 12-hour shifts a month, during which they go to emergency rooms when sexual-assault cases arrive. The organization, which employs 17 paid staff members, provides new volunteers with four hours of orientation about the charity itself and then 45 hours of training in sexual-assault advocacy over six weeks, and expects them to refresh their certification as state medical advocates with annual continuing-education courses. After formal training, volunteers are eased into their emergency-room duties, paired with a veteran volunteer for their first year, debriefed after responding to calls, and encouraged to request backup from the charity’s paid staff members for particularly difficult cases, such as those involving children or extreme violence.

The result of that rigorous preparation and continuous support of volunteers: The group handles more than 1,000 cases a year, or 75 percent of all sexual-assault advocacy in Chicago, a capacity for service only made possible because of the group’s volunteer-management practices, says the executive director, Vicky DiProva.

Nonprofit groups that work with vulnerable populations must help their volunteers deal with difficult emotional situations, says Susan Ellis, president of Energize, a Philadelphia management-consulting firm that specializes in volunteerism. “Volunteers do as many things as professional staff do,” says Ms. Ellis. “The important thing is to screen and train volunteers well so you don’t put emotionally fragile folks in difficult situations.”

That can be tough, however, when an organization depends on volunteers befriending the people they help. For example, four-fifths of the people who work in hospices, which provide end-of-life care for terminally ill patients and their families, are volunteers, according to estimates by the National Hospice and Palliative Care Organization, in Alexandria, Va. “Volunteers keep patients at the end of life connected to the community,” says John Millett, director of media relations and publications. “That is far more therapeutic than dying in a hospital.”

Unlike paid staff members, a hospice volunteer can devote all of his or her time to one patient, notes Gary Gardia, director of the Center for Compassionate Care, in Las Vegas. “At hospice, we actually train our volunteers to become attached to patients and their families and encourage them to build relationships,” he says. “When I’m dying, I want people nearby who are truly there for me.”

But most hospice organizations are also aware that they need to be “there” for their volunteers when the relationships they have built with dying patients end, Mr. Gardia says. They hold regular volunteer support meetings, and volunteer managers are trained to recognize when one of their charges might need to take a break. Volunteers are encouraged to set limits on their time commitment at the outset and to stay as close to that limit as possible, which delineates a personal boundary to protect the volunteer but also ensures consistent service to patients. “We know that as a patient nears death it’s not good for volunteers to burn out and start cutting back on their hours because they were unable to set limits up front,” Mr. Gardia says. “Cutting back feels like abandonment to patients and their families.”

Careful preparation of volunteers for emotionally devastating work may help weed out those who can’t handle that work’s impact — but that doesn’t necessarily mean that an organization has to lose those volunteers entirely. “You don’t have to grant wishes to work for Make-a-Wish,” notes Ms. Bender, who says that some volunteers chose to perform administrative or other tasks that do not involve direct contact with ailing clients. Even among wish granters, she says, volunteers are given options as to the kinds of cases they feel emotionally equipped to handle. Some, for example, choose not to work directly with children with AIDS, or do not visit clients while they are hospitalized.

Preparing volunteers for the emotional impact of their work may not only be the charitable thing to do — it’s a pragmatic means of helping an organization carry out its mission. For about the cost of two staff-member salaries, Rape Victim Advocates trains dozens of volunteers per year, Ms. DiProva says, making such training a cost-effective way of expanding her group’s capacity for service. “If you don’t have a good volunteer program,” she says, “you have to do lower-risk things with your volunteers.” And many organizations may not be able to afford to pay staff members to perform the assignments left unfilled.

Charity managers and consultants offer the following advice to organizations that wish to better prepare their volunteers for emotionally intense assignments:

Warn volunteers about difficult work — and be blunt. “You have to let people know there’s going to be an impact,” says Ms. DiProva. Of course, says Ms. Ellis, even the most graphic description of how tough the work can get may not prepare everyone: “People may intellectually believe they’re ready for something, but emotionally, they’re not.”

Screen carefully. “There’s a reason why people gravitate to this kind of work,” says Ms. Ellis. A wise nonprofit manager finds out what that reason is — and if it’s linked to personal experience, whether the would-be volunteer has enough perspective to cope when confronted with other people’s pain. “If it’s a hospice,” she says, “it’s entirely reasonable to ask about their experience with loss.”

At Rape Victim Advocates, Ms. DiProva says the subject of motivation is broached gently with prospective volunteers by telling them that some people who work in that field are themselves sexual-assault survivors and that the work can be emotionally intense for them. “We don’t ask for disclosure,” she says, “but at that point, people will often disclose their own history.” (For more information on job-interviewing techniques, including the legal limits placed on personal questions, see “Nonprofit Managers and Recruiters Offer Tips for Interviewing Job Candidates.”).

Make responsibilities clear. Careful training that covers all aspects of the work the volunteers will be doing can help increase their confidence, and lessen the likelihood that they’ll be overwhelmed, emotionally or otherwise. At the Iowa Center for AIDS Resources and Education, in Iowa City, where volunteer buddies assist persons living with HIV/AIDS, volunteers are trained to follow the professional code of conduct of the National Association of Social Workers, says Joseph Dobbert, the buddy program’s coordinator. They learn about infection control, to protect themselves from the AIDS virus, and how to keep track of their clients’ well being, noting the signs that indicate they need to ask for additional help.

Some organizations limit the number of hours new volunteers work, or, as Make-a-Wish does, pair rookies with more experienced volunteers as a means of providing support while volunteers learn to navigate rough emotional terrain.

Set boundaries. It’s tricky to tell a volunteer — whose primary job may be to bond with a client — to disengage emotionally. “If you’re in an AIDS buddy program,” Ms. Ellis says, “you don’t tell a buddy, hey, don’t become friends.” But a certain amount of distance is essential to keep volunteers from burning out. Organizations can help by setting rules and helping volunteers anticipate situations that may overwhelm them. The staff of the Iowa Center for AIDS Resources and Education conducts role-playing exercises with volunteers to teach them how to set personal boundaries. Make-a-Wish volunteers, Ms. Bender says, are advised not to stay in contact with clients’ families after granting their wishes.

At Rape Victim Advocates, volunteers are given practical guidelines aimed at helping them maintain boundaries — they are forbidden, for example, from driving victims home from the hospital. Rules, though, are made to be broken by soft-hearted volunteers, and in those cases a manager needs to intervene to protect the volunteer, the client, and the charity, Ms. DiProva says: “I’ve had volunteers try to find jobs for victims, or give them cash to buy food. We pull them in here and say, ‘What are you doing? You’re getting too involved.’”

Monitor volunteers for signs of burnout. Once volunteers complete training and have been on the job for a while, don’t forget about them. “The mistake you can make is to leave people out there dangling with no one to talk to,” says Ms. Ellis. Create opportunities for quick check-in conversations with the volunteers’ supervisor, and for more extensive debriefing after particularly stressful assignments. Offer work breaks after volunteers experience the loss of a client or other traumatic event, she says, or consider rotating volunteers out of certain assignments after a few months. (For more on detecting and managing compassion fatigue, which can result from caring for traumatized patients or clients, see “How Compassion Fatigue Can Overwhelm Charity Workers — and What to Do About It.”)

Acknowledge volunteers’ feelings. “People fall apart when they think they can’t talk about their emotions,” says Ms. Ellis. Giving volunteers a work environment that allows them to do just that will help them cope with intense assignments. At Make-a-Wish, says Ms. Bender, volunteers are taught to celebrate their successes and express their grief, and are often given thank-you notes after completing assignments. “When my teammate and I lost a child just 24 hours before his wish was to be fulfilled,” she says, “we received flowers from the Make-a-Wish staff.”

In general, Ms. Ellis says, a charity should follow the same procedures for training and supporting volunteers as it would for paid employees who are asked to do the same work. “Not every volunteer is suitable for every assignment, but I believe the right person with the right training can do any job,” Ms. Ellis says. “A well-trained volunteer won’t leave a patient or their family in the lurch, no matter how stressful it gets.”

How does your charity prepare volunteers for intensely emotional assignments?