The Measurement of Empathy and Its Efficacy in Psychotherapy

Objective: To develop and evaluate a feedback method for measuring and increasing therapists' empathic accuracy and reducing empathic errors in psychotherapy. Method: Sixteen (16) patient-therapist pairs were randomly assigned to intervention and control groups. All patients rated their own functioning using the GAF (Global Assessment of Functioning) and predicted the accuracy with which their therapists would estimate their ratings. Therapists rated the patient's GAF, predicted the patients' ratings of their own GAFs, and rated their confidence in their own predictions. In the intervention condition, therapist and patients discussed the previous session's ratings for a few minutes of the therapy session. Results: Intervention therapists showed greater empathic accuracy relative to controls on our empathy measure (t(14) = 2.69, p < .01) and increased empathy over time on the Barrett-Lenard Empathy subscale (t(32) = 3.21, p < .01). We also found significant effects on errors related to perceived accuracy of therapist empathy. Patients in the control group were found to perceive their therapists to be either more or less accurate than was actually the case (over/under-idealization), but such biases were not as strong in the intervention group. Similarly, therapists in the control group were likely to over-estimate their own accuracy (over-confidence) to a greater extent than intervention therapists. Affective responses to the instrument were positive overall and did not differ by condition. Conclusion: Empathy feedback and feedback concerning degrees of patient idealization and therapist confidence may be effective in improving functioning as well as in increasing empathic accuracy in psychotherapy.

Inclusion criteria

• Outpatient psychotherapy at University of Illinois at Chicago
• Age 18-65

Exclusion criteria

• Psychosis
• Suicidality
• Organic Brain Disorder