The Role of Empathy in Therapy and the Physician-Patient Relationship

This paper seeks to give an overview of the role of clinical empathy in therapy and in the physician-patient relationship. Researchers have offered definitions of empathy in the clinical context, and a number of validated measures exist. There is evidence from the health-related research literature to support the positive association of clinical empathy with improved therapeutic outcomes in a wide range of clinical settings. Clinical empathy is also understood to be a crucial component of the physician-patient therapeutic relationship. Barriers to the development and expression of empathy in the clinical context are explored, and ways of enhancing empathy discussed.

[1]  Pauline Irving,et al.  Empathy: towards a conceptual framework for health professionals. , 2004, International journal of health care quality assurance incorporating Leadership in health services.

[2]  R. Frankel,et al.  The effect of physician behavior on the collection of data. , 1984, Annals of internal medicine.

[3]  S. Myers,et al.  Empathic Listening: Reports on the Experience of being Heard , 2000 .

[4]  The process of cognitive therapy: the first dysfunctional thought changes less than the last one. , 1986, Behaviour research and therapy.

[5]  G. Barrett‐Lennard,et al.  The empathy cycle: Refinement of a nuclear concept. , 1981 .

[6]  L. Greenberg,et al.  Empathy: Where are we and where do we go from here? , 1997 .

[7]  Joseph M. Lalopa,et al.  Impact of Patient Empathy Modeling on pharmacy students caring for the underserved. , 2008, American journal of pharmaceutical education.

[8]  R. Squier.  A model of empathic understanding and adherence to treatment regimens in practitioner-patient relationships. , 1990, Social science & medicine.

[9]  G. Watt,et al.  More time for complex consultations in a high-deprivation practice is associated with increased patient enablement. , 2007, The British journal of general practice : the journal of the Royal College of General Practitioners.

[10]  J. Bensing,et al.  Analyzing the "nature" and "specific effectiveness" of clinical empathy: a theoretical overview and contribution towards a theory-based research agenda. , 2009, Patient education and counseling.

[11]  J. O'neill,et al.  Referrals between consultants. The wait to be seen in a specialist plastic surgery hand clinic , 2008 .

[12]  Ronald M Epstein,et al.  Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. , 2009, JAMA.

[13]  J. Layton,et al.  The use of modeling to teach empathy to nursing students. , 1979, Research in nursing & health.

[14]  Friedrich Edelhäuser,et al.  Empathy Decline and Its Reasons: A Systematic Review of Studies With Medical Students and Residents , 2011, Academic medicine : journal of the Association of American Medical Colleges.

[15]  S. Nolen-Hoeksema,et al.  Therapeutic empathy and recovery from depression in cognitive-behavioral therapy: a structural equation model. , 1992, Journal of consulting and clinical psychology.

[16]  J. Watson,et al.  Client-centered and experiential psychotherapy in the 21st century : advances in theory, research and practice , 2002 .

[17]  M. G. Haviland,et al.  The Medical Condition Regard Scale: Measuring Reactions to Diagnoses , 2002, Academic medicine : journal of the Association of American Medical Colleges.

[18]  M. Stewart,et al.  Communication patterns of primary care physicians. , 1997, JAMA.

[19]  PhD Dr. Jodi Halpern MD.  What is clinical empathy? , 2007, Journal of General Internal Medicine.

[20]  M. Johnston,et al.  The Effects of Physician Empathy on Patient Satisfaction and Compliance , 2004, Evaluation & the health professions.

[21]  E L La Monica,et al.  Construct validity of an empathy instrument. , 1981, Research in nursing & health.

[22]  M. Wirtz,et al.  General practitioner empathy, patient enablement, and patient-reported outcomes in primary care in an area of high socio-economic deprivation in Scotland--a pilot prospective study using structural equation modeling. , 2008, Patient education and counseling.

[23]  S. Mercer,et al.  Empathy and quality of care. , 2002, The British journal of general practice : the journal of the Royal College of General Practitioners.

[24]  A. Finset,et al.  Communicating with Alexithymic and Non-Alexithymic Patients: An Experimental Study of the Effect of Psychosocial Communication and Empathy on Patient Satisfaction , 2004, Psychotherapy and Psychosomatics.

[25]  M. Wirtz,et al.  Determinants and patient-reported long-term outcomes of physician empathy in oncology: a structural equation modelling approach. , 2007, Patient education and counseling.

[26]  Mark H. Davis.  Measuring individual differences in empathy: Evidence for a multidimensional approach. , 1983 .

[27]  E. L. Monica.  Construct validity of an empathy instrument. , 1981 .

[28]  M. Hojat,et al.  Physicians' Empathy and Clinical Outcomes for Diabetic Patients , 2011, Academic medicine : journal of the Association of American Medical Colleges.

[29]  L. Greenberg,et al.  Empathic resonance: A neuroscience perspective. , 2009 .

[30]  David Heaney,et al.  The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure. , 2004, Family practice.

[31]  P Maguire,et al.  Helping cancer patients disclose their concerns. , 1996, European journal of cancer.

[32]  Betty Chewning,et al.  Perception of empathy in the therapeutic encounter: effects on the common cold. , 2011, Patient education and counseling.

[33]  S. Mercer,et al.  Practitioner empathy, patient enablement and health outcomes: a prospective study of acupuncture patients. , 2006, Patient education and counseling.

[34]  L. Deloney,et al.  The medical student as patient navigator as an approach to teaching empathy. , 2002, American journal of surgery.

[35]  Jeanne C. Watson.  Re-visioning empathy. , 2002 .

[36]  Richard J Lilford,et al.  University of Birmingham A Systematic Review of Empathy Test in Medicine , 2022 .

[37]  J. Macnaughton.  The dangerous practice of empathy , 2009, The Lancet.

[38]  Matthew A. Davis,et al.  A perspective on cultivating clinical empathy. , 2009, Complementary therapies in clinical practice.

[39]  F. Platt,et al.  Let Me See If I Have This Right : Words That Help Build Empathy , 2001, Annals of Internal Medicine.

[40]  J. Morse,et al.  Exploring empathy: a conceptual fit for nursing practice? , 1992, Image--the journal of nursing scholarship.

[41]  J. Kleijnen,et al.  Influence of context effects on health outcomes: a systematic review , 2001, The Lancet.

[42]  M. Magee,et al.  Physician empathy in medical education and practice: experience with the Jefferson scale of physician empathy , 2003 .

[43]  C. Rogers.  The necessary and sufficient conditions of therapeutic personality change. , 1992, Psychotherapy.

[44]  R. Elliott.  Measuring Response Empathy: The Development of a Multicomponent Rating Scale , 1982 .

[45]  D. Roter,et al.  The relationship of physician medical interview style to patient satisfaction. , 1991, The Journal of family practice.

[46]  R. Elliott,et al.  Measuring Response Empathy : The Development of a Multicomponent Rating Scale , 2005 .

[47]  S. Mercer,et al.  A pilot prospective study on the consultation and relational empathy, patient enablement, and health changes over 12 months in patients going to the Glasgow Homoeopathic Hospital. , 2005, Journal of alternative and complementary medicine.

[48]  A. Mehrabian,et al.  A measure of emotional empathy. , 1972, Journal of personality.

[49]  Thomas J Nasca,et al.  Physician empathy: definition, components, measurement, and relationship to gender and specialty. , 2002, The American journal of psychiatry.

[50]  M. Wirtz,et al.  1114 POSTER Determinants and patient-reported long-term outcomes of physician empathy in oncology: A structural equation modelling approach , 2007 .

[51]  S. Mercer,et al.  Validity and reliability of the CARE Measure in secondary care , 2008 .

[52]  M. Magee,et al.  The Jefferson Scale of Physician Empathy: Further Psychometric Data and Differences by Gender and Specialty at Item Level , 2002, Academic medicine : journal of the Association of American Medical Colleges.

[53]  Anthony Suchman,et al.  Making Connexions: Enhancing the Therapeutic Potential of PatientClinician Relationships , 1993, Annals of Internal Medicine.

[54]  Edward Krupat,et al.  The Four Habits Coding Scheme: validation of an instrument to assess clinicians' communication behavior. , 2006, Patient education and counseling.

[55]  G. Watt,et al.  Relevance and practical use of the Consultation and Relational Empathy (CARE) Measure in general practice. , 2005, Family practice.

[56]  T. Shanafelt,et al.  The influence of personal and environmental factors on professionalism in medical education , 2007, BMC medical education.

[57]  G. Barrett‐Lennard,et al.  Dimensions of therapist response as causal factors in therapeutic change. , 1962 .