Date of Award

2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Clinical Psychology

Department

Psychology

Committee Chair and Members

Lisa W Samstag, Chair

Sara Haden,

Christopher Christian

Keywords

Attunement, Empathy Interoceptive awareness, Psychotherapy, Somatic countertransference

Abstract

Psychotherapist empathic attunement has been shown to contribute significantly to treatment outcomes (Bohart et al., 2002; Elliott et al., 2018), but psychotherapist factors that contribute to increased attunement have not been extensively studied. The present study’s model, based on Erskine’s (1998) model of attunement, examined the impact of therapist body awareness, embodied regulation, and personal distress empathy on attunement. Participants were N = 180 therapist trainees from various clinical fields who completed an online protocol. Results indicated that, as predicted, embodied regulation moderated the relationship between body awareness and empathic attunement, such that the relationship was significant and positive only when embodied regulation was above average. Additionally, results indicated that personal distress empathy negatively predicted empathic attunement. Contrary to expectations, results did not show a significant relationship between body awareness and personal distress empathy, whether moderated by embodied regulation or not. Interpretation of these findings considered the possible conceptual overlap between scales used to measure these disparate constructs. This study was the first to examine the impact of regulated body awareness on attunement in a therapist sample. Additionally, it provided further validity to a new measure of empathic attunement in therapy, the Patient’s Experience of Attunement and Responsiveness Scale (PEAR; Snyder & Silberschatz, 2017) and introduced a novel procedure for utilizing clinical research measures in a larger-scale online study. Clinical implications, future research recommendations, and study limitations are discussed.

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