Empathic reflections by themselves are not effective: Meta-analysis and qualitative synthesis.

Area of Science:

• Psychology
• Clinical Psychology
• Psychotherapy Research

Background:

• Empathic reflections are widely used in therapy to convey understanding.
• Distinguishing empathic reflections from the broader concept of empathy is crucial for research clarity.

Approach:

• A mixed methods systematic review was conducted.
• Definitions and subtypes of empathic reflection were explored, drawing on conversation analysis.
• Meta-analysis of 43 samples assessed the link between empathic reflections and effectiveness.

Key Points:

• No significant relationship was found between the presence/absence of empathic reflections and therapeutic effectiveness.
• Weak, non-significant support emerged for reflections of change talk and summary reflections.
• Assessment criteria for empathic reflections include session outcome and client response.

Conclusions:

• High-quality empathy sequences, where reflections are well-calibrated and adjusted, are likely more important than the mere presence of reflections.
• Future research should focus on the nuanced quality of therapist-client interaction within empathy sequences.
• Training and practice should emphasize sensitive calibration and adjustment of empathic reflections based on client feedback.