Components of empathy: A Delphi study

The aim of this study was to define the components of empathy in the helping professions through group discussion between experts who rely on empathy in their work.

In round 1 of the three round online Delphi study, we developed the draft definition based on healthcare education, affective neuroscience and psychology literature on empathy. Professionals practising in New Zealand and Australia in the fields of medicine, nursing, allied health, psychology, counselling, social work and education were invited to participate. In round 2, participants indicated their agreement with empathy components and suggested improvements. In round 3, experts received a summary of the group responses and rated the modified empathy components. Threshold for inclusion of components in the final definition was 70 % agreement.

Forty-three experts participated in round 2 and 25 in round 3. In round 2, 8 out of 12 components achieved 70 % agreement. Having considered participant feedback, multiple versions of some components were included in round 3 to improve their phrasing. Four components below the agreement threshold were updated and included in round 3, together with 3 new components.

The resulting definition of empathy focuses on sustainable ways empathy can be shown and the skills this capacity relies on. The components and sub-skills of empathy are self-reflection, which helps process empathic encounters and learn from them for the future; emotional intelligence, including self-regulation of emotions; self-awareness, specifically of own biases; avoiding judgement; active listening; and helpful action, understood as knowing what to do or say that another person may find helpful in a particular situation, especially when it is not possible to confirm their needs. The resulting empathy definition, highlighting its underlying skills, can guide the development of empathy fostering educational programs and the creation of measures that accurately reflect students' proficiency in these skills.