The purpose of this article is to describe empathy as a complex construct, and its implications for practice. A review of current literature affirms the central role of empathy in psychotherapy, and the importance of mastering it for effective practice. Contributions from perspectives of attitude, context and social neuroscience converge to suggest a dynamic complex construct, useful as a framework for practice application. Influenced by factors such as attitudes, contexts, and values, the quality of empathic engagement is shown to emerge from their unique mix, within and between therapist and patient, and is always grounded in shared, embodied humanity. The essential role of the therapist's self-regulation is demonstrated. A number of strategies for more consciously managing empathic engagement, and for balancing affect-regulation challenges with self-care are described.Keywords Clinical practice Á Empathy Á Professional development Á Psychotherapy Á Therapeutic empathy Defining empathy in clinical social work/psychotherapy has been a longstanding challenge (Barrett-Lennard 1981;