The DOI matches its Crossref record; 117 of the 118 references it cites were found in a registry or an index; none of the 7 sources its claims cite is checked for support yet.
Therapist empathy and client outcome: An updated meta-analysis.
Open accessAbstract
Put simply, empathy refers to understanding what another person is experiencing or trying to express. Therapist empathy has a long history as a hypothesized key change process in psychotherapy. We begin by discussing definitional issues and presenting an integrative definition. We then review measures of therapist empathy, including the conceptual problem of separating empathy from other relationship variables. We follow this with clinical examples illustrating different forms of therapist empathy and empathic response modes. The core of our review is a meta-analysis of research on the relation between therapist empathy and client outcome. Results indicated that empathy is a moderately strong predictor of therapy outcome: mean weighted r = .28 (p < .001; 95% confidence interval [.23, .33]; equivalent of d = .58) for 82 independent samples and 6,138 clients. In general, the empathy-outcome relation held for different theoretical orientations and client presenting problems; however, there was considerable heterogeneity in the effects. Client, observer, and therapist perception measures predicted client outcome better than empathic accuracy measures. We then consider the limitations of the current data. We conclude with diversity considerations and practice recommendations, including endorsing the different forms that empathy may take in therapy. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
38 Own result · 11 Own method · 7 Not checked yet · 6 Own interpretation · 3 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The correlation between standard error of r and effect size was .06,indicating an absence of bias deriving from smaller studies with less precise effects producing larger effects.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Overall Empathy-Outcome Association
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“having a smaller sample of clients (-.24)”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although the overall between-groups effect was statistically significant (Q = 70.15,df = 4, 76; p < .01)”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Smaller effects were found for mild/normal/physical problems (.17; k = 6)”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We found significant heterogeneity in the empathy-outcome association, pointing to the value of personalization and clinical judgment.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was some evidence that empathy-outcome association was stronger for clients in outpatient settings.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The largest empathy-outcome association was for severe/chronic incarcerated populations (.32; k = 15 studies)”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“slightly better than observer rated measures (.21; n = 102)”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
plaincorrelationaln = 102 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“client measures predicted outcome the best (mean weighted r = .27;k = 117 effects)”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“with their mean effect statistically smaller than effects for each of the other three measures (p < .05).”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
plainn = 34 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 12
- It may state two separate claims as one. 18
- The quote only partly states this claim. 1
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cochrane's Q 1039.2*348.68*I 2 72.2% 76.8% Fail safe number 13 33 * p < .001”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cochrane's Q 1039.2*348.68*I 2 72.2% 76.8% Fail safe number 13 33 * p < .001”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“each of these mean effects was significantly greater than zero (p < .001)but did not differ significantly from each other.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We found that the empathy-outcome association held up across a wide range of variables, both substantive (client presenting problem/severity, therapy format, theoretical orientation) and methodological (year of publication, level/size of unit at which empathy was measured).”
- Also stated in: § Abstract · hedged
“In general, the empathy-outcome relation held for different theoretical orientations and client presenting problems; however, there was considerable heterogeneity in the effects.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
plaincorrelationaln = 82 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Abstract · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We found a”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“average effects were somewhat smaller, at .21 (95% CI: .18-.24; equivalent to d = .43).”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Overall Empathy-Outcome Association
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cochrane's Q 1039.2*348.68*I 2 72.2% 76.8% Fail safe number 13 33 * p < .001”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This repeated finding, in more than 80 studies and now in multiple meta-analyses, leads to the following clinical recommendations:”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There is no evidence that therapists accurately predicting clients' own views of their problems or experiences or self-perceptions is effective.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This value was 33 studies for the study level effect of .28; the comparable number for effect level effects was only 12.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Overall Empathy-Outcome Association
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cochrane's Q 1039.2*348.68*I 2 72.2% 76.8% Fail safe number 13 33 * p < .001”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cochrane's Q 1039.2*348.68*I 2 72.2% 76.8% Fail safe number 13 33 * p < .001”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cochrane's Q 1039.2*348.68*I 2 72.2% 76.8% Fail safe number 13 33 * p < .001”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Using global outcome variables like client satisfaction resulted in larger associations between therapist empathy and outcome, possibly because of confounding between client perceptions of empathy and client ratings of post-therapy satisfaction.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As we have shown, empathy is a robust medium-sized predictor of client outcome in psychotherapy that holds across theoretical orientations, treatment formats, and client problems.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Any one of these conditions without the others would provide a distinctly different interpersonal climate and relationship.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“In fact, these and other problems are not restricted to empathy research but are common to all process-outcome research (Elliott, 2010).”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Therapist Mediators
What the sources say
- Not checked yetcites Elliott, 2010
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Overall, empathy typically accounts for more outcome variance than do specific treatment methods (compare Wampold's, 2015, estimate of d = .2for intervention effects).”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Overall Empathy-Outcome Association
What the sources say
- Not checked yetcites Wampold's, 2015
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Empathy will probably not prove effective unless it is grounded in authentic caring for the client.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The abstracts of the potential sources were screened by the four co-authors, with a sample of 200 studies to assess reliability (kappa = .61).”
- Also stated in: § Screening and Analyses · plain
“which were each evaluated by two of the co-authors (kappa = .45),with all disagreements resolved by discussion to consensus”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Screening and Analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Also stated in: § Screening and Analyses · plain
In the paper
“These 24 studies were added to 58 studies that were carried over from our prior metaanalysis (Elliott et al., 2011), resulting in a total of 82 samples of clients (from 80 separate studies), aggregated from 290 separate tests of the empathy-outcome association and encompassing a total of 6138 clients, who were seen for an average of 25 sessions.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Screening and Analyses
What the sources say
- Not checked yetcites Elliott et al., 2011
plainn = 82- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“study-level analyses used averaged individual effects within client samples before further analysis, thus avoiding problems of nonindependence and eliminating bias due to variable numbers of effects reported in different studies (Lipsey & Wilson, 2001).”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Screening and Analyses
What the sources say
- Not checked yetcites Lipsey & Wilson, 2001
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the funnel plot is quite symmetrical, making it unlikely that the overall effect would be shifted negatively if a larger number of more powerful studies were to be published.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Overall Empathy-Outcome Association
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“These include: (a) the questionable validity of some outcome measures (e.g., 15% of the studies included here used client-rated benefit or satisfaction with value of helpfulness of therapy as their main outcome measure); (b) restricted range of predictor and criterion variables; (c) confounding among many study characteristics (e.g., type of empathy and outcome variable, timing of empathy and outc”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Therapist Mediators
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“the 2011 meta-analysis was conducted on 57 studies (224 effects) and encompassed a total of 3,599 clients.The average weighted correlation between empathy and outcome was an r of .31.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Results of Previous Reviews
What the sources say
- Not checked yetcites Elliott, Bohart, Watson & Greenberg, 2011
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“(1) Precedence: The hypothesized causal variable must reliably precede the effect variable. Mixed: Not satisfied in all studies, but overall statistically significant (although smaller) effects are found when the precedence condition was satisfied.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We decided in this meta-analysis to apply a content validity criterion by including only studies in which the”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Confounding Between Empathy and Other Relationship Variables
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“This empathic engagement predicts better client outcomes [22]; however, leaves MHWs at increased risk of EBS [19, 23].”
From Interventions to address empathy-based stress in mental health workers: A scoping review and research agenda (2024) · cites this paper as [22]
The cited source says what the claim attributes to it.
In the citing paper
“People accessing mental health services have been found to have better outcomes if they experience compassionate [1] and empathic [2] relationships with staff caring for them.”
From Interventions to address empathy-based stress in mental health workers: A scoping review and research agenda (2024) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“In fact, therapist empathy and alliance have been found to be robust predictors of therapy success across multiple studies of different therapies and clinical populations (Elliott et al., 2018;Flückiger et al., 2018;Martin et al., 2000).”
From A mixed methods study of autistic adults' mental health therapy experiences (2023) · cites this paper as Elliott et al., 2018
In the citing paper
“On the common factors side, widely studied factors shown to correlate with outcomes include therapeutic alliance52, goal consensus and collaboration between therapist and patient66, and therapist empathy67.”
From A common factors perspective on mindfulness-based interventions (2022) · cites this paper as [67]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Overall Empathy-Outcome Association
“the comparable number for effect level effects was only 12.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
“Fail safe number 13 33”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Moderators and Mediators Meta-Analytic Moderator Analyses
“We did, however, replicate the significant differences we previously found among the empathy measurement perspectives, using effect level analyses (Table 3; between-groups Q, p < .001).”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
“Table 3 Causal Inference Conditions for Process-Outcome Correlational Research”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Screening and Analyses
“resulting in a total of 82 samples of clients (from 80 separate studies)”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
“Table 1 PRISMA Information for Empathy-Outcome Meta-analysis Stage Studies included Studies excluded Notes 1. Search Result: 2,222 Date of search: 3 March 2017 2. Abstract screening stage: Possible Empathy => Outcome studies 148 2,074 Not empathy => outcome studies 3. Screening for duplicates 133 15 Including 14 from Elliott et al., 2011 4. Full text retrieval 99 34 Unable to retrieve full text 5. Full text review & analysis, plus studies carried over from Elliott et al., 2011 24 + 58 = 82”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Overall Empathy-Outcome Association
“a study-level Cochrane's Q of 348.68 (p < .001)and a large I 2 of 72%.”
§ Therapist Empathy and Client Outcome: An Updated Meta-analysis > Diversity Considerations
“Cochrane's Q 1039.2*348.68*I 2 72.2% 76.8%”
Citations
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
(1979) · Medical Entomology and Zoology · Cited by 11,252
(2000) · Cited by 9,198
The necessary and sufficient conditions of therapeutic personality change.
Rogers, C. R. (1957) · Journal of Consulting Psychology · doi:10.1037/h0045357 · Cited by 5,599
Development and validation of the working alliance inventory
Horvath, A. O., & Greenberg, L. S. (1989) · Journal of Counseling Psychology · doi:10.1037//0022-0167.36.2.223 · Cited by 3,520
The social neuroscience of empathy
Singer, T., & Lamm, C. (2009) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2009.04418.x · Cited by 1,981
How important are the common factors in psychotherapy? An update
Wampold, B. E. (2015) · World Psychiatry · doi:10.1002/wps.20238 · Cited by 1,728
Rogers, C. R. (1967) · Medical Entomology and Zoology · Cited by 1,640
growth of interpersonal understanding
Selman, R. L. (1980) · Cited by 1,236
Psychotherapy relationships that work : therapist contributions and responsiveness to patients
Norcross, J. C. (2002) · Cited by 1,197
Research works printed but not linked: 26
- Barrington, B. L. (1967). The differential effectiveness of therapy as measured by the Thematic Apperception Test. In C. R. Rogers et al. (Eds.), The therapeutic relationship and its impact (pp. 337-352). Madison: University of Wisconsin Press. . [combined with Kiesler, Mathieu, Klein & Schoeninger, 1967, and Van der Veen, 1967]
- Beutler, L. E., Crago, M., & Arizmendi, T. G. (1986). Research on therapist variables in psychotherapy. In S. L. Garfield & A. E. Bergin (Eds.), Handbook of psychotherapy and behavior change (3 rd ed., pp. 257-310). New York: Wiley.
- Beutler, L. E., Johnson, D. T., Neville, C. W., & Workman, S. N. (1972). "Accurate empathy" and the AB dichotomy. Journal of Consulting and Clinical Psychology, 38, 372-375.
- Gurman, A.S. (1977). The patient's perception of the therapeutic relationship. In A.S.Gurman & A.M. Razin (Eds.), Effective Psychotherapy: A handbook of research (pp. 503-543). New York: Pergamon.
- Hamilton, J. C. (2000). Construct validity of the core conditions and factor structure of the Client Evaluation of Counselor Scale. The Person-Centered Journal, 7, 40-51.
- Hansen, J. C., Moore, G. D., & Carkhuff, R. R. (1968). The differential relationships of objective and client perceptions of counseling. Journal of Clinical Psychology, 24, 244-246.
- Ickes, W. (Ed.). (1997). Empathic accuracy. New York: Guilford.
- Johnson, S.M., Bradley, B., Furrow, J., Lee, A., Palmer, G., Tilley, D.G., & Woolley, S.R. (2005). Emotionally Focused Marital Therapy Workbook. New York: Brunner Routledge.
- Kiesler, D. J., Klein, M. H., Mathieu, P. L., & Schoeninger, D. (1967). Constructive personality change for therapy and control patients. In C. R. Rogers et al. (Eds.), The therapeutic relationship and its impact (pp. 251-294), Madison: University of Wisconsin Press. (Combined with Barrington, 1967, and Van Der Veen, 1967) *
- Lerner, B. (1972). Therapy in the ghetto. Baltimore: Johns Hopkins University Press.
- Martin, D. G. (2000). Counseling and therapy skills (2 nd ed.). Prospect Heights, Illinois: Waveland Press.
- Melnick, B., & Pierce, R. M. (1971). Client evaluation of therapist strength and positive- negative evaluation as related to client dynamics, objective ratings of competence and outcome. Journal of Clinical Psychology, 27, 408-410.
- Muller, J., & Abeles, N. (1971). Relationship of liking, empathy and therapists' experience to outcome in psychotherapy. Journal of Counseling Psychology, 18, 39-43.
- Orlinsky, D. E., Grawe, K., & Parks, B. K. (1994). Process and outcome in psychotherapy-noch einmal. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4 th ed., pp. 270-378). New York: Wiley.
- Orlinsky, D.E., Rønnestad, M.H., & Willutzki, U. (2003). Process and Outcome in Psychotherapy. In M.J. Lambert (Ed.), Bergin and Garfield's Handbook of Psychotherapy and Behavior Change (5th ed) (pp. 307-389). New York: Wiley.
- Parloff, M. B., Waskow, I. E., & Wolfe, B. E. (1978). Research on therapist variables in relation to process and outcome. In Garfield, S. L., & Bergin, A. E. (Eds.), Handbook of psychotherapy and behavior change (2 nd ed., pp. 233-282). New York: Wiley.
- Peake, T. H. (1979). Therapist-patient agreement and outcome in group therapy. Journal of Clinical Psychology, 35U, 637-646.
- Sachse, R. (1990b). The influence of therapist processing proposals on the explication process of the client. Person-Centered Review, 5, 321-344.
- Shlien, J. (1997). Empathy in psychotherapy: A vital mechanism? Yes. Therapist's conceit? All too often. In A. C. Bohart & L. S. Greenberg (Eds.), Empathy reconsidered: New directions in psychotherapy (pp. 63-80). Washington, DC: American Psychological Association.
- Strupp, H. H., Fox, R. E., & Lessler, K. (1969). Patients view their psychotherapy. Baltimore: Johns Hopkins Press.
- Truax, C.B. (1966). Therapist empathy, warmth, and genuineness and patient personality change in group psychotherapy: A comparison between interaction unit measures, time sample measures, and patient perception measures. Journal of Clinical Psychology, 22, 225-229.
- Truax, C.B., Carkhuff, R. R., & Kodman, F., Jr. (1965). Relationships between therapist- offered conditions and patient change in group psychotherapy. Journal of Clinical Psychology, 21, 327-329.
- Truax, C. B., & Mitchell, K. M. (1971). Research on certain therapist interpersonal skills in relation to process and outcome. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (1 st ed., pp. 299-344). New York: Wiley.
- Truax, C. B., & Wittmer, J. (1971). The effects of therapist focus on patient anxiety source and the interaction with therapist level of accurate empathy. Journal of Clinical Psychology, 27, 297-299.
- Truax, C. B., Wittmer, J., & Wargo, D. G. (1971). Effects of the therapeutic conditions of accurate empathy, nonpossessive warmth, and genuineness on hospitalized mental patients during group therapy. Journal of Clinical Psychology, 27, 137-142.
- Watson, J.C., & Prosser, M. (2002). Development of an observer rated measure of therapist empathy. In J. C. Watson, R. Goldman, & M Warner (Eds.), Client-centered and experiential psychotherapy in the 21st century: Advances in theory, research and practice (pp.303-314). Ross on Wye: PCCS Books.
Cited by
Sorted by citations
Sharma, A., Lin, I. W., Miner, A. S., Atkins, D. C., & Althoff, T. (2023) · Nature Machine Intelligence · doi:10.1038/s42256-022-00593-2 · Cited by 500
A Computational Approach to Understanding Empathy Expressed in Text-Based Mental Health Support
Sharma, A., Miner, A., Atkins, D., & Althoff, T. (2020) · Proceedings of the 2020 Conference on Empirical Methods in Natural Language Processing (EMNLP) · doi:10.18653/v1/2020.emnlp-main.425 · Cited by 268
Murphy, B. A., & Lilienfeld, S. O. (2019) · Psychological Assessment · doi:10.1037/pas0000732 · Cited by 247
Aldrup, K., Carstensen, B., & Klusmann, U. (2022) · Educational Psychology Review · doi:10.1007/s10648-021-09649-y · Cited by 373
The now and future of ChatGPT and GPT in psychiatry
Cheng, S., Chang, C., Chang, W., Wang, H., Liang, C., Kishimoto, T., Chang, J. P., Kuo, J. S., & Su, K. (2023) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.13588 · Cited by 216
Metadata
- Authors
- Elliott, R., Bohart, A. C., Watson, J. C., & Murphy, D.
- Affiliations
- University of Nottingham (GB)
- Corresponding author
- Elliott, Robert
- Venue
- Psychotherapy
- Published
- 2018-12
- Volume
- 55
- Issue
- 4
- Pages
- 399-410
- ISSN
- 0033-3204 (ISSN-L)
- 1939-1536
- OpenAlex
- W2897362601
- Semantic Scholar
- f8cb722ce1760eb9a601849b1586d8f6fccac372
- Cited by
- 495
- References
- 118
- Citations by year
- 2026: 97 · 2025: 86 · 2024: 58 · 2023: 85 · 2022: 65 · 2021: 53 · 2020: 31 · 2019: 17 · 2018: 2
- FWCI
- 30.26
- Type
- journal article
- Language
- en
- Open access
- Locations
- Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Nottingham ePrints (University of Nottingham) (acceptedVersion)
- Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (submittedVersion)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Social Sciences › Psychology › Clinical Psychology › Counseling Practices and Supervision
- Keywords
- therapist empathy, client outcomes, psychotherapy outcome, empathic accuracy, consumer perception, viewer perception, therapist perspectives, theoretical orientation
- MeSH terms
- Attitude of Health Personnel, Mental Disorders, Empathy, Humans, Professional-Patient Relations, Psychotherapy, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
