• Barbara L Vivino, Barbara J Thompson, Clara E Hill, and Nicholas Ladany.
• Independent Practice, Berkeley, CA 94707, USA. BVivino@aol.com
• Psychother Res. 2009 Mar 1;19(2):157-71.

AbstractFourteen therapists nominated by peers as compassionate defined compassion in psychotherapy as connecting with the client's suffering and promoting change through action. They indicated that compassion was broader and deeper than empathy, helps clients feel understood, and relieves symptoms. Although indicating that compassion was innate, therapists felt it could be further awakened. Factors facilitating compassion in therapy were therapists feeling clients' suffering, understanding client dynamics, identifying with and liking clients, client involvement, and a good therapy relationship. Hindering factors included clients being resistant, being aggressive, having serious pathology, or violating boundaries; therapists having interfering personal issues, feeling incompetent, or having negative reactions to or not liking clients; and a poor therapy relationship. A theory regarding compassion in psychotherapy is proposed.

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