Therapist empathy and client outcome: an updated meta-analysis
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 measur...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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American Psychological Association
2018
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| Online Access: | https://eprints.nottingham.ac.uk/51119/ http://psycnet.apa.org/record/2018-51673-006?doi=1 |
| _version_ | 1848798421064876032 |
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| author | Elliott, Robert Bohart, Arthur C. Watson, Jeanne C. Murphy, David |
| author_facet | Elliott, Robert Bohart, Arthur C. Watson, Jeanne C. Murphy, David |
| author_sort | Elliott, Robert |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T20:19:30Z |
| format | Article |
| id | nottingham-51119 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T20:19:30Z |
| publishDate | 2018 |
| publisher | American Psychological Association |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-511192018-10-23T11:12:43Z https://eprints.nottingham.ac.uk/51119/ Therapist empathy and client outcome: an updated meta-analysis Elliott, Robert Bohart, Arthur C. Watson, Jeanne C. Murphy, David 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. American Psychological Association 2018-12-01 Article PeerReviewed application/pdf en https://eprints.nottingham.ac.uk/51119/1/Empathy%20Meta-analysis%20Psychotherapy%20March%202018.pdf Elliott, Robert, Bohart, Arthur C., Watson, Jeanne C. and Murphy, David (2018) Therapist empathy and client outcome: an updated meta-analysis. Psychotherapy, 55 (4). pp. 399-410. ISSN 1939-1536 empathy psychotherapy relationship psychotherapy process-outcome research therapist factors meta-analysis doi:10.1037/pst0000175 http://psycnet.apa.org/record/2018-51673-006?doi=1 http://psycnet.apa.org/record/2018-51673-006?doi=1 |
| spellingShingle | empathy psychotherapy relationship psychotherapy process-outcome research therapist factors meta-analysis Elliott, Robert Bohart, Arthur C. Watson, Jeanne C. Murphy, David Therapist empathy and client outcome: an updated meta-analysis |
| title | Therapist empathy and client outcome: an updated meta-analysis |
| title_full | Therapist empathy and client outcome: an updated meta-analysis |
| title_fullStr | Therapist empathy and client outcome: an updated meta-analysis |
| title_full_unstemmed | Therapist empathy and client outcome: an updated meta-analysis |
| title_short | Therapist empathy and client outcome: an updated meta-analysis |
| title_sort | therapist empathy and client outcome: an updated meta-analysis |
| topic | empathy psychotherapy relationship psychotherapy process-outcome research therapist factors meta-analysis |
| url | https://eprints.nottingham.ac.uk/51119/ https://eprints.nottingham.ac.uk/51119/ https://eprints.nottingham.ac.uk/51119/ http://psycnet.apa.org/record/2018-51673-006?doi=1 |