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Empathy in Social Work Education: Are there differences between MSW students from online and traditional graduate programs?

Juan Carlos Araque, PhD and Bianca Harper, DSW, LCSW

USC School of Social Work

Additional faculty contributing to this research: Kristen Zaleski, PhD; Kim Finney, PhD; Jennifer Lewis, PhD; & Michal Sela-Amit, PhD

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How do we define empathy?

To share the experiences of another (Greenson, 1960).

“the act of perceiving, understanding, experiencing and responding to the emotional state and ideas of another person” (Barker, 2008, p. 141).

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Empathy: Literature Review

Kohut - Empathic Mirroring is essential in early childhood to avoid pathological narcissism

Attachment theory - Empathy is a product of secure attachment to a caregiver.

Neurobiology - Empathy is a function of the pre-frontal cortex (Cozolino, 2010)

Cognitive understanding, emotional attunement, and affect regulation - necessary ingredients for empathic ability (Cozolino, 2010; Dyche & Zayas, 2001; Berzoff, Flanaggan & Hertz, 2011).

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Gender and Empathy

Women are more empathic than men in Medicine (Chen et al., 2012; Hasan et al., 2013; Quince, Parker, Wood, & Benson, 2011;

Shariat, & Habibi, 2013)

Pharmacy (Fjortoft, Van Winkle, & Hojat, 2011)

Nursing (Fields et al., 2011; Hsiao, Tsai, & Kao, 2013; Ouzouni, & Nakakis, 2012),

Dentistry, Veterinary Science (Nunes et al., 2011)

Law (Wilson, Prescott, & Becket, 2012)

Men have been found to be more empathic in paramedic settings (Williams et al., 2012; Williams et al., 2013; Austin et al., 2007)

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Race/Ethnicity and Empathy

Latino students had higher levels of social empathy attitudes when compared to other ethnicities in a college sample (Segal, 2011).

Meta-analysis revealed Asian medical students had the biggest pre & post difference in empathy scores (Batt-Rawden, Chisolm, Anton, Flickinger, 2013).

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Social Work & Empathy

From Segal (2011),

“Actual research on empathy, as well as evidence of empathy training in the social work curriculum, remains scarce and sketchy. NASWs Encyclopedia of Social Work (Mizrahi & Davis, 2008) contains no entry for ‘empathy’- a glaring omission that illustrates the generally narrow and haphazard consideration of empathy in the social work literature (Freedberg, 2007; Raines, 1990)”.

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Our Research Study - Methods

Mixed methods, quantitative and qualitative approaches

Cross sectional, pre-experimental design.

Recruited 306 MSW students - sent email to all enrolled University of Southern California (USC) MSW graduate students.

Differences in gender, ethnicity, program year, method of study, and concentration designation were examined.

IRB approved

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Our Hypotheses

Females would be more empathic than males

Hispanic students would be more empathic than non-Hispanic students

First year students would have more empathy than second year students

Students in different concentrations would have different levels of empathy

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Questionnaire of Cognitive and Affective Empathy (QCAE)

Ten percent of the MSW student body (N=306) completed the QCAE

The QCAE is 31-item parametric scale rated on a 4-point Likert scale with the response options: "strongly agree," "slightly agree," "slightly disagree," and "strongly disagree."

This instrument has five subscales: perspective taking and online simulation within cognitive empathy; and emotion contagion, peripheral responsivity, and proximal responsivity within affective empathy.

Descriptive and inferential statistics in Qualtrics and SPSS software were used to determine variance among variables.

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Quantitative Results

Race/Ethnicity: Not statistically significant.

Year of school: Not statistically significant.

Gender: Statistically significant in affective empathy, but not in cognitive empathy.

Classroom learning vs. online learning: statistically significant in one area of affective empathy: emotion contagion. Not statistically significant in any other four subscales. Suggests the synchronization of personal emotion among students seems to occur more

frequently on-the-ground (traditional) than the online program.

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Qualitative Interviews

N = 34 students who were randomly selected from the sample of survey respondents.

27 females and 7 males.

Caucasian (16), Hispanic (8), African American (4), and Asian American (4)).

14 interviewees were first year MSW students and 18 were second year MSW students.

15 were traditional classroom students and 17 were students whose program is online.

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Interview Themes

Through coding and analysis the following three themes emerged from the student interviews:

1) self experiences of empathy

2) empathic challenges

3) empathy as an ongoing learning process.

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Self Experiences of empathy

Relatability:

…I was able to relate to a lot of what my clients were going through, having clients come into the school that I was at and sharing their experiences, having been in similar situations in the past definitely made it more relatable to what they were going through

…I would say some of the veterans. I think are, at least some of them are in line with some of the same struggles I have. Where it is easier to be empathetic to the veteran population, versus other populations.

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Self experiences of empathy

Empathic Deprivation (lack of empathy in childhood)

Because there’s times where I didn’t really get that…It would have been helpful and made a lot of things easier, so I think to see that need, that’s what motivates me to be empathetic towards other people. Because I didn’t really get that enough until I was older.

…I think in my life I have gone through a lot of things, and the support that I have gotten has been awesome, and I feel that if I would have had that at a younger age, I think I would have maybe gone further in life. So for me that’s my reason behind it, I want to help those little kids that didn’t get the help, if that makes sense, and give them the support, and emotional support that they would need.

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Empathic Challenges

Lack of Understanding

When I’m talking to somebody and I really just don’t know, like I haven’t been through the same thing, like same experience as them. So it’s kind of really hard for me to wrap my head around how they’re feeling or what that experience is like.

So now I am working with a client from a military background and I am not a military background so she just said how she has been feeling sad and…so I guess I couldn’t provide empathy because I couldn’t really put myself in her shoes and so I responded with like, oh that must be hard for you but that was being sympathetic not really empathetic at that moment, like I felt bad for her but couldn’t really relate.

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Empathic Challenges

Lack of role models

“I really had to learn empathy. It didn’t come naturally for me, growing up in an abusive home. It took me a really long time to really get to a place where I could frame things and understand things from someone else’s point of view, so it was a difficult struggle”.

“I think I use to me a more empathetic person. In fact, I know I used to be a more empathetic person in my childhood. I think that my military experience has colored my empathy quite a bit, especially my combat experience. Empathy is a liability in the warzone because you cannot be emotionally connecting with the situations that you find yourself in. Otherwise you’ll go crazy. Since coming home from that, I have found it extremely extremely difficult to connect with human suffering on the level of day-to-day systemic interactions”.

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Empathy as an ongoing learning process

Empathic Modeling

I see my mom’s ability to connect with her patients and just be there for them and you know I feel like I learned how to do that from her.

… I think what brought that student-professor relationship closer was when I was having personal issues, in my personal life, he noted that I was not myself in class. So he took me out of class and said, “I noticed you are acting a lot differently than you normally do and I just want to see if everything is okay”. And that went a long way. That was a good example of being that attuned to someone.

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Empathy as an ongoing learning process

Cognitive learning affects empathy

“…It’s been a lot of the things that we have had to study about generational cycles of, as far as marginalization, and umm, poverty, and you know, just the welfare cycle, and how umm, how drug abuse and violence and dysfunction at home affects a person…their brain, their makeup, just the way that they present in society and what they think is the real world in their eyes. I think we all grow up thinking everybody knows this sort of black and white, right and wrong, and I’ve really learned through school and internship that that’s not necessarily so”.

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Clinical Implications

Empathic mirroring is important per respondents self reports.

Empathy can change in adulthood

Empathy can develop despite adverse childhood circumstances

Emotionally connecting to a client’s past appears to be helpful in creating empathy for others

Mindfulness has promising results in enhancing empathy

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Pedagogical Implications

Educators need to create empathic connectedness in an online training format where students can feel emotion contagion

-(Mutual eye gaze per neurobiology is an important aspect of empathic connectedness… can this be achieved online?)

Educators need to address the disengaged (traumatized) students and help them to re-connect to others

Examine if we are teaching unknowingly to female students more often than male students?

Professor impact on empathy in a student

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Questions

Juan Carlos Araque, PhD

araque@usc.edu

Clinical Associate Professor

University of Southern California

School of Social Work

Bianca Harper, DSW, LCSW

bmharper@usc.edu

Clinical Assistant Professor

University of Southern California

School of Social Work