Empathy development in typical and high-risk child and adolescent cohorts: a socialisation based intervention

Empathy is critical for children’s and adolescents’ social understanding, pro-social behaviour, and moral reasoning (Decety & Holvoet, 2021; Hoffman 2008). Arrested empathy, conversely, is strongly associated with antisocial and offending behaviours (Trivedi-Bateman & Crook, 2021). This is particularly concerning for children and adolescents who are exposed to adverse childhood experiences and who have limited empathy socialisation opportunities. Despite the protective benefits of empathy development, to date, there is limited empirical support for caregiver-child based interventions targeting empathy in children and adolescents.

Reminiscing about everyday past experiences offers a particularly rich opportunity to learn about the diverse impact social situations can have on others’ emotional states and perceptions, especially when these are different to one’s own. Past research has shown how parents of younger children can be coached to discuss emotion and their causes when discussing everyday events together, using open-ended questions and detailed memory prompts to expand the conversation (see Corsano & Guidotti, 2018 for a review). This elaborative and emotion-rich style of reminiscing has shown longitudinal benefits for children’s own emotion talk and knowledge (Van Bergen et al., 2009). By including empathy specific skills into this empirically robust intervention, parents and caregivers might also support and strengthen developing empathy skills in children and adolescents.

In the first research of its kind, this thesis investigated the impact of a unique verbal scaffolding intervention on school-age children’s and adolescents’ empathy and associated capacities including emotion knowledge and moral reasoning. The reminiscing intervention focused on the use of elaborative and emotion-rich memory prompts, as in previous research, but also included a first-person perspective taking component. Study 1 recruited a typically developing middle-childhood cohort (M = 8 years 10 months, SD = 11 months), with parents taught to incorporate first-person perspective into the existing elaborative reminiscing paradigm. The addition of first-person perspective scaffolding aims to strengthen a focus on empathy skills. Using a randomised control trial design twenty-seven parent-child dyads took part. Study 2 recruited a high-risk adolescent cohort (M = 15 years 1 month, SD = 18.5 months) with complex trauma histories currently in statutory out-of-home care. Due to high rates of placement breakdowns and lack of carer consistency in statutory residential institutions (resulting from shift work and high turnover), caseworkers were identified as the most reliable caregivers for this cohort. Caseworkers, therefore, engaged in the same empathy-focused elaborative reminiscing taught to parents in Study 1. The lack of predictable and reliable caregiver presentation in this cohort represented a strong test of validity and generalisability to our intervention. Using an extended case study design, thirteen caseworker-adolescent dyads took part.

Despite the chronological age gap between the middle-childhood cohort in Study 1 and the adolescent cohort in Study 2, both cohorts performed similarly on measures of language and socioemotional competence. These results are consistent with research highlighting the detrimental impact of complex trauma on the development of language, emotion, empathy and moral reasoning skills. In Study 1, results showed that the verbal scaffolding intervention yielded statistically significant improvements in children’s emotion knowledge, empathy and empathy-based moral reasoning skills. In Study 2, benefits were also observed in the high-risk adolescent cohort. Specifically, improvements in emotion knowledge and empathy-based moral reasoning were noted. Overall, the results from this thesis support the role of socialisation practices as a powerful intervention for enhancing empathy development in typical and at-risk cohorts, including older adolescents.

The findings of this thesis have practical implications for how best to enrich the socioemotional development of children and adolescents. In addition to protecting children’s physical, sexual and emotional safety in different home environments, it is important that positive socio-emotional development is also supported. The findings highlight reminiscing which targets empathy as an appropriate trauma-informed intervention with relevance for children both in families and in out-of-home care. Furthermore, empathy may be key to reducing offending behaviour in at-risk youth who due to exposure to childhood abuse and/or neglect have critically compromised empathy and moral reasoning capacity.