Compassion in a Doctor-Patient Relationship: Objectively Measuring Compassionate Behavior Using the Emotional Availability (EA) Scales

Abstract

Most research on compassion utilizes self-report measures (Seppala, Simon-Thomas, Brown, Worline, Cameron, & Doty, in press). Indeed, when it comes to the measurement of self-compassion, the subjective report of the individual can provide an authentic window about compassion toward the self. How else can we understand another’s subjective feelings and experience about the suffering or concerns of another? Compassionate behavior toward another person, on the other hand, can and should be measured more objectively than self-report allows. Compassionate behavior toward another can best be measured by how that individual actually interacts with others. Here, we will describe an objective manifestation of compassionate behavior, and one that has a wide evidence base in developmental research on caregiver-child relationships—the concept of “emotional availability” or EA. We believe that this construct is applicable to patient-healer relationships, such as the doctor-patient relationship. The measurement of EA is through the EA Scales (Biringen, Robinson, & Emde, 1998; Biringen, 2008), which consist of 4 qualities for the doctor—sensitivity, appropriate structuring, nonintrusiveness, and nonhostility. The client’s feelings about the doctor’s behavioral and affective style is measured through two qualities: patient’s responsiveness to the doctor and the patient’s engagement and involvement of the doctor. We believe these qualities can be important to measure in a doctor-patient relationship, to assess in the medical school admissions process, as well as to nurture during medical training.