Got Empathy? A Latent Profile Analysis of Psychotherapists’ Empathic Abilities

ticipants completed the Interpersonal Reactivity Index ) [6], a multidimensional measure of empathy consisting of four different subscales: perspective taking (PT) measures the capacity to understand the perspective of others; fantasy (FS) measures the tendency to identify with characters from fictional situations, akin to PT; empathic concern (EC) measures feelings of compassion toward persons in distress; and personal distress (PD) measures self-oriented feelings of distress when facing others’ negative experiences. The internal consistency of the subscales was adequate: 0.75 for PT (mean 2.87 ±.53), 0.77 for FS (mean 2.38 ± 0.70), 0.72 for EC (mean 2.99 ± 0.53), and 0.84 for PD (mean 1.18 ± 0.6). Latent profile analyses were conducted using Mplus 8 to identify subpopulations of clinicians presenting distinct empathy profiles with a robust estimator to nonnormality (robust maximum likelihood). An elbow plot of various indices (AIC, CAIC, BIC, ABIC) was used to select the optimal number of profiles: the CAIC and the BIC reached their lowest values for the four-profile solution, which was also associated with a flattening out in the decrease of the AIC and ABIC. The four-profile solution was thus retained for interpretation and is illustrated in Figure 1. The first profile represented 23% of the respondents and was characterized by below average levels for PT, FS and EC, and the highest level of PD, suggesting a self-absorbed and under-regulated subgroup of clinicians, was labelled “insecure self-absorbed. ” Clinicians in this group likely perform rather poorly in both cognitive perspective-taking and in their emotional resonance with patients’ concerns, perhaps focusing largely on their own negative emotional reactions to others’ displays of distress. These clinicians – nearly one-quarter of the sample – may be at risk of becoming overwhelmed by patients’ problems, likely failing to work in the service of therapeutic progress. The second profile represented 26% of the clinicians who exhibited above-average levels for PT and FS, with EC at the highest level compared to other profiles, suggesting a highly empathic group, labelled “empathic immersion. ” Clinicians in this group tend to become immersed in others’ emotional experience and are oriented toward intuiting and identifying with the feelings of others. The third and largest profile represented 38% of the clinicians, reflecting “average” empathy and thus inferring the “average expectable clinician. ” These clinicians likely display adequate levels of emotional concern and perspective taking toward their patients, with occasional experiences of distress during sessions. Finally, the fourth profile was characterized by the highest level for PT, average level of EC, low level of FS, and lowest value for PD, revealing a more objective empathic style for 13% of the clinicians. These “rational empathic” clinicians would be inclined to adopt an intellectual understanding of their patients’ perspectives (probably based on observations and clinical theories), without emotionally sampling or identifying with their experience, and would probably be highly regulated in their interpersonal interactions. With regard to our secondary objective, multinomial logistic regressions revealed few significant associations between cliniDear Editor, In psychotherapy, clinician empathy is fundamental for guiding supporting behavior in response to the patient’s emotional plight. Empathy – the inferring of another’s emotional state – involves two main aspects: affective sharing and perspective-taking [1]. Affective sharing refers to vicariously experiencing another person’s emotional state with either a desire to help (empathic concern) or a tendency to withdraw (personal distress), whereas perspective-taking refers to deliberately imagining another person’s perspective to understand her/his feelings [2]. A recent meta-analysis [3] reports a significant aggregate association (r = 0.31) between empathy and psychotherapy outcome; empathy had the largest reported effect size among common and specific therapy factors in a recent review [4]. Evidence supporting the role of clinician empathy in psychotherapy has been based on research that considered conveyed empathy. Equally important, however, is the investigation of clinicians’ dispositional capacities for empathic functioning, especially considering that therapist effects have been found to be equal to or greater than effects of specific treatment interventions [4, 5]. Perceptions of clinician empathy likely reflect complex interactions between perceivers’ characteristics and behaviors and clinicians’ empathic dispositions – within contextual factors such as the setting, timing, and phase of the therapeutic relationship. Clinicians can vary in their level of empathy and differ in their ability to constructively utilize empathy in their clinical work. Despite the centrality of clinicians’ empathic abilities, empirical work regarding individual differences is, to our knowledge, nonexistent. The present study was developed to address this gap by investigating clinicians’ profiles of dispositional empathy. A secondary objective was to conduct a preliminary exploration of correlates of empathy profiles. Clinicians (n = 775) with active practice were recruited through professional associations. The participants identified as psychologists (63%), interns (15%), or other mental health professionals (22%) such as psychiatrists. Three-quarters (75%) were female, and the mean years of experience was 14.62 (SD = 11.27). Participants’ theoretical orientations were psychodynamic (44%), cognitive behavioral, (24%), humanistic (13%), and integrative (18%). The parReceived: August 10, 2018 Accepted after revision: September 30, 2018 Published online: November 2, 2018