Empathy and Affirmations

This page is part of an overall training activity provided by Clinical Tools, Inc. Our ImpactObesity training activity provides skills training for primary care providers.
Please refer to the ImpactObesity homepage to sign-up and begin the activity!

The use of empathy and affirmations in patient interviews is important in gaining patient connection and trust. These skills are useful in several steps of the motivational technique.

Definition Expressing an understanding of things as the patient feels, sees, and thinks about them (Rollnick et al., 2008). Empathy is also communicated through an expression of caring in your eyes, facial expression, tone of voice, and body language.

Rationale: When people feel empathy from someone, they feel understood and validated (Rollnick et al., 2008). When patients experience empathy from a provider, they are more likely to open up to the provider and to their own experience. They will be more comfortable examining their ambivalence, for example, about making a lifestyle change to lose weight. They will also be more open to gentle challenges from the provider.


Definition A supportive statement made by the provider in response to what a patient has said that verifies and acknowledges the patient's attempts to change their behavior (Miller & Rollnick, 2012).

Rationale: Failure to achieve weight loss goals can lead to a downward spiral of confidence and self-esteem accompanied by weight gain (Miller & Rollnick, 2012). A pattern of weight cycling up and down often results. This can be frustrating for both the clinician and patient. Use of affirmations can increase patients' confidence in their ability to make healthy changes. These statements show that the provider recognizes patient strengths, efforts, and successes in making the long-term change that is needed.

Example of Empathy and Affirmations

Ms. Campbell responded positively to the provider's question regarding a discussion concerning her weight.

I appreciate that you are interested in talking with me about weight and your health. [Affirmation] Please tell me more about your concerns.

I try to exercise, but when my arthritis is flaring up, I can't on some days.

I can see how this must be hard. [Expressing empathy] But you still try, which is a personal strength. [Affirmation statement] That is something that will help you in other important ways in a weight-loss program.

When To Use These Skills

Empathy and affirmations are especially helpful early in the Engaging step. This is when you are trying to connect with the patient and gain their trust and interest in making a change.

Connecting with the patient is also important later in the patient interview during the Eliciting step. This is when you guide the patient in stating their thoughts and feelings

View ReferencesHide References
Miller WR, Rollnick S. Motivational Interviewing. Helping People Change. Applications of Motivational Interviewing Series. New York: Guilford Press. 2012; 3rd edition: . Available at: http://www.guilford.com/books/Motivational-Interviewing/Miller-Rollnick/9781609182274
Rollnick S, Miller W, Butler C. Motivational interviewing in Health Care. Guilford Press. 2008. Available at: http://books.google.com/books?id=njcm0V_IprEC&dq=Using+motivational+interviewing+in+routine+care&lr=&source=gbs_navlinks_s Accessed on: 2014-12-16.