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

D uring 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
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,
left office, Barack Obama won the presidency in 2000; Ickes, 1997).
part by calling attention to an “empathy deficit” in In 2004, Decety and Jackson surveyed the numer-
government and public service. Identifying with ous definitions and conceptualizations of empathy
another person’s emotions—the phenomenon we found in academic and professional literature.They
call empathy—is the foundation on which all useful identified three subjective experiences and three
public service and, indeed, the social contract itself communicative abilities that, in one form or an-
is predicated. other, are universally cited as signature ingredients
Empathy is particularly important to social work of empathy (see Table 1).
practice. Clients experiencing empathy through As Table 1 reveals, there are two components to
treatment have improved outcomes. Empathic social empathy: the emotional and the cognitive. Vinton
work practitioners are more effective and can bal- and Harrington (1994) noted the difference between
ance their roles better. Social work practitioners can the two elements, as have many others (for example,
and should learn about emerging social–cognitive Davis et al., 2004). They labeled them (1) emotional
neuroscience research on empathy and use that empathy—the ability to be affected by the client’s
information to better serve their client popula- emotions—and (2) expressed [cognitive] empathy—the
tions. This article focuses on empathy as an asset to translation of such feelings into words.
practitioners. Historically, there has been some controversy as
to the relative primacy of the emotional/affective
What Is Empathy? elements of empathy and the expressed/cognitive
Barker (2003), in the Social Work Dictionary, defined elements (Cliffordson, 2001; Decety & Jackson,
empathy as “the act of perceiving, understanding, 2004; Funk, Fox, Chan, & Curtiss, 2008). For ex-
experiencing, and responding to the emotional state ample, Rogers (1957) and Hoffman (1981) focused
and ideas of another person” (p. 141). Barker’s defi- more on empathy as an innate and involuntary
nition is an abbreviated summary of the numerous response to an affective signal or prompt, whereas
definitions that have been put forward by influential behaviorists focused more on empathy as a learned

Gerdes
CCC and Segal$3.00 
Code: 0037-8046/11  / Importance of Empathy
©2011 National forofSocial
Association SocialWork Practice:
Workers Integrating New Science 141
 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
state
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.

communication, or as conscious role taking (Bat- (Bryant, 1982; Davis, 1983).The glaring problem in
son, 1991; Davis, 1996). Kohut (1959) was one of the current clinical outcome literature is that there
the first to articulate that both the conscious (for is still no agreed-on conceptualization of empathy.
example, perspective taking) and implicit or uncon- As a result, “operational definitions of empathy are
scious (for example, emotion sharing) processes are not consistent across studies” (Pithers, 1999, p. 258).
vital to empathy and must be integrated to achieve Measurement techniques for empathy vary so much
a true empathic reaction or response. that it has been difficult to engage in meaningful
comparisons or make significant conclusions about
Empathy in Existing Social empathy and how to cultivate it effectively in social
Work Literature workers and clients (Cliffordson, 2001).
It is hardly new to proclaim that empathy is a critical Today, numerous disciplines are researching
and essential ability for effective social work prac- and analyzing empathy. Recent groundbreaking
tice; this has been stated explicitly by many social research on this issue has emerged from primatol-
work educators (for example, Hepworth, Rooney, ogy and ethology (de Waal, 2003); neuroscience
Rooney, Strom-Gottfried, & Larsen, 2006; Orlinsky (Ramachandran, 2000); developmental psychology
& Howard, 1975; Shulman, 2009). Yet actual research (Batson, 2006; Batson et al., 2003); and, perhaps
on empathy, as well as evidence of empathy training most important, the nascent field of social–cognitive
in the social work curriculum, remains scarce and neuroscience (Decety & Jackson, 2004; Decety &
sketchy. NASW’s Encyclopedia of SocialWork (Mizrahi Lamm, 2006). This article is meant to bring find-
& Davis, 2008) contains no entry for “empathy”—a ings from this last field into social work’s body of
glaring omission that illustrates the generally narrow literature, thus reopening a discussion that could
and haphazard consideration of empathy in the social have powerful influence on the way social work-
work literature (Freedberg, 2007; Raines, 1990). ers conceptualize and measure empathy and, more
A generation of social workers, including the important, how they practice it.
present authors, were schooled using Rogers’s
(1959) conceptualization of empathy as the ability Importance of Empathy to
to perceive the internal emotional state of another Social Work
“as if ” they were that person. A nonjudgmental, Research demonstrates that empathy is an important
accepting reflection of the client’s emotional state tool for positive therapeutic intervention (Watson,
was critical to the effectiveness of the practitioner– 2002). Clients experiencing empathy through
client relationship. Later, Rogers (1975) revised his treatment by others inhibits antisocial behavior in
conceptualization of empathy from a “state” to more children and adolescents (Eisenberg, Spinard, &
of a “moment-to-moment process of felt meaning,” Sadovsky, 2005; Hoffman, 2000). Empathy inhibits
in which the practitioner was constantly checking aggression toward others (Weisner & Silbereisen,
the accuracy of his or her interpretation of the cli- 2003) and promotes healthy personal development
ent’s “felt meaning.” (Hoffman, 2001).The lack of empathy is correlated
In the 1980s, Rogers’ conceptualization of with bullying, aggressive behavior, violent crime,
empathy was overshadowed by psychologists and and sexual offending (Gini,Albieri, Benelli, & Altoe,
social workers who were more concerned with 2008; Joliffe & Farrington, 2004; Loper, Hoffschmidt,
implementing cognitive–behavioral interventions & Ash, 2001; Sams & Truscott, 2004).
and wanted empirical measurements for both A practitioner’s own level of empathy is correlated
affective and cognitive components of empathy with positive client outcomes (Forrester, Kershaw,

142 Social Work  Volume 56, Number 2  April 2011

Moss, & Hughes, 2008). Jensen, Weersing, Hoag- primatology, have identified the major physiologi-
wood, and Goldman (2005) completed a review cal mechanism of empathy and begun to elucidate
of 52 child psychotherapy treatment studies and how the experience of empathy actually occurs in
concluded that therapist empathy, attention, and the brain. Their findings give empirical support to
positive regard are essential to effective outcomes. research on empathy in social interactions.
Forrester et al. (2008) found that empathy is central Connecting these areas of research yields an
to effective communication in child protection situ- important and exciting conclusion: Empathy can
ations. Empathy is critical to both practitioner and be taught, increased, refined, and mediated to make
client outcomes. helping professionals more skillful and resilient.
Understanding how empathy works can help social
Science of Empathy: New Findings workers “in the trenches” connect more empathi-
and Their Implications cally with clients from a wider range of sociocultural
New research on empathy is rich and varied. Some backgrounds while making them less vulnerable to
of the emerging research is highlighted in Table becoming overwhelmed, burnt out, or dysfunction-
2. An exhaustive analysis of all findings falls well ally enmeshed with clients.
beyond the scope of a single article. This article
focuses on what we believe to be one of the most Mirror, Mirror: How Empathy Occurs
important bodies of work, the comparatively new in the Brain
field of social–cognitive neuroscience, and its im- One day, a researcher who was studying brain activ-
plications for social work practice. Researchers in ity in monkeys stumbled on a strange phenomenon:
this field, basing their work on observations from 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 &
Craighero, 2004).
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
Waal, 2002).
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).

Gerdes and Segal / Importance of Empathy for Social Work Practice: Integrating New Science 143
brain activity that indicated he was eating when in component on its own, the authors claimed, is in-
fact he was motionless. After some investigation, sufficient to produce empathy. Those components
the researcher realized that the monkey’s brain was are as follows:
reacting to seeing another animal eat. In short, part
of the motionless monkey’s brain appeared to be • affective sharing between the self and the
actually experiencing the other monkey’s sensations other, based on perception–action coupling
(Gallese, Fadiga, Fogassi, & Rizzolatti, 1996). that lead[s] to shared representations;
Much more research followed, with social– • self–other awareness. Even when there is some
cognitive neuroscientists picking up on the results temporary identification, there is no confusion
from primatology. Ultimately, the neuroscientists between self and other; [and]
identified a class of cells in the brain (both animal • mental flexibility [that is, emotion regulation]
and human) that they named “mirror neurons.” to adopt the subjective perspective of the
These cells fire when an individual observes another other and also regulatory processes. (Decety
person or animal having some sort of experience or & Jackson, 2004)
sensation. The discovery of mirror neurons shows
that the phrase “I feel your pain” may be literally The first component of the model, affective
true—not that the speaker is actually experiencing sharing with others, is largely an unconscious or
the other person’s feelings, but that the speaker’s automatic experience. When we listen to someone
brain creates very real sensations in response to describe his or her feelings verbally or observe
that other person’s experience (Kaplan & Iacoboni, gestures, facial expressions, and vocal tone, and so
2006). Mirror neurons appear to be the primary forth (that is, perception and action coupling), neural
physiological mechanism of empathy (Wolf, Gales, networks in our brains are stimulated by the “shared
Shane, & Shane, 2001). representations” and generate similar feelings within
Is this innate physiological ability mutable? Can us.This is the involuntary action of mirror neurons
people lacking sufficient empathy be taught to be and is therefore automatic.
more empathic? Further research has shown that Unlike affective sharing, the second and third
the brain is changeable, a phenomenon known as components of the empathy model—self–other
“neuroplasticity,” and deliberately changing one’s awareness and the mental flexibility to regulate
mental state begins with observing that mental state. one’s own emotions—are not automatic. On the
Social workers are trained to be self-reflective, and contrary, they are sophisticated cognitive skills that
this ability is central to enhancing empathy. Cog- allow humans to voluntarily take the perspective
nitively adopting the perspective of another evokes of others—and like other sophisticated cognitive
stronger empathic concern. In other words, thinking skills, they can be learned, increased, and perhaps
about another’s experience adds more empathy than ultimately even mastered (Decety & Lamm, 2006).
simply observing it (Batson et al., 2003; Jackson, Social workers can benefit enormously from being
Brunet, Meltzoff, & Decety, 2006; Lamm, Batson, educated to modulate their own experience of em-
& Decety, 2007).The practice of actively observing pathy cognitively. They can then both connect with
clients’ behaviors and simultaneously processing others—even those whose socioeconomic, cultural,
those behaviors cognitively are not new to social or physiological experience is very different from
work practice, but they have not been identified as their own—and prevent “empathic overarousal,”
critical to developing practitioner empathy. which can lead to personal distress, egoistic behav-
iors, or burnout (Eisenberg, 2000).
Components Necessary to
Generate Empathy Guide for Practitioners:
Following Kohut’s lead in combining the affective Enhancing Empathy
and cognitive aspects of empathy, Decety and Jackson Component 1: Affective Sharing/
(2004) and Decety and Lamm (2006) proposed the Perception and Action Coupling
first truly interdisciplinary conceptualization of the Establishing empathy is simple, though not always
phenomenon.There are three necessary, functional easy. We now know that the brain inherently and
components that dynamically interact to generate involuntarily triggers shared reactions neurologi-
the subjective experience of empathy. Any one cally when we are observing others’ experiences.

144 Social Work  Volume 56, Number 2  April 2011

This is most likely due to the involuntary firing of deeply listens to a woman’s story of a difficult child-
mirror neurons, the “brain cells that reflect the activity birth, noticing her tone and words and watching her
of another’s brain cells” (Rothschild, 2006, p. 42). nonverbal gestures, might begin to experience the
Beginning in infancy, mirror neurons help each hu- feelings of pain, fear, and joy that are associated with
man’s brain map the orafacial and manual gestures of giving birth. Like anyone who pays close empathic
others onto the baby’s own motor systems (Kaplan attention, he may also unconsciously mimic her facial
& Iacoboni, 2006).These shared representations are expression and body positions, a somatic “echo” of
stored or encoded in our neural networks and, when feelings that he himself could never physically ex-
stimulated, automatically enable us to empathize perience except through empathy. Educators who
with or share the feelings of another (Decety & familiarize social workers to the concepts of affective
Lamm, 2006). Researchers now believe that autism sharing and perception–action coupling will facili-
may in part be explained by a failure to develop or tate a more rewarding and productive experience
form adequate neural circuitry or mirror neurons for both the social workers and their clients.
that enable language and social brain pathways to
mature (Iacoboni & Dapretto, 2006). Component 2: Self–Other Awareness
The neural networks created by the shared rep- Affective sharing is crucial in all the helping profes-
resentation process of gestures, body language, and sions, but as documented in the social work literature,
vocal tone are like the “hardware” of the human it can also lead to emotional and physical burnout
brain. Other shared representations, such as words, (Eisenberg, 2000). Many social workers who have
are more like “software.”They capitalize on the in- a very strong capacity to share their clients’ feelings
nate capacity for empathy to create affective sharing have trouble disengaging from the clients and, thus,
through deliberate communication of feelings. Of take on many of the very burdens they are trying to
course, such representations are more specific and ease.This degree of enmeshment is not constructive;
controllable than the visceral, automatic empathic re- it prevents clear and constructive action. Surgeons
actions arising from hardwired somatic responses. are not allowed to operate on people with whom
Both of these neurological pathways to empathy they share deep emotional bonds precisely because
involve paying close attention to another person: not objectivity is required as a foundation for offering
theorizing or analyzing, but being fully attentive to help. A surgeon who fully identified with the pain
another’s behavior, facial expression, tone of voice, of a patient’s gunshot wound or shattered bones
choice of words, and so on. It is empirical observa- would require help rather than be able to give it.The
tion at its purest. This means that while theory is same is true of social workers who hope to heal the
necessary for analyzing and initiating solutions to wounds of poverty, violence, or mental illness.
a problem, the only thing a social worker must do From an educational perspective, social work-
to experience affective sharing or perception with ers should be taught that, counterintuitively, true
a client is to truly see the client’s actions, gestures, empathy cannot exist without a strong sense of self
facial expressions, and other behaviors and to truly as separate from other. Self-awareness allows us to
hear the words, tone of voice, and content of the disentangle our own feelings from the feelings of
client’s story. This is referred to as “perception and others, prevents empathic overarousal in emotion
action coupling” (Kaplan & Iacoboni, 2006). sharing, and allows us to make cognitive inferences
Too often, educational systems focus on cognitive about the mental state or perspective of others
understanding at the expense of clear, uncompli- (Decety & Lamm, 2006). In other words, self–
cated perception.Training of social workers should other awareness acts as a brake on the automatic
include alerting them to the dangers of blunting link between perception and emotion that occurs
or blocking their observational powers. Instructing in affective sharing and allows us to take a more
them to observe their clients mindfully—that is, detached perspective.
without imposing immediate cognitive categories Social workers who lack the awareness of being
on their behavior—can help free social workers’ separate from clients turn the reflexive aspects of
brains to automatically mirror a client’s subjective empathy into an intolerable burden for themselves.
experience. Without perceptual boundaries, they risk experienc-
For example, a male social worker who deliber- ing a client’s feelings of anger, depression, anxiety, or
ately puts aside his own intellectual constructs and joy as their own feelings.With self–other boundaries

Gerdes and Segal / Importance of Empathy for Social Work Practice: Integrating New Science 145
distinct, one person’s reactions to another’s suffering Self-regulation is typically conceptualized as
are typically altruistic; in the absence of such percep- a conscious, intentional effort to control one’s
tual boundaries, observation of another’s suffering thoughts, emotions, or behaviors. As a result, most
can cause the observer severe distress. theorists have emphasized that people who wish
The confusion of blending self and other works to control or change their behavior must pay close
both ways; social workers who lack clearly perceived conscious attention to their behavior and exert
self–other distinction may not only experience deliberate control over it (Baumeister, Heatherton,
others’ experiences as their own, but also project & Tice, 1994; Carver & Scheier, 1981; Duval &
their own motivations onto others, misconstruing Wicklund, 1972; Mischel, 1996).
the other’s experience (for example, someone who Mindfulness studies suggest that self-observation
usually weeps when angry may project anger onto is the key to controlling one’s own emotional state
another person who is weeping with grief or joy). (Langer, 1989).Trying to force a degree of feeling or
This results not in the deep understanding of real detachment is less effective than taking an observing
empathy but in the confusion and misunderstanding position in regard to one’s own emotions. In other
of overidentification. words, the way for social workers to modulate affec-
Again, mindful observation of reality can help tive sharing and achieve healthy self–other awareness
social workers achieve clear self–other awareness is to observe both the client and his or her own
while also experiencing affective sharing. If I truly thoughts and feelings. The part of the brain that
see what is happening in a given situation, I not self-observes is the part that can successfully toggle
only experience empathy for others, I also remain between affective sharing and healthy detachment
conscious of the fact that another’s pain, confu- (Schwartz & Begley, 2003).
sion, or sense of disempowerment are not my own.
Simply voicing this fact and teaching aspiring social Conclusion
workers to articulate it for themselves can help them Empathy in social work practice is not new, but it
modulate their experience of empathy later as they has not been stressed recently in the literature. In
deal with clients. light of new research and interdisciplinary findings,
the value and importance of empathy is critical. Re-
Component 3: Mental Flexibility and Self-/ search documents the value of empathy, our innate
Emotion Regulation abilities to be empathic, and the need to tap those
Mental flexibility is a sophisticated cognitive abil- innate abilities, and that this process can be learned.
ity that allows us to toggle back and forth between The three components described in this article are
absorbing another’s perspective and shutting it out, a start toward enhancing empathy for social work
between identifying with the other and identifying practitioners. Social work practitioners need to de-
solely with the self (Decety & Lamm, 2006). Eisen- velop their own empathic abilities to enhance their
berg, Smith, Sadovsky, and Spinard (2004) defined effectiveness with clients and to protect themselves
emotion regulation as “the process of initiating, from compassion or practice fatigue and burnout.
avoiding, inhibiting, maintaining, or modulating Awareness and active use of the three components of
the occurrence, form, intensity, or duration of in- affective sharing, self–other awareness, and emotion
ternal feeling states, emotion-related physiological regulation/mental flexibility will enhance empathy.
processes, emotion-related goals, and/or behavioral With emerging research and political commitment,
concomitants of emotion, generally in the service now is the right time to emphasize the place of
of accomplishing one’s goals” (p. 260). empathy in social work practice. 
This, too, is a fundamental key to using empathy
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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

148 Social Work  Volume 56, Number 2  April 2011