Learning Clinical and Cultural Empathy: A Call for a Multidimensional Approach to Empathy-Focused Psychotherapy Training

Although empathy is the one of the factors most strongly associated with good psychotherapy outcome, there is little research on how therapists become empathic. To better understand how empathy is developed, a critical-constructivist grounded theory analysis was conducted to examine novice therapists’ process of learning to be empathic. In addition, this study explored the relationship between clinical and cultural empathy. Findings revealed that cultural empathy is experienced by contemporary trainees as an inherent and necessary aspect of clinical empathy. Therapists’ clinical empathy served three crucial functions: (1) expanding their imaginative capacity so they could genuinely understand their clients, (2) sharing emotional experiences, which forges an sense of therapists' ethical obligation and promotes clients' trust, and (3) acting as a mechanism of change by directing clients' introspection strategically, leading to insight. Interviewees relayed that training broadened their capacity to engage these functions effectively across diverse clients and to overcome obstacles to accessing and expressing empathy effectively. Despite this, the students did not report receiving formal training related to empathy. The discussion considers the role of empathy training in terms of an ethics of care for diverse clients and recommends content to support the adequate and multidimensional training of this, this powerful common factor.