Empathy in person-centred psychotherapy

Everyone wants to feel understood. To feel like their experience is being truly received by the other person. Not just nodded at politely or given a quick “I hear you”, but genuinely, deeply got. When you’re sitting with a therapist, trying to make sense of difficult thoughts or painful feelings, that sense of being truly understood can make all the difference. This is the power of empathy, a central and fundamental element of person-centred psychotherapy.

So, what is empathy, really? Carl Rogers, the founder of person-centred psychotherapy, suggested that empathy was a vital component of helping relationships (Rogers, 1951). This came to form a key element of his theory of therapeutic change, which occurs within the context of relationships characterised by six necessary and sufficient conditions (Rogers, 1957). He described empathy as the ability to step into someone else’s world, “to sense the client’s private world as if it were your own, but without ever losing the “as if” quality” (Rogers, 1967, p. 284). That little “as if” matters. It’s what helps a therapist stay grounded while walking alongside you in your experience.

Empathy in therapy isn’t about fixing you, analysing you, or throwing advice your way. It’s about being present, listening with real attention, and caring enough to understand; not just the words you say, but the meaning behind them. When empathy is genuine, you can feel it. You feel seen, safe, and not alone in what you’re carrying. And research shows us how essential this is, studies have consistently showed that your experience of empathy in therapy is strongly linked to how much benefit you’ll get from it (Barrett-Lennard, 1962; Chui et al, 2022; Elliott et al, 2018)

It’s not about the therapist ticking a box or using a set technique. It’s about a real, human connection. Grant (2010) sees empathy as a process involving both client and therapist, where therapists’ need to attend carefully to what clients say in order to get what they mean. Empathy isn’t something the therapist does to the client, it’s something you create together, moment-by-moment. Ho (2024) suggests the concept of the Process of Interpersonal Empathy (PIE), that “through reciprocal interactions, the counselor and the client reach a mutual understanding, known as empathic understanding” (p. 45). As the client, you’re active in this process of empathy. Psychotherapy isn’t something that just happens to you, it’s something you’re an active part of. Person-centred psychotherapists believe that you're not broken or in need of repair, you’re a human being with the capacity to grow, change, and heal. Feeling empathically understood helps you tap into that capacity.

Now, a common misunderstanding, especially if you've seen therapy portrayed on TV, is that empathy is no more than the parroting of reflections (Wilkins, 2016). But person-centred empathy isn’t a technique but a values-based attitude. It’s a way of being, founded on that belief in your capacity to change and heal. Just repeating your words back to you feels inauthentic and mechanised. It’s about your psychotherapist being present, being real, and responding to you as you. Bozarth, a key person-centred theorist, refers to this as idiosyncrasy (Bozarth, 1998). Every therapeutic relationship is unique, and so empathy will look and feel different for each duo. It’s flexible, responsive, and deeply personal.

Is it really possible to be that empathic? Some critics, such as Masson (1998) say that no one can really be that accepting or understanding, that therapists are just playing a role. But from a person-centred perspective, empathy isn’t about perfection. It’s about trying. It’s about showing up for you, listening with care, and being willing to sit with you in the difficult and painful moments. And yes, we all have biases and blind spots. But in therapy, empathy is an ethical commitment to move beyond surface-level assumptions and really try to understand, no matter who you are or what you bring.

Empathy has consistently been shown to be one of the strongest predictors of positive outcomes in therapy — across all therapeutic modalities (Browne et al, 2021). "Research has consistently demonstrated that therapist empathy is one of the most potent predictors of client progress in psychotherapy across every therapeutic modality" (Watson, 2016, p. 115). When it’s really present, change is possible. You feel more able to open up. More able to reflect. And more able to grow and heal.

But it’s important to remember that in person-centred psychotherapy, empathy doesn’t stand alone. The conditions of empathy, congruence (authenticity) and UPR (unconditional positive regard) are inseparable. Together, they create a therapeutic environment where real change can happen. Elliott et al remind us that “research has shown empathy to be inseparable from the other relational conditions… Empathy will probably not prove effective unless it is grounded in authentic caring for the client” (2019, p. 277).

If you’ve ever had counselling where you didn’t feel understood, or felt seen just as a label or a collection of symptoms, it’s okay to want more than just someone who listens politely. You deserve a space where you feel truly seen. Person-centred psychotherapy can offer that, and so much more. But it starts with a relationship that feels safe, honest, and human.

References

Barrett-Lennard, G. T. (1962). Dimensions of Therapist Response as Causal Factors in Therapeutic Change. Psychological Monographs: General and Applied, 76(43), 1–36. https://doi.org/10.1037/h0093918

Bozarth, J. (1998). Person-Centred Therapy: A Revolutionary Paradigm. PCCS Books.

Browne, J., Cather, C., & Mueser, K. (2021, February 23). Common Factors in Psychotherapy. Oxford Research Encyclopedia of Psychology. Retrieved 10 Oct. 2024, from https://oxfordre.com/psychology/view/10.1093/acrefore/9780190236557.001.0001/acrefore-9780190236557-e-79

Chui, H., Li, X., & Luk, S. (2022). Therapist emotion and emotional change with clients: Effects on perceived empathy and session quality. Psychotherapy, 59(4), 594–605. https://doi.org/10.1037/pst0000442

Elliott, R., Bohart, A. C., Watson, J. C., & Murphy, D. (2018). Therapist empathy and client outcome: An updated meta-analysis. Psychotherapy, 55(4), 399–410. https://doi.org/10.1037/pst0000175

Elliott, R., Bohart, A. C., Watson, J. C., & Murphy, D. (2019). Empathy. In Norcross, J. C., & Lambert, M. J. (Eds.). Psychotherapy Relationships That Work, (pp. 245-287). Oxford University Press.

Grant, B. (2010). Getting the Point: Empathic Understanding in Nondirective Client-Centered Therapy. Person-Centered & Experiential Psychotherapies, 9(3), 220-235  https://doi.org/10.1080/14779757.2010.9689068

Ho, C. M. (2023). Process of interpersonal empathy: a proposed framework of empathy competence in psychotherapies. Person-Centered & Experiential Psychotherapies, 23(1), 39–53. https://doi.org/10.1080/14779757.2023.2174446

Masson, J. (1988). Against Therapy. Athenium.

Rogers, C. (1951). Client-Centred Therapy. Robinson.

Rogers, C. (1957). The Necessary and Sufficient Conditions of Therapeutic Personality Change. Journal of Consulting Psychology. 21(2), 95–103. Reprinted in Kirschenbaum, H., & Henderson, V.L. (Eds.) (1996). The Carl Rogers Reader. (pp. 219-235). Houghton Mifflin.

Rogers, C. (1967). On Becoming a Person, (1st ed.). Constable

Watson, J. C. (2016). The role of empathy in psychotherapy: Theory, research, and practice. In D. J. Cain, K. Keenan, & S. Rubin (Eds.), Humanistic psychotherapies: Handbook of research and practice (2nd ed., pp. 115–145). American Psychological Association. https://doi.org/10.1037/14775-005

Wilkins, P. (2016). Person-Centred Therapy: 100 Key Points and Techniques (2nd ed.). Routledge.