Therapist and client perceptions of empathy in simulated teletherapy sessions

Empathy is thought to be reduced in videoconference (VC) compared to face-to-face (F2F) therapy. To empirically test this possibility, therapist and client ratings of empathy and its correlates were examined in VC and F2F sessions. Forty-eight students in clinical training programs were randomly assigned to the role of ‘therapist’ or ‘client’, forming 24 dyads. Each dyad completed a simulated clinical session in F2F and in VC and reported on empathy and telepresence. Both therapist and client ratings of empathy were significantly lower in VC compared to F2F. Therapist empathy correlated with telepresence, particularly its physical subcomponent, and therapeutic presence, but these associations were not found for clients. The relationship between empathy and telepresence was investigated further in a real-world study. Twelve clients met with clinical psychology trainees over VC and reported on empathy and telepresence. The associations between therapist empathy, total telepresence, and the physical component of telepresence were replicated. Again, client ratings of empathy and telepresence did not correlate. These results provide the first empirical evidence that empathy is reduced in VC teletherapy compared to F2F and highlight the connection between the degree of empathy felt by therapists and their sense of telepresence during teletherapy.