The COVID-19 pandemic resulted in millions of deaths globally, leaving countless bereaved individuals. While the grief of those directly affected has been studied extensively, the vicarious grief (VG) experienced by helping professionals (HPs) who support them remains relatively unexplored. This study investigated the VG experiences of healthcare workers (HCWs), faith-based workers (FBWs), and mental health workers (MHWs) in the Philippines. The research questions addressed were: (1) the extent to which HPs experience VG; (2) differences in VG levels across HP types; (3) how HPs experience VG; and (4) how HPs cope with VG. The significance of this study lies in understanding the unique challenges faced by HPs during a global crisis, and subsequently, designing appropriate interventions and support systems to improve their mental health and well-being. Understanding VG in HPs is crucial because their capacity to provide effective support is directly affected by their emotional and psychological states.

Existing grief theories, such as Kübler-Ross's stages of grief and the meaning reconstruction approach, were considered. However, the study focused on vicarious grief, defined as grief evoked by another's loss without requiring an intimate relationship. Kastenbaum (1987) and Rando (2003) established the concept of VG, with Rando identifying two types: Type 1 (feeling what the bereaved must be like) and Type 2 (stimulated by both vicarious and personal losses). Factors influencing VG include physical and psychological distance, identification with the bereaved, empathy, and the death situation's characteristics. Previous research on VG often focuses on public mourning after disasters; however, research specifically on HPs' experiences and evidence-based data are limited. The COVID-19 pandemic presented an unprecedented level of exposure to death and bereavement for HPs, especially HCWs dealing with end-of-life care, FBWs providing sociospiritual support, and MHWs conducting grief counseling, creating a context ripe for exploring VG.

An explanatory sequential mixed-methods design was employed. Phase 1 involved a survey administered to 60 Filipino HPs (aged 22–64; 58.33% female) using the revised Vicarious Trauma Scale (VTS), adapted to measure VG. Phase 2 consisted of 12 in-depth interviews with HPs who scored moderately or highly on the VTS and met inclusion criteria (regular exposure to bereaved individuals due to COVID-19 deaths, no personal loss due to COVID-19). Four participants were selected from each sector (HCW, FBW, MHW). Interviews were conducted synchronously via video conferencing, lasting 1–2 hours, and recorded with consent. Data analysis involved descriptive statistics (Kruskal-Wallis test due to non-normality), Dunn's pairwise comparisons with Bonferroni correction for the survey data, and multi-perspectival Interpretative Phenomenological Analysis (mIPA) for interview data. The mIPA involved individual case analysis, identifying meaning patterns, clustering themes, and conducting cross-case analysis to identify superordinate themes. Researcher triangulation and consultations with a senior researcher ensured validity.

Quantitative analysis revealed that most respondents (89.9%) showed moderate to high levels of VG (M = 38.72, SD = 8.08). HCWs reported significantly higher VG levels than FBWs (p = .039), while MHWs did not differ significantly from HCWs or FBWs. Qualitative analysis, using mIPA, uncovered five superordinate themes: 1. **Acknowledging Contexts of Grief:** This theme encompassed understanding grief as a process (referencing Kübler-Ross's stages), acknowledging the unique circumstances of COVID-19-related deaths (e.g., swift disease progression, disruptions in grieving processes due to social isolation), and the challenges in communicating the news to bereaved individuals. 2. **Navigating Relations with the Bereaved:** This theme described the HPs’ experiences in disclosing news, processing emotions, and being present with the bereaved, highlighting the diverse roles of HCWs, FBWs, and MHWs in this process. HCWs focused on factual disclosure, FBWs on relational support and honoring memories, and MHWs on emotional processing and coping mechanisms. 3. **Sharing Others' Grief:** HPs empathetically shared the emotions of the bereaved, experiencing depressive affect, exhaustion, and anxious apprehension. The emotional toll of empathy was evident in their descriptions of physical symptoms and emotional exhaustion. 4. **Internalizing Encounters:** This theme focused on how encounters with the bereaved influenced HPs' perceptions of death, safety, society, and themselves. The frequency of death heightened the intensity of the experience, sometimes triggering memories of past losses. There were shifts in perspectives on human nature (witnessing both cruelty and kindness) and social structures (observing inequalities in healthcare). 5. **Negotiating Challenges:** HPs utilized various coping strategies, including strengthening spirituality, seeking support (from colleagues and family), reframing the situation, regulating emotions (mindfulness, disengagement), and engaging in stress-releasing activities (hobbies, exercise).

The findings highlight the significant impact of exposure to COVID-19-related bereavement on HPs' mental health, demonstrating moderate to high levels of VG, particularly among HCWs. The qualitative data revealed the complex nature of VG, encompassing both emotional and cognitive components aligning with Rando's (2003) Type 1 and Type 2 VG. The experience of VG led to both positive and negative outcomes: positive changes in life attitudes (appreciating life's finiteness, strengthening relationships) and negative impacts (intrusive thoughts, altered worldviews, heightened anxiety). The study underscores the significance of empathetic practices within the HP roles and their emotional cost. The varying VG levels across professions highlight the necessity of tailored interventions. The effective coping strategies identified—including seeking social support, engaging in self-care, and leveraging spiritual resources—offer insights for developing targeted interventions.

This study contributes to the limited literature on vicarious grief among helping professionals during the COVID-19 pandemic. The findings highlight the significant levels of VG experienced, particularly by HCWs, and demonstrate the need for comprehensive support interventions at the organizational level. Future research should focus on developing specific VG measurement tools, exploring the phenomenon in different contexts, and investigating the long-term impact of VG on HPs’ well-being. Tailored interventions should focus on psychoeducation, self-care skills training, and support groups to equip HPs with effective coping strategies and promote their well-being.

The study's limitations include the use of the revised VTS, a measure not specifically designed for VG, the sample's geographical and cultural limitations, and the relatively small sample size, limiting the generalizability of findings. Further research is needed using more targeted VG assessment tools and larger, more diverse samples. The cross-sectional nature of the study prevents determination of causality.