“Empathy is a specifiable and learnable skill for understanding
another’s meaning through the use of reflective listening…It requires sharp attention to each new client statement,
and the continual generation of hypotheses as to the underlying meaning”
and Rollnick, 1991)
An empathetic style:
Communicates respect for and acceptance of clients and their feelings
Encourages a nonjudgmental, collaborative relationship
Allows you to be a supportive and knowledgeable consultant
Sincerely compliments rather than denigrates
Listens rather than tells
Gently persuades, with the understanding that the decision to change is the client’s
Provides support throughout the recovery process
Empathetic motivational interviewing establishes
a safe and open environment that is conducive to examining issues and eliciting personal reasons and methods for change. Understanding each client’s unique perspective, feelings, and values is a fundamental
component of motivational interviewing. The therapist’s attitudes should
be of acceptance, not necessarily approval or agreement, understanding and recognizing that ambivalence about change is to
be expected. MI is most successful when a trusting relationship is established
between the therapist and the client.
Empathy “should not be confused with
the meaning of empathy as identification with the client or the sharing of common past experiences. In fact, a recent personal history of the same problem areas…may compromise a counselor’s ability
to provide the critical conditions of change (Miller and Rollnick, 1991). Reflective
listening is the key component to expressing empathy.
Miller and Rollnick state that if the therapist
is not listening reflectively but are instead imposing direction and judgment, they are creating barriers that impair the
therapeutic relationship. The client would most likely react by stopping, diverting,
or changing direction.
Twelve examples of such nonempathetic responses are identified:
Ordering or directing. Direction is given with a voice of authority. The speaker may be in a position of power (e.g., parent, employer) or the words may
simply be phrased and spoken in an authoritarian manner.
Warning or threatening. These messages are similar to ordering but they
carry an overt or covert threat of impending negative consequences if the advice or direction is not followed. The threat may be one the clinician will carry out or simply a prediction of a negative outcome if the
client doesn’t comply –for example, “If you don’t listen to me, you’ll be sorry.”
Giving advice, making suggestions, or providing solution prematurely or when unsolicited. The message recommends a course of action based on the clinician’s knowledge and personal experience. These recommendations often begin with phrases such as, “What I would do is…”
Persuading with logic, arguing, or lecturing. The underlying assumption
of these messages is that the client has not reasoned through the problem adequately and needs to help to do so.
Moralizing, preaching, or telling clients their duty. These statements
contain such words as “should” or “ought” to convey moral instructions.
Judging, criticizing, disagreeing, or blaming. These messages imply that
something is wrong with the client or with what the client has said. Even simple
disagreement may be interpreted as critical.
Agreeing, approving, or praising. Surprisingly, praise or approval also
can be an obstacle if the message sanctions or implies agreement with whatever the client has said. Unsolicited approval can interrupt the communication process and can imply an uneven relationship between
the speaker and the listener. Reflective listening does not require agreement.
Shaming, ridiculing, labeling, or name-calling. These messages express
overt disapproval and intent to correct a specific behavior or attitude.
Interpreting or analyzing. Clinicians are frequently and easily tempted
to impose their own interpretations on a client’s statement and to find some hidden, analytical meaning. Interpretive statements might imply that the clinician knows what the client’s real problem is.
Reassuring, sympathizing, or consoling. Clinicians often want to make
the client feel better by offering consolation. Such reassurance can interrupt
the flow of communication and interfere with careful listening.
Questioning or probing. Clinicians often mistake questioning for good
listening. Although the clinician may ask questions to learn more about the client,
the underlying message is that the clinician might find the right answer to all the client’s problems if enough questions
are asked. In fact, intensive questioning can interfere with the spontaneous
flow of communication and divert it in directions of interest to the clinician rather than the client.
Withdrawing, distracting, humoring, or changing that subject. Although
humor may represent an attempt to take the client’s mind off emotional subjects or threatening problems, it also can
be a distraction that diverts communication and implies that the client’s statements are unimportant.
Ethnic and cultural differences
must be considered when expressing empathy because they influence how both the clinician and the client interpret verbal and
In individual motivational interviewing, the therapist uses empathetic, reflective listening to convey understanding
and acceptance of the client (this appears to work to facilitate openness to change.
In structured group sessions, therapists use an empathetic style in interacting with group members, while still maintaining
control over the overall structure of the session. During sessions all group
members’ contributions were met with a reflective listening statement by the therapist and structured exercises are
designed to incorporate group members’ own words and ideas.