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Relationship between therapist empathy and client-perceived working alliance in China: A multilevel modelling analysis

This naturalistic study examined the relationship between two types of therapist empathy, intellectual empathy and empathic emotion, and client-perceived working alliance (WA) in China. The study adopted the definitions and assessment methods of empathy recommended by Duan and Hill and used the theory of WA by Bordin and WA Inventory-Short by Tracey and Kokotovic. Eighty-six clients and 43 therapists from a university counselling centre at a comprehensive university in China participated in the study. Therapist intellectual empathy and empathic emotion and client-reported WA measured in six consecutive sessions from the second through the seventh session were assessed for each session. The results of multilevel modelling analyses showed that client-perceived WA increased significantly session after session, and therapist empathic emotion significantly predicted Tasks of WA. Moreover, there was significant therapist effect associated with Bond. In the context of empathy and WA research findings reported in the USA, some of the non-significant results of this study were intriguing. We discuss the study results with particular attention to the Chinese cultural context and present suggestions for future research.