共情的双刃剑效应：COVID-19心理热线咨询师的继发性创伤应激和替代性创伤后成长

doi:10.3724/SP.J.1041.2021.00992

摘要/Abstract

摘要：

关注新型冠状病毒肺炎流行期间的心理援助热线咨询师由共情带来的消极和积极影响及机制, 并探究从消极影响转变为积极成长的内在机制具有重要的理论和实践意义。本研究以国内疫情期间, 776名在教育部华中师范大学心理援助热线平台上工作的咨询师(平均年龄42.57岁, 平均咨询经验12.44年)为研究对象, 使用问卷法测量热线心理咨询师的共情、正念、寻求意义、继发性创伤应激(Secondary Traumatic Stress, STS)和替代性创伤后成长(Vicarious Posttraumatic Growth, VPTG)。采用潜变量结构方程模型进行分析, 结果发现：(1)咨询师的共情正向预测STS和VPTG; (2) 正念在共情和STS间起部分中介作用, 寻求意义在共情和VPTG间起部分中介作用; (3) 共情还可以分别通过STS、STS-寻求意义、正念-STS、正念-STS-寻求意义的中介路径对VPTG起正向预测作用。该结果提示要辩证看待共情带来的消极和积极影响, 关注从消极反应到积极成长的转变, 这不仅能够深化共情及其影响的理论, 还能为相关研究应用提供启示。

关键词: 共情, 继发性创伤应激, 替代性创伤后成长, COVID-19, 正念, 寻求意义

Abstract:

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.

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.

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.

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.

Key words: empathy, secondary trauma stress, vicarious posttraumatic growth, COVID-19, mindfulness, search for meaning

中图分类号:

R395

赖丽足, 任志洪, 颜懿菲, 牛更枫, 赵春晓, 罗梅, 张琳. (2021). 共情的双刃剑效应：COVID-19心理热线咨询师的继发性创伤应激和替代性创伤后成长. 心理学报, 53(9), 992-1002.

LAI Lizu, REN Zhihong, YAN Yifei, NIU Gengfeng, ZHAO Chunxiao, LUO Mei, ZHANG Lin. (2021). 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. Acta Psychologica Sinica, 53(9), 992-1002.

图/表 5

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基本信息	被试
N	776
性别 (女性) (%)	80.4%
年龄 (M ± SD)	42.57 (7.90)
咨询经验(年) (M ± SD)	12.44 (5.92)
教育水平(N, %)
高中/专职院校	11 (1.4%)
本科	169 (21.8%)
硕士或者博士	596 (76.8%)
经历个人创伤事件
是	315 (40.6%)
否	461 (59.4%)
个案数 (M ± SD)	11.26 (15.52)
创伤个案数(M ± SD)	1.73 (3.76)

基本信息	被试
N	776
性别 (女性) (%)	80.4%
年龄 (M ± SD)	42.57 (7.90)
咨询经验(年) (M ± SD)	12.44 (5.92)
教育水平(N, %)
高中/专职院校	11 (1.4%)
本科	169 (21.8%)
硕士或者博士	596 (76.8%)
经历个人创伤事件
是	315 (40.6%)
否	461 (59.4%)
个案数 (M ± SD)	11.26 (15.52)
创伤个案数(M ± SD)	1.73 (3.76)

变量	M	SD	1	2	3	4	5	6	7	8	9
性别	0.80	0.40	-
年龄	42.57	7.90	0.03	-
VPTG	50.49	24.01	0.05	0.01	-
STS	18.04	4.64	0.02	-0.14^***	0.30^***	-
寻求意义	22.89	8.27	0.02	-0.17^***	0.23^***	0.23^***	-
共情	36.13	9.56	-0.04	-0.22^***	0.22^***	0.44^***	0.23^***	-
正念	69.98	9.17	0.09	0.21^***	-0.07^*	-0.51^***	-0.23^***	-0.35^***	-
创伤个案	1.73	3.76	0.01	0.07^*	0.06	-0.01	-0.02	-0.00	0.01	-
总个案	11.22	11.51	0.00	0.06	0.06	0.03	-0.01	-0.03	0.00	0.54^***	-

变量	M	SD	1	2	3	4	5	6	7	8	9
性别	0.80	0.40	-
年龄	42.57	7.90	0.03	-
VPTG	50.49	24.01	0.05	0.01	-
STS	18.04	4.64	0.02	-0.14^***	0.30^***	-
寻求意义	22.89	8.27	0.02	-0.17^***	0.23^***	0.23^***	-
共情	36.13	9.56	-0.04	-0.22^***	0.22^***	0.44^***	0.23^***	-
正念	69.98	9.17	0.09	0.21^***	-0.07^*	-0.51^***	-0.23^***	-0.35^***	-
创伤个案	1.73	3.76	0.01	0.07^*	0.06	-0.01	-0.02	-0.00	0.01	-
总个案	11.22	11.51	0.00	0.06	0.06	0.03	-0.01	-0.03	0.00	0.54^***	-

间接路径	间接效应估计值	p	间接效应解释总效应百分比%	95%的置信区间
间接路径	间接效应估计值	p	间接效应解释总效应百分比%	下限	上限
共情-寻求意义- VPTG	0.039	0.005	17.43	0.016	0.073
共情- STS - VPTG	0.077	< 0.001	14.39	0.047	0.120
共情- STS -寻求意义- VPTG	0.009	0.014	9.30	0.003	0.017
共情-正念- STS - VPTG	0.038	< 0.001	7.05	0.023	0.064
共情-正念- STS - 寻求意义- VPTG	0.004	0.019	4.50	0.001	0.009