Empathy and Mental Health Empathy and Mental Health shows mental health professionals how to employ a deeper understanding of subjective, objective, and interpersonal modalities of empathy in their practice. C hapters are full of case studies and examples that demonstrate em- pathy’s role in challenging and complex encounters, and as each concept and process is introduced, Dr. Clark discusses strategies for responding empathically. T e book has a sound theoretical grounding that is informed by extensive material on empathy and empathic understanding from the counseling and psychotherapy literature and related f elds of inquiry. Drawing from psychodynamic, existential-humanistic, cognitive be- havioral, and other contemporary orientations, this text makes empathy immediately useful and understandable to students and practitioners. Arthur J. Clark, EdD, is an emeritus professor at St. Lawrence University. He is the author of f ve books and over 50 articles and book chapters in the mental health f eld. Empathy and Mental Health An Integral Model for Developing T erapeutic Skills in Counseling and Psychotherapy Arthur J. Clark Cover image: © Getty Images First published 2023 by Routledge 605 T ird Avenue, New York, NY 10158 and by Routledge 4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN Routledge is an imprint of the Taylor & Francis Group, an informa business © 2023 Arthur J. Clark T e right of Arthur J. Clark to be identif ed as authors of this work has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereaf er invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice : Product or corporate names may be trademarks or registered trademarks, and are used only for identif cation and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Names: Clark, Arthur J., author. Title: Empathy and mental health : an integral model for developing therapeutic skills in counseling and psychotherapy / Arthur J. Clark. Description: New York, NY : Routledge, 2022. | Includes bibliographical references and index. Identif ers: LCCN 2022000484 (print) | LCCN 2022000485 (ebook) | ISBN 9780367764388 (hardback) | ISBN 9780367764371 (paperback) | ISBN 9781003168355 (ebook) Subjects: LCSH: Counseling—Methodology. | Psychotherapy— Methodology. | Empathy. Classif cation: LCC BF636.6 .C548 2022 (print) | LCC BF636.6 (ebook) | DDC 158.3—dc23/eng/20220307 LC record available at https://lccn.loc.gov/2022000484 LC ebook record available at https://lccn.loc.gov/2022000485 ISBN: 978-0-367-76438-8 (hbk) ISBN: 978-0-367-76437-1 (pbk) ISBN: 978-1-003-16835-5 (ebk) DOI: 10.4324/9781003168355 Typeset in Minion Pro by Apex CoVantage, LLC I dedicate this book to my wife, Marybeth. Empathy resides in your loving way of being. 0 CChapter 0 Contents About the Author xi Preface xii Chapter 1 T e Promise, Challenges, and Potential of Empathy in Counseling and Psychotherapy 1 T e Promise of Empathy in Counseling and Psychotherapy 4 Empathy and the T erapeutic Relationship 4 Empathy and Client Understanding 7 Empathy and Treatment Outcomes 9 T e Challenges of Empathy in Counseling and Psychotherapy 10 Def nitions of Empathy 11 E mpathy and Semantics 12 T erapeutic Scope and Empathy 1 4 T e Potential of Empathy in Counseling and Psychotherapy 14 I ntegral Model of Empathy 15 Integral Def nition of Empathy 16 E mpathic Use of Self 16 Further T oughts on Empathy in Counseling and Psychotherapy 17 Chapter 2 Subjective Empathy in Counseling and Psychotherapy 18 Subjective Empathy and the Experience of a Practitioner 18 Subjective Empathy in an Integral Model 1 9 Identif cation 20 Imagination 23 Intuition 27 vii viii Contents Embodiment 30 Further T oughts on Subjective Empathy in Counseling and Psychotherapy 33 Chapter 3 Objective Empathy in Counseling and Psychotherapy 34 Objective Empathy and the Experience of a Practitioner 34 O bjective Empathy in an Integral Model 3 6 D iagnostic Systems and Empathy 36 M ulticultural Perspectives and Empathy 3 9 T eories and Constructs in Counseling and Psychotherapy and Empathy 43 Dream T eories and Empathy 47 C ountertransference and Empathy 50 R esponse to T reat and Empathy 51 I ndividual Assessment and Empathy 54 Further T oughts on Objective Empathy in Counseling and Psychotherapy 57 Chapter 4 Interpersonal Empathy in Counseling and Psychotherapy 58 I nterpersonal Empathy and the Experience of a Practitioner 59 Interpersonal Empathy in an Integral Model 60 Strategic Skills in Counseling and Psychotherapy 60 Methodological Conceptions 61 Immediate and Extended Perspectives of a Client and Empathy 61 C ontent and Process and Empathy 6 3 Schema T eory and Empathy 65 First-Order Change, Second-Order Change, and Empathy 67 M ulticultural Dimensions and Empathy 71 E mpathy and Sympathy Distinctions 72 S tages of Counseling and Psychotherapy and Empathy 75 Practice Formulations 77 R esponse to T reat and Empathy 77 C ountertransference and Empathy 79 A lliance Ruptures and Empathy 81 D ream Work and Empathy 83 N onverbal Communication and Empathy 84 P ractitioner Distress, Trauma, and Empathy 85 I ndividual Assessment and Empathy 88 Contents ix Stage Skills in Counseling and Psychotherapy 95 Relationship Stage and Relational Skills 96 Ref ection of Feelings 96 Ref ection of Meaning 97 Encouragement 98 Immediacy 99 Questions 100 Silence 101 Self-Disclosure 102 I ntegration Stage and Integrative Skills 104 C onfrontation 104 Reframing 105 Cognitive Restructuring 106 Interpretation 108 A ccomplishment Stage and Accomplishable Skills 109 B reaking It Down 109 Catching Oneself 111 Acting As If 112 Further T oughts on Interpersonal Empathy in Counseling and Psychotherapy 113 Chapter 5 Integral Model of Empathy in Counseling and Psychotherapy: A Case Study 114 Relationship Stage 114 Integration Stage 125 Accomplishment Stage 129 Concluding T oughts on a Case Study in Counseling and Psychotherapy 133 Chapter 6 Empathy: Integral Model in Research, Training, and Practice 134 Historical Perspectives on Developing Empathy 135 Early T eorists in Empathy Training 135 Contemporary Initiatives in Empathy Training 137 Integral Model of Empathy in Research, Training, and Practice 140 Integral Model of Empathy 142 Stage Skills 143 S trategic Skills 145 Integral Model of Empathy and Student, Supervisee, and Practitioner Development 148 Empathy and Student Development 149