Empathy as ‘appraisal’
A new language-based approach to the exploration of clinical empathy
DOI:
https://doi.org/10.1558/japl.v7i2.145Keywords:
Discourse analysis, ‘appraisal’, empathy, attitudinal meaning, medical training, doctor-patient interactionAbstract
It is widely argued that empathy can and should be taught as part of medical training and attempts have been made to incorporate the teaching of empathy in medical school programmes of study. Empathy, however, is particularly difficult to define and measure. Various definitions and rating scales have been used but no systematic overview of the potential verbal realisation of empathy has so far been produced. This study is concerned with providing such an overview. The existing consultation training material aimed at medical professionals (e.g. Piasecky, 2003; Silverman et al. 2005 and Moulton, 2007) and relevant linguistic studies (Suchman et al. 1997; Wynn and Wynn, 2006 and Martinovsky et al. 2007) form the basis for the exploration of relevant dimensions of empathy and its potential verbal realisation. The ‘appraisal’ framework (Martin and White, 2005) developed within a systemic functional approach to discourse analysis is then used to help build a provisional framework of the levels of attitudinal (particularly, affective) expression inherent in empathic communication. Suggestions are made as to how the validity of the expressive categories identified may be tested and further refined and how the insights from this study may be applied within the medical context.
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Yu, Juping and M. Kirk (2008) Measurement of empathy in nursing research: systematic review. Journal of Advanced Nursing 64 (5): 440–454. http://dx.doi.org/10.1111/j.1365- 2648.2008.04831.x
Alligood, M. R. (1992) Empathy: the importance of recognizing two types. Journal of Psychosocial Nursing and Mental Health Services 30 (3): 14–17.
Aragno, A. (2008) The language of empathy: An analysis of its constitution, development and role in psychoanalytic listening. Journal of Psychoanalytic Association 56 (3): 713– 740. http://dx.doi.org/10.1177/0003065108322097
Bachelor, A. (1988) How clients perceive empathy: A content analysis of ‘received’ empathy. Psychotherapy 25: 227–240. http://dx.doi.org/10.1037/h0085337
Bonvicini, K. A., Perlin, M. J., Bylund, C. L., Carroll, G., Rouse R. A. and Goldstein, M. G. (2009) Impact of communication training on physician expression of empathy in patient encounters. Patient Education and Counselling 75: 3–10. http://dx.doi.org/10.1016/j. pec.2008.09.007
Damasio, A. (1994) Descartes’ Error: Emotion, Reason and the Human Brain. New York: Grosset/Putnam.
Davis, M. H. (1994) Empathy: A Social and Psychological Approach. Madison, WI: Brown and Benchmark.
Eggins, S. and Slade, D. (1997) Analysing Casual Conversation. London: Equinox.
Fox, R. and Lief, H. (1963) Training for ‘detached concern’. In H. Lief (ed.) The Psychological Basis of Medical Practice, 12–35. New York: Harper and Row.
Frankel, R. M. (2009) Empathy Research: A Complex Challenge. Patient Education and Counselling 75: 1–2. http://dx.doi.org/10.1016/j.pec.2009.02.008
Halliday, M. A. K. (1994) An Introduction to Functional Grammar. 2nd edn. London: Edward Arnold. Halliday, M. A. K. and Matthiessen, C. (2004) An Introduction to Functional Grammar. 3rd edn. London: Edward Arnold.
Halpern, J. (2001) From Detached Concern to Empathy: Humanizing Medical Practice. Oxford: Oxford University Press.
Hemmerdinger, J. M., Stoddart, S. D. R. and Lilford, R. J. (2007) A systematic review of tests of empathy in medicine. BMC Medical Education 7 (24). Available from http://www. biomedcentral.com/1472-6920-7-24
Hojat, M., Mangione, S., Nasca, T. J., Cohen, M. J. M., Gonnella, J. S., Erdmann, J. B., Veloski, J. and Magee, M. (2001) The Jefferson scale of physician empathy: development and preliminary psychometric data. Educational and Psychological Measurement 61: 349–365. http://dx.doi.org/10.1177/00131640121971158
Hojat, M., Gonnella, J. S., Nasca, T. J., Mangione, S., Veloksy, J. J. and Magee, M. (2002) Physician empathy: Definition, components, measurement and relationship to gender and specialty. American Journal of Psychiatry 159 (9): 1563–1569. http://dx.doi.org/ 10.1176/appi.ajp.159.9.1563
Kurtz, S. M. and Silverman, J.D. (1996) The Calgary-Cambridge Observation Guides: An aid to defining the curriculum and organising the teaching in communication training programmes. Medical Education 30: 83–89. http://dx.doi.org/10.1111/j.1365-2923.1996. tb00724.x
La Monica E. L. (1981) Construct validity of an empathy instrument. Research in Nursing and Health 4: 389–400. http://dx.doi.org/10.1002/nur.4770040406
Levinson, W., Gorawara-Bhat, R. and Lamb J. (2000) A study of patient clues and physician responses in primary care and surgical settings. Journal of American Medical Association 284: 1021–1027. http://dx.doi.org/10.1001/jama.284.8.1021
Lloyd, M. and Bor, R. (2009) Communications Skills for Medicine. 3rd edn. London, New York: Churchill Livingstone Elsevier.
Looi, J. C. L. (2008) Empathy and competence. Medical Journal of Australia 138 (7): 414– 416.
Martin, J. R. and White, P. R. R. (2005) The Language of Evaluation. New York: Palgrave.
Martinovski, B., Traum, D. and Marsella S. (2007). Rejection of empathy in negotiation. Group Decision and Negotiation 16: 61–76. http://dx.doi.org/10.1007/s10726-006-9032-z
Mercer, S. W., Maxwell, M., Heaney D. and Watt G. C. M. (2004) The consultation and relational (CARE) measure: Development and preliminary validation and reliability of an empathy-based consultation process measure. Family Practice 21 (6): 699–705. http:// dx.doi.org/10.1093/fampra/cmh621
Miller, W. R. and Rollnick, S. (2002) Motivational Interviewing: Preparing People for Change. 2nd edn. New York: The Guilford Press.
Moulton, L. (2007) The Naked Consultation: A Practical Guide to Primary Care Consultation Skills. Abingdon: Radcliffe.
Piasecky, M. (2003) Clinical Communication Handbook. Oxford: Blackwell Science.
Segal, E. S. (1995) Mantaining communication in a time of uncertainty. Archives of Family Medicine 4: 1066–1067. http://dx.doi.org/10.1001/archfami.4.12.1066
Silverman, J., Kurtz, S. and Draper, J. (2005) Skills for Communicating with Patients. 2nd edn. Abingdon: Radcliffe.
Spiro, H. (1992) What is empathy and can it be taught? Academia and Clinic 116 (10): 843–846.
Stephan, W. G. and Finlay, K. (1999) The role of empathy in improving intergroup relations. Journal of Social Issues 55 (4): 729–44. http://dx.doi.org/10.1111/0022-4537.00144
Street Jr, R. L., Gordon, H. S., Ward, M. M, Krupat, E. and Kravitz R. L. (2005) Patient participation in medical consultations: why some patients are more involved than others? Medical Care 43: 960–969. http://dx.doi.org/10.1097/01.mlr.0000178172.40344.70
Suchman, A. L., Markakis K., Beckman, H. B. and Frankel, R. (1997) A model of empathic communication in the medical interview. Journal of American Medical Association 277 (8): 678–682. http://dx.doi.org/10.1001/jama.277.8.678
Wynn, R. and Wynn, M. (2006) Empathy as an interactionally achieved phenomenon in psychotherapy: Characteristics of some conversational resources. Journal of Pragmatics 38: 1385–1397. http://dx.doi.org/10.1016/j.pragma.2005.09.008
Young, L. and Fitzgerald, B. (2006) The Power of Language: How Discourse Influences Society. London: Equinox.
Yu, Juping and M. Kirk (2008) Measurement of empathy in nursing research: systematic review. Journal of Advanced Nursing 64 (5): 440–454. http://dx.doi.org/10.1111/j.1365- 2648.2008.04831.x
Published
2011-11-08
Issue
Section
Articles
License
Equinox Publishing Ltd.
How to Cite
Pounds, G. (2011). Empathy as ‘appraisal’: A new language-based approach to the exploration of clinical empathy. Journal of Applied Linguistics and Professional Practice, 7(2), 145-168. https://doi.org/10.1558/japl.v7i2.145
