本研究以臺灣150位助人工作者（諮商/臨床心理師、社會工作師及專任輔導教師）為研究對象，探討同理失衡與專業生活品質之關聯，並以童年逆境經驗作為調節變項，檢驗其在此關係中所扮演的角色。
研究採問卷調查法，以同理失衡量表（ESS）測量同理壓抑與同理陷入，以專業生活品質量表（ProQOL-5）評估同情滿足、職業倦怠與次級創傷壓力，並以童年創傷問卷（CTQ-SF）評量情感虐待、情感忽略、性虐待、身體虐待與身體忽略五個逆境向度，共進行30組階層迴歸調節分析。
研究結果歸納出三項核心結論：第一，童年逆境經驗能夠調節同理失衡對專業生活品質的影響，但此調節歷程具有選擇性，顯示逆境與助人工作者職業健康之間的關係遠比過往研究所預設的更為複雜。第二，調節效果高度集中於同理壓抑路徑，說明助人者在工作中的情感隔離傾向與其早期逆境經驗之間存在深刻的交互影響；同理陷入路徑的調節效果較為有限，僅性虐待一個向度呈現出具有質性意涵的交叉型調節效果。第三，不同類型的童年逆境以各自獨特的心理機制介入助人者的職業生活，情感性逆境影響範圍最廣、身體性逆境主要作用於負向職業指標、性虐待則產生截然不同的質性調節效果，三者之間的差異性模式提示督導者與機構管理者，在提供助人工作者支持時，宜針對不同逆境背景者設計差異化的介入策略，並將創傷知情的視角系統性地納入專業培訓與督導歷程之中。

This study examined the relationship between empathic strain and professional quality of life (ProQOL) among 150 helping professionals in Taiwan—including counseling/clinical psychologists, social workers, and full-time guidance counselors—with adverse childhood experiences (ACEs) serving as moderating variables.
Participants completed three self-report measures: the Empathic Strain Scale (ESS), assessing empathic repression and empathic enmeshment; the Professional Quality of Life Scale-Version 5 (ProQOL-5), measuring compassion satisfaction, burnout, and secondary traumatic stress; and the Childhood Trauma Questionnaire-Short Form (CTQ-SF), evaluating five ACE subtypes: emotional abuse, emotional neglect, sexual abuse, physical abuse, and physical neglect. A total of 30 hierarchical regression moderation analyses were conducted.
Three core conclusions emerged from the findings. First, ACEs selectively moderated the relationship between empathic strain and ProQOL, suggesting that the link between childhood adversity and occupational health among helping professionals is considerably more complex than previously assumed. Second, significant moderation effects were concentrated on the empathic repression pathway, indicating a meaningful interaction between helpers' tendency toward emotional distancing at work and their early adversity histories; the empathic enmeshment pathway showed limited moderation, with only sexual abuse producing a qualitatively distinctive crossover effect on compassion satisfaction. Third, different types of childhood adversity operated through distinct psychological mechanisms—emotional adversity exerted the broadest influence, physical adversity primarily affected negative ProQOL outcomes, and sexual abuse generated a uniquely qualitative moderating effect. These differential patterns highlight the importance of adopting a trauma-informed perspective in professional training and supervision, and of tailoring support strategies to the specific types of adversity experienced by helping professionals, rather than applying a one-size-fits-all approach.

Abramovitz, R., & Bloom, S. L. (2003). Creating sanctuary: Toward the evolution of sane societies. Psychiatric Quarterly, 74(2), 119–134.
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Sage.
Allen, K. R. (1995). The closet in the classroom: Women's studies and lesbian and gay themes. Family Relations, 44(2), 134–141.
Altmann, T., & Roth, M. (2021). The role of empathy in burnout and compassion satisfaction among nurses. Psychology & Health, 36(12), 1441–1460.
Baglivio, M. T., & Wolff, K. T. (2020). Positive childhood experiences (PCE): Cumulative resiliency in the face of adverse childhood experiences. Youth Violence and Juvenile Justice, 19(2), 139–162.
Blount, A. J., Bjornsen, A. L., & Moore, M. M. (2018). Values and professional quality of life in counseling students. Adultspan Journal, 17(2), 64–76.
Brown, E. M., Carlisle, K. L., Burgess, M., Clark, J., & Hutcheon, A. (2022). Counseling students’ ACEs and professional quality of life. The Journal of Humanistic Counseling, 61(2), 82–93.
Brown, L. L., Ranadive, P., Cook, M., Acuña, A. J., Osman, A., Suiter, S. V., Pettit, A. C., & Shepherd, B. E. (2025). Relationships between psychological trauma, resilience, and professional quality of life. AIDS Care, 38(2), 310–320.
Browning, B. R., McDermott, R. C., & Scaffa, M. E. (2019). Transcendent characteristics as predictors of counselor professional quality of life. Journal of Mental Health Counseling, 41(1), 51–64.
Cheng, Y. C., Chen, C. H., Chou, K. R., Kuo, P. H., & Huang, M. C. (2018). Reliability and factor structure of the Chinese version of childhood trauma questionnaire-short form in patients with substance use disorder. Taiwanese Journal of Psychiatry, 32(1), 52–62.
Crandall, A., Miller, J. R., Cheung, A., Novilla, L. K., Glade, R., Novilla, M. L. B., Magnusson, B. M., Leavitt, B. L., Barnes, M. D., & Hanson, C. L. (2019). ACEs and counter-ACEs: How positive and negative childhood experiences influence adult health. Child Abuse & Neglect, 96, 104093.
Cuartero, M. E., & Campos-Vidal, J. F. (2019). Self-care and professional quality of life in social workers in Spain. Journal of Social Work, 18(5), 450–468.
Durak, H., Elik, E. G., & Elik, B. (2025). Emotional cognitive control and stress responses among helping professionals. Journal of Ethnic and Cultural Studies, 12(4), 20–47.
Etherington, K. (2009). Supervising helpers who work with the trauma of sexual abuse. British Journal of Guidance & Counselling, 37(2), 179–194.
Fye, H. J., Cook, R. M., Choi, Y., & Baltrinic, E. R. (2021). Professional quality of life and affective distress among prelicensed counselors. Journal of Counseling & Development, 99(4), 449–460.
Geoffrion, S., Lamothe, J., Morizot, J., & Giguère, C. É. (2019). Construct validity of the Professional Quality of Life (ProQOL) scale in a sample of child protection workers. Journal of Traumatic Stress, 32(4), 566–576.
Hamaideh, S., Khait, A. A., Al-Modallal, H., Masadeh, R., Hamdan-Mansour, A., & AlBashtawy, M. (2024). Professional quality of life, job satisfaction, and intention to leave among psychiatric nurses. Nursing Reports, 14(2), 731–741.
Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet Public Health, 2(8), e356–e366.
Kleineidam, N. J., & Fischbach, A. (2023). Emotional labour job characteristics in compassion work. Work & Stress, 37(4), 531–551.
Laverdière, O., Kealy, D., Ogrodniczuk, J. S., Chamberland, S., & Descôteaux, J. (2019). Psychotherapists’ professional quality of life: The role of helping motivations and real relationship. Journal of Traumatic Stress, 32(2), 207–215.
Lee, H., Boyd, R., Slack, K. S., Mather, R. S., & Murray, R. K. (2022). Childhood social support and adult health: The role of adverse childhood experiences. Journal of the Society for Social Work and Research, 13(3), 445–468.
Litam, S. D. A., Ausloos, C. D., & Harrichand, J. J. S. (2021). Stress and professional quality of life among counselors during COVID-19. Journal of Counseling & Development, 99(1), 51–61.
Mercer, L., Cookson, A., Simpson-Adkins, G., & van Vuuren, J. (2023). The prevalence of adverse childhood experiences (ACEs) in the health and social care workforce: A systematic review. Psychological Trauma: Theory, Research, Practice, and Policy, 15(S1), S232–S246.
Milne, L., Ratushniak, A., & Nguyen, H. (2024). How adverse childhood experiences impact the professional quality of life of residential care workers. Frontiers in Child and Adolescent Psychiatry, 3, 1423451.
Mosler, F., Christogianni, A., Singleton, S., Hales, T. G., Rennie, J., Colvin, L. A., & Caes, L. (2025). Evaluation of the current childhood adversity assessments in adults: A systematic review. Psychotherapy and Psychosomatics, 94(6), 389–412.
Newell, J. M., Nelson-Gardell, D., & MacNeil, G. (2016). Clinician responses to client traumas: A chronological review of constructs and terminology. Trauma, Violence, & Abuse, 17(3), 306–313.
Rauvola, R. S., Vega, D. M., & Lavigne, K. N. (2019). Compassion fatigue, secondary traumatic stress, and vicarious traumatization: A qualitative review. Occupational Health Science, 3, 297–336.
Ray, S. L., Wong, C., White, D., & Heaslip, K. (2013). Compassion satisfaction, compassion fatigue, and burnout in psychiatric nurses. Traumatology, 19(4), 258–267.
Reilly, D., Duyar, I., McBride, J., & Williams, R. (2025). Influence of teachers’ secondary traumatic symptoms on their burnout and compassion fatigue. OBM Integrative and Complementary Medicine, 10(1), 016.
Sánchez-Moreno, E., Roldán, I. N. D. L. F., Gallardo-Peralta, L. P., & Roda, A. B. L. D. (2015). Burnout, informal social support, and psychological distress among social workers. British Journal of Social Work, 45(8), 2368–2386.
Schmidt, M. R., Narayan, A. J., Atzl, V. M., Rivera, L. M., & Lieberman, A. F. (2020). Childhood maltreatment on the Adverse Childhood Experiences (ACEs) Scale versus the Childhood Trauma Questionnaire (CTQ) in a perinatal sample. Journal of Aggression, Maltreatment & Trauma, 29(1), 38–56.
Senreich, E., Straussner, S. L., & Cooper, C. E. (2020). Health, wellness, and workplace experiences of social workers. Journal of Gay & Lesbian Social Services, 32(2), 209–239.
Shu, Y., Zhang, Z., Wang, H., Wang, C., Dou, L., Wang, W., Zhang, L., Bi, J., & Wu, M. (2025). The impact of adverse childhood experiences on adult health and behaviors. BMC Public Health, 25, 1950.
Southern, S. (2007). Countertransference in the treatment of trauma. The Family Journal, 15(3), 295–302.
Sprang, G., Clark, J. J., & Whitt-Woosley, A. (2007). Compassion fatigue, compassion satisfaction, and burnout: Factors impacting a professional’s quality of life. Journal of Loss and Trauma, 12(3), 259–280.
Stamm, B. H. (2010). The Concise ProQOL Manual (2nd ed.). https://proqol.org
Wagaman, M. A., Geiger, J. M., Shockley, C., & Segal, E. A. (2015). The role of empathy in burnout, compassion satisfaction, and secondary traumatic stress among social workers. Social Work, 60(3), 201–209.
Zarse, E. M., Neff, M. R., Yoder, R., Hulvershorn, L., Chambers, J. E., & Chambers, R. A. (2019). The adverse childhood experiences questionnaire: Two decades of research. Cogent Medicine, 6(1), 1581447.
Zyromski, B., Baker, E., Betters-Bubon, J., Dollarhide, C. T., & Antonides, J. (2020). Adverse childhood experiences: A 20-year content analysis of counseling journals. Journal of Counseling & Development, 98(2), 133–142.
蔡依玲、陳婉真、黃禎慧 (2015).心理助人工作者「同理失衡量表」之編製。輔導與諮商學報，37(2)，57–72。