The empathic process and its mediators. A heuristic model.

Clinical empathy research has been plagued with conceptual and methodological difficulties. This paper describes a model of the empathic process that enables clinicians, teachers, and researchers to examine specific components of the model and to determine the influence of particular mediators on the empathic process. Empathy is conceptualized as a three-phase time-sequenced process rather than as a multidimensional or multicomponent phenomenon. Stripped of detail, the empathic process reveals an inducement phase, a matching phase, and a participatory-helping phase. By examining these phases, it becomes possible to distinguish empathy from closely related concepts such as sympathy. Each of the phases reveals numerous mediating variables that influence the outcome of the phase, i.e., whether the process of empathy continues or an alternate terminal point is reached. Many of these mediators are derived from existing conceptual and empirical work on empathy. Particular attention is paid to situational or contextual mediators of empathy. Contextual mediators have only recently been acknowledged as an important variable in the empathic process. For clinicians, identification of contextual variables that may be responsive to intervention is a critical step in the modification of the clinical environment. We would suggest that clinical empathy research is largely the study of these mediating influences and should be recognized as such.