The Construction and Testing of a New Empathy Rating Scale

Western Michigan University ScholarWorks at WMU Master's Theses Graduate College 8-1980 The Construction and Testing of a New Empathy Rating Scale Gary D. Gray Western Michigan University Follow this and additional works at: https://scholarworks.wmich.edu/masters_theses Part of the Educational Psychology Commons Recommended Citation Gray, Gary D., "The Construction and Testing of a New Empathy Rating Scale" (1980). Master's Theses. 1864. https://scholarworks.wmich.edu/masters_theses/1864 This Masters Thesis-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Master's Theses by an authorized administrator of ScholarWorks at WMU. For more information, please contact maira.bundza@wmich.edu.

THE CONSTRUCTION AND TESTING OF A NEW EMPATHY RATING SCALE by G ary D. Gray A T h e sis S u b m itted to th e F a c u lty o f th e G rad u ate C o lle g e i n p a r t i a l f u lf i llm e n t o f th e D egree o f M aster o f A rts D epartm ent o f P sychology W estern M ichigan U n iv e rs ity K alam azoo, M ichigan A u g u st, 1980

ACKNOWLEDGMENTS T h is s tu d y was p o s s ib le o n ly b ecause o f th e p e rs e v e ra n c e and in tr e p id n e s s o f th e fo u r r a t e r s who d ev o ted many h o u rs i n h e lp in g to c o n s tr u c t th e em pathy r a t i n g s c a le and e s p e c ia lly i n th e d i f f i c u l t d e c isio n -m a k in g ta s k o f r a t i n g th e s u b j e c t s ' 324 w r itte n re s p o n s e s. I am in d e b te d to Jo an M cg innis, J e f f P in g e l, Mai R o b e rtso n, and S an d ra S a n d e rs. I w ish a ls o to acknow ledge th e e f f o r t s o f C h ris K oronakos, n o t o n ly i n e d i tin g t h i s t h e s i s, b u t f o r making c r i t i c a l and u s e f u l s u g g e s tio n s c o n c e rn in g th e d e s ig n o f t h i s stu d y. Gary D. Gray i i

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1315253 GRAY* GARY DON THE C0NSTRUCT10JI AND TESTING OF A NEW EMPATHY RATING SCALE. WESTERN MICHIGAN UNIVERSITY. M.A., 1980 Unheisty MicrpfBrns international *» n. z e e s r o a d, a n n a r b o r, m i «s i o 6

TABLE OF CONTENTS INTRODUCTION... 1 METHODS... 6 PAGE Empathy T ra in in g Method... 6 C lie n ts, S u b je c ts, and R a t e r s... 6 R a tin g o f S u b je c ts ' R esponses... 7 M ethods o f A ssessin g I n t e r r a t e r A greem ent... 8 S t a t i s t i c a l A nalyses... 10 RESULTS... 11 A Comparison o f th e R a tin g s Given to th e Two Groups o f N aive and E x p erien ced S u b je c ts B efore and A fte r Empathy T r a i n i n g... 11 The R a tin g s o f I n d iv id u a l S u b je c ts w ere Compared B efo re and A f te r T r a i n i n g... 13 R a tin g s o f S u b je c ts R esponses to a V a rie ty o f C lie n t S tatem en ts... 15 Use o f th e Empathy R a tin g S cale to D e te c t In d i v id u a l S u b je c t's I d io s y n c r a tic P a tte r n s in A cq u irin g Empathy S k i l l s... 20 I n t e r r a t e r Agreem ent: C a lc u la tio n o f th e O v e ra ll P e rc e n t D e v ia tio n... 22 I n t e r r a t e r A greem ent: Comparison o f In d iv id u a l R a t e r 's Ranking o f S u b je c t R esponses w ith th a t o f th e P an el o f R a te rs... 24 DISCUSSION... 26 APPENDIX A... 36 APPENDIX B... 42 APPENDIX C... 45

TABLE OF CONTENTS (Continued) PAGE APPENDIX D... 47 BIBLIOGRAPHY... 52 iv

LIST OF TABLES TABLE NO. PAGE 1 A COMPARISON OF THE RATINGS GIVEN TO THE TWO GROUPS OF NAIVE AND EXPERIENCED SUBJECTS BEFORE AND AFTER EMPATHY TRAINING... 12 2 RATINGS OF INDIVIDUAL SUBJECT RESPONSES TO ALL NINE CLIENT'S STATEMENTS BEFORE AND AFTER EMPATHY TRAINING... 14 3 RATINGS OF NAIVE SUBJECT RESPONSES TO NINE DIFFERENT CLIENT STATEMENTS BEFORE AND AFTER EMPATHY TRAINING... 16 4 RATINGS OF ALL SUBJECT RESPONSES TO NINE DIFFERENT CLIENT STATEMENTS BEFORE AND AFTER EMPATHY TRAINING... 18 5 COMPARISON OF THE NUMBER OF SUBJECTS RECEIVING HIGHER, LOWER, OR THE SAME RATING AFTER EMPATHY TRAINING... 19 6 CLIENT STATEMENTS UPON WHICH INDIVIDUAL SUBJECTS RECEIVED HIGHER RATINGS AFTER EMPATHY TRAINING... 21 7 INTERRATER AGREEMENT: CALCULATION OF THE OVERALL PERCENT DEVIATION... 23 8 PERCENT INTERRATER AGREEMENT IN RANKING THE RESPONSES OF NAIVE AND ALL SUBJECTS... 25 v

INTRODUCTION Empathy i s an a p p r o p r ia te s u b je c t f o r r e s e a r c h f o r th e fo llo w in g re a s o n s : a w id e ly -a c c e p ta b le d e f i n i t i o n o f em pathy i s a v a i la b l e ; em pathy has been claim ed - b u t n o t u n e q u iv o c a lly pro v en - to b e one o f th e key elem en ts i n e s ta b l is h in g th e r a p e u tic com m unication and i n g e n e ra tin g a b e n e f i c i a l th e r a p e u tic outcom e; th e m ost e f f i c i e n t m ethods f o r te a c h in g em pathy have n o t b een c o m p le te ly d e fin e d ; th e p e rs o n a l c h a r a c t e r i s t i c s o f th e em pathy t r a i n e r and t r a i n e e, w hich co u ld in f lu e n c e th e te a c h in g and le a r n in g o f em pathy s k i l l s, hav e n o t b een c l e a r l y i d e n t i f i e d. B ecause em pathy i s an a p p r o p r ia te r e s e a r c h s u b je c t, new empathy m e asu rin g in s tru m e n ts a r e b e in g d ev elo p ed and o ld e r in s tru m e n ts a re b e in g c o n tin u a lly m o d ifie d i n an a tte m p t to in c r e a s e th e r e l i a b i l i t y and v a l i d i t y o f a s s e s s in g em pathy. The h i s t o r y o f em pathy and i t s many d e f i n i t i o n s have b een r e - veiw ed by a number o f a u th o rs (D eutsh & M adle, 1975; M anucia, 1967; and S h a rp, 1974). However, m ost a u th o rs hav e a c c e p te d and u t i l i z e d th e d e f i n i t i o n o f T ruax and M itc h e ll (1 9 7 1 ). They w ro te th a t " A c c u ra te em p ath ic u n d e rs ta n d in g in v o lv e s th e a b i l i t y to p e rc e iv e and com m unicate a c c u r a te ly and w ith s e n s i t i v i t y b o th th e f e e l in g s and e x p e rie n c e s o f a n o th e r p e rso n and t h e i r m eaning and s i g n i f i c a n c e." One o f th e n o v e l a s p e c ts o f th e c u r r e n t r e s e a r c h i s t h a t t h i s d e f i n i t i o n was d is s e c te d in t o th r e e com ponent c a te g o r ie s : th e le a d - in re s p o n s e, th e f e e l in g w ord, and th e s o u rc e o f f e e l in g c a t e g o r ie s. The le a d - in re s p o n s e c a te g o ry was p r im a r ily concerned w ith th e a b i l i t y to "com m unicate a c c u r a te ly and w ith s e n s i t i v i t y ; " th e f e e l in g word 1

2 c a te g o ry w ith " f e e lin g s and e x p e rie n c e s ;" and th e so u rc e o f f e e lin g c a te g o ry w ith "m eaning and s ig n if i c a n c e." T hese th r e e c a te g o rie s form ed th e fo u n d a tio n i n th e c o n s tr u c tio n o f th e new empathy r a tin g s c a le. The a b i l i t y to re sp o n d e m p a th ic a lly h a s been claim ed to prom ote b o th th e r a p e u tic com m unication and b e n e f i c i a l th e r a p e u tic outcome i n an im p re ssiv e number o f s tu d ie s (B e rg in, 1966; B erg in & Solomon, 1970; C a rk h u ff, 1969; C ark h u ff & B erenson, 1976; C arkhuff & P ie r c e, 1977; G azda, A sbury, B a lz e r, C h ild re n s, D e s e lle & W a lte rs, 1973; Hammond, H epw orth & S m ith, 1977; Long & S c h u ltz, 1973; Luborsky, C h an d ler, A uerbach, Cohen & B achrach, 1971; T ruax & M itc h e ll, 1971). B a s ic a lly, th e r e s u l t s o b ta in e d by th e s e i n v e s t ig a t o r s can be sum m arized by th e c o n c lu s io n s o f T ruax and M itc h e ll (p. 310, 1971) t h a t " T h e ra p is ts o r c o u n s e lo rs who a r e a c c u r a te ly e m p a th ic...a r e in d e e d e f f e c t i v e. A lso, th e s e f in d in g s seem to h o ld w ith a wide v a r i e t y o f t h e r a p i s t s and c o u n s e lo rs,.... and w ith a w ide v a r ie ty o f c l i e n t s and p a t i e n t s. [ I n a d d i t i o n ], th e s e fin d in g s h o ld in a v a r i e t y o f th e r a p e u tic c o n te x ts and i n b o th in d iv id u a l and group p sy c h o th e ra p y o r c o u n s e lin g." T hus, th e c la im i s t h a t th e r a p is ts who a r e a c c u r a te ly em pathic com m unicate w e ll w ith t h e i r c l i e n t s and t h e i r c l i e n t s su b se q u e n tly d is p la y th e r a p e u tic im provem ent. However, th e s e c la im s have been c h a lle n g e d and c r i t i c i z e d by s e v e r a l in v e s t ig a t o r s (G a rfie ld & B e rg in, 1971; Gurman, 1977; K urtz & Grummon, 1972; L am bert, D e Ju lio & S te i n, 1978; R appaport & C hinsky, 1 972). T hese in v e s t i g a t o r s have su g g e ste d t h a t rig o ro u s and exhaust i v e a tte m p ts to c o r r e l a t e t h e r a p i s t em pathy s k i l l s w ith th e ra p e u tic

3 outcom e have been la c k in g ; t h a t em pathy e f f e c t s w ere d i f f i c u l t to a s c e r t a i n b ecause m ost s tu d ie s em ployed t h e r a p i s t s w ith o n ly m o d erate em pathy s k i l l s ; t h a t few s tu d ie s have com pared th e c l i e n t s, th e t h e r a p i s t 's and in d e p en d en t r a t e r 's judgm ents o f em pathy s k i l l s and a tte m p te d to c o r r e l a t e th e s e w ith outcom e s tu d ie s. T hus, th e a v a i l a b i l i t y o f an unam biguous and e a s i l y u t i l i z e d em pathy r a t i n g s c a le c o u ld be a u s e f u l a d ju n c t i n d e te rm in in g th e c u r r e n tly c o n tro v e r s i a l r o l e o f em pathy in b o th th e r a p e u tic com m unication and outcom e. C oncerning th e m ost e f f i c i e n t m ethods f o r te a c h in g em pathy, Gurman (1977) and Lam bert e t a l. (1978) have n o te d t h a t no s in g le tr a i n i n g method h as b een d em o n stra te d u n e q u iv o c a lly to be th e m ost e f f ic a c io u s m ethod. The l a t t e r a u th o rs have p o in te d o u t th a t many s tu d ie s on t r a i n i n g m ethods f a i l e d to p ro v id e d a ta ab o u t th e r e l i a b i l i t y o f th e r e s u l t s o b ta in e d, and t h a t m ost s tu d ie s o m itte d c o n t r o l groups o r used them i n c o r r e c t l y. A u n iv e rs a lly - a c c e p te d empathy r a t i n g s c a le would a llo w a d i r e c t com parison o f d i f f e r e n t m ethods o f te a c h in g em pathy, and a llo w some judgm ents a s to th e e f f ic a c io u s n e ss o f each m ethod. The p e rs o n a l c h a r a c t e r i s t i c s o f th e t r a i n e r and th e tr a i n e e have been su g g e ste d to be im p o rta n t v a r ia b le s i n a c q u irin g empathy s k i l l s. W ith r e s p e c t to th e t r a i n e r, A very (1976) found t h a t th e n a tu re o f th e t r a i n e r in flu e n c e d how th e t r a i n e e s ra te d em pathy w h ile T ruax and M itc h e ll (1971) n o te d t h a t th e ch an ces a re two o u t o f th r e e t h a t a t r a i n e e w i l l be ta u g h t by a t r a i n e r who i s e i t h e r i n e f f e c t i v e o r h a rm fu l. W ith r e s p e c t to th e t r a i n e e, a number o f elem en ts have b een su g g e ste d to be im p o rta n t i n a c q u irin g em pathy, e. g., th e

4 t r a i n e e 's a b i l i t y to f a n ta s i z e ( S to tla n d, M athews, J r., Sherm an, H ansson, & R ic h a rd so n, 1978) o r th e t r a i n e e 's a b i l i t y to d e s c r ib e th e c h a r a c t e r i s t i c s o f an em p ath ic p e rso n (Hogan, 1969). A u s e f u l em pathy r a t i n g s c a le w ould f a c i l i t a t e th e u n d e rs ta n d in g and i d e n t i f i c a tio n o f p e rs o n a l v a r ia b le s w hich in f lu e n c e th e a c q u i s i tio n o f em pathy s k i l l s.. The s c a le w ould a ls o a llo w some e v a lu a tio n o f th e r e l a t i v e im p o rtan ce o f " i n t r i n s i c " em pathy s k i l l s compared -w ith th o s e w hich could be a c q u ire d by t r a i n i n g. The p re c e d in g comments w ould j u s t i f y th e need f o r a u n i v e r s a l l y - a c c e p ta b le em pathy r a t i n g s c a le ; h e n c e, i t i s n o t s u r p r i s i n g th a t num erous, and i n many c a se s e s s e n t i a l l y r e p e t i t i o u s, s c a le s have been c o n s tru c te d, u s u a lly a lo n g th e l i n e s o f th e s c a le d ev elo p ed by T ruax (1967). A ll th e s c a le s c o n ta in g ra d e s and a n u m e ric a l s c o re i s a s s ig n e d to each g ra d e : th e la r g e r th e number, th e g r e a t e r th e presum ed le v e l o f em pathy s k i l l (C a rk h u ff, 1969; Gazda e t a l., 1973, p. 71; Hammond e t a l., 1977, pp. 98-103; T ruax and C a rk h u ff, 1967, pp. 58 and 59; T ruax and M itc h e ll, 1971). However, many o f th e s c a le s seem h ard to u se b e c a u se th e g ra d e s tend to o v e r la p, te n d to be d i f f i c u l t to c o n c e p tu a liz e, te n d to la c k s p e c i f i c i t y, and te n d to r e q u ir e g lo b a l ju d g m en ts. T h e re fo re, b e c a u se em pathy i s an a p p r o p r ia te s u b je c t f o r th e afo rem en tio n ed re a s o n s, and b e c a u se th e c r e a tio n o f more e f f i c i e n t in s tru m e n ts f o r m easu rin g em pathy would be o f v a lu e to te a c h e r s, s tu d e n ts, c l i n i c i a n s and r e s e a r c h e r s a l i k e (and h o p e fu lly th e c l i e n t w ould be th e u ltim a te b e n e f i c i a r y ), th e p u rp o se o f t h i s r e s e a r c h was to c o n s tr u c t and t e s t a new em pathy r a tin g s c a le.

The n o v e l a s p e c ts i n c o n s tr u c tin g t h i s new em pathy s c a le w ere, a s m entioned p r e v io u s ly, t h a t i t w as d e riv e d from a d i s s e c t i o n o f a com m only-accepted d e f i n i t i o n o f em pathy i n t o th r e e c a t e g o r ie s ; t h a t e a c h o f th e s e th r e e c a te g o r ie s w ere f u r t h e r s u b d iv id e d in t o f iv e g ra d e s to s im p lif y th e r a t i n g o f s u b j e c t s ' w r i t t e n re s p o n s e s ; and t h a t th e p a n e l o f r a t e r s who u sed th e s c a l e a s s i s t e d i n i t s cons t r u c t i o n. I n t e s t i n g th e em pathy r a t i n g s c a le f o r i t s e f f i c i e n c y, u t i l i t y v e r s a t i l i t y and r e l i a b i l i t y, i. e., i n a s s e s s in g i t s o v e r a l l m e r i t, th e fo llo w in g c r i t e r i a w ere e s ta b l is h e d : th e s c a le sh o u ld b e a b le to d i f f e r e n t i a t e s u b je c ts who had p re v io u s em pathy t r a i n i n g from th o s e who had n o n e; s u b je c ts sh o u ld r e c e iv e h ig h e r r a t i n g s a f t e r t r a i n i n g i n a c o u rs e p u r p o s e f u lly d e sig n e d t o in c r e a s e em pathy s k i l l s th e s c a le sh o u ld b e c a p a b le o f r a t i n g s u b j e c t s em p ath ic re sp o n ses to a w id e v a r i e t y o f c l i e n t s ta te m e n ts ; and an a c c e p ta b le l e v e l o f i n t e r r a t e r ag reem ent sh o u ld be a c h ie v e d u s in g th e s c a le.

METHODS Empathy T ra in in g M ethod A m u ltif a c e te d p ro c e d u re was used a s th e em pathy t r a i n i n g m ethod. The m ethod was d evelo p ed by M. R o b e rtso n, D epartm ent o f P sy ch o lo g y, W estern M ichigan U n iv e r s ity (P sy cholo g y 6 6 1 ). T h is c o u rs e fo cu sed on e x p e rim e n ta l p ro b le m -so lv in g in t e r v e n tio n s a p p lie d on an in d i v id u a l c l i e n t b a s i s. The te c h n iq u e s em ployed in c lu d e d l e c t u r e s, d e m o n s tra tio n s, re a d in g m a t e r i a l, p r a c t i c e i n w r itin g re s p o n s e s to w r i t t e n c l i e n t s ta te m e n ts, p r o v is io n o f a fe e lin g -w o rd l i s t and le a d - in p h ra s e s to u se i n re sp o n d in g to c l i e n t s ta te m e n ts, o b s e rv a tio n and c r i t i q u i n g o f l i v e t h e r a p i s t - c l i e n t ( i. e., s tu d e n t- s tu d e n t) i n t e r a c t i o n s, e x p e rie n c e b e in g a c l i e n t, and l i v e p r a c t ic e a s a t h e r a p i s t. C lie n ts, S u b je c ts, and R a te rs T hree groups o f p e o p le w ere in v o lv e d i n t h i s s tu d y : n in e c l i e n t s, e ig h te e n s u b j e c t s, and f i v e r a t e r s. The n in e c l i e n t s, th r e e m ales and s i x fe m a le s, ran g ed i n age from 13 to 44 y e a r s. Some o f th e c l i e n t s w ere s tu d e n t s, some w ere m e n ta l h e a lth p r o f e s s io n a ls and some w ere a s s o c ia t e s o f th e i n v e s t i g a t o r. An a tte m p t was made to e s t a b l i s h a t y p i c a l t h e r a p i s t / c l i e n t s e s s io n environm ent betw een th e i n v e s t i g a t o r and th e c l i e n t s. The c l i e n t s w ere asked to r e f l e c t on any c u r r e n t e v e n t o f s ig n if i c a n c e to them. P o r tio n s o f th e s e s s io n w ere ta p e -re c o rd e d and segm ents w ere ch o sen f o r u s e i n t h i s s tu d y. T hese segm ents a re r e f e r r e d to a s " c l i e n t s ta te m e n ts " and a r e 6

7 re p ro d u c e d i n A ppendix A. The n in e c l i e n t s ta te m e n ts w ere s e le c te d to r e p r e s e n t a broad sp e c tru m o f e m o tio n s, e v e n ts and c irc u m sta n c e s. A ll th e s ta te m e n ts w ere a u th e n tic and g e n u in e ; no r o le - p la y in g was u s e d. The c l i e n t s gave v e r b a l p e rm is sio n t o allo w t h e i r s ta te m e n ts to b e h e a rd by th e s u b je c t s. E ig h te e n s u b je c ts w ere em ployed i n t h i s s tu d y. A ll w ere g ra d u a te s tu d e n ts i n th e 1979 W in ter S em ester o f P sychology 661, W estern M ichigan U n iv e r s ity. S ix s u b je c t s, numbers 2, 3, 6, 7, 8 and 9 d e n ie d p re v io u s t r a i n i n g i n em pathy and w ere d e s ig n a te d "n a iv e " s u b je c t s. The s u b je c ts w ere i n s t r u c t e d to w r ite em pathic re sp o n se s to th e ta p e -re c o rd e d c l i e n t s ta te m e n ts on th e f i r s t and l a s t days o f a 12-week t r a i n i n g p e rio d (se e A ppendix B ). They w ere a ls o p ro v id e d w ith a t r a n s c r i p t o f th e c l i e n t s ta te m e n ts to re a d w h ile l i s t e n i n g to th e ta p e to a s s u re com prehension. The s u b je c ts w ere g iv e n one m in u te to w r i t e t h e i r re s p o n s e. S in ce 18 s u b je c ts w ere r a te d tw ic e, b e fo re and a f t e r em pathy t r a i n i n g, on t h e i r re sp o n ses to 9 c l i e n t s ta te m e n ts, a t o t a l o f 324 re s p o n ses w ere r a te d. F iv e r a t e r s s c o re d th e s u b j e c t s ' re sp o n se s to c l i e n t s ' s ta te m e n ts u s in g th e p ro c e d u re d e s c rib e d below. The r a t e r s w ere th e c o u rs e i n s t r u c t o r s and fo u r g ra d u a te s tu d e n ts in C lin ic a l P sy ch o lo g y who had se rv e d a s t r a i n e r s i n th e c o u rse. R a tin g o f S u b je c ts ' R esponses In r a t i n g th e s u b j e c t s ' re s p o n s e s, th e r a t e r s d id n o t know th e i d e n t i t y o r number o f th e s u b j e c t, n o r w h eth er th e re s p o n se b e in g r a te d was w r i t t e n b e f o r e o r a f t e r th e t r a i n i n g p e rio d. The new ly-

8 c o n s tru c te d em pathy r a t i n g s c a le was u sed by th e r a t e r s. The s c a le was composed o f th r e e s e p a r a te c a te g o r ie s w hich w ere f u r th e r s u b d iv id e d in t o f iv e g ra d e s (s e e A ppendix C ). The r a t e r s a s s ig n e d a l e t t e r g ra d e (A, B, C, D, o r F) to each o f th e th r e e c a t e g o r ie s. The l e t t e r s w ere l a t e r c o n v e rte d to num bers f o r co m p u tatio n (A = 5, F = 1 ). The th r e e c a te g o r ie s i n w hich th e s u b j e c t s ' re s p o n s e s w ere ra te d in c lu d e d th e le a d - in re s p o n s e (th e w ords o r p h ra s e s im m ed iately p re c e d in g th e " f e e lin g " w o rd ), th e f e e l i n g word o r w o rd s, and th e so u rce o f th e f e e l in g ( i. e., th e c o n te n t a s s o c ia te d w ith th e f e e lin g w o rd ). The lo w est p o s s ib le r a t i n g was 3 (1 + 1 + 1 = 3) and th e h ig h e s t p o s s ib le r a t i n g was 15 (5 + 5 + 5 = 1 5 ). Some exam ples o f s u b je c t re s p o n se s and th e r a t i n g s a ssig n e d to them by th e r a t e r s a r e shown i n A ppendix D. T hree sam ple re s p o n ses w ere s e le c te d f o r e a c h c l i e n t s ta te m e n t: th e re s p o n s e w hich re c e iv e d tb e lo w est r a t i n g ; th e re s p o n s e w hich re c e iv e d a r a t i n g c l o s e s t to 9 (th e m id p o in t on th e s c a l e ) ; and th e re s p o n s e w hich re c e iv e d th e h ig h e s t r a t i n g. M ethods o f A sse ssin g I n t e r r a t e r Agreem ent Two in d e p e n d e n t s t a t i s t i c a l m ethods o f a s s e s s in g i n t e r r a t e r agreem ent w ere em ployed to enhance th e c la im o f h ig h i n t e r r a t e r ag reem en t. The m ethods in v o lv e d c a l c u la tio n o f an o v e r a l l p e rc e n t d e v ia tio n and K e n d a ll's c o e f f i c i e n t o f c o n co rd a n ce, W (K en d all, 1955). A low p e rc e n t o b ta in e d from th e form er method coupled to g e th e r w ith a h ig h v a lu e o b ta in e d from th e l a t t e r method would su g g e st t h a t an a c c e p ta b le l e v e l o f i n t e r r a t e r agreem ent had b een

9 a t t a i n e d. A h y p o th e tic a l exam ple o f how th e o v e r a l l p e rc e n t d e v ia tio n was c a lc u la te d may b e i n s t r u c t i v e. Assum ing th e f iv e r a t e r s ' s c o re s f o r a g iv e n s u b j e c t 's re sp o n se w ere 8, 9, 10, 11 and 12, th e av era g e s c o re w ould b e c a lc u la te d to b e 10 (8 + 9 + 10 + 11 + 12/5 = 5 0 /5 = 1 0 ). The in d i v id u a l p e rc e n t d e v ia tio n f o r th e f iv e r a t e r s would b e, r e s p e c t iv e l y, 20%, 10%, 0%, 10%, and 20%. The a v e ra g e p e rc e n t d e v ia tio n o f th e f iv e r a t e r s f o r t h a t p a r t i c u l a r s u b j e c t 's re sp o n s e w ould be 12% (20 + 10 + 0 + 10 + 20/5 = 60/5 = 1 2 ). The o v e r a l l p e rc e n t d e v ia tio n was th e n com puted f o r each c l i e n t s ta te m e n t to t e s t f o r any b ia s i n g e f f e c t s ; b ia s in g p e rh a p s g e n e ra te d from th e r a t e r s ' d i f f e r e n t i a l r e a c tio n s t o a g iv e n c l i e n t s ta te m e n t. The o v e r a l l p e rc e n t d e v ia tio n w as o b ta in e d by com puting th e mean o f th e a v e ra g e p e rc e n t d e v ia tio n s, 36 p e r c l i e n t s ta te m e n t (18 s u b je c ts r a te d tw ic e, b e fo re and a f t e r em pathy t r a i n i n g ). To a s s i s t in g iv in g th e s e v a lu e s some p e r s p e c tiv e, i t m ight be n o te d t h a t th e la r g e s t av era g e p e rc e n t d e v ia tio n t h e o r e t i c a l l y p o s s ib le w ould b e 71% (assum ing h y p o th e tic a l r a t e r s ' s c o re s o f 3, 3, 3, 3, and 1 5 ); th e s m a lle s t d e v ia tio n w ould be 0% ( t o t a l a g re e m e n t). I n te rm s o f o v e r a l l p e rc e n t d e v ia tio n, a v a lu e l e s s th a n 20% ( i. e., 80% "ag reem en t") would be g e n e r a lly c o n sid e re d a c c e p ta b le. The K e n d a ll c o e f f i c i e n t o f co n cord ance, W, was c a lc u la te d u s in g a fo rm u la w hich c o r r e c t s f o r t i e s i n ra n k in g ( S ie g e l, 1956, p. 2 3 4 ). W can v a ry betw een z e ro and o n e. AW o f z e ro m eans, i n th e c u r r e n t c o n te x t, a t o t a l la c k o f i n t e r r a t e r agreem ent w h ile a W o f one means th e r a t e r s ag reed p e r f e c t l y i n ra n k in g th e s u b j e c t s ' re s p o n s e s. In

10 th e c u r r e n t s tu d y, W w as m u ltip le d b y 100 t o c o n v e rt th e c o e f f i c i e n t to a p e r c e n t. T hus, when W i s la r g e and s i g n i f i c a n t, t h i s s u g g e s ts t h a t th e r a t e r s a p p lie d e s s e n t i a l l y th e same c r i t e r i o n i n ra n k in g th e s u b j e c t s ' re s p o n s e s. The s t a t i s t i c a l s ig n i f i c a n c e o f W was com puted u s in g th e c h i s q u a re t e s t i n th e fa s h io n d is c u s s e d by S ie g e l (1356, p. 2 3 6 ). When th e c h i sq u a re t e s t was s i g n i f i c a n t, t h i s m eant t h a t th e n u l l h y p o th e s is could b e r e je c te d a t th e le v e l o f s ig n if i c a n c e shown, i. e., th e n u l l h y p o th e s is t h a t th e ra n k in g s by th e f iv e r a t e r s o f th e s u b j e c t s ' re s p o n s e s w ere u n r e la te d t o, in d e p e n d e n t o f, and la c k e d co n co rd a n ce w ith one a n o th e r. S t a t i s t i c a l A naly ses S tu d e n t's _t t e s t was used to t e s t f o r s t a t i s t i c a l l y s i g n i f i c a n t d if f e r e n c e s. The a c t u a l fo rm u la u sed was th e Form ula C _t t e s t w hich i s u sed f o r p r e - v e rs u s p o s t - t r i a l s tu d ie s on d ep en d ent sam p les. The t^ t e s t was used to t e s t th e n u l l h y p o th e s is t h a t th e r a t i n g s f o r e ach s u b j e c t 's re s p o n s e s to e a c h c l i e n t 's s ta te m e n t w ould be th e same i r r e s p e c t i v e o f p re v io u s t r a i n i n g a s w e ll a s a f t e r em pathy t r a i n i n g. The p r o b a b i l i t y (p) v a lu e s d is p la y e d in th e t a b le s r e p r e s e n t th e p r o b a b i l i t y o f a Type I e r r o r, i. e., th e p r o b a b i l i t y t h a t a tr u e n u l l h y p o th e s is was r e j e c t e d. The s ta n d a rd d e v ia tio n (SD) v a lu e s d is p la y e d in th e ta b le s w ere com puted u s in g N -l.

RESULTS A Com parison o f th e R a tin g s G iven to th e Two G roups o f N aive and E x p erien ced S u b je c ts B efo re and A f te r Empathy T ra in in g One c r i t e r i o n w hich w ould su p p o rt th e n o tio n t h a t th e em pathy r a t i n g s c a le had m e rit was t h a t th e s c a le sh o u ld be a b le to d i f f e r e n t i a t e n a iv e s u b je c ts ( i. e -, th o s e -who d en ied any p re v io u s em pathy t r a i n i n g ) from e x p e rie n c e d s u b je c t s. As T ab le 1 show s, t h e r e was a s t a t i s t i c a l l y s i g n i f i c a n t d if f e r e n c e betw een th e b e f o r e - t r a i n i n g r a t i n g s o f th e n a iv e s u b je c t s, 7.4, and th o s e o f th e e x p e rie n c e d s u b j e c t s, 10.5 (p <.0 1 ). In a d d itio n, th e r e w as a ls o a s t a t i s t i c a l l y s i g n i f i c a n t d if f e r e n c e betw een th e o v e r a l l in c r e a s e i n th e r a t i n g s r e c e iv e d by th e two gro u p s a f t e r t r a i n i n g, v i z., 5.1 f o r th e n a iv e s u b je c ts and 2.0 f o r th e e x p e rie n c e d s u b je c ts ( j^.o l). E x p ressed a s p e r c e n ta g e s, th e n a iv e s u b je c ts re c e iv e d r a t i n g s 116% h ig h e r th a n t h e i r b e fo re t r a i n i n g r a t i n g s ; th e e x p e rie n c e d s u b je c t s, 27% h ig h e r. The o v e r a l l p e rc e n ta g e in c r e a s e s f o r a l l s u b je c ts was 46%. B oth g ro u p s re c e iv e d i d e n t i c a l r a tin g s a f t e r t r a i n i n g (1 2.5 ). T h e re fo re, th e s c a le was c a p a b le o f d i f f e r e n t i a t i n g betw een gro u p s o f n a iv e and e x p e rie n c e d s u b je c t s. F u rth e rm o re, th e s c a le was s e n s i t i v e to th e e f f e c t s o f em pathy t r a i n i n g ; b o th groups re c e iv e d h ig h e r r a t i n g s a f t e r t r a i n i n g. 11

12 Table 1 A C om parison o f th e R a tin g s G iven to th e Two Groups o f N aive and E x p erien ced S u b je c ts B efo re and A f te r Empathy T ra in in g Mean R a tin g ± 1 SD Number S u b je c ts Group. B efore A fte r In c re a s e 6 N aive 7.4 ± 1.6 12.5 ± 1.2 5.1 ± 1.5 12 E x p erien ced 10.5 ± 0.6 12.5 ± 0.8 2.0 ± 0.7 N ote: A ll v a lu e s w ere s i g n i f i c a n t l y d i f f e r e n t from each o th e r a t <.0 1 (e x c e p t f o r th e two a f t e r t r a i n i n g r a tin g s o f 12.5 and 1 2.5 ).

13 The R a tin g s o f I n d iv id u a l.s u b je c ts Were Compared B efo re and A fte r T ra in in g A nother c r i t e r i o n f o r s t a t i n g t h a t t h i s s c a le h a s m e rit i s t h a t th e r a t i n g s o f s u b je c ts, when view ed i n d i v id u a l ly, sh o u ld in c r e a s e a f t e r em pathy t r a i n i n g. In d e e d, a s th e r e s u l t s i n T ab le 2 show, th e re sp o n s e s o f a l l 18 s u b je c ts re c e iv e d h ig h e r r a t i n g s a f t e r th e t r a i n i n g p e r io d. The in c r e a s e s i n r a t i n g s ran g ed -fro m a low o f 0.6 ( s u b je c t 14) to a h ig h o f 7.0 ( s u b je c t 3 ). The a v e ra g e o v e r a l l in c r e a s e was 3.0, s i g n i f i c a n t a t <.0 1 Of th e 18 s u b je c ts s tu d ie d, 15 (83%) re c e iv e d s t a t i s t i c a l l y s i g n i f i c a n t h ig h e r r a tin g s a f t e r t r a i n i n g a t <.1. At <.0 5, 13 o f 18 (72%) re c e iv e d h ig h e r r a t i n g s. The in c r e a s e s i n r a tin g s fo llo w in g th e t r a i n i n g p e rio d w ere much g r e a t e r i n th e 6 n a iv e s u b je c ts com pared w ith th e 12 e x p e rie n c e d s u b je c ts. T hus, o f th e 7 s u b je c ts who re c e iv e d th e h ig h e s t p r o p o r tio n a l in c re a s e s a f t e r t r a i n i n g, 6 w ere n a iv e s u b je c ts. The n a iv e s u b je c ts and t h e i r n u m e ric a l r a t i n g in c r e a s e s w e re, r e s p e c t iv e l y, s u b je c t e i g h t, 3.5 ; s u b je c t n in e, 3.6 ; s u b je c t se v e n, 4.5 ; s u b je c t tw o, 5.5 ; s u b je c t s i x, 6.6 ; and s u b je c t t h r e e, 7.0. T hese r e s u l t s a r e c o n s is te n t w ith th e e x p e c ta tio n t h a t a u s e f u l r a t i n g s c a le w ould be a b le to d e t e c t th e e f f e c t s o f em pathy t r a i n i n g on in d iv id u a l s u b je c t s, and in a d d itio n, t h a t i t would b e a b le to show th e d i f f e r e n t i a l r e a c tio n s o f n a iv e and e x p e rie n c e d in d iv id u a ls to em pathy t r a i n i n g.

14 Table 2 R a tin g s o f I n d iv id u a l S u b je c ts R esponses to A ll N ine C l i e n t s ' S ta te m e n ts B efo re and A f te r Empathy T ra in in g O v e ra ll R a tin g ± 1 SD Subj e c t B efore A fte r R a tin g Change S ig n ific a n c e 1 9.7 + 2.8 0 13.3 + 1.36 + 3.6 p<.01 2^ 7.0 + 2.9 7 12.5 + 0.7 5 + 5.5 3a 6.0 + 1.81 13.0 ± 1.21 + 7.0 p<.06 4 9.9 + 2.55 11.6 ± 2.0 2 + 1.7 p<.06 5 10.4 + 1.29 12.8 + 1.3 1 + 2.4 A o I-* o V p. 6 a 6.1 + 2.6 9 12.7 + 1.05 + 6.6 p<.01 7a 8.4 + 2.5 8 12.9 + 9.80 + 4.5 p<.01 8a 6.7 + 1.53 10.2 + 3.15 + 3.5 p<.03 9a 10.2 + 3.10 13.9 ± 0.5 4 + 3.6 p<.01 10 11.0 + 2.32 12.9 + 1.3 0 + 1.9 p<.10 11 11.6 + 2.8 9 13.8 + 6.2 2 + 2.2 p<.03 12 1 0.8 + 2.67 13.2 + 1.06 + 2.4 p<.01 13 10.5 + 2.1 3 12.1 ± 2.7 5 + 1.6 a A 00 14 10.2 ± 2.6 8 10.8 ± 2.1 8 + 0.6 p<.56 15 11.2 ± 1.34 13.0 ± 1.42 + 1.8 p<.01 16 10.6 + 1.71 12.1 ± 2.3 5 + 1.5 X) A H 17 10.3 + 1.62 12.7 + 9.75 + 2.4 p <.01 18 9.7 + 1.19 11.9 + 3.2 0 + 2.2 p<.07 A verages 9.5 1.8 0 12.5 ± 0.9 5 3.0 ± 1.8 0 p <.01 T hese w ere n a iv e s u b je c ts who d en ied h a v in g any p re v io u s empathy t r a i n i n g

15 R a tin g s o f S u b je c ts ' R esponses to a V a r ie ty o f C lie n t S ta te m e n ts I n o rd e r f o r an em pathy r a t i n g s c a le to have b ro ad a p p l i c a b i l i t y, th e s c a le sh o u ld be a b le to r a t e s u b j e c t s ' re s p o n s e s t o a w id e v a r i e t y o f c l i e n t s ta te m e n ts. I n a d d i tio n, th e s c a le sh o u ld b e a b le to d e t e c t s u b je c t changes i n empathy s k i l l s a f t e r t r a i n i n g, i r r e s p e c t i v e o f th e m agnitude o f t h a t change. T hree d i f f e r e n t m ethods w ere used to t e s t th e s e c r i t e r i a. In th e f i r s t two m eth o d s, th e n u m e ric a l in c r e a s e i n r a t i n g s and th e p e rc e n t in c re a s e s in r a t i n g s a f t e r em pathy t r a i n i n g w ere com puted f o r e ach c l i e n t s ta te m e n t f o r n a iv e s u b je c ts (T ab le 3) and f o r a l l s u b je c ts (T able 4 ). T h is s e g r e g a tio n was perform ed b e c a u se th e m agnitu d e o f change was much g r e a t e r w ith n a iv e s u b je c ts com pared to a l l s u b je c ts. T able 3 shows t h a t n a iv e s u b je c ts re c e iv e d s t a t i s t i c a l l y s i g n i f i c a n t r a t i n g in c r e a s e s a f t e r u n d erg o in g em pathy t r a i n i n g f o r e ig h t o f n in e c l i e n t s ta te m e n ts (jk -O l). The r a t i n g in c r e a s e f o r c l i e n t s ta te m e n t t h r e e was s t a t i s t i c a l l y s i g n i f i c a n t a t j><.1. The a v e ra g e p e rc e n t in c r e a s e f o r n a iv e s u b je c ts a f t e r t r a i n i n g a c ro s s a l l n in e c l i e n t s ta te m e n ts was 126%. T h is v a lu e i s s l i g h t l y h ig h e r th a n t h a t n o te d e a r l i e r (116%) and i s due to c o m p u ta tio n a l a r t i f a c t s in tro d u c e d by ro u n d in g o f f num bers. In s p e c tio n o f th e n u m e ric a l r a t i n g changes (a v e ra g e = 5.1 ± 1.5 ) show t h a t, w ith th e e x c e p tio n s o f c l i e n t s ta te m e n ts th r e e and e i g h t, a l l th e r a t i n g changes w ere w ith in one s ta n d a rd d e v i a tio n o f th e a v era g e (and c l i e n t s ta te m e n t e ig h t was b a r e ly o u ts id e th e r a n g e ). T hus, th e s c a le d e te c te d changes i n th e r a t i n g s o f n a iv e s u b je c ts

16 Table 3 R a tin g s o f N aive S u b je c t R esponses to N ine D if f e r e n t C lie n t S ta te m e n ts B efo re and A f te r Empathy T ra in in g C lie n t O v e ra ll R a tin g ± 1 SD R a tin g P e rc e n t S ta te m e n t B efore A fte r Change In c re a s e 1 8.4 + 2.6 1 2.5 + 1.1 + 4.1 76% 2 7.8 + 3.6 1 3.3 + 1.0 + -5.5 114% 3 9.4 + 2.7 11.7 + 2.5 + 2. 3a 36% 4 8.0 + 2.5 1 1.8 + 2.1 + 3.8 76% 5 7.0 + 2.9 1 3.3 + 1.4 + 6.3 158% 6 6.5 + 2.6 1 2.4 + 2.9 + 5.9 169% 7 8.0 + 3.1 12.7 1.0 ' + 4.7 194% 8 5.8 + 1.6 1 2.8 + 2.2 + 7.0 250% 9 6.7 + 3.8 12.5 + 2.0 + 5.8 157% A verages 7.5 + l. l b 1 2.6 0. 6b 5.1 ± 1.5 126%b The b e fo re and a f t e r r a tin g s f o r re s p o n s e s to c l i e n t s ta te m e n t th r e e w ere s t a t i s t i c a l l y s i g n i f i c a n t a t _ =.1. A ll th e o th e r r a t i n g s w ere s t a t i s t i c a l l y s i g n i f i c a n t a t _p<.01. b T hese v a lu e s w ere s l i g h t l y h ig h e r th a n th o s e shown i n T able 1. T h is i s due to a c o m p u ta tio n a l a r t i f a c t in tro d u c e d by ro u n d in g o f f num bers.

17 a f t e r t r a i n i n g i n a r e l a t i v e l y u n ifo rm fa s h io n a c ro s s a v a r ie ty o f c l i e n t s ta te m e n ts. I n th e second m ethod, th e e n t i r e s u b je c t p o p u la tio n was exam ined (T ab le 4) and, a lth o u g h th e m agnitude o f th e changes was s m a lle r, th e s c a l e a ls o d is c r im in a te d f a i r l y ev en ly a c ro s s a l l c l i e n t s ta te m e n ts. The p e r c e n t in c r e a s e h e re was 46% (compared w ith 126% f o r th e n a iv e s u b je c ts ) and th e av era g e r a t i n g change was 3.0 ± -0.8 2 (com pared w ith 5.1 ± 1.5 f o r n a iv e s u b j e c t s ). A gain, m ost o f th e r a t i n g changes w ere w ith in one s ta n d a rd d e v ia tio n o f th e a v e ra g e r a t i n g change; c l i e n t s ta te m e n ts s i x and e ig h t w ere b a r e ly o u ts id e th e ra n g e. However, c l i e n t s ta te m e n t th r e e was more th a n two s ta n d a rd d e v ia tio n s from th e a v e ra g e. I n th e t h i r d m ethod, a p a ra m e te r d i f f e r e n t th a n r a t i n g changes was em ployed, v i z., th e a c t u a l number o f s u b je c ts who changed (o r rem ained th e same) a f t e r em pathy t r a i n i n g was d eterm in e d f o r each c l i e n t s ta te m e n t (T able 5 ). The a v e ra g e number o f s u b je c t s who re c e iv e d s t a t i s t i c a l l y s i g n i f i c a n t h ig h e r r a t i n g s was 11 (.0 5 < jp <.l); th o s e who re c e iv e d low er r a t i n g s averaged 0.5 (0.5 < p < l); and th e a v e ra g e number who rem ained th e same was 6.5. I n s p e c tio n o f th e v a lu e s shows t h a t th e number o f s u b je c ts who re c e iv e d im proved r a tin g s was f a i r l y u n ifo rm a c ro s s a l l c l i e n t s ta te m e n ts (w ith th e e x c e p tio n o f c l i e n t s ta te m e n t t h r e e ). T h e re fo re, th e s c a le was u s e f u l in d e te c tin g im provem ent a c ro s s a v a r i e t y o f c l i e n t s ta te m e n ts a f t e r s u b je c ts underw ent em pathy t r a i n i n g. T h is was tr u e i r r e s p e c t i v e o f w h eth er th e p aram eter m easured was th e m agnitu d e o f th e in c re a s e d r a t i n g change o r th e a c t u a l in c re a s e i n th e number o f s u b je c ts r e c e iv in g h ig h e r r a t i n g s.

18 Table 4 R a tin g s o f A ll S u b je c t R esponses to N ine D if f e r e n t C lie n t S ta te m e n ts B efo re and A f te r Empathy T ra in in g C lie n t O v e ra ll R a tin g ± 1 SD R a tin g P e rc e n t S tatem en t B efore A fte r Change In c re a s e 1 9.9 + 2.6 4 1 2.8 + 1.0 7 + 2.9 42% 2 9.7 + 2.8 3 13.1 + 0.9 2 + -3.4 51% 3 1 0.6 + 2.1 6 11.8 + 1.7 8 + 1.2 16% 4 9.7 + 2.37 12.3 + 1.53 + 2.6 39% 5 9.7 + 2.8 6 12.8 + 2.5 0 + 3.1 46% 6 8.9 + 2.7 3 1 2.8 + 1.95 + 4.0 68% 7 9.6 + 2.6 2 12.3 ± 1.8 8 + 3.3 55% 8 7.8 + 2.4 8 11.7 + 2.7 7 + 3.9 71% 9 1 0.1 + 3.7 0 13.0 ± 1.84 + 2.9 41% A verages 9.5 + 0.82 12.5 + 0.5 2 3.0 ± 0.8 2 46% The' r a t i n g changes a f t e r t r a i n i n g w ere s i g n i f i c a n t l y d i f f e r e n t f o r a l l c l i e n t s ta te m e n ts (e x c e p t no. th r e e ) a t <.0 1. The r a t i n g change f o r c l i e n t s ta te m e n t th r e e was s t a t i s t i c a l l y s i g n i f i c a n t a t p =.0 8.

19 Table 5 Com parison o f th e Number o f S u b je c ts R eceiv in g H ig h e r, Lower, o r th e Same R a tin g A fte r Empathy T ra in in g C lie n t S tatem en t Number S u b je c ts W ith H igher R a tin g s Number S u b je c ts W ith Lower R a tin g s p<.05.0 5 < p <.l p<.05.0 5 < p <.l Number S u b je c ts W ith Same R atin g s 1 9 2 1 0 6 2 8 3 1 0 6 3 4 3 1 0 12 4 8 2 0 0 8 5 11 1 0 0 6 6 12 2 0 0 4 7 11 1 0 1 5 8 9 3 0 1 5 9 10 0 1 0 7 A verage 9.1 V V 11 (.<!) 1.9 / 0. 44 0.0 6» V 0.5 6.5 ( <.l)

Use o f th e Empathy R a tin g S c a le to D e te c t I n d iv id u a l S u b je c t's I d io s y n c r a t ic P a tte r n s i n A c q u irin g Empathy S k i l l s One u n a n tic ip a te d fin d in g t h a t em erged d u rin g t h i s s tu d y su g g e s te d t h a t th e s c a le co u ld b e u t i l i z e d f o r s tu d ie s on in d iv id u a l s u b j e c t 's i d i o s y n c r a t i c p a t te r n s i n a c q u ir in g em pathy s k i l l s. In fo rm a tio n on t h i s p o in t was o b ta in e d by d e te rm in in g i f th e s u b je c ts im proved u n ifo rm ly o r d i f f e r e n t i a l l y a c ro s s th e n in e d i f f e r e n t c l i e n t s ta te m e n ts. The r e s u l t s o f t h i s a n a l y s i s (T ab le 6) i n d i c a te t h a t e a c h s u b je c t re c e iv e d h ig h e r r a t i n g s to th e v a r io u s c l i e n t s ta te m e n ts i n a t o t a l l y id i o s y n c r a tic f a s h io n : n o t one s u b je c t m atched a n o th e r i n term s o f th e c l i e n t s ta te m e n ts upon w hich th e s u b je c ts re c e iv e d s t a t i s t i c a l l y s i g n i f i c a n t im proved r a t i n g s ( < 1 ).

21 Table 6. C lie n t.s ta te m e n ts Upon Which I n d iv id u a l S u b je c ts R eceived H ig h er R a tin g s A fte r Empathy T ra in in g Subj e c t Number C lie n t S ta te m e n t Upon Which th e Subj e c t R eceived H igher R a tin g s ( <.1 ) 3 2 3 4 5 6 7 8 9 9 2 3 4 5 6 8 18 2 3 6 7 8 10 2 3 6 8 17 2 4 6 8 2 5 7 8 9 15 2 6 7 9 6 2 4 5 6 7 8 9 5 4 5 6 7 9 13 4 6 9 7 5 6 7 8 9 2 3 4 5 6 7 8 9 1 2 4 5 6 7 8 11 2 4 8 4 2 5 6 8 14 3 7 8 16 5 6 7 12 5 6 7 8 9

22 I n t e r r a t e r A greem ent: C a lc u la tio n o f th e O v e ra ll P e rc e n t D e v ia tio n T able 7 shows t h a t th e f i n a l o v e r a l l p e rc e n t d e v ia tio n fo r th e in d i v id u a l r a t e r from th e co n sen su s o f th e p a n e l o f r a t e r s was 10.9%. T h is v a lu e was com puted from th e o v e r a l l p e rc e n t d e v ia tio n i n r a t i n g th e re sp o n ses to each o f th e n in e c l i e n t s ta te m e n ts. The a n a ly s is was conducted i n t h i s way to see i f th e i n t e r r a t e r agreem ent was u n ifo rm a c ro s s a l l n in e s ta te m e n ts. W ith th e e x c e p tio n o f c l i e n t s ta te m e n t e i g h t, th e d e v ia tio n o f th e in d iv id u a l r a t e r s from th e consen su s s c o re o f th e p a n e l o f r a t e r s was f a i r l y u n ifo rm, i. e., e x c lu d in g c l i e n t s ta te m e n t e i g h t, th e ra n g e i n th e o v e r a l l p e rc e n t d e v ia tio n was from 8.8 to 12.6%. T h is im p lie s t h a t th e in d iv id u a l r a t e r s, u s in g th e r a t i n g s c a l e, d id n o t r e a c t d i f f e r e n t i a l l y to p a r t i c u la r c l i e n t s ta te m e n ts. S in ce th e o v e r a l l p e rc e n t d e v ia tio n s w ere re a so n a b ly uniform a c ro s s c l i e n t s ta te m e n ts, and th e f i n a l o v e r a l l p e rc e n t d e v ia tio n was o n ly 10.9%, t h i s s u g g e s ts t h a t an a c c e p ta b le l e v e l o f i n t e r r a t e r agreem en t was a t ta in e d u s in g th e em pathy r a tin g s c a le.

23 Table 7 I n t e r r a t e r A greem ent: C a lc u la tio n o f th e O v e ra ll P e rc e n t D e v ia tio n C lie n t S tatem en t O v e ra ll P e rc e n t D e v ia tio n ± 1 SD 1 9.6 ± 5.3 2 8.8 ± 4. 1 3 11.2 ± 7.0 4 10.1 ± 4.8 5 9.8 ± 4.5 6 10.8- ± 6.4 7 12.6 ± 8.1 8 14.9 ± 9.0 9 10.2 ± 5.9 F in a l A verage 1 0.9 ± 1. 9

24 I n t e r r a t e r A greem ent: Com parison o f I n d iv id u a l R a te r s R anking o f S u b je c t R esponses w ith t h a t o f th e P a n e l o f R a te rs A' second m ethod o f a s s e s s in g i n t e r r a t e r agreem ent u t i l i z e d K e n d a ll's c o e f f i c i e n t o f co n cord ance, W (K e n d a ll, 1955, S ie g e l, 1956). When W e q u a ls z e ro, t h i s means t h a t th e r a t e r s t o t a l l y d is a g re e i n t h e i r ra n k in g ; when W e q u a ls o n e, th e r a t e r s t o t a l l y a g re e. In th e c u r r e n t s tu d y, th e c o e f f i c i e n t was m u ltip lie d, by 1-00 to c o n v e rt th e c o e f f i c i e n t to a p e r c e n t. The o v e r a l l i n t e r r a t e r agreem ent i n ra n k in g th e s i x n a iv e subj e c t s was 85%; in ra n k in g a l l th e s u b je c t s, 74% (T able 8 ). These v a lu e s w ere s t a t i s t i c a l l y s i g n i f i c a n t a t <.0 0 1. T hus, i r r e s p e c t i v e o f w h eth er th e s u b je c ts b e in g ran k ed w ere n a iv e s u b je c ts o r th e e n t i r e s u b je c t p o p u la tio n, th e r e was a h ig h d e g re e o f i n t e r r a t e r ag reem ent.

25 Table 8 P e rc e n t I n t e r r a t e r A greem ent i n R anking th e R esponses o f N aive and A ll S u b je c ts C lie n t S ta te m e n t N aive S u b je c ts A ll S u b je c ts 1 81% 77% 2 85% 69% 3 87% 64% 4 81% 76% 5 91% 80% 6 91% 77% 7 74% 71% 8 87% 76% 9 86% 74% A verage 85% 74%

DISCUSSION Four m ajo r c r i t e r i a w ere s e t f o r t h w h ich, i f a c h ie v e d, would s u g g e s t t h a t th e new em pathy r a t i n g s c a le t h a t was t e s t e d h e r e may be o f v a lu e i n s e v e r a l a re a s o f em pathy re s e a r c h. T hese c r i t e r i a a p p e a r to have been m et i n th e c u r r e n t s tu d y. The f i r s t c r i t e r i o n w as t h a t r a t e r s u s in g th e s c a l e sh o u ld be a b le to d i f f e r e n t i a t e s u b je c ts who had p re v io u s em pathy t r a i n i n g from th o s e who had none (n a iv e s u b j e c t s ). U sing th e s c a l e, an av era g e r a t i n g o f 7.4 was a s s ig n e d to th e n a iv e s u b je c ts w h ile th e e x p e rie n c e d s u b je c ts re c e iv e d a r a t i n g o f 1 0.5. T hus, th e s c a le d id d i f f e r e n t i a t e n a iv e from e x p e rie n c e d s u b je c t s. I t may be u s e f u l to c o n s id e r th e s ig n if i c a n c e o f th e numbers used i n o th e r r a t i n g s c a le s com pared w ith th e c u r r e n t s c a le. H ost r a t i n g s c a le s c o n ta in g ra d e s and a n u m e ric a l s c o re i s a s s ig n e d to e ach g ra d e : th e la r g e r th e num ber, th e g r e a te r th e presum ed le v e l o f em pathy s k i l l s. In a d d i tio n, m ost s c a le s c o n ta in a "m in im ally f a c i l i t a t i v e " s c o re somewhere n e a r th e m id d le. For in s ta n c e, T ruax and M itc h e ll (1971) im ply t h a t a r a t i n g o f fo u r on t h e i r n in e p o in t s c a le i s a m in im a lly f a c i l i t a t i v e s c o re. C ark h u ff (1969) su g g e ste d t h a t th r e e on h is f iv e p o in t s c a le i s m in im a lly f a c i l i t a t i v e. O th ers have made m inor v a r i a t i o n s i n th e n u m e ric a l r a t i n g ra n g e and th e m in im a lly f a c i l i t a t i v e s c o re (Gazda e t a l., 1973, p. 7 1 ; Hammond e t a l., 1977, pp. 9 8-1 0 3 ). The ra n g e o f p o s s ib le s c o r e s u s in g th e em pathy r a t i n g s c a le c o n s tru c te d i n t h i s stu d y was th r e e to f i f t e e n and i t was hoped t h a t a s c o re o f n in e would r e p r e s e n t a m in im ally f a c i l i t a t i v e s c o r e. T hus, i t was g r a tif y in g to fin d t h a t th e n a iv e 26

27 s u b je c ts d id in d e ed s c o re below n in e (7.4 ) b e fo re t r a i n i n g w h ile th e e x p e rie n c e d s u b je c ts w ere r a t e d h ig h e r th a n n in e (1 0.5 ) b e fo re t r a i n i n g. The seco n d c r i t e r i o n was th e e x p e c ta tio n t h a t s u b je c ts sh o u ld r e c e iv e h ig h e r s c a le r a t i n g s a f t e r t r a i n i n g i n a c o u rse p u rp o s e fu lly d e sig n e d to in c r e a s e em pathy s k i l l s. T h is c r i t e r i o n was m et. However, i t was n o t a n t ic ip a te d t h a t e v e ry one o f 18 s u b je c ts w ould r e c e iv e h ig h e r r a t i n g s a f t e r t r a i n i n g. A lthough n o t a l l th e 18 in d iv id u a l h ig h e r r a t i n g s w ere s t a t i s t i c a l l y s i g n i f i c a n t, 83% o f th e s u b je c ts re c e iv e d h ig h e r r a t i n g s s i g n i f i c a n t a t <.1 a n d '72% a t <.0 5. T here i s re a s o n to s p e c u la te t h a t th e s e la r g e p e rc e n ta g e in c r e a s e s w ere a c t u a l l y m in im al v a lu e s b e c a u se th e s u b je c t p o p u la tio n c o n ta in e d su ch a h ig h p ro p o r tio n o f e x p e rie n c e d s u b je c ts (12) com pared w ith n a iv e s u b je c ts (6 ). F o r in s ta n c e, th e e x p e rie n c e d s u b je c ts re c e iv e d p o s t - t r a i n i n g r a t i n g in c r e a s e s o f o n ly 27% w h ile th e p o s t - t r a i n i n g r a t i n g in c r e a s e s o f th e n a iv e s u b je c ts was 116%. T his h ig h p ro p o rtio n o f e x p e rie n c e d s u b je c ts p ro b a b ly w e ig h ted th e o v e r a l l r e s u l t s tow ard th e low er f ig u r e f o r o v e r a l l im provem ent o f 47%. However, th e im p o rta n t p o in t i s t h a t th e s c a le could d e t e c t th e e f f e c t s o f an ---------- em pathy t r a i n i n g program on a p o p u la tio n composed p r im a r ily (tw o- t h i r d s ) o f a lre a d y e x p e rie n c e d s u b je c t s, i. e., th e s c a le i s c a p a b le o f a h ig h d e g re e o f d is c r im in a tio n. The t h i r d c r i t e r i o n was t h a t th e s c a le sh o u ld be c a p a b le o f r a t i n g s u b j e c t s ' re sp o n s e s to a w ide v a r i e t y o f c l i e n t s ta te m e n ts. T h is c r i t e r i o n a p p e a rs to b e m et. The c l i e n t s ta te m e n ts used in t h i s s tu d y w ere s e le c te d f o r t h e i r v a r i a t i o n i n le n g th, c o n te n t,

28 c l i e n t a g e, s i t u a t i o n a l e le m e n ts, and i n th e i n t e n s i t y and n a tu re o f th e a f f e c t b e in g e x p re s s e d. I n term s o f th e l a t t e r, th e n in e c l i e n t s ta te m e n ts r e p re s e n te d a v a r i e t y o f em otions ra n g in g from re se n tm e n t and a n g e r, to d e p re s s io n and h e lp le s s n e s s, to f e a r, to p eace and h a p p in e s s. S in c e th e q u a n t i t a t i v e im provem ent was ap p ro x im a te ly th e same a c ro s s alm o st a l l th e s ta te m e n ts, t h i s would su g g e st t h a t th e t r a i n i n g method r e s u lte d in a b ro a d -s c a le im provem ent in em pathy s k i l l s and t h a t th e im provem ent was n o t lim ite d to a narrow ran g e o f em otions and s i t u a t i o n s. M oreover, s in c e ap p ro x im a te ly th e same r a t i n g changes w ere o b serv ed a c ro s s th e n in e c l i e n t s ta te m e n ts used in t h i s s tu d y, t h i s in d i c a te s t h a t th e s c a le may have b ro a d e r a p p l i c a b i l i t y i n r a t i n g re sp o n ses to a d i f f e r e n t s e t and v a r i e t y o f c l i e n t s ta te m e n ts. The fo u r th c r i t e r i o n was t h a t an a c c e p ta b le le v e l o f i n t e r r a t e r agreem ent should b e ach iev ed u s in g t h i s new s c a le. Two in d epen d en t m ethods w ere em ployed to a s s e s s i n t e r r a t e r ag reem ent. In th e f i r s t o f th e s e m ethods, i t was shown t h a t an in d iv id u a l r a t e r 's s c o re f o r a p a r t i c u l a r w r i t t e n re s p o n s e u s u a lly d e v ia te d from th e av era g e s c o re o f th e f iv e r a t e r s by o n ly 10.9%. In th e second m ethod, w hich employed th e t r a d i t i o n a l ra n k in g te c h n iq u e o f K en d all (S ie g e l, 1956), th e i n t e r r a t e r agreem ent i n r a t i n g th e n a iv e s u b j e c t s re s p o n se s w ere found to be q u ite h ig h : e i g h ty - f iv e p e rc e n t (one-hundred p e rc e n t means t o t a l ag reem en t, z e ro p e rc e n t means no a g re e m e n t). The i n t e r r a t e r agreem ent was s e v e n ty -fo u r p e rc e n t when a l l th e s u b j e c t s re sp o n s e s w ere used a s th e c r i t e r i a f o r a s s e s s in g ag reem en t. T hese r e s u l t s w ere s t a t i s t i c a l l y s i g n i f i c a n t a t <.0 0 1. The low le v e l