Conceptualizing Empathy in Cognitive Behaviour Therapy: Making the Implicit Explicit

Abstract

Although empathy has been shown to play an important role in therapeutic outcomes for cognitive-behaviour therapy (CBT) as for other therapies, there has been remarkably little discussion or research on empathy in the CBT literature. This paper seeks to make the implicit explicit: to conceptualize the nature and function of therapeutic empathy within CBT. It proposes a model of therapeutic empathy with four key elements: Empathic attunement, Empathic attitude/stance, Empathic communication, and Empathy knowledge. The model points to the importance of the “person of the therapist” and self-reflection in the development of therapeutic empathy; and describes how the specific contribution of CBT knowledge and skills can help therapists understand clients' moment-to-moment experiences and, if used sensitively, can enhance the empathic process. The paper indicates how therapists may use different modes of empathic processing to process experience under different circumstances, and how empathy fulfils a variety of functions within CBT. This conceptualization has considerable implications for therapists, trainers, supervisors and researchers including: more accurate identification and targeted strategies to address therapeutic empathy problems; recognition of the value of personal experiential work and self-reflection in empathy training; increased understanding of the functions of empathy; and development of finer-grained clinical and research measures.