Pathways to empathy in mental health care providers

Stigmatization contributes to morbidity associated with mental illness, impeding treatment - from recognition and help-seeking, to recovery and resocialization.  In contrast, empathy in mental health clinical practice is associated with less stigmatization and better outcomes. Among providers, empathy may be under-utilized as a positive therapeutic tool, and levels of empathy may be diminished by heavy clinical workloads. Strategies for “teaching empathy” have been proposed, and different forms of empathy training for medical and mental health professionals have been evaluated. This review summarizes the effectiveness of the most studied forms of formal empathy training - communication skills, simulation, audiotape analyses, perspective-taking and mindfulness training - as well as informal empathy training achieved by increased exposure to relevant populations. Effectiveness, assessed by a variety of metrics, was detected for several training approaches, applied to different cohorts of clinical providers and trainees, with effect sizes ranging from smaller to large. Despite the substantial variations in designs and target cohorts, the evidence suggests that empathy can be taught effectively to mental health providers, in a manner that should enhance clinician awareness and utilization of empathy as a tool to reduce stigmatization and improve life quality among patients with mental illness.