Empathic Accuracy and Compassion Fatigue Among Therapist Trainees Jennifer L. O’Brien VA Boston Healthcare System, Jamaica Plain, Massachusetts David A. F. Haaga American University Psychotherapists are in the challenging position of needing to (a) listen to traumatic self-disclosures well enough to form empathically accurate responses to clients and (b) keep such self-disclosures and their own emotional reactions to them private, without (c) becoming burned out or suffering excessively from compassion fatigue. To shed light on these phenomena, we compared trait empathy as well as empathic accuracy and compassion fatigue in response to a standard videotaped trauma self-disclosure among advanced (fourth-/fifth-year graduate students, n  18) and novice (first-year graduate students, n  18) therapist trainees and age- and gender-matched nontherapists (n  36). As expected, therapist trainees reported substantially (d  .77) less compassion fatigue than did nontherapists, and the trainees were substantially (d  .81) more accurate on a multiple-choice empathic accuracy test. However, therapist trainees did not differ from nontherapists in trait empathy or on a free-response measure of empathic accuracy. Advanced trainees did not differ from novice trainees on any measure. These results tentatively suggest that therapist trainee resilience in managing the stress of receiving traumatic self-disclosure stems more from selection, than retention or training/experience effects. Further research is needed to examine if these conclusions would hold up with interactive discussions rather than standard videotaped disclo- sures, or a wider range of therapist training and experience. A central implication of such an inquiry would be to determine the utility of promoting therapist resilience in clinical training programs. Keywords: empathy, empathic accuracy, therapist training, compassion fatigue Interacting with distressed persons has the potential to be inher- ently upsetting, and may even lead the listener to feel depressed and anxious themselves (Marcus & Nardone, 1992; Strack & Coyne, 1983). Gurtman, Martin, and Hintzman (1990) found the contagion effect existed even when research participants watched distressed individuals in a video. As a result, there is a tendency for listeners to reject distressed disclosers from social interactions. Therapists, of course, find themselves frequently interacting with depressed and anxious individuals and are in no position to com- municate such a rejection. This raises the question, what differen- tiates those who choose a career in which they are constantly exposed to individuals in distress, from those who do not choose this profession? And second, how might therapists remain simul- taneously empathic and manage their own reactions in the face of repeated exposure to distressing material presented by clients? The study described here explored two salient constructs with regard to these questions; empathy and compassion fatigue. Exposure to intensely negative emotions and experiences pre- sented by patients can take a psychological toll on therapists, and at worst potentially result in “burnout” (Freudenberger, 1975), “vicarious trauma” (VT) (McCann & Pearlman, 1990) or “com- passion fatigue” (CF) (Collins & Long, 2003). CF (sometimes referred to as “secondary traumatic stress disorder” or STS) refers to a state of tension and preoccupation in which the individual experiences symptoms similar to posttraumatic stress disorder (PTSD) following exposure to traumatizing material presented by a patient. It is distinct from burnout among mental health profes- sionals (Boscarino, Figley, & Adams, 2004). In particular, whereas burnout is characterized as emotional exhaustion in the wake of long-term exposure to frustrating and stressful aspects of one’s work (Maslach, 1982), CF can in principle occur after a single exposure to traumatic material (Figley, 1983). CF is also theoret- ically distinct from VT, in that VT is more descriptive of a change in therapists’ schemata about themselves and the world that result from hearing about trauma from clients, as opposed to CF which is more specifically tied to PTSD-like symptoms. Baird and Kracen (2006) posited that due to lack of exact definitions of these constructs in the literature (burnout, CF, VT, STS), it has been challenging for researchers to use these concepts within a clinical framework. Elwood and colleagues (2011) further argued that clarifying these concepts and identifying a more specific course and nature of symptoms can facilitate development and implemen- tation of treatment programs to target clinicians who experience such reactions. This article was published Online First July 6, 2015. JENNIFER L. O’BRIEN received her MA and PhD in clinical psychology from American University. She is currently a postdoctoral fellow in clinical psychology at the VA Boston Healthcare System. Her areas of professional interest include clinical interventions for mood and anxiety disorders in veteran populations, behavioral health interventions, and the intersection of aging and gender on individual development. DAVID A. F. HAAGA received his PhD in clinical psychology from the University of Southern California. He is currently Professor and Chair of Psychology at American University. His areas of research interest include cognitive behavior therapy, assessment, smoking cessation, and trichotil- lomania. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Jennifer L. O’Brien, VA Boston Healthcare System, Psychology Service (116B), 150 S. Huntington Ave, Jamaica Plain, MA 02130. E-mail: obrjennifer@gmail.com This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Professional Psychology: Research and Practice © 2015 American Psychological Association 2015, Vol. 46, No. 6, 414 – 420 0735-7028/15/$12.00 http://dx.doi.org/10.1037/pro0000037 414