Research Synthesis With Meta-Analysis of Empathy Training Studies in Helping Professions

Purpose: Social work has identified empathy as an important relationship variable associated with positive client outcomes, but there is disagreement regarding what empathy is and if it can be taught.  Over the past 50 years, hundreds of empathy training studies have been conducted in social work and other helping professions, but the results have varied widely.  Research synthesis and meta-analysis of this large body of research were implemented to determine if training can increase empathy in helping professionals and to identify variables that influence training outcomes.  Studies conducted with adult professionals or students were included from helping professions with relevance for social work education that viewed empathy as an essential relationship variable associated with positive client outcomes.  The included studies came from social work, counseling, education, medicine, nursing, psychology, and rehabilitation counseling. 

Method: A narrative review of the literature identified variables that were thought to be associated with the variation in findings in empathy training studies.  These included trainee characteristics, the operationalization of empathy, methodological issues, and training approach.  Eight research questions were developed to explore the impact of publication bias and each of these variables on study outcome.  A comprehensive search protocol and predetermined inclusion criteria were established.  A coding scheme was developed with high levels of intercoder and intracoder agreement.  The search protocol was implemented and a PRISMA diagram documents exclusions at each level of coding.  A random effects model was implemented and a series of subgroup, moderator, and sensitivity analyses were implemented to address each research question. 

Results: Eighty of the 94 studies in the research synthesis provided data for inclusion in the meta-analysis.  A large overall effect of 0.999 was found (p=0.000, n=76) with significant heterogeneity (Q =972.06, p=0.000, I²=91.400).  Included studies dated from 1966 to 2010, and evidence of publication bias was found.  Subgroup and moderator analysis indicated that the field from which the study came, the empathy construct under study, the type of rater used to assess empathy, the measure that was administered, and the training approach that was implemented were significantly related to outcome.  In the analysis of outcome by field, the effect for social work was large at 1.073 (p=0.012).  Didactic with experiential training also produced a large effect (1.933, p=0.011).  Larger effects were found when empathy was conceptualized and measured behaviorally or cognitively.  Empathy construct, type of rater, and empathy measure appeared to be related to each other as well as to outcome. 

Implications: Further analysis of moderators is needed to inform the inclusion of empathy training in social work curricula.  However, this study provides evidence that didactic and experiential training, methods consistent with current social work education, can increase the empathic ability of social work students.