Mindfulness and Empathy in Social Work Death Education

Background: Social workers will likely encounter clients facing traumatic grief and death, no matter their specific area of practice. However, little academic coursework is available in this area. Being faced with death-related content may provoke anxiety and avoidance in providers, but mindfulness and empathy may help providers regulate their emotions and responses and reduce the risk of burnout and secondary traumatic stress.

Purpose and methods: This study evaluates the effectiveness of a graduate experiential death education course on mindfulness and empathy in a sample of 189 students over three consecutive cohorts. The intensive three-week course is offered in a School of Social Work and includes mindfulness exercises, in-class discussions, reflective journaling, documentary films, lectures, literary quotes, music, poetry, a creative arts project, and a bereavement panel discussion. Two self-report measures, the Five Facet Mindfulness Questionnaire (FFMQ) and the Questionnaire of Cognitive and Affective Empathy (QCAE), were given at the beginning and end of the course. The FFMQ has five subscales of mindfulness: observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity of inner experience. The QCAE separates empathy into cognitive and affective aspects and has five subcomponents. Perspective taking and online simulation fall under cognitive empathy and emotion contagion, proximal responsivity, and peripheral responsivity fall under affective empathy.

Results: The sample was predominantly female (88.5%), with a mean age of 30.58 (SD = 9.22). The overall reliability of both measures at both times was very good (α = .84 to .92). The five FFMQ subscales had acceptable to good reliability (α = .79 to .93). Three of the five QCAE subscales had acceptable to good reliability (α = .74 to .89), while two had only poor to moderate reliability (α = .52 to .64). Results show statistically significant increases on both overall mindfulness (t(165) = 9.64, p < .001, 95% CI [6.84, 10.37]) and empathy (t(159) = 5.93, p< .001, 95% CI [2.23, 4.45]), as well as in all five subscales of the FFMQ and in all but one of the QCAE subscales. Emotion contagion did not significantly increase. This is an intriguing finding, as this aspect may be linked to burnout and emotional exhaustion, undesired outcomes in social work students and practitioners.

Conclusions and implications: Results suggest that a death education course may be effective in increasing mindfulness and empathy in social work students. Increased mindfulness may help students cope more effectively with their own emotions, making them better able to be fully present with difficult death-related class material as well as more empathic with clients. Increases in cognitive and affective empathy may also benefit students encountering clients experiencing traumatic death by allowing for greater attunement and sensitivity. Ideally, increased mindfulness and empathy would improve students' ability to meet the needs of traumatized and grieving clients while maintaining their own sense of equilibrium and sense of well-being. Focusing on empathy and mindfulness in death education may be an important tool for preparing social work students for practice.