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Carkhuff & Truax 1967

 Carkhuff and Truax Empathy Scales (Truax & Carkhuff, 1967)

"This was the first empathy scale to reliably operationalize empathy into specific behaviors and statements and was specifically developed for use in teaching empathy to students in the helping professions. This scale is completed by an observer or team of observers as they watch participants respond to a stimulus person or in a role-play setting. The scale originally developed as a nine-point scale but was later revised (Carkhuff, 1969) as a five-point empathy scale with a rating of one representing low levels of empathic responding and five as high levels of empathy. 

The Carkhuff and Truax scales have been used and validated in research (Truax & Carkhuff, 1967) and continue to be widely used both in social work education (Hepworth et al., 2010; Larsen & Hepworth, 1978) to teach and train in empathy. The Carkhuff and 45 Truax scales are no longer the instruments of choice outside of professional training programs"

"Truax developed an 8 point empathy scale, while Carkhuff developed a 5 point scale. Carkhuff’s Scale is a simplification of the Truax Scale" (BRINK 1991)

"Accurate Empathy Scale - Truax
(Excerpt from Carl Rogers Empathic: An Unappreciated Way of Being)

Then there is the Accurate Empathy Scale, devised by Truax and others for use by raters (Truax, 1967). Even small portions of recorded interviews can be reliably rated by this scale. The nature of the scale may be indicated by giving the definition of Stage 1, which is the lowest level of empathic understanding, and Stage 8, which is a very high (though not the highest) degree of empathy.

Here is Stage 1: Therapist seems completely unaware of even the most conspicuous of the client's feelings.
His responses are not appropriate to the mood and content of the client's feelings. His responses are not appropriate to the mood and content of the client's statements and there is no determinable quality of empathy, hence, no accuracy whatsoever. The therapist may be bored and disinterested or actively offering advice, but he is not communicating an awareness of the client's current feelings (Truax, 1967, pp. 556-7).

Stage 8 is defined as follows: Therapist accurately interprets all the client's present acknowledged feelings.
He also uncovers the most deeply shrouded of the client's feeling areas, voicing meanings in the client's experience of which the client is scarcely aware ... He moves into feelings and experiences that are only hinted at by the client and does so with sensitivity and accuracy. The content that comes to life may be new but it is not alien.

While the therapist in Stage 8 makes mistakes, mistakes do not have a jarring note but are covered by the tentative character of the response. Also the therapist is sensitive to his mistakes and quickly alters or changes his responses in midstream, indicating that he more clearly knows what is being talked about and what is being sought after in the client's own explorations. The therapist reflects a togetherness with the patient in tentative trial and error exploration. His voice tone reflects the seriousness and depth of his empathic grasp. (Truax,1967, p. 566)."

by Dustin K MacDonald

"Level 1: Low Level of Empathic Responding
  • Communicating little or no awareness or understanding of the caller’s feelings
  • Responses are irrelevant or abrasive
  • Changing the subject, giving advice, etc.
Level 2: Moderately Low Level of Empathic Responding
  • Responding to the surface message of the caller but omitting feelings or factual aspects of the message.
  • Inappropriately qualifying feelings (e.g.,“somewhat,” “a little bit,”“kind of”)
  • Inaccurately interpreting feelings (e.g., “angry”for “hurt,”“tense”for “scared”).
  • Level 2 responses are only partially accurate, but they show an effort to understand
Level 3: Interchangeable or Reciprocal Level of Empathic Responding
  • Verbal and nonverbal responses at level 3 show understanding and are essentially interchangeable with the client’s obvious expressions, accurately reflecting the client’s story and surface feelings or state of being
Level 4: Moderately High Level of Empathic Responding
  • Somewhat additive, accurately identifying the client’s implicit underlying feelings and/or aspects of the problem.
  • Volunteer’s response illuminates subtle or veiled facets of the client’s message, enabling the client to get in touch with somewhat deeper feelings and unexplored meanings and purposes of behavior.
  • Level 4 responses thus are aimed at enhancing self-awareness.
Level 5: High Level of Empathic Responding
  • Reflecting each emotional nuance, and using voice and intensity of expressions finely attuned to the client’s moment-by-moment experiencing, the volunteer accurately responds to the full range and intensity of both surface and underlying feelings and meanings
  • Volunteer may connect current feelings and experiencing to previously expressed experiences or feelings, or may accurately identify implicit patterns, themes, or purposes.
  • Responses may also identify implicit goals embodied in the client’s message, which point out a promising direction for personal growth and pave the way for action.
  • Responding empathically at this high level facilitates the client’s exploration of feelings and problems in much greater breadth and depth than responding at lower level"
Also see (Empathic Understanding, C.H Patterson)