This paper examines empathy as a practice component that is particularly significant in its relationship to self-determination in the discharge process in acute hospital settings. Empathy is also emphasized as an essential ingredient to a psychosocial assessment that leads to accurate problem formulation and preciseness in planning. Current theories on empathy are discussed in a literature review, while pertinent practice issues are presented in several case vignettes. Theory and practice confirm that empathic skills can develop on both sentient and cognitive levels over time. This development is enhanced by supervision that utilizes the worker's capacity for self-awareness.