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I know how you feel - I think.

The attempts of a psychotherapist to experience a patient's feelings and perspective can contribute invaluably to successful therapy. But according to University of Cincinnati researchers, a therapist's opinion of his or her ability to "empathize" with a patient may differ from the opinion of the patient or a clinical supervisor. And the patient's perception of empathy, they say, best predicts how much the patient will improve.

Psychiatrist Noel K. Free and his colleagues followed 59 individuals who received up to 12 weekly sessions of "psychodynamic" psychotherapy in an outpatient clinic. In this approach, therapists concentrate on a patient's current problems and how they relate to past experiences and to the patient-therapist relationship. The 13 therapists in the study were psychiatric residents who regularly discussed cases with two experienced supervisors.

Three outcome measures were obtained at the beginning and end of therapy: The patients filled out a checklist of psychological symptoms, and therapists specified major symptoms based on patients' chief complaints and rated patients on a scale of psychological functioning. After the third and sixth sessions, therapist empathy was rated by patients, therapists and supervisors. Each group was asked, among a number of related questions, whether the therapist appreciated what the patient's experiences meant to him or her.

There was no signficant agreement among patients, therapists and supervisors on therapist empathy, report the investigators in the August AMERICAN JOURNAL OF PSYCHIATRY. Patients who felt their theapist was more empathic reported a significant reduction of hostility on the checklist at the end of therapy; these patients also had markedly better interpersonal relationships, according to their therapists. But empathy ratings by therapists and supervisors were not associated with any measures of patient improvement.

If appears, say the researchers, tha a patient's positive perception of therapist empathy is vital for progress to be made. They were "a litle humbled" that the empathy ratings of experienced clinical superivosrs wree not related to patient improvement. Supervisors may have been swayed, say Free and coworkers, by residents who were able to relate most comfortably to them during clinical presentations.

The investigators suggest that patients' perceptions of therapist empathy might best be plumbed by using audio- or videotapes of sessions to supplement presentations and clinical notes.
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Title Annotation:research on psychotherapist empathy with patients
Publication:Science News
Date:Aug 24, 1985
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