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Relation to Research

  • Rogers (1975) formulation and Barret-Lennard’s (1981) cyclical model.
  • Empathic emotions/affective empathy previously identified and empirically supported
  • Absence of "cognitive empathy" as a theme

Implications

  • Metaphors: helpful strategy to empathize with E.P. clients?
  • Medication compliance: empathy a cornerstone?
  • Counsellor education:
  • Empathy is a holistic process (goes beyond verbal responses rated on a scale)
  • Cultivation of empathic aura qualities?
  • Non-verbal communication training essential

Delimitations & Limitations

  • Qualitative design a delimitation: exploratory, not explanatory
  • Small sample size
  • Possible researcher bias

Further Research

  • Relational Cycle model
  • Medication compliance
  • Cognitive empathy & psychosis
  • Metaphors & treatment

Therapist

"Relational Cycle"

Model of Empathy

Empathy

Client

Method

How do clients experiencing early psychosis perceive empathy in the therapeutic encounter?

Carl Rogers, 1975

Partnership with a Lower Mainland Early Psychosis Intervention program

Qualitative Design: Thematic Analysis (Braun & Clarke, 2006)

Analysis & Discussion

Semi-structured interviews: 2 participants

Perceptions of

Empathy

in Early Psychosis

A Qualitative Analysis

David Lindskoog, MA

Results

Empathy Themes

Contextual Analysis Themes

Empathic Actions

Empathic Aura

Empathic Emotions

Perceptions of Treatment

Understanding Psychosis Metaphorically

"That's how I kind of sense [empathy]... their way, their talking, where's their focus... um, are they putting in an effort."

Non-Verbal Empathy

"It's just... her essential being. It's like, you could tell that's what she was meant to be doing: helping people."

A Cog in the Medical Machine

"I can't exactly pinpoint what she had... she had that nurturing, sort of caring sphere about her."

Too Many Clients, Not

Enough Resources

"It's a difficult thing to describe. Kind of like... very subtle facial features. I mean... the same way you can tell if somebody's fake laughing."

Two Worlds Metaphor

Blindness & Colour

Metaphor

"I'm sensing a desire that they want to feel what I'm feeling…. [To get] as close to experiencing the stuff that's going on in my head as they can possibly get."

"You could tell that she was genuinely, very interested in what I'm saying, like very intent and very focused, almost leaning in fact, in front of her chair as I'm talking."

"It felt basically like it was a computer…. Basically I could type in everything, and pills would spit out.... If this is what it's going to be like, where there's no empathy, then I may as well just type it into a computer, and I could diagnose myself."

"I'm just another person in this machine. I understand building relationships takes time, takes energy. I understand that we don't have infinite resources to put somebody in a chair that's well-rested and genuinely cares about what [clients] say."

"There's no feeling or emotion that I can relate [psychosis] to. It's kind of like a blind person that's never seen the colour blue… you can't explain that colour to the person."

Everything in my world seemed like a dream.... This entity was showing me a world that was the real world - I started believing in [the entity’s] world more than [the real] world.

"Empathy is something that you can feel for someone, but you don't do it. You feel empathy for lots of things... but you never really act on it…. As soon as you start acting on it, then that means that it changed to caring."

"Just the way she talked, like her aura about her - like, she seemed really caring, rather than... like a nuisance."

Non-Empathic Therapist Qualities

"Out of everything, [empathy]'s probably the very top of the list. It's like asking a question – you don't know what to ask unless you know what problem you're facing."

Disagreements Regarding Treatment

Lack of Passion

“It’s their job, like not so much their passion...”

“This was not right for me... they weren't really listening to that.”

"I'd be able to open up more, I would have more credibility for what they're telling me."

Making Assumptions

“you know, your problems aren't really that severe…”

Empathic Aura

197 Codes

2 Participants

6 Themes

Empathic Emotions

?

"

Perhaps, if we wish to become better therapists, we should let our clients tell us whether we are understanding them accurately!

Narrative Report

Themes

Coding

Transcription

Emotions

Empathic Actions

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