Bereaved in Me: Understanding the Vicarious Grief Experiences Among Helping Professionals During the COVID-19 Pandemic

As of May 2022, over 6.2 million people worldwide had died due to COVID-19, with each death affecting multiple bereaved individuals. In collectivist societies with close kinship ties, the impact is likely amplified. Helping professionals who support the bereaved may themselves carry a burden of grief. While research on grief has often focused on those directly bereaved, vicarious grief—grief evoked by another’s loss without an intimate relationship—remains relatively unexplored. This study addresses that gap by examining vicarious grief among helping professionals working with those bereaved by COVID-19 deaths, specifically healthcare workers (HCWs), faith-based workers (FBWs), and mental health workers (MHWs). The research asks: (1) To what extent do helping professionals experience vicarious grief? (2) Are there differences in vicarious grief levels by professional sector? (3) How do helping professionals experience vicarious grief? and (4) How do they cope with vicarious grief? The purpose is to understand the nature, extent, and coping related to vicarious grief in pandemic contexts to inform support and interventions.

Grief theories have evolved from stage-based models like Kübler-Ross to approaches emphasizing meaning-making and the reconstruction of assumptive worldviews. The meaning reconstruction perspective highlights the intersubjective, cultural, and contextual nature of grief. Continuing bonds theory challenges the need to sever ties with the deceased and recognizes ongoing relationships maintained within communities, situating helping professionals in the bereaved’s relational processes. Vicarious grief (VG) was described by Kastenbaum as genuine grief experienced in response to another’s loss, with manifestations resembling but not identical to direct loss (e.g., weeping, emptiness, sleep and appetite disturbances, preoccupation). Rando differentiated Type 1 VG (empathic experiences of another’s loss) from Type 2 VG (vicarious experiences that activate one’s own unresolved losses and disrupt assumptions about self and world). Factors shaping VG include helper–bereaved distance, identification with the bereaved, empathy/sympathy processes, and death characteristics (unpredictability, uncontrollability). Related constructs (vicarious trauma, secondary traumatic stress, compassion fatigue) emphasize empathy-based strain but often do not center specifically on secondhand engagements with death and loss. Existing VG literature frequently addresses public mourning in disasters and is limited in evidence-based studies among helping professionals. During COVID-19, helping professionals faced unprecedented exposure to death; disrupted funerary practices and patient isolation worsened grief outcomes and increased emotional demands on HCWs who often communicated bad news. FBWs presided over rituals and provided sociospiritual support, and MHWs managed surges in grief-related mental health concerns, potentially elevating VG risk. Given differing occupational roles, the study posited sector differences in VG and adopted a multi-perspectival interpretative phenomenological analysis (mIPA) to consider relational and intersubjective dimensions across groups.

Design: An explanatory sequential mixed-methods design was used. Phase 1 comprised a survey of 60 helping professionals to measure vicarious grief levels. Phase 2 comprised 12 in-depth interviews to explore lived experiences among those reporting VG.

Participants: Phase 1 included 60 Filipino helping professionals aged 22–64 (M = 37.28, SD = 12.64), 58.33% female and 41.67% male, from three sectors: HCWs (40%), FBWs (28.33%), and MHWs (31.67%). Phase 2 purposively sampled 12 participants (four per sector) who: (a) regularly engaged bereaved individuals due to COVID-19 as part of their work; (b) had not lost a close friend/significant other/family member to COVID-19 (to ensure vicarious rather than personal grief); and (c) scored moderate (29–42) or high (43–56) on the revised Vicarious Trauma Scale (VTS). Interviewees’ roles included patient/relative communication (HCWs), ministry and pastoral counseling (FBWs), and clinical practice and psychosocial interventions (MHWs).

Measures: Phase 1 used the revised VTS (Vrklevski & Franklin, 2008), adapted to specify grief as the traumatic material (Benuto et al., 2018). The scale has 8 items rated 1–7; internal consistency in this sample was acceptable (α = .80). Phase 2 used a semi-structured interview guide covering work context, experiences of VG, difficulties, and coping. Interviews were conducted in English/Filipino via video conferencing, lasted 1–2 hours, and were recorded with consent.

Procedures: Ethics approval was secured. Participants provided informed consent and were monitored for well-being during the interview and at two follow-ups (monthly intervals). Participants received PHP 200 (~USD 3.75) for data connectivity.

Data Analysis: Quantitative analyses included descriptive statistics and a Kruskal–Wallis test (normality not met) to compare VG scores across sectors; Dunn’s pairwise comparisons with Bonferroni correction identified specific group differences. Qualitative data were analyzed using multi-perspectival IPA: (1) idiographic case readings, (2) identification of patterns of meaning, and (3) clustering into themes, followed by cross-case analysis across sectors to derive superordinate themes and subthemes. Validity was supported through coder comparison, triangulation meetings, and researcher reflexivity with supervision (research team had no grief counseling or critical care background, providing an outsider perspective).

Quantitative: Most respondents reported moderate (51.67%) or high (38.33%) levels of vicarious grief (Total M = 38.72, SD = 8.08). Cognitive dimension items averaged 4.19 (SD = 1.59) and affective dimension items averaged 4.67 (SD = 1.79). VG levels differed significantly by sector (Kruskal–Wallis χ2(2, N = 60) = 6.47, p = .039). HCWs (M = 36.98) reported higher VG than MHWs (M = 28.84) and FBWs (M = 23.21). Post hoc tests indicated HCWs scored significantly higher than FBWs, particularly on items related to exposure to COVID-19-death-related distress, feeling overwhelmed by workload, and difficulty staying optimistic. MHWs did not differ significantly from either group.

Qualitative: Five superordinate themes emerged across sectors:

• Acknowledging contexts of grief: Participants referenced grief as a process, often invoking stage models but noting nonlinearity; COVID-specific disruptions (isolation, altered funerary practices) and rapid disease progression complicated mourning and shaped communications with families.
• Navigating relations with the bereaved: HCWs emphasized candid disclosure and assurance about end-of-life comfort; FBWs framed accompaniment as a relational journey and community holding; MHWs focused on emotional processing, coping, and resilience building. Presence and shared silence were valued across roles.
• Sharing others’ grief: Strong empathy was central, with reports of sadness, crying, emotional exhaustion, physical fatigue, reduced motivation, and anxiety (including somatic arousal and intrusive worries).
• Internalizing encounters: Repeated exposure intensified confrontation with mortality, with spillover effects outside work (triggers during media consumption, anticipatory anxiety). Identification with bereaved clients evoked personal losses. Heightened health vigilance was common. Views of society shifted, highlighting systemic inequities, frustrations with healthcare structures, and observations of both human cruelty and kindness. Some reported positive reappraisals (valuing time, pursuing passions, strengthening relationships).
• Negotiating challenges: Coping included spirituality/faith (especially FBWs), social support (peer, collegial, family/friends), reframing (focusing on controllable aspects; accepting limits), mindfulness and self-reflection, role disengagement between sessions and after work, and stress-relief activities (media, hobbies, physical exercise). Limited organizational supports (e.g., psychosocial processing sessions) were mentioned and perceived as helpful.

The findings indicate that helping professionals working with COVID-19 bereavement commonly experience vicarious grief at moderate to high levels. The qualitative data illustrate Type 1 VG through empathic alignment with mourners leading to depressive affect, exhaustion, anxiety, and tears, and Type 2 VG via intrusive thoughts, activation of prior losses, and challenges to assumptive worldviews. Pandemic-specific conditions (rapid decline, visitation restrictions, disrupted rituals) intensified these experiences. Sector differences aligned with role exposures: HCWs’ proximity to end-of-life events and responsibility for breaking bad news were linked to higher VG than FBWs, who may leverage spiritual frameworks and ritual structures to buffer distress; MHWs’ VG was comparable and not significantly different from other sectors, possibly reflecting broad exposure to trauma narratives. Despite distress, participants also reported elements of vicarious posttraumatic growth, including renewed life priorities, appreciation of relationships, and strengthened prosocial beliefs, though some also reported increased cynicism and perceptions of injustice. Coping strategies that combined personal practices (mindfulness, reframing, leisure), relational supports (peer and family), and limited organizational resources were perceived as helpful, underscoring the importance of multi-level supports. The results support the need for sector-tailored interventions that address both prevention and early response to VG, given its less visible manifestations compared to other occupational stress reactions.

This study contributes empirical evidence on vicarious grief among helping professionals during the COVID-19 pandemic, demonstrating substantial affective and cognitive impacts and delineating sector-specific experiences. It identifies five thematic domains that capture how professionals contextualize grief, relate to bereaved clients, internalize repeated loss exposure, and employ coping strategies. The work underscores the importance of institutional supports, psychoeducation, and sector-tailored debriefing to mitigate VG and promote well-being and potential growth. Future research should develop VG-specific assessment tools, examine overlaps with related constructs (e.g., disenfranchised grief, vicarious trauma), analyze demographic and contextual moderators, and explore VG across diverse cultural and organizational settings.

The study used the revised Vicarious Trauma Scale adapted to grief, which may not fully capture nuances unique to vicarious grief; VG-specific instruments are needed. The qualitative and quantitative samples were relatively small and limited to Filipino helping professionals, constraining generalizability. Demographic and contextual moderators were not deeply examined. The cross-sectional design limits causal inference. Future work should develop and validate VG measures, test broader samples and contexts, and compare theoretical frameworks (e.g., disenfranchised grief) for convergence and distinction.