In the field of medicine, empathic providers have been found to bring numerous benefits to a clinical encounter as they are better able to elicit detailed and thorough case histories, build rapport and therapeutic alliance with patients, and foster greater compliance with treatment recommendations. Despite its multiple benefits, empathy has not been researched systematically within the field of speech-language pathology. In medical training, empathy has been found to decline by the time medical students are introduced to direct patient care. Currently, no information is available regarding the empathy trajectory of novice speech-language pathologists. The goal of the current project was to determine the effect of one semester of clinical experience on the perceived and self-reported empathy of novice speech-language pathology clinicians during their first semester of graduate school. A convergent parallel mixed-method design was used in two stages (pre/post). Both quantitative and qualitative data were gathered concurrently during two distinct moments in time (i.e. pre-test: during the first week of exposure to clients in clinic; post-test: at the end of the first semester of clinic). Quantitative and qualitative data analyses were completed separately at the conclusion of each stage, with data integration taking place during final interpretation. Quantitative findings revealed that novice speech-language pathology students were able to identify high vs. low levels of relational empathy as depicted in two video-recorded clinical interviews using a modified CARE measure (Mercer, Maxwell, Heaney, & Watt, 2004) even prior to exposure to clinical practice. In addition, these perceptions remained stable from pre-test to post-test. Qualitative comments written by novice clinicians regarding each video were analyzed using a-priori codes. Analysis of the qualitative data corroborated the quantitative findings except for mild nuances pertaining to observations about the caregiver in the video, which tended to occur more frequently at pre-test and less so at post-test. The significance of these qualitative findings was questionable, but it was hypothesized that clinicians may have become more “detached” from the caregiver’s perspective after they were exposed to direct work with clients in the clinic. Novice clinicians’ levels of self-reported empathy were also observed to remain stable from pre-test to post-test, as evidenced by quantitative findings from the Empathy Assessment Index (EAI – Gerdes, Segal, & Lietz, 2012). Analysis of the subtests from the EAI showed that all clinicians tended to have lower scores for emotional regulation as compared with other components such as affective response, affective mentalizing, perspective taking, or self-other awareness. Qualitative analysis of an exit interview in which novice clinicians were asked to list the most frustrating and most rewarding aspects of their semester showed that aspects of the semester which were perceived as frustrating were often balanced by those which were perceived as rewarding. In addition, direct work with clients and caregivers was listed by far as one of the most rewarding experiences for novice clinicians, particularly as it pertained to client progress. Factors which could potentially lead into burnout were noted in the list of frustrating items, but these occurred more infrequently. Further investigations into the empathy trajectory of novice speech-language pathology students are recommended especially using a cross-sectional or longitudinal design to determine if empathy remains stable over the course of training or whether it suffers a decline as academic, personal, and patient/caseload demands become more challenging and multifaceted. Possible investigations following clinicians after the completion of their clinical fellowship year would also be recommended as novice clinicians transition from trainees to full-fledged providers.

The aim of this research was to longitudinally and quantitatively investigate sense of coherence (SOC) and coping strategies as predictors of compassion satisfaction (CS) and compassion fatigue (CF) as measured by secondary traumatic stress (STS) and burnout (BT) during the first six months of training in a professional psychology training programme. Trainee therapists’, “dramatically shift” their “focus of functioning over time” to adorn the personality and self of the therapist (Rønnestad & Skovholt, 2003, p. 28). This adaptive process may initially unravel over six months as trainees balance client and workload stressors (Hill, Sullivan, Knox & Schlosser, 2007; Tryssenaar & Perkins, 2001). However, research on the developmental processes behind the negative (CF) and positive (CS) avenues of therapeutic stressors is lacking in the trainee therapists’ population, especially quantitatively (Schwing, LaFollette, Steinfeldt & Wong, 2010; Thériault, Gazzola & Richardson, 2009). This research aimed to explore these issues in relation to professional development through SOC and coping as predictors of CS and CF over a six month training period. Variables were investigated quantitatively through the Professional Quality of Life Scale (ProQOL) (Stamm, 2010) the Brief COPE (BCOPE) (Carver, 1997) and the 29-item self-report Orientation to Life Questionnaire (OLQ) (Antonovsky, 1987). As such, the primary focus of this research was on how SOC and coping strategies were utilised by trainee therapists as process variables in predicting the positive (CS) and negative (CF) avenues of therapeutic work over a six month period of psychotherapy training. Findings suggested that, at the beginning of training, sense of coherence was directly associated with the core outcome variables (CS and CF (as measured by STS and BT). When trainee therapists started seeing clients two months later, the effect of SOC was mediated by coping. At the end of training, only coping was directly associated with outcome variables as the effect of SOC on CS and CF disappeared. These implications are further discussed in the research.

The goal of this work is to introduce the phenomenon of compassion from the aspect of psychology. The theoretical part of the diploma thesis presents efforts made up to now to define compassion from a psychological point of view. The theoretical part of this work deals with the description of compassion in terms of evolutionary, social psychology and neuroscience. Based on the theoretical assumption that the relationship of a person towards himself or herself and towards other people is interconnected, this work also focuses on a description of a psychological construct of self-compassion. The empirical part of the diploma thesis is devoted to the translation of a new self-evaluation questionnaire called the Multidimensional Compassion Scale from USA, and the verification of the psychometric characteristics of the questionnaire and its convergent and discriminant validity. For the sake of questionnaire verification, the Toronto Alexithymia Scale (TAS-20) was used, as well as the Interpersonal reactivity Index (IRI), a dimension called Compassionate reaction to one's own experiences from the Self-compassion Scale (SCS-26-CZ) questionnaire, and a dimension called Nonjudging intrapsychic experiences from the Five Aspects of Mindfulness Questionnaire (DPAV). Items of low difficulty were found within...

Compassion Focused Therapy (CFT) is an emerging transdiagnostic treatment which aims to attenuate common psychological problems including shame and self-criticism through building compassionate skills. These problems are considered relevant and implicated in the maintenance of eating disorders. Imagery in particular has attracted attention as an important treatment technique for its strong links with memory. The aim of this thesis was to explore the effect of Compassion Focused Imagery (CFI) in women with sub-clinical eating disorder symptoms. Paper 1 is a systematic review of the CFT literature across disorders and in transdiagnostic groups. The main aims of the review were to evaluate the literature, synthesise the content of CFT across studies and provide preliminary effect size calculations. Eighteen articles were identified including clinical and non-clinical, treatment and experimental studies. The current body of evidence includes transdiagnostic samples, eating disorders, psychosis, acquired brain injury, depression, posttraumatic stress disorder (PTSD), personality disorder, individuals high in self-criticism and those with acne. The review includes a synthesis of intervention content, modalities, training and supervision of CFT within the literature. Strongest evidence was identified within transdiagnostic groups with more limited evidence for CFT within PTSD, personality disorders, acne sufferers and high self-critics. Effect sizes varied from 0-0.9 across shame, self-criticism and self-compassion outcomes. The area is limited by few controlled evaluations and heterogeneous content of interventions. Paper 2 is an experimental study of the effect on CFI in an analogue (sub-clinical) sample of women with elevated levels of eating disorder symptoms. Following baseline assessments measuring shame, self-criticism, self-compassion and stress, anxiety and depression, women with global scores of 2.5 or over on the Eating Disorders Examination Questionnaire (EDE-Q) were randomly allocated to either CFI condition in which they were instructed to create an image of a compassionate other or to a neutral imagery condition which involved creating an image of a neutral object. A third group of individuals with global scores of 1.0 or less on the EDE-Q were recruited for comparison only. Following a practice period of five-to-seven days, participants were assessed a final time. Controlling for baseline scores, significantly greater reductions in shame were reported in the CFI group compared with the neutral imagery group. Increases in self-compassion and decreases in self-criticism and depression, anxiety and stress were favourable in the CFI group compared with those in the neutral imagery group; however, these findings did not reach statistical significance. Compassion focused imagery appeared to be well tolerated within the CFI group. Clinical and theoretical implications and future research directions are discussed. The third chapter offers a reflective discussion on the methodological strengths and weaknesses, clinical and theoretical implications beginning with the systematic review followed by the empirical paper. Chapter 3 concludes with a final section on personal and professional reflections throughout the research process.

As helping professionals, music therapists show compassion to their clients but may lack necessary self-care skills to prevent burnout and promote well-being. Due to a lack of research in this area, this study investigated reported levels of compassion for others, self-compassion, burnout, secondary traumatic stress, and compassion satisfaction among music therapists in relation to age, gender, and years of professional experience. A survey of 575 board certified music therapists in the USA revealed higher levels of compassion for others than self-compassion, low levels of burnout and secondary traumatic stress, and high levels of compassion satisfaction. Burnout strongly negatively correlated with both self-compassion and compassion satisfaction and strongly positively correlated with secondary traumatic stress. A MANCOVA revealed significant differences in compassion for others and compassion satisfaction based on gender, with female participants reporting significantly higher scores for both constructs. Additionally, there was a trend related to self-compassion and compassion levels increasing over time. There were strong associations between compassion and self-compassion with burnout and secondary traumatic stress; therefore, it would benefit music therapists to cultivate compassion practices to lower burnout risk.

The purpose of this study is to explore Filipino service care providers’ experience of compassion fatigue. Compassion fatigue is a common experience among health care professionals and can contribute to feelings of hopelessness and adverse behaviors in caring for patients. In California, there are a large number of Filipinos who are employed as care providers for older adults; however, there is limited research available regarding Filipino workers in the United States. This study took on a qualitative design that utilized face-to-face interviews to gain more insight into Filipino service care providers’ experience of compassion fatigue in relation to their employment. Factors that were explored in interviews were exposure to terminally ill individuals, coping and self-care strategies, and working environments. The results of this study indicated participants appeared to experience compassion satisfaction, rather than compassion fatigue. Furthermore, recommendations for future research were discussed. These recommendations included the need to explore experiences of compassion satisfaction in this population and to look into the experience of Filipino service care providers who were born in the United States, rather than in the Philippines, to determine whether Filipino cultural values of caring can act as a buffer against the effects of compassion fatigue.

<p><p>Studiens syfte var att utifrån tidigare forskning (Hallén, 2007, 2008) undersöka konsekvenser av att känna empati. Genom en faktoriell inomgruppsdesign (2x2) besvarade 51 frisörer en enkät om hur de påverkas på kort och lång sikt av att känna empati med sina kunder. Resultaten visade att empati med någon som mår dåligt upplevdes leda till betydligt mer negativa effekter än empati med någon som mår bra, på både kort och lång sikt. Vidare upplevdes effekterna som mer intensiva på kort sikt än på lång, oavsett om individen man empatiserat med mått dåligt eller bra. En tänkbar förklaring till skillnaden över tid är att de emotioner vi specifikt erfar genom andra avtar på samma sätt såsom minnen av egna emotioner gör generellt.</p></p>

<p>Motstridig forskning finns om huruvida empati är en riskfaktor eller en skyddande faktor för yrkesverksamma inom omhändertagande yrken som frekvent kommer i kontakt med trauman och mänskligt lidande. Två alternativ finns inom forskningen: compassion fatigue och compassion satisfaction. Syftet med studien var att undersöka hur yrkesverksamma inom ett omhändertagande yrke, psykiatrin, påverkas av situationer i vilka de ofta behöver känna empati med patienter. Tjugoen respondenter deltog i en kvalitativ studie där öppna frågeformulär användes. Resultatet visade att sådana situationer leder till negativa känslor på kort sikt men positiva på lång sikt, något som tidigare inte har påvisats. Vidare framkom att typen av situation man empatiserar med är av betydelse, och att situationer där barn är inblandade verkar påverka starkast.</p>

<p>En tidigare studie har visat att negativa effekter av att känna empati är övervägande på kort sikt medan positiva effekter är övervägande på lång sikt, gällande psykiatripersonal. Med den aktuella studien avsågs att undersöka huruvida liknande tendenser finns hos en generell population. 253 högskolestudenter deltog, och i en mellangruppsdesign besvarade hälften en enkät belysande upplevelser på kort sikt medan den andra hälften besvarade en likadan enkät belysande upplevelser på lång sikt. Resultatet visade att empati har olika effekter beroende på tidsperspektivet även för människor generellt, i form av mer positiva effekter på lång sikt. Denna effekt återfanns bland såväl kvinnor som män, och bland yngre såväl som äldre. En tänkbar förklaring är att intrycket blir ett annat med tidsmässig distans.</p> / <p>Evidence from an earlier study suggests that negative consequences of feeling empathy are predominant in the short-term, while positive consequences are predominant in the long-term, regarding psychiatry staff. This study investigated whether similar tendencies exist among a general population. 253 university students participated, and a between-subjects design was used in which half of the participants answered questionnaires illustrating experiences in the short-term, and the other half questionnaires illustrating experiences in the long-term. Also for people in general, the results showed that empathy has different effects depending on the time perspective through more positive effects in the long-term. This effect was valid, irrespective of gender or age. A possible explanation is that the impression changes with the distance that time brings.</p>

Motstridig forskning finns om huruvida empati är en riskfaktor eller en skyddande faktor för yrkesverksamma inom omhändertagande yrken som frekvent kommer i kontakt med trauman och mänskligt lidande. Två alternativ finns inom forskningen: compassion fatigue och compassion satisfaction. Syftet med studien var att undersöka hur yrkesverksamma inom ett omhändertagande yrke, psykiatrin, påverkas av situationer i vilka de ofta behöver känna empati med patienter. Tjugoen respondenter deltog i en kvalitativ studie där öppna frågeformulär användes. Resultatet visade att sådana situationer leder till negativa känslor på kort sikt men positiva på lång sikt, något som tidigare inte har påvisats. Vidare framkom att typen av situation man empatiserar med är av betydelse, och att situationer där barn är inblandade verkar påverka starkast.