The qualities that make a good psychotherapist

You can study and get the best training, but it is unlikely that you are going to be a good psychotherapist unless you have the qualities that are outlined in an article in the current issue of Psychotherapy and Psychosomatics. In psychotherapy, clinician empathy is fundamental for guiding supporting behavior in response to the patient's emotional plight.

This study was developed to address clinicians' profiles of dispositional empathy. Clinicians with active practice were recruited through professional associations. Participants completed a multidimensional measure of empathy evaluating: perspective taking (PT) measures the capacity to understand the perspective of others; fantasy (FS) measures the tendency to identify with characters from fictional situations, akin to PT; empathic concern (EC) measures feelings of compassion toward persons in distress; and personal distress (PD) measures self-oriented feelings of distress when facing others' negative experiences.

Twenty-three percent of the respondents scored below average levels in most scales suggesting a self-absorbed and under-regulated subgroup of clinicians, labelled "insecure self-absorbed." Clinicians in this group likely perform rather poorly in both cognitive perspective-taking and in their emotional resonance with patients' concerns, perhaps focusing largely on their own negative emotional reactions to others' displays of distress. Twenty-six percent of the clinicians exhibited above-average levels compared to other profiles, suggesting a highly empathic group, labelled "empathic immersion." Clinicians in this group tend to become immersed in others' emotional experience and are oriented toward intuiting and identifying with the feelings of others. Average clinicians (38 percent) likely display adequate levels of emotional concern and perspective taking toward their patients, with occasional experiences of distress during sessions. The fourth group of clinicians (13 percent) revealed a "rational empathic" profile inclined to adopt an intellectual understanding of their patients' perspectives (probably based on observations and clinical theories), without emotionally sampling or identifying with their experience.

Based on these profiles, the "fit" between patients' needs and clinicians' empathic range and flexibility (i.e., how modifiable under given conditions) should be an area of future research. Indeed, the question of how to handle clinicians who appear empathically unfit is an important and thorny issue for the field to consider.