关注助人者的心理健康:共情疲劳的涵义、结构及其发生机制

Attention for the Mental Health among the Helpers:the Connotation,Structure and Mechanism of Compassion Fatigue

共情疲劳是心理咨询师、消防战士、急救医护人员等助人者救助受创伤人员后出现的特有的心理健康问题。共情疲劳的二因素模型含二次创伤与职业倦怠,三因素模型还包括共情满足。共情疲劳的临床症状与创伤后应激障碍、二次创伤、替代(间接)性创伤、倦怠相似,但上述概念并不等同于共情疲劳。共情疲劳是助人者在间接接触创伤性事件并向他人共情的前提下,产生共情压力,降低了对他人共情的兴趣与能力,出现二次创伤症状,产生工作倦怠感。同时,助人者人口统计学特征(如婚姻状况、学历、工作年限、个人创伤史等)、接触或暴露于创伤事件的程度、个人心理资源都会影响共情疲劳发生的过程。

Compassion fatigue（CF） is a peculiar mental health problem for the helpers（e.g.,Psychotherapist,fire fighter and paramedic） who helped the traumatic client.The two-factor model of CF includes the secondary trauma（ST） and job burnout（JB）,and the three-factor model of CF includes the compassion satisfaction（CS） besides the ST and JB.The clinical symptoms of CF are similar with post-traumatic stress disorders（PTSD）,ST,vicarious trauma（VT） and burnout,while none of them could represent CF.Empathy for others and indirect exposure to traumatic events are preconditions of CF which brings about compassion pressure and reduces the capacity and interest in being empathic.And the second traumatic symptoms and the feeling of job burnout are the consequences of CF.Simultaneously,the helper＇s demographics（e.g.,marital status,education background,years working and personal traumatic history）,the degree of exposure to traumatic events and personal psychological resources would affect the generating course of CF.