695398

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ISW0010.1177/0020872817695398International Social WorkAl-Ma’seb

Article i s w

International Social Work

2017, Vol. 60(6) 1537­–1547
Factors that affect the empathy © The Author(s) 2017
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DOI: 10.1177/0020872817695398
https://doi.org/10.1177/0020872817695398
clinical social workers in Kuwait journals.sagepub.com/home/isw

Hend Al-Ma’seb
Kuwait University, Kuwait

Abstract
Empathy is an important tool that clinical social workers use during their interventions with
clients. This study aims to explore the knowledge base on empathy among clinical social workers
in Kuwait. It investigates the relationship between empathy and three constructs and some
demographic variables. The sample (N = 527) consisted of clinical social workers practicing in
Kuwait. The findings revealed significant relationships (1) between empathy, compassionate
contextual assessment, intrinsic help and emotional support, and gender; (2) between empathy,
compassionate contextual assessment, and participants’ majors in college; and (3) between
empathy, intrinsic help and emotional support, and participants’ income.

Keywords
Clinical social work, empathy, empathy constructs, Kuwait, social workers

Introduction
Empathy is an important tool that clinical social workers use during their interventions with clients.
Social work researchers emphasize the importance of empathy in social work practice (Gerdes and
Segal, 2009, 2011; Grant, 2013; King and Holosko, 2012; Raines, 1990; Savageau, 2013). Some
social work researchers consider empathy as a core principle in the field, and others consider it as
a critical and essential skill to social work (Campbell and Christopher, 2012; Grant, 2013; King
and Holosko, 2012; Shapiro and Carlson, 2009). In addition, empathy is a central element for a
healthy relationship between social workers and clients (Gerdes and Segal, 2009, 2011). Many of
the behavior and development theories, such as cognitive-behavioral and crisis-intervention
approaches, highlight the importance of the role that empathy plays between social workers and
clients (King and Holosko, 2012). For example, in clinical settings, empathy has played an essen-
tial role in developing a productive relationship between social workers and clients (King and
Holosko, 2012; Raines, 1990; Savageau, 2013).

Corresponding author:
Hend Al-Ma’seb, Department of Sociology and Social Work, College of Social Sciences, Kuwait University, P.O. Box
68168, Kaifan 71962, Kuwait.
Email: hendbatel@hotmail.com
1538 International Social Work 60(6)

Although there are many definitions that identify ‘empathy’, the concept is not so well defined
(Cuff et al., 2014). Barnett and Mann (2013) illustrated that earlier studies about empathy viewed
the concept as a receptive and understanding emotional response to other individuals. In recent
studies, researchers have considered other elements of empathy. For example, Cuff et al. (2014)
studied 43 definitions of ‘empathy’; and from them, they gleaned eight themes associated with
empathy. This ambiguity about the concept can lead to confusion about the concept itself and how
it might be approached in research or used in the field. Below is a review of some definitions. The
Dictionary of Social Work (Barker, 2014) defines ‘empathy’ as ‘The act of perceiving, understand-
ing, experiencing, and responding to the emotional state and ideas of another person’ (p. 139).
Others have defined empathy as something that we think about, then feel, and finally we do some-
thing about what we think and feel (King and Holosko, 2012). Empathy is also defined as interper-
sonal communication (Freedberg, 2007). Therefore, empathy can be used as an interpersonal reply
to transmit meaning, emotion, thoughts, and content (Compton et al., 2005). In addition, Shapiro
et al. (2006) explained that empathy means the social worker ‘adopts the client’s perspective,
views situations through her eyes, and vicariously experiences the client’s emotions’ (p. 20).
Furthermore, empathy is more likely the social worker using his or her imagination to describe the
client’s experiences and how he or she felt during a particular experience, and this can only happen
when the social worker listens carefully to the client, observes her body language, and uses her
knowledge (Shapiro et al., 2006). However, Grant (2013) explained that such definitions do not do
justice to the true meaning of empathy; nor do they realize the capacity of empathy to lead to dis-
tress. Therefore, it is important for clinical social workers to be capable of empathizing with the
clients in their practice so that they can feel their pain or distress. Social workers have to ‘experi-
ence the affect, process it, and then take appropriate, effective, empathy-driven action’ (Gerdes and
Segal, 2009: 121–22). In order to be empathic, social workers need to understand the clients’ cir-
cumstances and act based on their analysis of the situation (Gerdes and Segal, 2009). Siegel et al.
(2009) believed that when individuals have high empathy, they are motivated by the best things
that people can do for each other (Turner, 2009).
Cuff et al. (2014) demonstrated that the concept of empathy is related to several themes, includ-
ing ‘differentiating empathy from other concepts’, and these concepts are compassion, tenderness,
and sympathy. They also identified ‘congruent or incongruent’ empathy (2014). They explained that
congruent empathy is based on ‘the accuracy of perception and cognitive understanding’ (p. 7).
Furthermore, they explained that empathy is influenced by two processes, automatic and control,
and it can be a consequence of the communication between the trail and states’ influences (2014).
Cuff et al. (2014) also discussed the behavioral outcome of empathy, which usually is a result of
the empathy process, but does not necessarily happen at all times and is not considered an element
of empathy. In addition, stimuli such as imagination, previous experience, and third party are asso-
ciated with and can affect empathy (Blair, 2005; Cuff et al., 2014)
Many scholars in social work have considered empathy to be a multidimensional construct
that encompasses affective, cognitive, and behavioral dimensions (Baldner and McGinley, 2014;
Cliffordson, 2001; Cuff et al., 2014; Gerdes and Segal, 2009; Kinman and Grant, 2011; Oxley,
2011; Savageau, 2013). King and Holosko (2012) discussed the affective, cognitive, and behav-
ioral dimensions of empathy. The affective dimension can be described as an interactive process
that involves someone’s emotional communication and concern for another, and it leads indi-
viduals to feel the other’s personal experience (King and Holosko, 2012; Oxley, 2011). In addi-
tion, Heberlein and Saxe (2005) explained that affective empathy is the ability of the observer to
discover and experience another person’s emotional status. The affective dimension consists of
caring, which meets the needs of others by using specific training skills (Lee-Hsieh et al., 2005).
The cognitive dimension of empathy includes flexible thinking, interpersonal awareness, and
Al-Ma’seb 1539

openness, and helps in understanding someone else’s experiences when trying to help him or her
(King and Holosko, 2012). Furthermore, cognitive empathy is when ‘the individual represents
the internal mental state of another individual’ (Blair, 2005: 699). The cognitive dimension con-
sists of interpersonal sensitivity, which refers to someone’s ability to make a good judgment
about someone else from their nonverbal indication (Carney and Harrigan, 2003) and perspec-
tive taking, which is the ability to understand others’ opinions correctly (Cliffordson, 2002).
Furthermore, Cuff et al. (2014) discussed in their study whether empathy is a cognitive or affec-
tive notion, and they concluded that empathy consists of both cognitive and affective factors.
Heberlein and Saxe (2005) demonstrated that while the two constructs, that is, cognitive and
affective empathy, can be distinguished from each other, there is an interaction between them.
The third dimension of empathy is the behavioral dimension, which refers to one’s ability to
reiterate awareness of emotions and views back to the client (Stepien and Baernstein, 2006). The
behavioral dimension consists of altruism, which is the attempt to help people and reduce their
distress (Bierhoff and Rohmann, 2004), and the therapeutic relationship can be described as an
important instrument in bringing about change and growth in the client (Lambert and Barley,
2001).
One of the few studies conducted on empathy is by Grant (2013), who investigated the relation-
ship among reflective ability, wellbeing, and the dimensions of empathy, such as perspective tak-
ing, concern, and distress, among a sample of 359 social work students. The results showed that
students have a high level of empathic concern and distress. In addition, Grant (2013) found that
social work students could be protected from empathic distress by reflective ability.
Duan and Kivlighan (2002) examined the relationship between cognitive and affective empathy
and counselors’ pre-session mood and clients’ session assessment among 27 counselors and 58
participants. They found that cognitive and affective empathy can play a role in clients’ satisfaction
with therapy. Nerdrum and Lundquist (1996) compared a group of social work students who joined
a 3-month communication skills training program and a control group of social work students who
did not receive such training. They found that social work students who were exposed to the train-
ing program had higher levels of empathic communication skills than did the students in the con-
trol groups.
Empathy had a huge effect on the outcome of therapies and on clients’ lives. For example,
Morrison (2007) illustrated that empathy significantly contributed to job success. In addition,
Gerdes and Segal (2011) illustrated that the outcomes of interventions improved when the clients
experienced empathy during the interventions. Furthermore, social workers who were able to use
empathy in their work with clients were more effective and could assess their roles better (Gerdes
and Segal, 2011). In addition, Shapiro and Izett (2008) demonstrated that clients who experience
more empathy in their treatment are more likely to succeed in their therapy.
Al-Qahtani (2005) evaluated the roles of social workers in reform institutions in Riyadh among
a sample of 12 social workers and 120 juvenile delinquents. The results of his study showed that
50 percent of social workers reported that empathy played an essential role in reducing the propor-
tion of juvenile delinquents who returned to deviation, 41.7 percent reported that empathy played
an average role in reducing the juvenile delinquents’ deviation, and 8.3 percent reported that empa-
thy had little significance in reducing the deviation.
Empathy is widely used by social workers during therapy. However, it is still under investiga-
tion in social work research and very few empirical studies on empathy have been conducted
(Barlow and Hall, 2007; King and Holosko, 2012). Gerdes and Segal (2009) illustrated that there
are reasons behind the limited presence of empathy in social work research. They reviewed some
of these reasons, which are the appearance of empathy everywhere in social work practice, lack of
a solid concept of empathy, and disregard for the importance of empathy.
1540 International Social Work 60(6)

Significance of the study

To the best of the author’s knowledge, no empirical study, to date, in Kuwait has examined social work-
ers’ knowledge of empathic helping process. This study is the first to examine this issue in Kuwait.
Therefore, it is important to explore social workers’ knowledge about empathy, which will help to
improve their ability to practice empathy. The current study will assist social workers in the field of clini-
cal social work in Kuwait to measure their knowledge of cognitive, affective, and behavioral constructs.

Purpose of the study

The purpose of this study is to explore social workers’ knowledge of empathy in the field of clinical
social work in Kuwait and its three constructs (compassionate contextual assessment (CCA),
intrinsic helping and emotional support (IHS), accepting and attentive collaborative inquiry (ACI)).
In addition, it will investigate whether there are any differences among the three constructs of
empathy (CCA, IHS, and ACI) and gender, monthly income of the participants, and the partici-
pants’ majors at university.
The current study will examine the differences between three variables (gender, major in col-
lege, and income) and three constructs of empathy. The first variable, gender, was chosen in this
study because several empirical studies have found differences between the genders with regard to
empathy. Many studies have shown that females show greater empathy than males (Baron-Cohen
and Wheelwright, 2004; Rueckert and Naybar, 2008; Schulte-Rüther et al., 2008). The social work-
ers in Kuwait who participated in the study came from different academic backgrounds, including
majors in sociology or psychology, and not only social work. Therefore, the second variable, major
in college, was selected in this study to examine whether the academic backgrounds of the partici-
pants made a difference in their clinical uses of empathy. For example, those who were sociology
majors had not taken any courses, or received training, in social work skills. In addition, we
included the social workers’ income as a third variable that may have an effect on empathy, as so
far it has not been examined in social work literature.

Research hypotheses
•• There is a significant difference between gender and the three constructs of empathy (CCA,
IHS, ACI) among a sample of social workers in Kuwait.
•• There is a significant difference between the monthly income of the participants and the
three constructs of empathy (CCA, IHS, ACI) among a sample of social workers in Kuwait.
•• There is a significant difference between the participants’ majors at the university and the
three constructs of empathy (CCA, IHS, ACI) among a sample of social workers in Kuwait.

Methodology
This study is a quantitative descriptive research design. One of the purposes of this quantitative
research is to provide an accurate description of the relationships among variables (Johnson and
Christensen, 2008).

Sample and data collection

This study used a non-probability, convenience-sampling method to recruit the study participants.
The sample consisted of social workers who have experience in direct social work practice. The
Al-Ma’seb 1541

social workers who participated in this study had clinical experience, which provided opportunities
to use empathy during their work. The sample size of this study is 527 (n = 527). The author con-
tacted the public and private social work organizations in Kuwait, such as The Ministry of
Education, The Ministry of Social Affairs and Labor, and The Ministry of Health, to distribute the
questionnaires among social workers who practice in these organizations. The social workers were
asked to participate in this study voluntarily. Those who agreed to participate in the study filled out
the questionnaires and sent them back to the author. There were 1000 questionnaires distributed
during 3 months and only 527 were returned, resulting in a response of 52.7%.

Participants
A total of 527 social workers participated voluntarily in this study. Their ages ranged from 20 to
60 years (mean = 37 years). A total of 58.1 percent were females and 40.8 percent were males. A
total of 53.5 percent were Kuwaiti and 46.3 percent were non-Kuwaiti. The majority of the sample
was married (81.6%), followed by those who were single (13.3%), divorced (4%), and widowed
(0.4%). In terms of their income, 74.8 percent were in the middle-income range, 13.3 percent had
low income, and 9.4 percent had high income. Regarding their majors at university, 73.2 percent of
the participants reported they had social work majors, 15.9 percent reported that they were major-
ing in sociology, and 9.7 percent reported that they were majoring in psychology.

Instrument of the study

The participants in the current study were asked to complete a questionnaire that included a
cover letter to inform them of their rights. In the first part of the questionnaire, the participants
were asked to provide some demographic information, such as marital status, age, district
where they live, and gender. The second part of the questionnaire included the Empathy Scale
for Social Workers (ESSW) developed by King and Holosko (2012). The author used the ESSW
because it is one of the few standardized measures for evaluating the social workers’ knowledge
of empathy in the field of clinical social work in Kuwait based on three constructs: CCA, IHS,
and ACI.
The ESSW is a 41-item instrument that asks respondents to rate their thoughts, feelings, and
actions when they use empathy in their practice in response to self-descriptive statements.
Responses were made on a five-point Likert scale, ranging from 1 = never, 2 = rarely, 3 = some-
times, 4 = often, and 5 = always. King and Holosko (2012) developed their model of empathy based
on three steps, which are review of empathy literature, empathy scales, and expert reviewers
licensed in clinical social work. The ESSW has three sub-scales, with each subscale representing
one type of empathy dimension. The first subscale represents CCA, which means the structure for
knowing the experience of receiving and providing social work services; the second subscale rep-
resents IHS, which describes the behavioral dimension during the empathic helping process; and
the third represents ACI, which ‘describe[s] the relationship style and quality inherent in direct
social work practice’ (King and Holosko, 2012: 180). The ESSW was valid and reliable, and the
α-value for the entire scale was 0.83 (King and Holosko, 2012).
The language of the ESSW was English. Therefore, the ESSW was translated into Arabic. The
translation was conducted independently by three individuals who were well informed about
Arabic and English languages. After that, the author conducted a field test of the Arabic version of
the questionnaire, utilizing a panel of judges consisting of three professors from the Department of
Sociology and Social Work at Kuwait University who are familiar with the study. In the evaluation,
some modifications in wording were required to account for the cultural context for some of the
1542 International Social Work 60(6)

Table 1.  Correlation among the subscales of the ESSW.

ESSW subscales 1 2 3
1 CCA 1.00 0.71** 0.65**
2 ACI 0.71** 1.00 0.62**
3 IHS 0.65** 0.62** 1.00

ACI: accepting and attentive collaborative inquiry; CCA: compassionate contextual assessment; IHS: intrinsic helping and
emotional support.
**Correlation is significant at 0.01 level (two-tailed).

Table 2. Coefficient α, mean score, and SD for the entire scale and subscales (N = 527).

Scale (number Coefficient α Mean SD Per-item

of items) score mean
ESSW (41) 0.89 155.78 16.37 3.79
CCA (10) 0.79 40.31 5.48 4.03
ACI (8) 0.73 32.69 4.30 4.08
IHS (4) 0.74 17.72 2.45 4.43

ACI: accepting and attentive collaborative inquiry; CCA: compassionate contextual assessment; ESSW: Empathy Scale
for Social Workers; IHS: intrinsic helping and emotional support.

items hence, some items were changed based on the suggestions of the panel. In addition, the
author discussed each item with some of the participants, and the participants reported full under-
standing of the items.

Internal consistency
The internal consistency was calculated using Cronbach’s α. The internal consistency for the entire
scale alpha was 0.89. The reliability alpha scores of these subscales were found to be as follows:
CCA (α = 0.79), ACI (α = 0.73), and IHS (α = 0.74), all of which are considered satisfactory.

Results
The researcher used correlations among CCA, ACI, and IHS to test the relationships among these
variables, which formed the ESSW. The results showed a positive correlation between CCA and
ACI (r = 0.71, p < 0.01), and between CCA and IHS (r = 0.65, p < 0.01). Furthermore, a positive cor-
relation was found between ACI and IHS (r = 0.62, p < 0.01; see Table 1).
The overall ESSW mean score is 155.78 (3.79 per item mean), which is considered a little
higher than the midpoint of 3 on a Likert scale of 1–5. The mean values of the three subscales per
item range between 4.3 and 4.4, indicating that all of the per-item means for the three subscales are
above the midpoint 3 (Table 2).

Gender
A t-test was conducted to find differences between gender and the ESSW and three subscale scores
(CCA, ACI, and IHS). The results showed that there are significant differences between gender and
Al-Ma’seb 1543

Table 3.  T-test between gender and scale and subscale scores.

Male Female df ’ t

  M SD M SD
CCA 39.62 5.94 40.77 5.14 476 −2.24*
ACI 32.42 4.73 32.86 4.02 488 −1.10
IHS 17.27 2.84 18.04 2.10 507 −3.43***
ESSW 153.58 18.51 157.33 14.60 519 −2.57**

ACI: accepting and attentive collaborative inquiry; CCA: compassionate contextual assessment; ESSW: Empathy Scale
for Social Workers; IHS: intrinsic helping and emotional support; SD: standard deviation.
***p < 0.001, **p < 0.01, *p < 0.05 (two-tailed).

Table 4.  One-way ANOVA between majors and scale and subscale scores.

Social Work Psychology Sociology Others df’ F

  M SD M SD M SD M SD
CCA 40.62 5.32 37.72 5.17 40.83 6.09 39.25 6.12 520 4.54**
ACI 32.73 4.29 31.61 3.77 33.30 4.79 32.71 4.23 477 1.47
IHS 17.82 2.37 17.05 2.61 17.78 2.53 16.81 3.27 489 2.24
ESSW 156.36 16.16 150.05 15.58 157.88 17.77 151.00 16.93 508 3.09*

ACI: accepting and attentive collaborative inquiry; ANOVA: analysis of variance; CCA: compassionate contextual assess-
ment; ESSW: Empathy Scale for Social Workers; IHS: intrinsic helping and emotional support; SD: standard deviation.
**p < 0.01, *p < 0.05 (two-tailed).

ESSW (t = −2.57, p = 0.01), with a mean of 153.58 for male social workers and a mean of 157.33
for female social workers. In addition, there are significant differences between gender and CCA
(t = −2.24, p = 0.05), with a mean of 39.62 for male social workers and a mean of 40.77 for female
social workers. Another significant difference was found between gender and IHS (t = −3.43,
p = 0.001), with a mean of 17.28 for male social workers and a mean of 18.04 for female social
workers. However, the analysis indicated that the mean values of ACI did not differ significantly
at p < 0.05 (see Table 3).

Major at the university

One-way analysis of variance (ANOVA) was conducted to test differences between groups in
terms of the majors and the ESSW and three subscale scores (CCA, ACI, and IHS). The partici-
pants reported different majors, which are Social Work, Sociology, Psychology, and others. There
are significant differences between the majors of the participants and the CCA, F(3, 474) = 4.549,
p = 0.004. Participants who had majored in Social Work or Sociology scored significantly higher on
the CCA subscale than did those who had majored in Psychology and other majors. In addition,
there are significant differences between the majors of the participants and the ESSW, F(3,
517) = 3.098, p = 0.02. Participants who had majored in Social Work or Sociology scored signifi-
cantly higher on ESSW than did those who had majored in Psychology and other majors. However,
the analysis indicated the means of ACI, and IHS scores did not differ significantly at p < 0.05 (see
Table 4).
1544 International Social Work 60(6)

Table 5.  One-way ANOVA between income and scale and subscale scores.

Low income Middle income High income df ’ F

  M SD M SD M SD
CCA 40.06 5.59 40.35 5.30 41.14 5.91 470 0.59
ACI 33.00 4.20 32.65 4.16 33.70 4.14 481 1.42
IHS 17.21 2.82 17.75 2.34 18.40 1.65 500 3.62*
ESSW 154.90 16.46 155.58 15.61 161.67 16.24 512 3.46*

ACI: accepting and attentive collaborative inquiry; ANOVA: analysis of variance; CCA: compassionate contextual assess-
ment; ESSW: Empathy Scale for Social Workers; IHS: intrinsic helping and emotional support; SD: standard deviation.
*p < 0.05 (two-tailed).

Income
One-way ANOVA was conducted to test differences between the ESSW and three sub-scale scores
(CCA, ACI, and IHS) and the participants’ monthly income, where the participants’ income was
divided into low income, middle income, and high income. The results show that there were signifi-
cant differences between the participants’ monthly income and ESSW, F(2, 498) = 3.628, p = 0.027.
The participants who had a high income scored significantly higher on ESSW; they were followed
by those who had a middle income and those who had a low income. In addition, there was a signifi-
cant difference between the participants’ monthly income and IHS, F(2, 510) = 3.462, p = 0.032. The
participants who had a high income scored significantly higher on IHS, followed by those who had
a middle income and those who had a low income. Moreover, there were no significant differences
between the CCA and ACI with regard to the participants’ monthly income at p < 0.05 (see Table 5).

Discussion
The current study investigated the knowledge of clinical social workers in Kuwait about empathy
and its constructs. It is the first empirical research in Kuwait investigating this issue. The findings
indicated that the clinical social workers who participated in this study have a high knowledge of
empathic help. They practice positive CCA. In other words, they are able to understand the experi-
ence of receiving and providing social work services. In addition, the social workers who partici-
pated in this study display high IHS, which means they are able to give emotional support to their
clients. Furthermore, they have high ACI.
These results indicate that clinical social workers in Kuwait are able to understand the affective,
cognitive, and behavioral constructs of empathy and can apply them during the helping process. In
short, they have the ability to feel, think, and act during the therapy, using empathic skills. Moreover,
the results of this study indicate that clinical social workers in Kuwait have high empathy, which
would improve the helping process and which, in turn, could reflect on the outcomes. For example,
a client who experienced empathy from the social worker during intervention would be more likely
to succeed in his or her therapy and more likely to have improved outcomes (Duan and Kivlighan,
2002; Gerdes and Segal, 2011; Shapiro and Izett, 2008).
The current study also explored whether variables, such as gender, monthly income of the par-
ticipants, and the participants’ majors at the university, are associated with empathy and its three
constructs: CCA, ACI, and IHS.
The results show that the male social workers in Kuwait who participated in the study express
more knowledge of empathic helping experience than the female participants. In addition, the male
participants have more positive CCA than the female participants. Furthermore, males have high
Al-Ma’seb 1545

IHS compared to females. The results show that there are no differences between female and male
social workers in Kuwait in the third construct of empathy, which is ACI. These results were surpris-
ing because there is a belief that females are more empathic than males (Eisenberg and Lennon,
1983). These results could be related to the fact that the majority of the male social workers who
participated in this study are non-Kuwaiti, in contrast to the majority of the female social workers
who are Kuwaiti. The male social workers are from countries like Egypt and Jordan but are working
in Kuwait at the present time. They completed their Bachelor’s degree in social work at universities
other than Kuwait University, which may offer more courses or training on empathy than those
available in the Department of Sociology and Social Work at Kuwait University.
An additional significant difference among groups was related to the participants’ undergradu-
ate majors. Practitioners who majored in Social Work or Sociology reported a higher degree of
knowledge of empathic helping experience than did those with degrees in Psychology and other
fields. Furthermore, practitioners who had majored in Social Work or Sociology reported higher
CCA than did those with degrees in Psychology and other fields. However, participants did not
show any differences in the ACI and IHS constructs. These results could be related to the fact that
the Social Work and Sociology majors all study in one department, the Department of Sociology
and Social Work, where students are required to take courses in both majors. In addition, the Social
Work curriculum in the Bachelor’s program offers a Social Work Skills course, in which the stu-
dents receive training and acquire intensive information on social work skills. Other departments
at Kuwait University such as the Psychology Department do not offer such courses, which may
lead to students learning less about empathy in general and having a weakness in their ability to
practice empathy in the field. Nerdrum and Lundquist (1996) emphasized the importance of train-
ing in empathy to increase the knowledge of social work students.
The findings of this study indicate that participants who have a high income reported greater
knowledge of empathic helping experience than did those with middle and low income. In addi-
tion, social workers who have a high income reported higher IHS than did those with middle and
low incomes. This result may be due to high-income social workers being able to pay the fees for
social work programs that provide training and information about different subjects in social work.
In addition, they may be in a position to afford the cost of attending conferences and workshops in
the field of social work. Additional research could further interpret and clarify this result.

Implications for clinical social work

The current study contributes new knowledge to the field of Clinical Social Work, as it is the first
empirical study to explore this area in Kuwait. In addition, the findings of this study will equip
clinical social workers with a deeper understanding of the nature of empathy in the field of Clinical
Social Work in Kuwait. It will help clinical social workers recognize the constructs of empathy and
the essential role of empathy when working with clients. The self-assessment survey on empathy
may help social workers to improve their skills, especially in the clinical field, where they have to
interact with clients and use their skills as a tool, which can enhance the effectiveness of the ther-
apy. The social work practice supervisors in Kuwait would be able to evaluate such skills among
the social workers in their agencies and organizations to discover the need for more training or
workshops for their staff.

Future research and recommendations

There are only a few studies on empathy among clinical social workers in Kuwait, indicating a
need in Kuwait for conducting more research in this area. Researchers could investigate the rela-
tionship between empathy and therapy outcomes. In addition, it would be useful to conduct
1546 International Social Work 60(6)

comparative studies between social workers who have been exposed to empathy training programs
and those who have not. Furthermore, there is a need for research to investigate why the high-
income social workers have more empathy than the middle- and low-income social workers.
Based on the findings of this study, the researcher recommends regular evaluation for social
workers’ skills, especially empathic skills, which will help supervisors make appropriate decisions
about future workshops and trainings programs. Social workers need to attend social work confer-
ences and training programs that can help them to improve their skills and knowledge base, so they
can provide better service to their clients.

Funding
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit
sectors.

References
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Author biography
Hend Al-Ma’seb is Associate Professor in the department of Sociology and Social Work, College of Social
Sciences, Kuwait University.