Moving from Moral Distress to Moral Emotion: A Socioecological Model

Abstract

Among social workers, morally relevant distress has been associated with negative emotional and physical outcomes for the practitioner as well as increased intent-to-leave and burnout. Moral distress, a term that arose in the nursing literature, has traditionally been understood as the discomfort that arises when one knows the right thing to do, but is unable to act on that knowledge. However, social workers’ perspectives and experiences of moral distress have not been fully explored, including whether certainty and constraint are central features. A diverse sample of 20 master’s prepared social workers participated in individual semi-structured interviews exploring experiences they identified as morally or ethically troubling or distressing. Grounded theory was used to guide analysis of respondent interviews and revealed that constraint was a common, but not essential feature of morally distressing scenarios. Additionally, uncertainty was often described as an aspect of the experience. The Model of Moral Emotion emerged during the analytic process, demonstrating the layered and contextual nature of a range of morally challenging emotions (e.g., anxiety, depression, anger, traumatic stress). Within this model, moral emotion is shaped by the features of the moral scenario (i.e., constraint, conflicts, complexity, complicity, and trespass) and the individual’s capacity, via internal and external resources, to work through practice challenges. This micro level experience is nested within the mezzo level of practice (e.g., agency context, resources, and culture), the macro level of practice (e.g., sociopolitical, economic, and historical context), and the practitioner’s development as an individual and professional (chronosystem). The Model of Moral Emotion is best suited for use as an assessment tool with students and practitioners to explore how and in what contexts moral emotion develops, how it is experienced or impacts the practitioner, and what actions or responses are needed. Future research will benefit from exploration of the positive end of the moral emotion spectrum (e.g., moral courage), the nuances of diverse cultural understandings of moral emotion, and possible adaptation of the model for quantitative analysis.