Title: The Efficacy of Empathy Training: A Meta-Analysis of Randomized Controlled Trials
DOI or Website Link: http://dx.doi.org/10.1037/cou0000093
Publication: Journal of Counseling Psychology
Authors: Emily Teding van Berkhout and John M. Malouff
Date: 2016
Affiliation(s): University of New England, Australia
Citation: Teding van Berkhout, E., & Malouff, J. M. (2016). The efficacy of empathy training: A meta-analysis of randomized controlled trials. Journal of Counseling Psychology, 63(1), 32–41.
Abstract: Cut and pasted:
High levels of empathy are associated with healthy relationships and prosocial behavior; in health professionals, high levels of empathy are associated with better therapeutic outcomes. To determine whether empathy can be taught, researchers have evaluated empathy training programs. After excluding 1 outlier study that showed a very large effect with few participants, the meta-analysis included 18 randomized controlled trials of empathy training with a total of 1,018 participants. The findings suggest that empathy training programs are effective overall, with a medium effect (g 0.63), adjusted to 0.51 after trim-and-fill evaluation for estimated publication bias.
Moderator analyses indicated that 4 factors were statistically significantly associated with higher effect sizes:
(a) training health professionals and university students rather than other types of individuals,
(b) compensating trainees for their participation,
(c) using empathy measures that focus exclusively on assessing understanding the emotions of others, feeling those emotions, or commenting accurately on the emotions, and
(d) using objective measures rather than self-report measures.
Number of hours of training and time between preintervention assessment and postintervention assessment were not statistically significantly associated with effect size, with 6 months the longest time period for assessment. The findings indicate that
(a) empathy training tends to be effective and
(b) experimental research is warranted on the impact of different types of trainees, training conditions, and types of assessment.
Topic Area:
(In which field / sector / perspective was this study conducted?)
Meta-analysis
(How was empathy defined?)
For this meta-analysis, we defined empathy as
understanding the emotions another person is feeling,
feeling the same emotions another person is feeling,
or commenting accurately on the emotions another person is feeling.
(Were any benefits of empathy mentioned?)
Studies have demonstrated that psychotherapist empathy is an important feature of successful treatment by
psychologists (Watson, Steckley, & McMullen, 2014),
social workers (Gerdes & Segal, 2009), and
substance abuse counselors (Moyers & Miller, 2013).
Studies have also found that empathy is associated with
better patient outcomes for physicians (Hojat et al., 2011) and
increased patient adherence to treatments (Vermeire, Hearnshaw, Van Royen, & Denekens, 2001).
In nonprofessionals, research results have indicated that high levels of empathy are associated with
enhanced personal relationships (Long, Angera, Carter, Nakamoto, & Kalso, 1999) and
prosocial behavior (Telle & Pfister, 2012).
(What were the methods used to train empathy?)
Not applicable - a meta-analysis
From lit review: Empathy training programs employ a number of methods. In a review, Lam et al. (2011) found that the most common methods included experiential training (instructors provide “experiences” such as games and role-play), didactic (lecture based), skills training (lectures, demonstrations and practice), and mixed methods. Many of these correspond to methods found in behavioral skills training, which includes modeling, instructions, rehearsal, and feedback (Mittenberger, 2015). For the present meta-analysis, we divided training methods into those that included all four components of behavioral skills training and those that did not include all four components.
From lit review: There is currently no consensus regarding the optimum length of time for an empathy training course or whether differences in duration or intervals impact training outcomes. Some reviews of interpersonal skills training, including empathy training, have suggested a training length of 1–3 days (Berkhof, van Rijssen, Schellart, Anema, & van der Beek, 2011), and others, such as Butters (2010), failed to find an association between training time and effect size, concluding that as little as 1 hr may be effective.
(Who participated in this study / training?)
N/A
(About the assessment: How was the change in empathy measured before/after the intervention/method?)
Meta-analysis of 18 studies
Result:
(What was the result?) Among results, these seem relevant to project:
Use of behavioral skills training principles. Empathy training studies involving all four components of behavioral skills training (instruction, modeling, practice, and feedback) had higher, but not significantly higher, effect sizes than other studies. The trend found is consistent with the meta-analytic conclusion of Hill and Lent (2006) that helping-skills training programs using multiple behavioral skills training methods produce significantly higher effect sizes than programs that do not.
Type of empathy trained. Studies that targeted cognitive and behavioral, or cognitive, affective, and behavioral, empathy showed higher, but not significantly higher, effect sizes than studies targeting cognitive and affective empathy. It could be that behavioral training provides a valuable aspect to training. Interestingly, all included studies targeted at least cognitive empathy. This may be because cognitive empathy is considered to involve processes that can be consciously acquired, whereas affective empathy is considered to be more autonomic, and behavioral empathy is considered to occur in response to the affective or cognitive empathy process (Batt-Rawden et al., 2013; Elliott, Bohart, Watson, & Greenberg, 2011; Jolliffe & Farrington, 2004).
Training length. The metaregression found no significant evidence that number of training hours was associated with effect size. It is possible that these results are a consequence of population differences rather than the unimportance of training dose. This analysis involved populations ranging from children with disabilities to physicians, and it is possible that the time needed to produce empathy changes in each group varies. For example, Berkhof et al. (2011) have suggested that between 1 and 3 days of training is effective for physicians, while Gresham, Sugai, and Horner (2001) have suggested that over 30 hr of training is insufficient for children with disabilities. Thus, although the current results suggest that the amount of training has no effect on outcome, the nonsignificant result should be interpreted with caution.
Posted By:
Dorothy Della Noce
Notes:
(Any other relevant information)
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