141Gerdes and Segal / Importance of Empathy for Social Work Practice: Integrating New ScienceCCC Code: 0037-8046/11 $3.00 ©2011 National Association of Social Workers
Importance of Empathy for Social Work
Practice: Integrating New Science
Karen E. Gerdes and Elizabeth Segal
Empathy is more important than ever to a national population worried about difficult political
and socioeconomic situations. During the last 10 years, an enormous amount of research has
been carried out to elucidate the nature, mechanism, and function of empathy. New research
from social–cognitive neuroscience and related fields indicates that, like language or eye–hand
coordination, empathy is an innate human capability that can be greatly enhanced by purposeful
and informed guidance. Empathy is particularly important to social work practice. Clients
experiencing empathy through treatment have improved outcomes. Empathic social work
practitioners are more effective and can balance their roles better. Social work practitioners
can and should learn about emerging research on empathy and use that information to better
serve their client populations. This article, emphasizing research of the past decade, focuses on
empathy and its benefits as an asset to social work practitioners.
KEy worDS: affective sharing; emotion regulation; empathy;
perception–action coupling; social–cognitive neuroscience
During the last decade of the 20th century, then-President Bill Clinton made a politi-cal catch phrase of the term “I feel your
pain.” As mawkish as this may have sounded to cynics,
it resonated with voters. Eight years after Clinton
left office, Barack obama won the presidency in
part by calling attention to an “empathy deficit” in
government and public service. Identifying with
another person’s emotions—the phenomenon we
call empathy—is the foundation on which all useful
public service and, indeed, the social contract itself
Empathy is particularly important to social work
practice. Clients experiencing empathy through
treatment have improved outcomes. Empathic social
work practitioners are more effective and can bal-
ance their roles better. Social work practitioners can
and should learn about emerging social–cognitive
neuroscience research on empathy and use that
information to better serve their client popula-
tions. This article focuses on empathy as an asset to
What Is Empathy?
Barker (2003), in the Social Work Dictionary, defined
empathy as “the act of perceiving, understanding,
experiencing, and responding to the emotional state
and ideas of another person” (p. 141). Barker’s defi-
nition is an abbreviated summary of the numerous
definitions that have been put forward by influential
thinkers over the past 90 years. These luminaries
include psychoanalysts (Freud,1921; Kohut, 1959;
reik, 1948), humanistic therapists (rogers, 1957),
psychologists (Davis, 1994), and social and devel-
opmental psychologists (Batson, 1987; Hoffman,
2000; Ickes, 1997).
In 2004, Decety and Jackson surveyed the numer-
ous definitions and conceptualizations of empathy
found in academic and professional literature. They
identified three subjective experiences and three
communicative abilities that, in one form or an-
other, are universally cited as signature ingredients
of empathy (see Table 1).
As Table 1 reveals, there are two components to
empathy: the emotional and the cognitive. Vinton
and Harrington (1994) noted the difference between
the two elements, as have many others (for example,
Davis et al., 2004). They labeled them (1) emotional
empathy—the ability to be affected by the client’s
emotions—and (2) expressed [cognitive] empathy—the
translation of such feelings into words.
Historically, there has been some controversy as
to the relative primacy of the emotional/affective
elements of empathy and the expressed/cognitive
elements (Cliffordson, 2001; Decety & Jackson,
2004; Funk, Fox, Chan, & Curtiss, 2008). For ex-
ample, rogers (1957) and Hoffman (1981) focused
more on empathy as an innate and involuntary
response to an affective signal or prompt, whereas
behaviorists focused more on empathy as a learned
142 Social Work Volume 56, Number 2 April 2011
communication, or as conscious role taking (Bat-
son, 1991; Davis, 1996). Kohut (1959) was one of
the first to articulate that both the conscious (for
example, perspective taking) and implicit or uncon-
scious (for example, emotion sharing) processes are
vital to empathy and must be integrated to achieve
a true empathic reaction or response.
Empathy In ExIstIng socIal
It is hardly new to proclaim that empathy is a critical
and essential ability for effective social work prac-
tice; this has been stated explicitly by many social
work educators (for example, Hepworth, rooney,
rooney, Strom-Gottfried, & Larsen, 2006; orlinsky
& Howard, 1975; Shulman, 2009). yet actual research
on empathy, as well as evidence of empathy training
in the social work curriculum, remains scarce and
sketchy. NASw’s 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).
A generation of social workers, including the
present authors, were schooled using rogers’s
(1959) conceptualization of empathy as the ability
to perceive the internal emotional state of another
“as if ” they were that person. A nonjudgmental,
accepting reflection of the client’s emotional state
was critical to the effectiveness of the practitioner–
client relationship. Later, rogers (1975) revised his
conceptualization of empathy from a “state” to more
of a “moment-to-moment process of felt meaning,”
in which the practitioner was constantly checking
the accuracy of his or her interpretation of the cli-
ent’s “felt meaning.”
In the 1980s, rogers’ conceptualization of
empathy was overshadowed by psychologists and
social workers who were more concerned with
implementing cognitive–behavioral interventions
and wanted empirical measurements for both
affective and cognitive components of empathy
(Bryant, 1982; Davis, 1983). The glaring problem in
the current clinical outcome literature is that there
is still no agreed-on conceptualization of empathy.
As a result, “operational definitions of empathy are
not consistent across studies” (Pithers, 1999, p. 258).
Measurement techniques for empathy vary so much
that it has been difficult to engage in meaningful
comparisons or make significant conclusions about
empathy and how to cultivate it effectively in social
workers and clients (Cliffordson, 2001).
Today, numerous disciplines are researching
and analyzing empathy. recent groundbreaking
research on this issue has emerged from primatol-
ogy and ethology (de waal, 2003); neuroscience
(ramachandran, 2000); developmental psychology
(Batson, 2006; Batson et al., 2003); and, perhaps
most important, the nascent field of social–cognitive
neuroscience (Decety & Jackson, 2004; Decety &
Lamm, 2006). This article is meant to bring find-
ings from this last field into social work’s body of
literature, thus reopening a discussion that could
have powerful influence on the way social work-
ers conceptualize and measure empathy and, more
important, how they practice it.
ImportancE of Empathy to
research demonstrates that empathy is an important
tool for positive therapeutic intervention (watson,
2002). Clients experiencing empathy through
treatment by others inhibits antisocial behavior in
children and adolescents (Eisenberg, Spinard, &
Sadovsky, 2005; Hoffman, 2000). Empathy inhibits
aggression toward others (weisner & Silbereisen,
2003) and promotes healthy personal development
(Hoffman, 2001). The lack of empathy is correlated
with bullying, aggressive behavior, violent crime,
and sexual offending (Gini, Albieri, Benelli, & Altoe,
2008; Joliffe & Farrington, 2004; Loper, Hoffschmidt,
& Ash, 2001; Sams & Truscott, 2004).
A practitioner’s own level of empathy is correlated
with positive client outcomes (Forrester, Kershaw,
table 1: subjective and communicated aspects of Empathy
subjective Experience communicative capability
Feeling what another person is feeling Making an affective response to another person/sharing the other person’s emotional
Knowing what another person is feeling The cognitive capacity to take the perspective of the other person (perspective taking)
Having the intention to respond The regulatory ability to keep track of and separate the origins of feelings of self from
compassionately to another person’s distress the origins of feelings of the other person
Source: Decety, J., & Jackson, P. L. (2004). The functional architecture of human empathy. Behavioral and Cognitive Neuroscience Reviews, 3, 71–100.
143Gerdes and Segal / Importance of Empathy for Social Work Practice: Integrating New Science
Moss, & Hughes, 2008). Jensen, weersing, Hoag-
wood, and Goldman (2005) completed a review
of 52 child psychotherapy treatment studies and
concluded that therapist empathy, attention, and
positive regard are essential to effective outcomes.
Forrester et al. (2008) found that empathy is central
to effective communication in child protection situ-
ations. Empathy is critical to both practitioner and
scIEncE of Empathy: nEW fIndIngs
and thEIr ImplIcatIons
New research on empathy is rich and varied. Some
of the emerging research is highlighted in Table
2. An exhaustive analysis of all findings falls well
beyond the scope of a single article. This article
focuses on what we believe to be one of the most
important bodies of work, the comparatively new
field of social–cognitive neuroscience, and its im-
plications for social work practice. researchers in
this field, basing their work on observations from
primatology, have identified the major physiologi-
cal mechanism of empathy and begun to elucidate
how the experience of empathy actually occurs in
the brain. Their findings give empirical support to
research on empathy in social interactions.
Connecting these areas of research yields an
important and exciting conclusion: Empathy can
be taught, increased, refined, and mediated to make
helping professionals more skillful and resilient.
Understanding how empathy works can help social
workers “in the trenches” connect more empathi-
cally with clients from a wider range of sociocultural
backgrounds while making them less vulnerable to
becoming overwhelmed, burnt out, or dysfunction-
ally enmeshed with clients.
mIrror, mIrror: hoW Empathy occurs
In thE BraIn
one day, a researcher who was studying brain activ-
ity in monkeys stumbled on a strange phenomenon:
The monkey the researcher was studying showed
table 2: key research findings on Empathy
field major finding
Primatology Monkeys have mirror neurons or mirror cells that respond to the goal-directed actions of others
(that is, the monkeys have neurological responses to the experiences of other individuals, “feeling”
the experience secondhand, the necessary condition for empathy). This discovery led to the iden-
tification of the physiological mechanism for perception–action coupling in humans (Rizzolatti &
Social–cognitive neuroscience Perception–action coupling and mirror neurons have been observed in humans as well—that is,
the perception of emotion in one individual activates neural mechanisms in an observer, allowing
the observer to resonate with the emotional state of the individual being observed (Preston & de
Perspective taking—that is, cognitively adopting the perspective of another—evokes stronger
empathic concern. In other words, thinking about another’s experience adds more empathy than
does simply observing it (Batson et al., 2003; Jackson, Brunet, Meltzoff, & Decety, 2006; Lamm,
Batson, & Decety, 2007).
Self-awareness is an essential condition for making inferences about the mental states of others
(Decety, 2005; Decety & Sommerville, 2003; Sommerville & Decety, 2006).
“Empathy relies both on bottom-up [or unconscious] information processing (shared neural
systems between first-hand emotional experience and the perception or imagination of the other’s
experience), as well as top-down [conscious–cognitive] information processing that allows modula-
tion and self-regulation. Without self-regulation, information processing would lose flexibility and
would become primarily bound to external stimulations” (Decety & Lamm, 2006, p. 1160).
Empathy deficits with different etiologies (for example, brain lesions or degenerative neurologi-
cal conditions) are highly correlated with sociopathy, conduct disorders, narcissistic personality
disorder, and antisocial behaviors (Decety & Jackson, 2004).
Gender-related studies of empathy and brain function suggest that female humans may use mir-
ror neurons more extensively than male humans. This adds support to the theory that men and
women rely on different neurological strategies to assess other’s subjective experiences and that,
in general, women have a higher tendency toward empathic experiences than do men (Schulte-
Ruther, Markowitsch, Shah, Fink, & Piefke, 2008).
Psychology Neuroplasticity allows us to deliberately change negative emotional states by understanding and
observing the operation of our own brains (Lutz, Greischar, Rawlings, Ricard, & Davidson, 2004;
Schwartz & Begley, 2003).
144 Social Work Volume 56, Number 2 April 2011
brain activity that indicated he was eating when in
fact he was motionless. After some investigation,
the researcher realized that the monkey’s brain was
reacting to seeing another animal eat. In short, part
of the motionless monkey’s brain appeared to be
actually experiencing the other monkey’s sensations
(Gallese, Fadiga, Fogassi, & rizzolatti, 1996).
Much more research followed, with social–
cognitive neuroscientists picking up on the results
from primatology. Ultimately, the neuroscientists
identified a class of cells in the brain (both animal
and human) that they named “mirror neurons.”
These cells fire when an individual observes another
person or animal having some sort of experience or
sensation. The discovery of mirror neurons shows
that the phrase “I feel your pain” may be literally
true—not that the speaker is actually experiencing
the other person’s feelings, but that the speaker’s
brain creates very real sensations in response to
that other person’s experience (Kaplan & Iacoboni,
2006). Mirror neurons appear to be the primary
physiological mechanism of empathy (wolf, Gales,
Shane, & Shane, 2001).
Is this innate physiological ability mutable? Can
people lacking sufficient empathy be taught to be
more empathic? Further research has shown that
the brain is changeable, a phenomenon known as
“neuroplasticity,” and deliberately changing one’s
mental state begins with observing that mental state.
Social workers are trained to be self-reflective, and
this ability is central to enhancing empathy. Cog-
nitively adopting the perspective of another evokes
stronger empathic concern. In other words, thinking
about another’s experience adds more empathy than
simply observing it (Batson et al., 2003; Jackson,
Brunet, Meltzoff, & Decety, 2006; Lamm, Batson,
& Decety, 2007). The practice of actively observing
clients’ behaviors and simultaneously processing
those behaviors cognitively are not new to social
work practice, but they have not been identified as
critical to developing practitioner empathy.
componEnts nEcEssary to
Following Kohut’s lead in combining the affective
and cognitive aspects of empathy, Decety and Jackson
(2004) and Decety and Lamm (2006) proposed the
first truly interdisciplinary conceptualization of the
phenomenon. There are three necessary, functional
components that dynamically interact to generate
the subjective experience of empathy. Any one
component on its own, the authors claimed, is in-
sufficient to produce empathy. Those components
are as follows:
• affective sharing between the self and the
other, based on perception–action coupling
that lead[s] to shared representations;
• self–other awareness. Even when there is some
temporary identification, there is no confusion
between self and other; [and]
• mental flexibility [that is, emotion regulation]
to adopt the subjective perspective of the
other and also regulatory processes. (Decety
& Jackson, 2004)
The first component of the model, affective
sharing with others, is largely an unconscious or
automatic experience. when we listen to someone
describe his or her feelings verbally or observe
gestures, facial expressions, and vocal tone, and so
forth (that is, perception and action coupling), neural
networks in our brains are stimulated by the “shared
representations” and generate similar feelings within
us. This is the involuntary action of mirror neurons
and is therefore automatic.
Unlike affective sharing, the second and third
components of the empathy model—self–other
awareness and the mental flexibility to regulate
one’s own emotions—are not automatic. on the
contrary, they are sophisticated cognitive skills that
allow humans to voluntarily take the perspective
of others—and like other sophisticated cognitive
skills, they can be learned, increased, and perhaps
ultimately even mastered (Decety & Lamm, 2006).
Social workers can benefit enormously from being
educated to modulate their own experience of em-
pathy cognitively. They can then both connect with
others—even those whose socioeconomic, cultural,
or physiological experience is very different from
their own—and prevent “empathic overarousal,”
which can lead to personal distress, egoistic behav-
iors, or burnout (Eisenberg, 2000).
guIdE for practItIonErs:
component 1: affective sharing/
perception and action coupling
Establishing empathy is simple, though not always
easy. we now know that the brain inherently and
involuntarily triggers shared reactions neurologi-
cally when we are observing others’ experiences.
145Gerdes and Segal / Importance of Empathy for Social Work Practice: Integrating New Science
This is most likely due to the involuntary firing of
mirror neurons, the “brain cells that reflect the activity
of another’s brain cells” (rothschild, 2006, p. 42).
Beginning in infancy, mirror neurons help each hu-
man’s brain map the orafacial and manual gestures of
others onto the baby’s own motor systems (Kaplan
& Iacoboni, 2006). These shared representations are
stored or encoded in our neural networks and, when
stimulated, automatically enable us to empathize
with or share the feelings of another (Decety &
Lamm, 2006). researchers now believe that autism
may in part be explained by a failure to develop or
form adequate neural circuitry or mirror neurons
that enable language and social brain pathways to
mature (Iacoboni & Dapretto, 2006).
The neural networks created by the shared rep-
resentation process of gestures, body language, and
vocal tone are like the “hardware” of the human
brain. other shared representations, such as words,
are more like “software.” They capitalize on the in-
nate capacity for empathy to create affective sharing
through deliberate communication of feelings. of
course, such representations are more specific and
controllable than the visceral, automatic empathic re-
actions arising from hardwired somatic responses.
Both of these neurological pathways to empathy
involve paying close attention to another person: not
theorizing or analyzing, but being fully attentive to
another’s behavior, facial expression, tone of voice,
choice of words, and so on. It is empirical observa-
tion at its purest. This means that while theory is
necessary for analyzing and initiating solutions to
a problem, the only thing a social worker must do
to experience affective sharing or perception with
a client is to truly see the client’s actions, gestures,
facial expressions, and other behaviors and to truly
hear the words, tone of voice, and content of the
client’s story. This is referred to as “perception and
action coupling” (Kaplan & Iacoboni, 2006).
Too often, educational systems focus on cognitive
understanding at the expense of clear, uncompli-
cated perception. Training of social workers should
include alerting them to the dangers of blunting
or blocking their observational powers. Instructing
them to observe their clients mindfully—that is,
without imposing immediate cognitive categories
on their behavior—can help free social workers’
brains to automatically mirror a client’s subjective
For example, a male social worker who deliber-
ately puts aside his own intellectual constructs and
deeply listens to a woman’s story of a difficult child-
birth, noticing her tone and words and watching her
nonverbal gestures, might begin to experience the
feelings of pain, fear, and joy that are associated with
giving birth. Like anyone who pays close empathic
attention, he may also unconsciously mimic her facial
expression and body positions, a somatic “echo” of
feelings that he himself could never physically ex-
perience except through empathy. Educators who
familiarize social workers to the concepts of affective
sharing and perception–action coupling will facili-
tate a more rewarding and productive experience
for both the social workers and their clients.
component 2: self–other awareness
Affective sharing is crucial in all the helping profes-
sions, but as documented in the social work literature,
it can also lead to emotional and physical burnout
(Eisenberg, 2000). Many social workers who have
a very strong capacity to share their clients’ feelings
have trouble disengaging from the clients and, thus,
take on many of the very burdens they are trying to
ease. This degree of enmeshment is not constructive;
it prevents clear and constructive action. Surgeons
are not allowed to operate on people with whom
they share deep emotional bonds precisely because
objectivity is required as a foundation for offering
help. A surgeon who fully identified with the pain
of a patient’s gunshot wound or shattered bones
would require help rather than be able to give it. The
same is true of social workers who hope to heal the
wounds of poverty, violence, or mental illness.
From an educational perspective, social work-
ers should be taught that, counterintuitively, true
empathy cannot exist without a strong sense of self
as separate from other. Self-awareness allows us to
disentangle our own feelings from the feelings of
others, prevents empathic overarousal in emotion
sharing, and allows us to make cognitive inferences
about the mental state or perspective of others
(Decety & Lamm, 2006). In other words, self–
other awareness acts as a brake on the automatic
link between perception and emotion that occurs
in affective sharing and allows us to take a more
Social workers who lack the awareness of being
separate from clients turn the reflexive aspects of
empathy into an intolerable burden for themselves.
without perceptual boundaries, they risk experienc-
ing a client’s feelings of anger, depression, anxiety, or
joy as their own feelings. with self–other boundaries
146 Social Work Volume 56, Number 2 April 2011
distinct, one person’s reactions to another’s suffering
are typically altruistic; in the absence of such percep-
tual boundaries, observation of another’s suffering
can cause the observer severe distress.
The confusion of blending self and other works
both ways; social workers who lack clearly perceived
self–other distinction may not only experience
others’ experiences as their own, but also project
their own motivations onto others, misconstruing
the other’s experience (for example, someone who
usually weeps when angry may project anger onto
another person who is weeping with grief or joy).
This results not in the deep understanding of real
empathy but in the confusion and misunderstanding
Again, mindful observation of reality can help
social workers achieve clear self–other awareness
while also experiencing affective sharing. If I truly
see what is happening in a given situation, I not
only experience empathy for others, I also remain
conscious of the fact that another’s pain, confu-
sion, or sense of disempowerment are not my own.
Simply voicing this fact and teaching aspiring social
workers to articulate it for themselves can help them
modulate their experience of empathy later as they
deal with clients.
component 3: mental flexibility and self-/
Mental flexibility is a sophisticated cognitive abil-
ity that allows us to toggle back and forth between
absorbing another’s perspective and shutting it out,
between identifying with the other and identifying
solely with the self (Decety & Lamm, 2006). Eisen-
berg, Smith, Sadovsky, and Spinard (2004) defined
emotion regulation as “the process of initiating,
avoiding, inhibiting, maintaining, or modulating
the occurrence, form, intensity, or duration of in-
ternal feeling states, emotion-related physiological
processes, emotion-related goals, and/or behavioral
concomitants of emotion, generally in the service
of accomplishing one’s goals” (p. 260).
This, too, is a fundamental key to using empathy
effectively and beneficially. A social worker who can-
not “turn on” receptiveness to others’ experiences
will never bridge the gap between his or her own
experience and that of a client. By the same token,
a social worker who cannot turn off the empathic
awareness of a client’s despair or anxiety after the
workday quickly experiences emotional burnout
and can no longer serve that client.
Self-regulation is typically conceptualized as
a conscious, intentional effort to control one’s
thoughts, emotions, or behaviors. As a result, most
theorists have emphasized that people who wish
to control or change their behavior must pay close
conscious attention to their behavior and exert
deliberate control over it (Baumeister, Heatherton,
& Tice, 1994; Carver & Scheier, 1981; Duval &
wicklund, 1972; Mischel, 1996).
Mindfulness studies suggest that self-observation
is the key to controlling one’s own emotional state
(Langer, 1989). Trying to force a degree of feeling or
detachment is less effective than taking an observing
position in regard to one’s own emotions. In other
words, the way for social workers to modulate affec-
tive sharing and achieve healthy self–other awareness
is to observe both the client and his or her own
thoughts and feelings. The part of the brain that
self-observes is the part that can successfully toggle
between affective sharing and healthy detachment
(Schwartz & Begley, 2003).
Empathy in social work practice is not new, but it
has not been stressed recently in the literature. In
light of new research and interdisciplinary findings,
the value and importance of empathy is critical. re-
search documents the value of empathy, our innate
abilities to be empathic, and the need to tap those
innate abilities, and that this process can be learned.
The three components described in this article are
a start toward enhancing empathy for social work
practitioners. Social work practitioners need to de-
velop their own empathic abilities to enhance their
effectiveness with clients and to protect themselves
from compassion or practice fatigue and burnout.
Awareness and active use of the three components of
affective sharing, self–other awareness, and emotion
regulation/mental flexibility will enhance empathy.
with emerging research and political commitment,
now is the right time to emphasize the place of
empathy in social work practice.
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Karen E. Gerdes, PhD, is associate professor, and Elizabeth
Segal, PhD, is professor, College of Public Programs, School
of Social Work, Arizona State University, 411 North Central
Avenue, Suite 800, Phoenix, AZ 85004; e-mail: [email protected]
Original manuscript received January 26, 2009
Final revision received August 7, 2009
Accepted September 24, 2009