Empathic reflections by themselves are not effective: Meta-analysis and qualitative synthesis

Figures & data

Table I. Conversation analysis transcription notation.

Symbol	Meaning
[	starting point of overlapping talk
]	endpoint of overlapping talk
(1.5)	silence measured in tenths of seconds
(.)	hearable untimed pause < .2 sec
.	falling intonation at end of utterance
,	continuing intonation at end of utterance
wor-	truncated, cut-off speech
wo:rd	prolongation of sound
word = word	latching (no audible break between words)
#word	markedly upward shift in pitch
word	Emphasis
.hhh	audible inhalation, # of h’s indicate length
Hhh	audible exhalation, # of h’s indicate length
heh/huh/hah/hih	laugh particles
((cough))	audible non-speech sounds
italics (blue)	non-verbal behavior (actor indicated by initial)
bold	examples of key activities

Table

Table

Figure 1. PRISMA diagram for empathic reflection meta-analysis.

Figure 2. Funnel plot of empathic reflection-effectiveness effects by standard error: study level effects.

Table II. Effect-level effects across change process criteria and temporal level.

Research Design	Effects	Samples	Clients	Mean Weighted r	Within Group Q	I^2
				(95% CI) [d]
Within-Session:	136	24	1217	.020 (-.024, .065) [.04]	73.4	–
Sequential process	82	17	743	-.01 (-.13, .10) [-.03]	14.7	–
Sequential experiential	42	7	144	.04 (-.19, .27) [.08]	.8	–
Process-process correlational	12	5	409	.14 (-.08, .35) [.28]	23.4*	53%
Post-session (Process-outcome)	11	3	72	.01 (-.27, .29) [.02]	2.1	–
Post-therapy (Process-outcome)	67	22	1734	.03 (-.06, .13) [.06]	29.6	–
Between groups Q (totals)	(214)	(43)	(2710)	4.37 (df = 5, 229) (ns)

Notes: 95% CI: 95% confidence interval. Mean correlations and significance tests (vs. null hypothesis r = 0) for subgroups calculated using Fisher's z scores and a restricted maximum likelihood random effects model using Wilson’s (2021) macros for SPSS and weighting by inverse error and number of effects per study. Some samples used multiple criteria; ns for clients therefore exceed subtotals and grand total.

*p < .05.

Wilson, D. B. (2021). SPSS meta-analysis macro. Computer software. http://mason.gmu.edu/~dwilsonb/MetaAnal.html.

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