Development of the Therapist Empathy Assessment Scale (TEAS) and comparison of therapists' empathy levels across specializations

Background As one of the strongest predictors of therapeutic outcome, the assessment of empathy from the client's perspective within a multidimensional framework is of critical importance. The aim of this study was to develop the "Therapist Empathy Assessment Scale" (TEAS), based on Richard Erskine's Integrative Psychotherapy approach, and to compare the empathy levels of therapists from different psychotherapeutic orientations in terms of both client perception and self-report. Methods The study was conducted with two independent samples: 315 clients (M age = 35.9 years, 82.5% female) currently in therapy and 100 therapists (M age = 41.0 years, 82.0% female) with at least one year of clinical experience. Clients completed the TEAS to assess their therapists' empathy, while therapists completed the Toronto Empathy Questionnaire (TEQ) for self-reported empathy. The construct validity of the TEAS was examined using Exploratory Factor Analysis and Confirmatory Factor Analysis. Convergent and discriminant validity were assessed using Average Variance Extracted and the Fornell-Larcker criterion. Reliability was evaluated through Cronbach's alpha, Composite Reliability, and test-retest correlations. Independent samples t-tests were used to compare empathy levels across eight therapeutic orientations. Results The analyses demonstrated that the TEAS is a valid and reliable 19-item instrument consisting of four subscales: Cognitive Empathy, Affective Empathy, Empathic Concern, and Behavioral Empathy (Cronbach's α = .82-.93). Comparisons across therapeutic orientations revealed that clients of therapists practicing Integrative Psychotherapy and Transactional Analysis reported significantly higher perceived empathy scores on all TEAS subscales and the total score compared to other orientations. In contrast, EMDR and Schema Therapy showed significantly higher scores only in the Behavioral Empathy dimension. However, therapists' self-reported empathy levels (measured by TEQ) did not differ significantly across orientations. Conclusions These results confirm that the TEAS is a psychometrically robust tool for psychotherapy research. Furthermore, the findings suggest that therapeutic orientation determines not the therapist's "internal empathy capacity," but rather how this capacity is expressed in the session and perceived by the client.