The present findings suggest that psycho-oncologists experience professional grief as a natural and generally adaptive emotional response to patient deaths. The emotions reported—such as sorrow, sadness, grief, and occasionally helplessness—are emotionally similar to personal grief, though the low to moderate levels of grief assessed with the TRIG-D indicate that the intensity is lower than in personal grief²². Descriptively, the level of grief reported in our sample was somewhat lower than that observed in the Israeli sample investigated by Engler-Gross et al.², potentially suggesting differences in experience or contextual factors. Previous findings on the impact of professional grief in healthcare professionals have been mixed ^4–6,28, with some studies highlighting predominantly negative effects and others noting potential for growth. In our sample of psycho-oncologists, the experience of professional grief was not reported alongside long-term or global negative effects on personal or professional life. In fact, many participants reported positive psychological outcomes, particularly with respect to their views on life, death, and their sense of purpose.

Emotions such as guilt, which are commonly reported among physicians⁵, played a negligible role in the responses of psycho-oncologists. This divergence may be attributable to the distinct nature of their professional responsibilities. Unlike physicians, psycho-oncologists do not make medical decisions or bear the burden of treatment side effects or outcomes, which may shield them from feelings of moral responsibility or failure. These differences suggest that while professional grief is a common phenomenon across healthcare professions, its emotional expression and psychological consequences may vary depending on role-specific factors. Further comparative studies across disciplines are warranted to clarify such distinctions.

Coping mechanisms reported by participants were diverse, yet consistently rated as important. The presence of colleagues—both in informal and formal settings— emerged as a central support structure. Colleagues were not only identified as the most important source of support, but could also facilitate emotional relief, rated as the most important coping strategy. Compared to other healthcare professions, psychological disciplines may be generally more oriented toward emotional self-reflection and the open expression of one’s own emotional responses, for instance through established formats such as clinical supervision^31–34. It is possible that this professional culture and training foster a greater readiness to acknowledge and process difficult emotions following patient deaths. This, in turn, might serve as a protective factor—potentially contributing to the comparatively lower levels of distress observed in this sample relative to findings from studies involving physicians or nurses^4,7. While this interpretation is plausible, it requires further investigation to be substantiated. Nevertheless, these findings underscore the value of peer-based coping and highlight the potential for institutions to promote collegial exchange through regular supervision, peer discussion rounds, or the creation of informal spaces for supportive interaction.

In addition to social coping strategies, individual practices such as adopting an accepting attitude toward death and commemorating deceased patients were also perceived as highly beneficial. These coping mechanisms do not require the presence of others and may be particularly important in promoting self-regulated adaptation to loss.

The positive impacts reported by many participants may be understood in light of the concept of post-traumatic growth—defined as positive psychological change following the struggle with a traumatic event³⁵. While it is most likely that none to few patient deaths may be experienced as traumatic, some encounters can be deeply moving or even destabilizing for individual professionals. The fact that many psycho-oncologists reported constructive outcomes from their experiences with death—such as strengthened values or deeper perspectives on life—suggests that professional grief may, in some cases, be a path to growth rather than distress. This interpretation aligns with research showing that perceived social support, feeling connected to others and reflective training can foster post-traumatic growth^36–39. Viewing patient deaths as unavoidable distressing events, that yet yield an opportunity for post-distress growth may offer a useful framework: while grief responses are typically adaptive, insufficient coping resources or particularly distressing circumstances may still give rise to negative effects. As with post-traumatic stress and growth, these reactions may represent two sides of the same coin.