The double-edged-sword effect of empathy: The secondary traumatic stress and vicarious posttraumatic growth of psychological hotline counselors during the outbreak of COVID-19

Abstract

<p id="p00005">The novel Coronavirus Disease 2019 (COVID-19) outbreak increases public mental stress and pandemic-related trauma. Timely and comprehensive online mental health services have been deployed across China. Hotline counselors can be exposed to the stress and trauma experienced by callers indirectly. They may experience secondary traumatic stress (STS) as a result of their empathetic engagement with traumatized clients, and they may also experience vicarious posttraumatic growth (VPTG). The present study examined negative and positive change in hotline counselors concurrently and explored the mechanisms of both positive and negative outcomes. <p id="p00010">Participants were 776 counselors (81% female, average age = 42.57 ± 7.90, average years of experience = 12.44 ± 5.92) recruited from MOE-CCNU Mental Health Service Platform, the biggest official telephone-based and online psychological support platform in China during COVID-19 period. Empathy and VPTG were measured by revised Chinese versions of self-report questionnaires. STS was assessed by the corresponding subscale of the Professional Quality of Life Scale. The Chinese Meaning in Life Questionnaire was used to assess participants’ search for life meaning. Mindfulness was evaluated by Mindful Attention Awareness Scale. Latent variable structural equation modeling was applied. <p id="p00015">After controlling age, trauma cases and total cases, counselors’ empathy was positively associated with STS and VPTG. Results revealed that empathy was positively associated with STS and VPTG. Mindfulness mediated this association between empathy and STS. Search for meaning mediated the relationship between empathy and VPTG. Additionally, the association between empathy and VPTG was also mediated through other four significant mediating pathways: (a) secondary trauma stress, (b) secondary traumatic stress and search for meaning, (c) mindfulness and search for meaning, and (d) mindfulness and secondary trauma stress and search for meaning. <p id="p00020">Our findings support that empathy lead to both positive and negative outcomes among hotline counselors during COVID-19 period in China, highlighting dialectical insights into trauma workers’ experiences. When counselors engage in others’ traumatic experience, their vicarious negative emotional experience may be a pathway to growth, and search for life meaning is an important factor in that growth.