Early psychotherapeutic empathy, alliance, and client outcome: Preliminary evidence of indirect effects

Abstract

The association between psychotherapeutic empathy and client outcome is well established, yet the mechanisms underlying this association remain poorly understood. We hypothesized that early experiences of empathy influence outcome through the working alliance. To test this hypothesis, we used archival data collected from 56 clients (mean [M] age = 19.5 years, 83.9% female, 76.8% White) who reported mild, moderate, or severe depressive symptoms at screening and pretreatment assessments and then received five sessions of evidence-based psychotherapy. Therapists (M age = 26.0 years, 50% female, 100% White) were six students in a clinical psychology PhD program. Results of bootstrap analyses were consistent with the idea that early experiences of empathy strengthen the alliance (specifically the goals and tasks facets), which in turn facilitates improvements in depressive symptoms and psychological well-being. While preliminary, these results implicate a specific pathway of change in the treatment of depression.

Virtue, flourishing, and positive psychology in psychotherapy: An overview and research prospectus.

“…There is some evidence that therapist virtues may affect treatment. Greater client-rated therapist empathy was indirectly associated with improvement in client well-being and symptoms through higher client ratings of the working alliance (McClintock, Anderson, Patterson, & Wing, 2018). By comparison, only therapist-rated hope in their clients, pre- and posttreatment, significantly predicted symptom reduction, whereas client-rated hope did not (Coppock, Owen, Zagarskas, & Schmidt, 2010).…”

Psychometric Properties of the Farsi Version of the Schwartz Outcome Scale

“…Schwartz Outcome Scale-10 (SOS-10) is a brief, userfriendly and cost-efficient tool assessing well-being and psychological health in a wide variety of populations and clinical situations. Naturally, SOS-10 is atheoretical, therefore, clinicians with any approach can use this measure to assess the effectiveness of their intervention; this scale can also be applied in both research and practice settings (11)(12)(13)(14). This scale has been translated into several languages such as French (6), Czech (15), Spanish (16), and Arabic (17), indicating that the use of SOS-10 has been extended since its development.…”

“…Psychometric analysis of this scale has demonstrated good reliability and validity in both clinical and nonclinical settings among adults and adolescents (10,15,(18)(19)(20). Also, its psychometric features make it a noteworthy measure due to its generality, promptness and ease of administration and scoring (7,14,(21)(22)(23)(24).…”

Measuring Alliance Toward Embodied Virtual Therapists in the Era of Automated Treatments With the Virtual Therapist Alliance Scale (VTAS): Development and Psychometric Evaluation

“…Empathy is considered an important component of psychotherapeutic practice and has been shown to strengthen alliance through goals and tasks [38], yet it is not typically associated with artificial human actors. Therefore, categories for measuring empathic behavior from a study entitled A Virtual Therapist That Responds Empathically to Your Answers [34] were used to construct novel items.…”