PSYCHOTHERAPY: THEORY, RESEARCH AND PRACTICE

VOLUME 8, #2, SUMMER, 1971

ANXIETY ABOUT THE ACT OF COMMUNICATING

AND PERCEIVED EMPATHY
WILLIAM D. PIERCE
Westside Community Mental Health Center
2201 Sutler Street
San Francisco, California 94115

Rogers (1957) views empathic understand-
ing as one of the necessary and sufficient con-
ditions for therapy. He further postulated that
it is effective only if the client perceives the
therapist's empathy. Thus, the importance of
empathy does not depend exclusively on the
empathic ability of the therapist, but also on
the perception of empathy by the client.
Pierce (1965) suggested that empathy be
viewed as a part of the total interaction be-
tween two people and not as a personality
trait or variable of one person. Focus should
be placed on variables functioning in the in-
teraction situation. With this approach as
a guide, Pierce found when the timing of E's
responses was "appropriate," the E was per-
ceived as more empathic than in the "inappro-
priate" interview condition. There was also an
inverse correlation between perceived empa-
thy scores and post-interview anxiety scores.
No shifts in anxiety level were demonstrated
between conditions (Pierce, 1965; Pierce and
Mosher, 1967).
The present study replicated the Pierce
(1965) study, using the same interview condi-
tions and measures, and in addition employed
a subjects X treatments design with repeated
measures, in order to answer the question: if
anxiety about the act of communicating is re-
duced, will the other person be perceived as
more empathic?
The experimental design included four
treatment condition groups:
Group I. Inappropriate Interview; Appro-
priate Interview
Group II. Appropriate Interview; Inappro-
priate Interview
Group III. Inappropriate Interview; Inap-
propriate Interview
120
Group IV. Appropriate Interview; Appro-
priate Interview
METHOD
The interview conditions were based on a
standard interview procedure investigated by
Matarazzo (1962).
Appropriate Timing Interview—In this
condition, the E attempted to respond appro-
priately to the S with a statement. The E did
not interrupt the S nor did E allow more than
five seconds of silence to elapse. The appropri-
ate timing interview lasted for 15 minutes.
Inappropriate Timing Interview—This con-
dition was divided into three periods. The
first period was two minutes of the appropri-
ate condition. The second period was the in-
terruption period. Here the E interrupted the
5's speaking approximately every five seconds
with a statement. The period lasted for five
minutes. The third period was the silent pe-
riod. Here the E did not respond to the 5 for a
fixed period of 12 seconds after the last utter-
ance of the 5". If a criterion of three periods of
12 seconds of silence was reached within five
minutes the interview terminated. If not, then
the interview continued. If at the end of eight
minutes the three periods criterion of 12 sec-
onds of silence had not been reached, the in-
terview terminated. Thus, the silence period
lasted a minimum of five minutes to a maxi-
mum of eight minutes. The Inappropriate In-
terview lasted a minimum of 12 minutes to a
maximum of 15 minutes.
To insure that only timing differentiated
the conditions, all interviews were further
standardized by the use of 14 nondirective
type statements by the E. The statements were
attempted to be said in a warm, accepting,
 ANXIETY ABOUT THE ACT OF COMMUNICATING AND PERCEIVED EMPATHY
and understanding manner and were selected
to fit the context of the interview. The inter-
viewer statements were: Um Humra; Reflec-
tion of S's last statement; You feel that (last
statement said); I don't quite understand, tell
me more about that; How does this make you
feel about yourself; Tell me more about your-
self; Can you tell me a little more about that;
Yes, I can understand that; That must be a
rough sort of feeling; I agree, it must be diffi-
cult; These are (this is a) good or bad
point(s) as you see them (it); Yes, that
seems to make sense; I think I am beginning
to understand; I might feel that way too.
MEASURES
Anxiety was measured before and after each of
the two interview periods. To obtain a measure of
anxiety, 16 items were selected from the Test Anxiety
Questionnaire (T.A.Q.) (Mandler & Sarason, S. B.,
1952) and the Test Anxiety Scale (T.A.S.) (Sarason
& Ganzer, 1962). The items were modified to re-
fer to an interview rather than a testing situation.
The items were in questionnaire form as in the
Mandler-Sarason T.A.Q. The split-half reliability co-
efficient for the Anxiety Questionnaire (A.Q.) was
.89 for N = 30; p < .01 (Pearson r with Spearman-
Brown correction). Judges ratings of S anxiety from
taped interviews compared to A.Q. ratings showed
a point correlation (Phi) of .60. To obtain an
anxiety measure before and after the interviews,
three administrations of the A.Q. were given, A.Q. 1,
A.Q. 2, A.Q. 3. A.Q. 1 items were in the present
tense and A.Q. 2 and 3 items were in the past
tense.
Perceived empathy was measured by a
modification of the empathic understanding
scale of the client-form of the Barrett-Lennard
Relationship Inventory (1959).
Eight positive and eight negative empathy items
were used and scored with a six-point Likert-type
scale. Examples: Empathic positive—"He tried to
understand exactly how I saw things"; Empathic
negative—"He understood my words but did not
know how I felt." The split-half reliability coeffi-
cient for the Emp. was .74 for N = 30; p < .01
(Pearson r with Spearman-Brown correction).
PROCEDURE
The 55 were 60 males who volunteered for the
study while enrolled in an undergraduate psychology
course at the Ohio State University. The Ss were ran-
domly assigned to one of the four interview condition
groups. All Ss were seen individually in the interview
conditions.
It was explained to the Ss that all interviews would
121
be tape recorded for purposes of research and that a
stop-watch would be used to exactly time the inter-
view. It was explained that the purpose of the study
was to find out how college students think and feel
about themselves. Instructions were then read.
(1) Instructions: "In this interview your instruc-
tions are to describe yourself and to express
what you think about yourself and how you
feel about yourself. Since the time for the in-
terview will be limited, I will give you a few
minutes to organize your thoughts so you can
present them to me better."
The 5 was then asked to complete A.Q. 1 while be-
ing left alone for three minutes.
(2) The interviewer returned and began interview
condition one, Appropriate or Inappropriate,
depending on treatment group. At the comple-
tion of interview one, the S was asked to com-
plete A.Q. 2 after which the interview would
continue.
(3) The E returned and said, "I'll reread the in-
structions just to remind you and then you can
just continue. In this interview your instruc-
tions are to describe yourself and to express
what you think about yourself, and how you
feel about yourself. O.K. you can continue."
Interview condition 2, depending on treatment
group, was initiated.
(4) At the termination of the second interview
condition, the 5 was asked to complete A.Q. 3
and Emp. The order of presentation of the
scales was counterbalanced.
(5) E explained the study to S, encouraged ques-
tions and comments and when the study had
been discussed to S's satisfaction he was
thanked and released.
RESULTS
JUDGMENT OF INTERVIEWER STATEMENTS
The primary manipulation in the interview condi-
tions was the appropiateness of timing of the inter-
viewer statements. In order not to confound timing
and affective tone, it was necessary that the manner
in which the interviewer said the statements was consis-
tent in both the Appropriate and Inappropriate timing
interview conditions. Thus, the interviewer attempted
to say the statements in a warm and accepting man-
ner, to control for vocal cues. In order to check this,
all interviews were tape recorded. At the termination
of the study interviews were randomly selected and
from these interviews sixty interviewer statements
were randomly selected. Thirty statements came from
the Appropriate and thirty from the Inappropriate
condition. Three advanced graduate students in clini-
cal psychology acted as judges. The judges were in-
formed that one-half the statements came from each
condition. A two out of three judges consensus for
each of the sixty statements was tabulated.
A X2 test for independence was done on the
consensus of judge's ratings for correctness and in-
correctness. The resulting X2 value (XJ = .077,
df = 1) was not significant. Further inspection shows
122 WILLIAM D. PIERCE

that judges tended to rate statements as Appropriate appropriateness of timing of interviewer state-
more often than Inappropriate, at a rate approxi- ments. In the interview conditions (I. and
mately two to one. It is concluded that the manner
in which the interviewer said the statements was IV.) where there was a significant reduction
not significantly different for the two interview in anxiety, Emp. scores were significantly
conditions. On the whole, the statements were ap- greater than in the interview conditions (II.
parently said in a warm, accepting manner. Ss in and III.) where there was no significant
an Appropriate timing interview condition perceived change in anxiety.
the E as more empathic than in an Inappropriate
interview condition. (The t-values, t = 3.01, df = 28 To further check the relationship between
between conditions I. and II. and t = 1.99, df = 28 anxiety and perceived empathy, a Pearson
between III. and IV. were both significant at the product moment correlation was done on A.Q.
.05 level.) 3 scores and Emp. scores for the 60 Ss. The r
5s in an Appropriate interview show less anxiety
than when in an Inappropriate interview. (The F- between these two variables was —.33, and
value = 8.49 between A.Q. scores was significant at was significant at the .05 level. This finding
the .01 level; the F-value = 3.S3 for the interaction indicates the higher the A.Q. score the lower
of interview condition and A.Q. scores was significant the Emp. score. Though the amount of vari-
at the .05 level.) F-values for differences between ance accounted for by the r is not great, an
A.Q. scores in groups I. (F = 7.57) and IV.
( F = 10.32) were significant at the .01 level. inverse relationship between anxiety and per-
ceived empathy is suggested by the basic hy-
There was no significant difference in A.Q. pothesis.
scores between interview conditions II. and
III. Anxiety reduced from the end of the In- DISCUSSION
appropriate condition to the end of the Appro- The results indicated that in Appropriate
priate condition. Anxiety level did not change timing Ss perceived the interviewer as more
significantly during the Inappropriate condi- empathic. Also, the results of this study dem-
tion. onstrated an inverse relationship between anx-
For interview condition IV. anxiety was re- iety and perceived empathy. These findings
duced during the first interview and did not were previously reported by Pierce & Mosher
change significantly during the second. Anxiety (1967). These results have been replicated.
was significantly less at the end of IV. than at The results of the present study further in-
the end of III. (t = 2.21, df = 28 significant dicated that Ss in an Appropriate interview
at the .05 level for a two-tailed test.) showed less anxiety than when in an Inappro-
The results indicate in interview condition priate interview. Thus shifts in anxiety level
I. a significant decrease in anxiety between were demonstrated, i.e., anxiety reduction.
conditions; in I. and IV. during Appropriate Pierce & Mosher (1967) concluded that tim-
timing. In interview conditions II. and III. ing of statements was a variable. Present re-
there was no significant change in anxiety. sults did not confirm this. The results of the
Anxiety was significantly less at the end of in- present study did indicate that anxiety reduc-
terview condition IV. than at the end of inter- tion is related to perceived empathy. Hence,
view condition III. when a reduction in anxiety occurred, higher
The significant reductions in anxiety were perceived empathy scores occurred.
associated with the Appropriate conditions An important concept in regard to both
while no significant change was associated testing and therapy situations is to "establish
with the Inappropriate conditions. Thus, less rapport with the patient." The patient should
anxiety is shown by people in the Appropriate feel at ease or less anxious. Thus, establishing
condition than in the Inappropriate condition. good rapport has been an important situa-
The data do not indicate that Inappropriate tional variable in dealing with patients. How-
timing, as defined in this study, influences ever, the research on empathy has not dealt
anxiety. Appropriate timing sometimes did with this type of concept directly. One reason
and sometimes did not function to decrease for this may be due to the view that empathy
anxiety. is a personality variable and hence, personal-
The reductions in anxiety are related to a ity variables have been dealt with exclusively,
change in perceived empathy, rather than the rather than situational variables.
 ANXIETY ABOUT THE ACT OF COMMUNICATING AND PERCEIVED EMPATHY 123

If the empathic process is viewed as part of chology, 1952, 47, 166-173.

the total interaction between two people and
not as a personality trait of one, then vari-
ables functioning within the interaction situa-
tion, the situational variables become impor-
tant in the study of empathy.
REFERENCES
BARRETT-LENNARD, G. T . The relationship inven-
tory: A technique for measuring therapeutic di-
mensions of an interpersonal relationship. Mimeo-
graphed paper read at the Annual Conference of
the Southwestern Psychological Association in St.
Augustine, Florida, April 24, 1959.
MANDLER, G. & SARASON, S. B. A study of anxiety
and learning. Journal of Abnormal and Social Psy-
MATARAZZO, J. D. Prescribed behavior therapy: Sug-
gestions from interview research. In A. J. Bach-
rach (ED.), Experimental foundations of clinical
psychology. New York: Basic Books, 1962.
PIERCE, W. D. Anxiety and perceived empathy. Un-
published Master's thesis, The Ohio State Univer-
sity, 1965.
PIERCE, W. D. & MOSHER, D. L. Perceived empathy,
interviewer behavior, and interviewee anxiety.
Journal of Consulting Psychology, 1967, 3 1 , 101.
ROGERS, C. R. The necessary and sufficient conditions
of therapeutic personality change. Journal of Con-
sulting Psychology, 1957, 2 1 , 95-103.
SARASON, I. G. & GANZER, V. Anxiety, reinforcement,
and experimental instructions in a free verbaliza-
tion situation. Journal of Abnormal and Social
Psychology, 1962, 65, 300-307.

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