Therapist Empathy and Client Outcome: An Updated Meta-Analysis

• Main Authors: Bohart, A.C (Author), Elliott, R. (Author), Murphy, D. (Author), Watson, J.C (Author)
• Format: Article
• Language: English
• Published: American Psychological Association Inc. 2018
• Subjects: article; Attitude of Health Personnel; controlled study; empathy; Empathy; health personnel attitude; human; human experiment; Humans; mental disease; Mental Disorders; meta analysis; Meta-analysis; perception; procedures; Professional-Patient Relations; professional-patient relationship; psychology; psychotherapy; Psychotherapy; Psychotherapy process-outcome research; Psychotherapy relationship; theoretical study; Therapist factors; treatment outcome; Treatment Outcome
• Online Access: View Fulltext in Publisher

 Put simply, empathy refers to understanding what another person is experiencing or trying to express. Therapist empathy has a long history as a hypothesized key change process in psychotherapy. We begin by discussing definitional issues and presenting an integrative definition. We then review measures of therapist empathy, including the conceptual problem of separating empathy from other relationship variables. We follow this with clinical examples illustrating different forms of therapist empathy and empathic response modes. The core of our review is a meta-analysis of research on the relation between therapist empathy and client outcome. Results indicated that empathy is a moderately strong predictor of therapy outcome: mean weighted r-.28 (p .001; 95% confidence interval [.23, .33]; equivalent of d-.58) for 82 independent samples and 6,138 clients. In general, the empathy-outcome relation held for different theoretical orientations and client presenting problems; however, there was considerable heterogeneity in the effects. Client, observer, and therapist perception measures predicted client outcome better than empathic accuracy measures. We then consider the limitations of the current data. We conclude with diversity considerations and practice recommendations, including endorsing the different forms that empathy may take in therapy. © 2018 American Psychological Association.