Therapist empathy,homework compliance,and outcome in cognitive behavioral therapy for generalized anxiety disorder: partitioning within- and between-therapist effects

Although client-perceived therapist empathy relates to positive therapy outcomes, including in cognitive behavioral therapy (CBT), little is known about how empathy exerts its ameliorative effect. One possible way is by promoting clients’ subsequent homework compliance, a variable that also predicts positive outcomes in CBT. The present study sought to investigate simultaneously, in the context of 43 therapist–client dyads receiving 15 sessions of CBT for generalized anxiety disorder, (1) the association of early client-perceived therapist empathy (averaged over sessions 1, 3, 5) with mid-treatment client homework compliance (averaged over sessions 6, 8, 10); (2) the association of mid-treatment homework compliance on client posttreatment worry severity; and (3) the indirect effect of early perceived therapist empathy on posttreatment worry through mid-treatment homework compliance. Given that clients were nested within therapists, we examined both within- and between-therapist differences in clients’ ratings of therapist empathy and homework compliance, and tested both of these indices as predictors of the relevant dependent variables in a multilevel model. At the within-therapist level (i.e., differences between clients within a given therapist’s caseload), greater early empathy was associated with greater mid-treatment homework compliance. At the between-therapist level (i.e., differences between therapists across all of their cases), greater between-therapist homework compliance was related to lower posttreatment worry. Finally, homework compliance was not found to mediate the relationship between empathy and posttreatment outcome. The results underscore the importance of parsing client and therapist effects, and are discussed with regard to their training and research implications.     

Being Empathic: The Role of Motivation to Empathize and the Nature of Target Emotions

The effect of the observer's motivation to empathize and the nature of the target person's emotions on empathy was examined. The study distinguished intellectual empathy, the extent to which the observer takes the target person's perspective, and empathic emotion, the extent to which the observer feels the target emotions. Intellectual empathy was measured via attribution errors that the observer made in attributing the target person's situation, and empathic emotion by the congruence between the emotions of the target person and the observer. The first experiment showed that pleasant emotions and sadness elicited more empathic emotion than did shame and anger. The second experiment revealed that motivation increased intellectual empathy when the target person was sad, and empathic emotion when the target person was happy. Intellectual empathy and empathic emotion appeared to be distinguishable constructs and could correlate under certain conditions.     

The effects of dispositional empathy on emotional reactions and helping: A multidimensional approach

Recent research indicates that an affective state termed empathic emotion, and characterized by feelings of sympathy and compassion for another, is associated with altruistic responding. That is, persons experiencing high levels of empathic emotion offer help to another even when escape from the situation is easy. Persons experiencing high levels of another emotional state—personal distress—help much less when escape from the situation is easy. A study was conducted to test two related hypotheses. The first was that individual differences in empathy can influence empathic emotion and personal distress, above and beyond the influence of situational factors. The second hypothesis was that this effect of individual differences is due to variation in emotional and not cognitive empathy. The results provide support for both hypotheses. Regarding hypothesis 1, a significantly greater proportion of the variance in emotional reactions was accounted for when individual difference factors were included as predictors. Hypothesis 2 was also supported: It was found that a dispositional measure of emotional empathy was clearly related, and a dispositional measure of cognitive empathy was clearly unrelated, to these emotional reactions. The results provide support for a multidimensional view of empathy.     

团体咨询成员的相互共情及其与效果的关系——社会关系模型在团体咨询研究中的应用

研究旨在探讨团体成员的相互共情及其与团体效果的关系。共收集10个团体,53名成员的数据,运用社会关系模型分析。结果发现：1.成员自评相互共情得分较高,但互评相关不显著;2.共情水平与会谈效果正相关,与团体反治疗性因素负相关;3.被共情水平与不信任负相关;4.共情准确性与团体治疗性因素正相关。结论：成员自评相互共情水平较高,但互评不匹配。成员自评共情水平越高,会谈效果越好,受团体反治疗性因素阻碍更少。越被准确评估情绪效价的成员,从治疗性因素中获益更多。     

Children's Understanding and Experience of Mixed Emotions: The Roles of Age,Gender, and Empathy

ABSTRACT. The present study examined the development of children's ability report understanding and experiencing allocentric mixed emotions, and explored the relation of gender and empathic ability to these skills. Participants (128 elementary school-aged children [63 boys, 65 girls]) were shown a movie clip with bittersweet themes to elicit mixed emotions. Findings from this study are consistent with prior research (Larsen, To, & Fireman, 2007), supporting a developmental progression in children's ability to both understand and report experiencing mixed emotions, with the two as distinct skills and children reporting understanding earlier than experiencing of emotions. Consistent with previous research, girls performed significantly better on the emotion experience task. Finally, results provided evidence that empathy partially mediates the relationship between age and reports of mixed emotion experience, but no evidence that empathy plays a role in mixed emotional understanding.     

Therapeutic relationship and progress in the first six sessions of individual psychotherapy: A panel analysis

The temporal nature of the associations between client-rated therapist empathy and acceptance, and both client-and therapist-assessed therapeutic progress at sessions 2 and 6 were examined pairwise with cross-lagged panel correlatation (CLPC) and linear structural relationships (LISREL) analyses in 37 clients treated in weekly individual sessions of long-term psycoanalytic and person-centred therapy by 37 experienced therapists. Although none of the cross-lagged differences in the three CLPC analyses which met the necessary conditions for interpretation were significant, two of them approached it, suggesting that session 2 client-rated progress was a stronger determinant of session 6 therapist empathy and acceptance than vice versa. However, the LISREL analyses indicated that while session 2 client-rated progress was unrelated to session 6 therapist acceptance, session 2 therapist empathy was negatively correlated with session 6 client-rated progress. furthermore, both session 2 therapist empathy and acceptance were positively associated with session 6 therapist-rated progress, thereby providing some support for the therapeutic role of these two therapist variables as postulated by person-centred theory.     

It takes two: the interpersonal nature of empathic accuracy

Although current theories suggest that affective empathy (perceivers' experience of social targets' emotions) should contribute to empathic accuracy (perceivers' ability to accurately assess targets' emotions), extant research has failed to consistently demonstrate a correspondence between them. We reasoned that prior null findings may be attributable to a failure to account for the fundamentally interpersonal nature of empathy, and tested the prediction that empathic accuracy may depend on both targets' tendency to express emotion and perceivers' tendency to empathically share that emotion. Using a continuous affect-rating paradigm, we found that perceivers' trait affective empathy was unrelated to empathic accuracy unless targets' trait expressivity was taken into account: Perceivers' trait affective empathy predicted accuracy only for expressive targets. These data suggest that perceivers' self-reported affective empathy can indeed predict their empathic accuracy, but only when targets' expressivity allows their thoughts and feelings to be read.     

I'm Embarrassed for You: The Effect of Valuing and Perspective Taking on Empathic Embarrassment and Empathic Concern

Much research has investigated the cognitive‐perceptual factors that promote empathic concern. However, little research has investigated such factors for a related emotion: empathic embarrassment. We suggest that 2 factors promote empathic embarrassment for a target in a compromising situation: liking the target, and imagining oneself in the target's situation. Results revealed that liking a socially compromised target increases both empathic concern and empathic embarrassment (Experiment 1). Furthermore, imagining the person's thoughts and feelings increases empathic concern and a desire for future exposure to the person, whereas imagining oneself in the person's situation primarily increases empathic embarrassment (Experiment 2). Implications of these results for future empathy research and applications for those who suffer from chronic embarrassability are discussed.     

Therapeutic relationship and outcome seen by clients in first and third session of individual therapy

Rogers' assertion that therapeutic improvement results from clients seeing their therapist as genuinely empathic and unconditionally accepting was explored in the first and third session of individual therapy with 24 clients. This proposition was partly supported in that higher combined levels of these therapist qualities as seen by clients after session one was associated with higher self-esteem and lower need for approval after session three, when these two variables after session one were respectively controlled. However, no support for this assumption was found for depression and anxiety, in that lower depression and greater anxiety after session one was associated with higher levels of these therapist qualities after session three. These latter two findings imply that the subsequent therapist qualities may have resulted from earlier anxiety and depression.     

Empathy in adolescence: Relations with emotion awareness and social roles

In this study, we aimed at gaining a better understanding of the individual differences contributing to feelings of empathy in adolescents. Therefore, we examined the extent to which emotion awareness (e.g., recognizing and appreciating one's own and the emotions of others) and a tendency for certain social roles (e.g., helping or teasing peers when being bullied) are related to adolescents’ levels of empathy. The sample was comprised of 182 adolescents aged between 11 and 16. Empathy and emotion awareness were assessed using self‐report measures. Peer reports were used to indicate adolescents’ different social roles: Bullying, defending the victim, and outsider behaviour. Outcomes demonstrated that evaluating one's own and the emotions of others, and more defending nominations were associated with both affective and cognitive empathy, whereas aspects of emotion awareness which are linked with internalizing symptoms were related to empathic distress, suggesting maladaptive emotion appraisal. Furthermore, outsider behaviour was associated with empathic distress, emphasizing a self‐focused orientation. In contrast, more bullying was negatively associated with cognitive empathy. Overall, these outcomes demonstrate that, besides social roles, emotion awareness is an important factor for adaptive empathic reactions, whereas emotion dysregulation might cause distress when witnessing the negative feelings of others.     

Emotion Regulation and Empathy: Which Relation with Social Conduct?

A shared consensus among researchers deals with the positive association between the ability to effectively regulate and manage one's emotion and the engagement in empathic behavior and morally desirable actions. This study was designed to investigate how dispositional reliance on suppression and reappraisal differently impacted on the cognitive and affective components of empathy and on social conduct, distinguishing among prosocial, internalizing, and externalizing behaviors. Two hundred nineteen middle adolescents were enrolled and fulfilled self-reports assessing emotion regulation strategies, empathy, and social behaviors. The results suggest that there are important distinctions among the emotion regulation strategies and the components of empathy as they relate to one another and to prosocial behavior and problem conduct. Specifically, cognitive reappraisal was related to prosocial behavior through empathic concern. While internalizing behavior was associated with emotion regulation strategies, externalizing behavior was only related to perspective-taking ability. Delimitations and practical implications were discussed.     

The Developmental Trajectory of Empathy and Its Association with Early Symptoms of Psychopathology in Children with and without Hearing Loss

Empathy enables people to share, understand, and show concern for others’ emotions. However, this capacity may be more difficult to acquire for children with hearing loss, due to limited social access, and the effect of hearing on empathic maturation has been unexplored. This four-wave longitudinal study investigated the development of empathy in children with and without hearing loss, and how this development is associated with early symptoms of psychopathology. Seventy-one children with hearing loss and cochlear implants (CI), and 272 typically-hearing (TH) children, participated (aged 1–5 years at Time 1). Parents rated their children’s empathic skills (affective empathy, attention to others’ emotions, prosocial actions, and emotion acknowledgment) and psychopathological symptoms (internalizing and externalizing behaviors). Children with CI and TH children were rated similarly on most of the empathic skills. Yet, fewer prosocial actions were reported in children with CI than in TH children. In both groups, affective empathy decreased with age, while prosocial actions and emotion acknowledgment increased with age and stabilized when children entered primary schools. Attention to emotions increased with age in children with CI, yet remained stable in TH children. Moreover, higher levels of affective empathy, lower levels of emotion acknowledgment, and a larger increase in attention to emotions over time were associated with more psychopathological symptoms in both groups. These findings highlight the importance of social access from which children with CI can learn to process others’ emotions more adaptively. Notably, interventions for psychopathology that tackle empathic responses may be beneficial for both groups, alike.

     

Feeling and Thinking of Others: Affective and Cognitive Empathy and Emotion Comprehension in Prosocial/Hostile Preschoolers

This study aims at investigating the affective and cognitive components of empathy in relation to both emotion comprehension and prosocial/hostile behaviors in preschoolers. A total of 219 children (54% boys; aged between 3 and 6: mean age 4.10) and 20 teachers (two for each class: group A and group B) took part in this research. Pupils’ empathy and hostile/prosocial roles were assessed by teacher reports [Belacchi and Farina, 2010] and children's emotion comprehension by a nonverbal test [Test of Emotion Comprehension: Pons and Harris, 2000; adapted by Albanese and Molina; 2008]. As expected, the results showed a significant influence of gender, with girls being more empathic than boys, according to all of the teachers’ perception. Contrary to our expectations, no systematic age influence emerged. Regarding the relations of children's emotion comprehension with both empathy measures and their prosocial/hostile attitudes, we have found: (1) a low significant relation with the total empathy measure, according to all the teachers, but with the cognitive empathy only according to teachers B; (2) a robust negative relationship of both affective and cognitive empathy with Hostile roles and with Outsider role, contrary to a positive correlation of only affective empathy with Prosocial roles. No relationships emerged between empathy measures and Victim role.     

Empathy, an integrative model

Empathy research has yielded various separate insights into empathy and its correlates. Yet a comprehensive theoretical account that situates these factors within a larger framework is lacking. In this paper a conception of empathy is proposed and defended, which makes it possible to provide an encompassing reconstruction of the processes that are characteristic of empathic encounters. This conception situates empathy within a context of communication. Doing so allows one to connect various treads in empathy research, but at the same time urges one to take new factors into account. It is argued that empathy is a response to a specific demand occurring in a specific context. The type of answer persons are able to provide depends on four types of factors. First, there are the psychological empathic components. We argue that empathy should be seen as a combination of (especially) parallel and reactive emotions, against a background of specific cognitive abilities. Second, it is argued that empathy is aided by a twofold control system, comprised of judgements and forms of self-control. Third, personality factors play a part in how a person responds to demands. Finally, but most importantly, it is pointed out that specific relational factors codetermine empathic reactions. In this paper we describe the theoretical background of our model and provide an elaborated account of the four factors that determine empathic acts in a given context. We illustrate the viability of our model by presenting observational data of children's empathic acts.     

Empathy-based helping: is it selflessly or selfishly motivated?

A substantial body of evidence collected by Batson and his associates has advanced the idea that pure (i.e., selfless) altruism occurs under conditions of empathy for a needy other. An egoistic alternative account of this evidence was proposed and tested in our work. We hypothesized that an observer's heightened empathy for a sufferer brings with it increased personal sadness in the observer and that it is the egoistic desire to relieve the sadness, rather than the selfless desire to relieve the sufferer, that motivates helping. Two experiments contrasted predictions from the selfless and egoistic alternatives in the paradigm typically used by Batson and his associates. In the first, an emphatic orientation to a victim increased personal sadness, as expected. Furthermore, when sadness and empathic emotion were separated experimentally, helping was predicted by the levels of sadness subjects were experiencing but not by their empathy scores. In the second experiment, enhanced sadness was again associated with empathy for a victim. However, subjects who were led to perceive that their moods could not be altered through helping (because of the temporary action of a "mood-fixing" placebo drug) were not helpful, despite high levels of empathic emotion. The results were interpreted as providing support for an egoistically based interpretation of helping under conditions of high empathy.     

Forgiveness, Empathy and Gender—A Malaysian Perspective

Recent theorising has suggested that in non-Western collectivist contexts, the need for social harmony may play a greater role than empathy in motivating forgiveness, and that women may be more impacted than men by this cultural value. In this study, a sample of 233 Malaysian undergraduate students, 100 males and 133 females, recruited from four English-mediated universities completed the Interpersonal Reactivity Index (IRI) and the Transgression-Related Interpersonal Motivations Inventory-12 (TRIM-12) to assess dimensions of empathy and forgiveness. Women exhibited greater empathic concern than men, but not greater perspective-taking. Men were less forgiving in terms of revenge-seeking behaviour, but men and women did not differ in avoidance of transgressors. The relationships between empathic concern and both facets of forgiveness were similar for men and women, as was the relationship between empathic concern and avoidance. However, the relationship between perspective-taking and avoidance was stronger among men than women. We found little support for the prediction that in this collectivist cultural context, perspective-taking would play a greater role than empathic concern in forgiveness. Further research is recommended to explore empathy and forgiveness in non-Western populations, with a need to take into account cultural factors.     

团体成员共情的影响因素及作用模型——基于扎根理论

本研究旨在探索团体咨询成员共情的概念、影响因素及其作用。运用扎根理论对11名团体咨询成员的访谈资料分析,共形成11个轴心编码。根据编码间的关系得到如下结果：1. 团体成员共情包括共情理解、共情表达和共情感知;2. 团体成员共情理解的影响因素为相似性、观点采择;共情感知的影响因素为相似性和共情表达;3. 团体成员共情通过促进成员关系、认知领悟和情感支持提升团体效果。据此构建了团体成员共情的影响因素及作用模型。     

Dissociation between cognitive and affective empathy in youth with Asperger Syndrome

Autism spectrum conditions, among them Asperger Syndrome (AS), are generally described as entailing deficits in “cognitive empathy” or “theory of mind”. People with AS tend to have difficulties recognizing emotions, although the extent of these difficulties is still unclear. This study aimed to assess empathic profile in youth with AS (N = 38) and controls matched on age, sex and IQ. The study aimed to test if a dissociation between cognitive and affective empathy exists in AS. The study also aimed to explore emotion recognition in people with AS, and how it relates to emotional valence (positive, negative, and neutral emotions). The AS group scored lower than controls on cognitive empathy but scored within the average range on affective empathy. A deficit in emotion recognition was found in the AS group for positive emotions. These results confirm earlier findings in cognitive empathy and provide new insight about emotion recognition abilities in this population.     

The impact of empathy and reappraisal on emotional intensity recognition

Empathy represents a fundamental ability that allows for the creation and cultivation of social bonds. As part of the empathic process, individuals use their own emotional state to interpret the content and intensity of other people’s emotions. Therefore, the current study was designed to test two hypotheses: (1) empathy for the pain of another will result in biased emotional intensity judgment; and (2) changing one’s emotion via emotion regulation will modulate these biased judgments. To test these hypotheses, in experiment one we used a modified version of a well-known task that triggers an empathic reaction We found that empathy resulted in biased emotional intensity judgment. To the best of our knowledge, this is the first demonstration of a bias in the recognition of emotional facial expressions as a function of empathy for pain. In experiment two, we replicated these findings in an independent sample, and further found that this biased emotional intensity judgment can be moderated via reappraisal. Taken together, our findings suggest that the novel task used here can be employed to further explore the relation between emotion regulation and empathy.     

A daily investigation of the role of manager empathy on employee well-being

In a daily diary study, the authors investigated the top-down influence of manager empathy on a process model of employee well-being. Sixty employees supervised by one of 13 managers completed a daily survey for 2 weeks, producing a total of 436 observations. Hierarchical linear modeling results revealed that, at the daily level, employees who reported somatic complaints made less progress on their goals and felt lower levels of positive affect and higher levels of negative affect. At the group level, cross-level main and interactive effects of manager empathy were observed, such that groups of employees with empathic managers experienced lower average levels of somatic complaints, and daily goal progress was more strongly related to positive affect for groups of employees with empathic managers. We discuss the implications of these results for the emerging literature on leaders as managers of group emotion.