Elizabeth Manzano Boulton, Eric Davis
9 min
Selecting a theoretical orientation is a pivotal, yet often overwhelming, developmental task for counselors-in-training. With hundreds of theories available, many students struggle to find a framework that aligns with their personal values, worldviews, and personality traits. This study sought to determine whether a counselor’s level of empathy—a core component of the therapeutic alliance—acts as a predictor for the theoretical orientation they gravitate toward during their training.
Researchers surveyed 166 counselors-in-training using two primary instruments: the Toronto Empathy Questionnaire (TEQ) to measure empathy levels, and the Theoretical Evaluation Self-Test (TEST) to assess inclinations toward seven major theoretical schools (psychodynamic, biological, family therapy, ecosystems, cognitive, pragmatic, and humanistic). The study utilized quantitative correlation and regression analyses to identify if empathy could predict these theoretical choices, while also collecting demographic data to examine potential patterns in student preferences.
The data indicated that overall empathy levels do not significantly predict or correlate with the adoption of any specific theoretical orientation. While some individual items on the empathy scale showed minor correlations with specific theories—for instance, those favoring humanistic theories displayed higher scores on items related to altruism and sensitivity to social disrespect—these findings were not robust enough to suggest a broad, systematic link. Perhaps most notably, the study revealed a disconnect between the theoretical orientation students claimed to prefer and the actual results of the self-test, indicating that many trainees may lack the necessary self-awareness to accurately identify which clinical approaches truly align with their personal beliefs.
The authors suggest that counselor education programs should prioritize experiential learning and self-awareness activities. Rather than focusing solely on clinical skills, curriculum should include workshops or dedicated segments that help trainees explore their own worldviews, thereby enabling them to consciously select a theoretical framework that is congruent with their authentic selves. This congruence is theorized to increase professional retention and improve the quality of the therapeutic relationship.
Alex: That creates two views of preference: a label someone chooses, and a pattern inferred from their answers. Neither is an observation of their actual counseling practice.
Sam: The study measured questionnaire responses, not observed sessions. The orientation questionnaire has 30 items covering approaches including cognitive, family, biological, and humanistic theories. Humanistic approaches emphasize people’s experience and capacity for change.
Alex: And what did the empathy measure capture? A general self-description, or responses to particular situations?
Sam: Both, through the Toronto Empathy Questionnaire. Its 16 items ask about emotional responses and behaviors, then combine them into an overall score. One statement says, “I enjoy making other people feel better.” Another asks about becoming excited when someone else feels excited.
Alex: Those could reflect different aspects of empathy. Did the researchers compare the total score, the individual answers, or both?
Sam: They did both. They tested associations between overall empathy and each framework score, then examined individual empathy items. They also used regression to ask whether overall empathy could predict framework scores. That separation matters because the broad and item-level results were different.
Alex: Let’s take the broad result first. Was there no relationship at all, or just no useful predictive pattern?
Sam: There was a small negative association between total empathy and biological orientation, which emphasizes organic and genetic factors. The correlation was about minus point one six and met the authors’ significance threshold. The other framework scores had no statistically significant associations with total empathy.
Alex: So calling the result simply “no relationship” would erase an exception. But a small association with one framework does not establish a way to choose among approaches.
Sam: Nor did the regression establish that. Overall empathy did not significantly predict the orientation scores. That supports the narrower takeaway: in this sample, the empathy total did not provide a reliable guide to theoretical inclination.
Alex: What appeared when they stopped adding everything together and looked at individual answers?
Sam: Some individual items correlated with particular frameworks. Enjoying making others feel better was positively associated with humanistic inclination. Being upset by disrespectful treatment was also associated with humanistic inclination. These are concrete examples of associations that the total empathy score did not reveal.
Alex: Could someone hear that and conclude that humanistic trainees were the most empathetic overall?
Sam: They shouldn’t. The overall empathy score was not significantly associated with humanistic orientation. The authors explicitly caution that the distribution of trainees across frameworks does not demonstrate a relationship with empathy. Individual-item findings and an overall relationship are different claims.
Alex: Then let’s return to the mismatch. What did trainees say they preferred, compared with what the orientation questionnaire suggested?
Sam: About sixty-four percent named cognitive behavioral therapy, an approach addressing patterns of thinking and behavior. But the questionnaire placed the largest group toward humanistic theories, followed by ecosystems approaches. So the most common stated preference differed from the most common questionnaire-based inclination.
Alex: That comparison is suggestive. But does it show trainees lack self-awareness, or could the questionnaire and the question simply capture different things?
Sam: The authors interpret the discrepancies as possibly indicating limited self-awareness or knowledge about selecting a fitting framework. I would treat that as a hypothesis, not an established deficit. These measures do not directly demonstrate why the answers differed.
Alex: The question bundled identification, beliefs, and intended future practice together. And the questionnaire was assessing inclination. That makes the mismatch a starting point for discussion, rather than proof that one answer is wrong.
Sam: There is another measurement caution. The authors say the orientation questionnaire addresses social workers and other helping professionals, not specifically counselors-in-training. They recommend research on adapting it for trainees, especially early in their education.
Alex: How far beyond this program would you carry the results?
Sam: Not far without replication. Everyone came from the same program, and the authors explicitly question external validity. Anonymous online self-report could also invite socially desirable answers. Trainees differed in their exposure to theory courses and supervised practice, which could affect both understanding and self-report.
Alex: Then the educational recommendations need to stay separate from what the survey actually tested.
Sam: The authors propose self-awareness activities, including a course segment or workshop examining personal beliefs and professional aims. A final project could ask trainees to explain their selected framework and how it matches their beliefs. The study did not test whether those activities improve fit, empathy, or counseling outcomes.
Alex: Who should read the full article, and where should they begin?
Sam: Counselor educators and researchers studying professional development should read the Results alongside the Limitations. Focus first on the contrast between overall empathy scores and individual-item associations. Then examine the recommendations for adapting orientation measures to trainees. Those sections clarify both the study’s contribution and the unanswered measurement questions.
Alex: And what should everyone else remember?
Sam: In this program, empathy scores did not reliably tell trainees which counseling approach fit them. A preferred label and a questionnaire-based inclination are reasons for reflection, not a verdict on professional identity.
Alex: Thanks for listening.