Nonverbal empathy and perceived therapist warmth and competence: An experimental video vignette study.

Maaß, Ulrike; Weck, Florian · Patient Educ Couns · 2026

rct · Level II

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Abstract

This study examined how nonverbal empathy affects perceptions of therapists' competence and warmth. It also looked at the influence of the Big Five, self-rated empathy, and secure attachment, on these perceptions. A between-subjects online randomized controlled trial involved 257 participants (average age 41.57 years, with 66.1% identifying as female), who were randomly assigned to view one of two video clips. These videos depicted a therapist demonstrating either high (E + ) or low (E-) nonverbal empathy during a simulated therapy session. Nonverbal empathy was conveyed through the intensity of eye contact, nodding, appropriate facial expressions, leaning forward, slow speech, and a soft voice. Participants evaluated the therapist's competence and warmth and reported their own Big Five personality traits and secure attachment. One-way MANOVA and path models were used for analysis. Significant differences were found between the study groups, with the E + group perceiving the therapist as warmer (d = 0.70), but not more competent (p = 0.141). The participants' variables were not significantly related to perceptions of therapists' competence and warmth. However, more insecurely attached participants judged the E + therapist as more competent than the E- therapist. The findings highlight the important role of nonverbal cues in shaping how therapists are perceived, especially regarding factors that influence the therapeutic alliance. Therapists should self-monitor their gestures, tone, and facial expressions, and nonverbal communication should be emphasized in therapy training.

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