Rethinking clinical empathy: The relevance of empathy affect in child welfare work in Chile

Abstract

This article proposes re-evaluating traditional views of empathy in child welfare work, advocating for recognizing the role of affect in empathic relationships. Traditionally, clinical empathy has been described as a unidirectional relationship where clinical workers must remain neutral, setting aside their perceptual frameworks to become ‘mirrors’ of their clients. Through a grounded theory analysis of data collected in Chile, this article reveals that child welfare workers establish dynamic empathic connections via ‘Empathy Affect’. The study underscores the importance of affective dimensions in social work practice and policy design.

Keywords

Child welfare work Chile emotions empathy empathy affect

Introduction

Empathy is a widely utilized concept in the social sciences (see, e.g. Hochschild, 1983; Ruiz-Junco, 2021) and has been broadly studied in clinical work¹ and care-oriented professions (such as therapy, counseling, and clinical social work). Empathy has been empirically shown to be essential for positive outcomes in clinical practice (Watson, 2021); thus, it is considered a key skill for clinical workers to cultivate and enact as part of their jobs (Gerdes and Segal, 2011; Mullins, 2011).

Based on a non-exhaustive systematized search of publications by the American Psychological Association (APA) and the National Association of Social Workers (NASW), this article identifies three dominant traits of an ideal-typical empathy interaction between clinical workers and their clients. First, the worker and client must establish a relationship based on a unidirectional empathic interaction, whereby the worker takes on the client’s perspective to understand what the latter is going through. Second, this professional must rationalize or identify their feelings, distinguishing them from the client’s and putting them aside while interacting with the client. Third, the worker must become a doppelgänger, a double or mirror of the client, thus adopting their perceptual frameworks. These three traits are at the basis of a clinical empathy script that workers learn, defined by adopting a ‘neutral’ perspective throughout this process and by achieving therapeutic ‘distance’ from their clients and themselves.

Child welfare work is one of the clinical labor contexts in which empathy greatly impacts not only the quality of workers’ relationships with their clients but also workers’ mental health. As we know, the emotional script of clinical empathy is part of the foundations of the professional socialization of clinical workers (Caringi et al., 2012; Halevi Hochwald et al., 2022; Moudatsou et al., 2021). There are two main reasons for this. First, the enactment of clinical empathy enhances clients’ clinical outcomes (Yu et al., 2022). Second, engaging in the emotion management of empathy (Hjärpe, 2023) is a mental health protective strategy for child welfare workers (Wagaman et al., 2015), who are constantly exposed to secondary trauma and burnout resulting from hearing children’s stories of neglect and abuse (Genç and Buz, 2020).

This emotional impact is worsened by the neoliberalization of welfare policy, that is, the incorporation of business-oriented strategies into care work (Whitaker, 2019). Besides managing empathic interactions in a highly emotional context, these professionals now find themselves torn between the demands of the private sector and traditional welfare principles focused on clients’ well-being.

Given that empathy is a key factor in clinical outcomes, it is crucial to study the role of empathy in clinical work in countries like Chile, where the rise of neoliberalization in the sector threatens the protection of children’s and workers’ rights. Particularly, the Chilean child welfare system has been one of the most affected by neoliberal transformations. In 1979, the National Service for Minors (SENAME) was created amid a military dictatorship and profound socio-economic reforms. Since the 1990s, SENAME presented a systematic crisis (United Nations [UN], 2002, 2015, 2018), leading to its closure, a reformulation of the child protection policy in 2022, and the consequent opening of the new National Service of Specialized Protection of Childhood and Adolescence (Mejor Niñez). One of the main reasons for SENAME’s closure was the marketization of child protection services – that is, the implementation of a child protection policy by third-sector private organizations receiving a governmental economic subsidy for each child they work with. As the UN (2018) Committee on the Rights of the Child pointed out, the Chilean financialization model based on economic subsidies to private organizations has sustained the system’s labor precariousness and aggravated children’s rights violations.

Drawing on data from a qualitative study with child welfare workers in Chile – psychologists, social workers, and other professionals who can occupy the same roles in the provision of clinical work in this country – this article examines how they form empathetic relationships with clients, the role of affect in such a process, and the implications this has for clinical practice. This article combines interpretive and affective approaches to empathy to explore how these workers form empathetic relationships with clients and its implications (Mühlhoff, 2019; Padwell, 2014; Ruiz-Junco, 2017). From this perspective, empathy interactions are defined by the actions of imagining and sharing the thoughts and feelings of another (by using their biographical and cultural knowledge) and by the associated affects – participants affecting other(s) and being affected by the different bodies and (im)materialities present in the situated empathic interactions.

The study’s findings show that child welfare workers do not abide by the script mentioned earlier but form empathic relationships that offer innovative solutions to these workers’ therapeutic and human challenges. The changing intensities of affect that move between human and non-human bodies (Seigworth and Gregg, 2010) allow clinical workers to experience unintended and creative ways to perform their work and connect in empathic interactions with their clients.

Empathy and clinical work

An extensive literature discusses empathy in clinical psychology and social work (Cuff et al., 2016). Despite this vast scholarship, no consensus exists on its definition (Coplan and Goldie, 2011). One of the reasons for this lack of agreement is the existence of numerous theoretical approaches to the concept. For example, in Freudian psychoanalysis, empathy is considered a tool in the therapeutic process (Grant and Harari, 2011), while Rogerian theory views empathy as a paramount ability to carry on a successful therapy (Arnold, 2014).

To understand what is common among these approaches, a non-exhaustive systematization of the views on empathy by the most referenced theories – psychoanalytic theory, cognitive behavioral therapy theory, humanist theory, and cultural therapy – appearing in articles, newsletters, and book reviews published on the APA’s (a global impact organization in the advancement of psychology and mental health) and the NASW’s (the largest organization of professional social workers in the world) online databases over the last 20 years (2003–2023), was conducted. These databases were selected because of their hegemonic role in shaping counseling and social work practice beyond their geographical context, including countries in the Global South.

Empathy in clinical psychological and social work literature

The reviewed literature presents three interrelated traits of an ideal-typical empathy interaction between clinical worker and client. The first is the need to establish a relationship between worker and client. The literature recognizes empathy as a way of being with another (Greenberg, 2018). So, empathy is a relationship. The worker not only perceives the client but also what the client perceives about themselves (Wilson, 2011). This relationship is viewed as unidirectional, whereby the worker ‘gives’ empathy, and the client ‘receives’ it.

The second involves the worker’s rationalization of their perceptual frameworks. Workers must engage in self-analysis, setting aside their biases and perception habits and rationalizing their feelings. By doing so, they put their needs outside their ‘attention box’ so that they do not interfere with the therapeutic process, separating themselves (their experiences and frames) from what their client is experiencing (Krug and Schneider, 2016) and solely focusing on the client’s experience.

Finally, the third trait is that the worker needs to become the client’s doppelgänger. That is, a double or mirror of the client, someone who walks with them, even when it involves going against their values (Ellis and Dryden, 1997; Jordan, 2017).

Throughout this process, the worker must adopt a neutral attitude. They must be able to neutralize their thoughts and feelings to avoid contaminating the process. Then, they must immerse themselves in an ‘empathic state’ with the client while distancing themselves from the former (Arnold, 2014). In sum, the ‘empathic’ worker must struggle with the ambivalence of their role: They need to take on the client’s role while avoiding being emotionally close to them.

In practice, these traits shape an emotional script that is part of the contemporary ‘emotion management’ of empathy in the workplace (Hochschild, 1983). Workers are expected to follow scripts for managing their emotions based on norms about how to act and feel in certain job situations (see Harris, 2015). In the case of clinical workers, this scripted way of being empathic is partly derived from educational programs, which emphasize the development of empathetic skills because they are essential for building rapport with clients, understanding their needs, and effectively supporting them through challenging situations (Rosa et al., 2014). In Chile, empathy is a key concept in care-oriented careers – such as social work and psychology – aimed at equipping students with theoretical knowledge and practical abilities crucial for professional practice (Morales Aguilera, 2015; Rodríguez and Salinas, 2015).

Thus, our article asks, ‘to what extent do child welfare workers in a context of labor precarity like Chile follow this clinical empathy script and engage in empathic relationships at work, and how?, By integrating the Empathy Affect idea into an interpretive framework to study empathy, the analysis shows how Chilean child welfare workers circumvent the behavioral conditioning of the aforementioned script in favor of empathic relationships that escape the conscious, cognitive understanding of emotions. Inspired by affect theory (Mühlhoff, 2019; Padwell, 2014), this article advances the proposition that imagining and sharing the thoughts and feelings of others involve both an emotional and an affective process that emerges into consciousness often because of its intensity and inter-corporeal character.

Methodology

Setting

SENAME was created in 1979 during a military dictatorship amid profound socio-economic reforms (Farias Antognini, 2019). With the support of the Chilean upper class, the charity of the Church, and the unpaid care work of volunteering women, SENAME sought to transform the child protection system. One of the main characteristics of this transformation involved outsourcing child welfare to private organizations, which were charged with implementing state-designed programs that would be financed and supervised by SENAME. Private organizations had to offer their services through public bidding. When successful, they received an economic subsidy and held a temporary contract with SENAME, all subject to fulfilling performance indicators (Garcia-Meneses et al., 2021).

In this context, the State acts as the manager and economic provider for SENAME. At the same time, the latter is responsible for administering the State’s financial investment and directly supervising the private organizations, both technically and financially. Thus, while private organizations execute child welfare policies, the Chilean State designs, supervises, and funds child welfare practices.

Over the years, SENAME’s ability to protect children’s rights was strongly questioned. Therefore, since the 1990s, there have been different attempts to modify the Chilean protection system, which failed to stop the outsourcing of child welfare. Instead, outsourcing was consolidated, and according to the UN report conducted in 2018, the externalization and subsidiary financialization of the child welfare system in Chile has enabled violence and abuse against the children and adolescents who receive its services (UN, 2018).

Due to mounting criticisms, the new National Service for the Specialized Protection of Children and Adolescents (Mejor Niñez) replaced SENAME in October 2021. As introduced earlier in the article, this has not been free of controversy. The subsidiary mechanism in the new policy has been found to be problematic (Jara Leiva, 2021). Although the State should be the guarantor of the beneficiaries’ rights, it continues delegating its responsibility for the care of children and adolescents to private organizations, which are evaluated by their performance based on indicators that fail to grasp the complexity involved in working with these vulnerable populations.

This socio-historical backdrop sheds light on the meaning of empathy for these workers. As it will be discussed, in the eyes of these professionals, the system cannot empathize with children and adolescents. In their interpretation, empathy is the counter-emotion that they embody, making them different from the system that alienates those that it subsumes, themselves included.

Data and method

This article is based on a larger qualitative study of child welfare workers from the Child Protection Service in Chile. The study participants had an average age of 31 (the youngest was 28, and the oldest was 45). All worked in the country’s central area, and their experience in SENAME ranged from 1 to 8 years (see Table 1).

Table 1.

Sample grid of research participants.

Pseudonyms	Research phase	Profession	Program	Years of professional trajectory	Years working in the child protection system
Karina	Pilot	Psychologist	Focused Prevention Program (PPF)	3	3
Susana	Pilot	Social worker	Focused Prevention Program (PPF)	4	1
Maria	Pilot	Psychologist	Specialized Intervention Program (PIE)	4	2
Patricia	Pilot	Social worker	Focused Prevention Program (PPF)	4	4
Rocio	Main study	Sociologist	Residence	4	1
Vanessa	Main study	Psychologist	Specialized Program on Severe Sexual Abuse and Mistreatment (PRM)	7	6
Daniel	Main study	Psychologist*	Specialized Intervention Program (PIE)	7	5
Jimena	Main study	Social worker	Focused Prevention Program (PPF)	4	4
Mayra	Main study	Social worker	Specialized Foster Families (FAE-PRO)	8	8
Karol	Main study	Secretary	Specialized Program on Severe Sexual Abuse and Mistreatment (PRM)	9	7
Beatriz	Follow-up	Psychologist	Focused Prevention Program (PPF)	3	3
Carolina	Follow-up	Social worker	Focused Prevention Program (PPF)	4	4
Pedro	Follow-up	Psychologist*	Specialized Program on Severe Sexual Abuse and Mistreatment (PRM)	7	6
Arturo	Follow-up	Psychologist*	Specialized Program on Severe Sexual Abuse and Mistreatment (PRM)	8	7

The participants marked with an asterisk identified themselves as male.

The second author collected data through a digital ethnography (Pink et al., 2016) from June to September 2020. This method was selected due to the study being conducted during the COVID-19 pandemic, when preventive measures, including social distancing, were in place. Digital ethnography is used to study social phenomena exclusively through digital environments and technologies. Conducting ‘remote’ or ‘distance’ video-based research (Pink, 2021) allows for ‘collaborative and empathetic learning and knowing with and about participants’ experiences’ (Pink et al., 2022: 416), thus being methodologically flexible without neglecting the relationship with participants and the depth of data (Gökçe et al., 2020).

A total of 14 workers from different programs financed by SENAME participated (Table 1). Four participated in the pilot phase, six in the main study, and four in the follow-up phase. The pilot phase consisted of online interviews, allowing the second author to adapt her previous in-person research experience knowledge to a digital research context. The main study used four interconnected data-collection techniques: active virtual individual interviews (Denzin, 2001); group workshops guided by the collective biography method (Davies and Gannon, 2006); everyday work digital diaries (Vokes and Atukunda, 2021), which included pictures, audios, notes, texts, and stories written and collected by the workers themselves; and communication between the research team and participants through email and WhatsApp (Gómez Cruz and Ardèvol, 2013). Finally, the follow-up phase included two group workshops aiming at deepening the analysis of specific topics. As Gökçe et al. (2020) noted, this combination of ethnographic methods, called ‘ethnographic patchwork’, is useful for researchers during the COVID-19 pandemic; by ‘patching’ together multiple forms of data gathered via different research techniques, researchers can collect robust qualitative data and circumvent the limitations of doing research under constantly changing pandemic conditions.

The participants were selected through oriented information sampling (Flyvbjerg, 2011). Instead of choosing cases randomly, this sampling approach involves selecting specific cases likely to provide rich, in-depth insights relevant to the research question. To be selected, participants had to work in private organizations financed by SENAME in a non-leadership position. Directors and supervisors, who are in leadership positions, were excluded from this study because they do not have direct contact with children and adolescents. In contrast, administrative and clinical workers were included because they interact daily with these children and their families.

The first contact with participants was made through a gatekeeper – the Intercompany Union of Subcontracted Workers for Children and Youth – and then through the workers who accepted to be part of the study. Regarding research ethical safeguards, this research was accepted by the Ethics Committee of Pontificia Universidad Católica de Valparaíso, Chile, and all research participants were given written informed consent before starting the first individual or group session, which was confirmed in the following sessions.

Data analysis

For the purposes of this article, the empirical examination was limited to the complete set of 16 active virtual individual interviews (Denzin, 2001), which provided in-depth data about the participants’ empathic work experiences, and the five group workshops guided by the collective biography method, which offered joint reflections on corporal-affective aspects of daily work emphatic interactions.

Individual and group interviews were subject to grounded theory analysis (Charmaz, 2014). The data emerging from the individual interviews reinforced the data from the group interviews, and vice versa. Both qualitative techniques equally contributed to the findings.

Following the grounded theory approach, the data analysis was first conducted through in vivo codification (Charmaz, 2014). The two authors executed the initial coding separately and discussed their codes. They then re-coded the data during focused coding, paying special attention to empathic relationships. After initial and focused coding, they conducted an affective analysis of the relevant data to elucidate the affective dimension of empathy. The affective analysis articulated two techniques: textual-affective analysis (Cromby, 2012) and fleshy words (Enciso, 2015). Both techniques consider that affect and language are mutually interwoven. Thus, affect resonates with meaning-making, amplifying it. Accordingly, the data were not analyzed ‘word by word’; rather, the intention was to understand affect and the affective assemblages emerging from the relation of the research participants with diverse elements present in their daily work (Nishida, 2017).

Findings

Empathy affect and affective closeness with clients

One of the key findings of this study is that participants found themselves going against prescribed professional empathy norms, which are normative ways of enacting empathy in a professional context, whose behavioral patterns are partly based on training and professional socialization; that is, instead of adopting an emotional and affectively neutral standpoint, workers often discovered themselves engaged in empathic relationships based on affective closeness.

Affective closeness generates a type of empathy affect between people, attracting them to each other. Such empathy affect is embodied inter-corporeally, including non-human bodies. It may begin as a non-conscious energy in empathy interactions but can also be generated through conscious efforts to connect with others. This energy can have different intensities, creating waves of affective movement that resonate between bodies (Mühlhoff, 2019).

In the following excerpt, Daniel tells a story illustrating how empathy affect is part of empathic client relationships.

I started to read literature a lot (. . .) more than reading other stuff, so I started to read books with stories about lost teens. I always liked them [the stories], but I searched for them intentionally. It helped me a lot; it helped me to connect with the teens, but it also irremediably helped me to connect with myself, with my own adolescence (. . .) also with the process of facing adulthood (. . .) I believe that if one is not able to empathize with a kid or adolescent, in this line of work, then one is lost.

Daniel created empathic relationships in two interrelated ways. First, he read stories of teens who were struggling with life. Because of the similarity between the stories he read and the lives of the clients he worked with, he gained insights into his clients’ thoughts and feelings. Thus, reading stories allowed him to connect with his clients. However, it also allowed him to connect with his past self. By reading and re-experiencing his adolescent self, he was better able to imagine and share thoughts and feelings with his clients while, at the same time, gaining an increased affective closeness with them that he may not have predicted.

Reading is not the only way a child welfare worker can form an empathic relationship with clients. An important way in which workers empathize with clients is through face-to-face interaction. During the COVID-19 pandemic, this interaction took place online, which, in the opinion of some participants, took away a layer of ‘warmness’ that is part of empathic relationships. As Maria saw it, interacting in-person aroused in her a sense of ‘human warmness’, whereas interacting online brought a sensation of ‘coldness’. This coldness created a sense of doubt about her understanding of the client’s thoughts and feelings.

In contrast, face-to-face client interaction allowed Maria to ‘read’ them. In-person, she understood something about the client through gestures and non-verbal communication that was not verbally expressed during the conversation. In her own words:

Even if you do not speak to me, I can read another thing [different from the one overtly expressed] over and over again.

This quote illustrates how workers and clients can affectively relate in-person in ways that go beyond what is verbally expressed. The ‘warmness’ experienced in face-to-face interactions with clients is thus related to the presence of affective energies between the interactants’ bodies.

Another way in which child welfare workers empathize with clients is by refusing to judge them. The neoliberal economic model has been characterized by attributing a negative judgment to all those viewed as ‘losers’ of the system – the marginalized, oppressed, and socio-economically disadvantaged. Rather than attributing individual responsibility to the client for their difficult personal situation, participants considered the client’s plight the result of structural circumstances, such as poverty and classism. They believed that if they had been put in the same structural position as their clients, they would have had the same experiences. As Karina put it, one has ‘to finally realize that this could happen to oneself’.

Therefore, these workers accepted the client as they were without attaching stereotypical images or prejudices to their understanding of the client, recognizing and valorizing the client’s experiences from a socio-cultural perspective. This acceptance connects workers and clients and militates against professional power dynamics. As Jimena affirmed:

They [the clients] are always viewed as the object that I can repair, right? (. . .) but when one really [professionally] intervenes, one sees (. . .) it is not like that, maybe they are bodies that are resisting.

Refusing to look at the clients as ‘violent’, Jimena ‘humanized’ them. This decision takes away the workers’ fears and helps workers connect with clients. As Rocio mentioned:

I learned not to be afraid of children and also learned to get to know them, what they like, what they don’t like, to anticipate their crises (. . .) I now understand that they sometimes get emotionally deregulated for certain reasons, and try to be as empathic as possible with them (. . .), and to put body and feelings to that childhood, not to treat them like patients. . .we share a lot of things.

This excerpt illuminates Rocio’s refusal to treat clients as ‘patients’. She affirmed her desire ‘to be as empathic as possible’. Her way of being empathic involves sharing ‘a lot of things’ with them. In contrast to the system, which views clients abstractly as numbers, she connected with them affectively, considering them holistically as people with bodies and feelings. Negatively affected by the system, she affects and is affected by the clients. The waves of affect linking Rocio and her clients to the system resulted in affective resistance to the latter and affective closeness between her and her clients.

A final way in which workers empathize with clients is through non-human bodies or objects that mediate their relationship. Daniel expressed the following about one of his clients:

He had to go to court, and he got in very bad shape, and I had the BRILLIANT IDEA of telling him: ‘We go anyway’. (. . .) I walked with him to the courthouse. On our way there, he was rude to many people, crossed the street in a very bad way, hit a car, stole from a market (. . .). A policeman saw him, and I had to speak to the policeman while he was running away. He was very sad because his mom wasn’t there, then, he was very angry (. . .) he started sobbing. It was a catharsis of cries and shouts, and we were both lying on the floor, and he was crying (. . .) (silence, sighing) I was more used to working with adults, so seeing . . . such a young guy and so . . . lost in the world . . . I felt that I suffered with him that day (. . .) I remember having felt a lot of fear of not being able to control him (. . .) We have to assume that we don’t have control over anything that can happen, and it’s like swimming against the current. I couldn’t grab him and take him away because he was so off, so I had to find another way. The deal ended up being how to buy him cigarettes and take him for a smoke far away . . . (silence).

This fragment sheds light on the emotional intensity of situations that child welfare workers experience. In Daniel’s narrative, we can see – at least – three things. First, the worker feels incompetent in managing the adolescent’s emotional breakdown and fears losing control. Second, the worker releases his need for control and achieves further affective closeness by surrendering jointly ‘to the flow’. Third, both merge their viewpoints in shared suffering, each becoming the space where the other can rest by sharing a common object, which is not external to the empathic relationship but a constitutive part of it.

This empathy interaction differs from ideal-typical empathy, specifically regarding the worker’s rationality and affective distance. As mentioned, the clinical empathy script suggests putting the professional’s personal experiences and feelings aside for them to become a doppelgänger of their clients. Yet, the narrative illuminates another form of empathy, starting with the worker’s fear of failing to contain his client’s emotionality and the realization that he needs to accept events just as they come, even if they are chaotic. Instead of remaining in therapeutic control of the situation, he suffers jointly with the client – feeling his anger, sadness, and desperation.

Thus, the worker finds a creative way out of the seemingly impossible therapeutic situation by feeling both his feelings and the client’s. The worker buys an object – cigarettes – and decides to smoke with the client. This idea comes from an everyday activity both had performed before. It is not part of the professional script of clinical psychology and counseling, but a social practice embedded in a cultural context.

In this example, cigarettes mediate the client–worker relationship, changing the normative expectations of a professional relationship and thus affecting both the adolescent’s and worker’s body dispositions and feelings. Through an affective lens, cigarettes are objects with agency intervening in the relationship between the client and the worker, coupling with them and affecting their bodies by channeling or constraining their capacity to change how they are experiencing life. Cigarettes allow the worker to control the situation, generating a sense of calm in himself and his client while strengthening the empathic relationship.

Empathy affect and its residual intensity

Once the empathic relationship is formed, empathy affect can become residual, living on both consciously and non-consciously, accumulating in the bodies and minds of those who incarnate it. This residual empathy affect, whose life is prolonged after empathy interaction(s), is an excess of affective energy with a sensory ‘weight’ that can be felt in different parts of the body and the mind. It may be felt as a form of exhaustion, as Daniel put it, after going through a difficult and stressful workday:

That day (. . .) I felt exhausted (laughter). I remember I had to go to a birthday celebration (. . .), and I fell asleep on the way there (. . .), and I also left [the celebration] very early.

While it is common for residual empathy affect to be felt and expressed as fatigue, it can also appear in other forms. This was evident in accounts where workers were apart from their clients and empathically compared their experiences with their clients’ experiences, thus recognizing new emotions. In the following case, Vanessa, by empathic comparison, realized that she is not her clients, that she is separate from them, that her situation is comparatively better than the clients’ situation; that she is her own body and they are their own; and that, because of their affective closeness, she and they are affectively and bodily intertwined. This is how she described it:

The families were already in trouble, but now, with the rain, many of them have it worse (. . .) just like that, a family was showing us the ceiling, and I felt very guilty because I was drinking a latte. Here [I was], very warmly clothed, calm, and I was feeling so distressed because they were showing me that their wall was falling. And this has happened these weeks because of the rain. Other days, it is because there is no money, because there is uncertainty, and I feel that I have the emotion, like here, like a sensation that I am going to explode.

As can be gathered, a residual empathy affect, generated by their empathic relationship, erupts in the worker’s body, morphing into something else. Because of this, the worker felt guilty as she enjoyed a warm drink in a safe location while her clients were in an unsafe building, threatened by the inclement weather. The residual affect and the new feelings were ultimately evident in her bodily awareness of her separation from the clients, but also in feeling the sensations of her own body connected to theirs. She was feeling a residual empathy affect that morphed into guilt and then connected to anger, with its ultimate expression becoming a sensation that her body was disintegrating.

To conclude, the residual intensity of empathy affect can sometimes be deeply felt in the body. This is unsurprising given that the participants work directly with many clients and constantly empathize with them. Rocio explained:

In the beginning, I used to cry, I don’t know, it was very bad for me, I don’t know, the children’s crises, because we know their history, so (. . .) we feel their suffering, and that was awful.

The residual intensity of Rocio’s affect was, however, manifested surprisingly. She claimed to have premonitory bodily experiences when she anticipated problems with the children who were under her care. When asked about her feelings, she mentioned:

At first, I felt it in the hands (. . .), but now I am very much feeling it in the throat (. . .) Sometimes it is hard for me to speak louder, or my voice suddenly vanishes, and I feel a heaviness in my throat, like swollen.

This residual affectivity highlights that workers embody empathy, living it through their bodies, as it becomes inscribed in themselves like a memory that returns and comes to remind them of their connection to their clients.

Discussion

The contribution of this study to the design of social work practice and welfare policy is a revised notion of clinical empathy, which incorporates the notion of empathy affect. The present study sheds light on the limitations of the clinical empathy framework, showing that child welfare workers create empathic affective relationships with clients, which are opposed to the clinical empathy script of the counseling and social work profession, as well as ideologically to the structure of Chile’s child welfare system. As previously noted, the study participants stated that this system did not fully protect their clients and claimed that, unlike the system, they protected their clients by being empathic. Nevertheless, one of the major findings of this investigation is that the empathy affect that flows between child welfare workers is not socially and emotionally sustainable in Chile’s neoliberal context. This is so because of unfair and exploitative working conditions tied to the increasing precarity of work and the lack of a robust social fabric caused by decades of disinvestment in social assistance programs.

Although child welfare is vital, sustaining care practices as part of their job becomes challenging for this sector’s professionals because the Chilean child welfare system is built with an ideal neoliberal working subject in mind: a person who does not need care (Garcia-Meneses et al., 2021). However, the study participants opposed traditional ways to engage in clinical practice, rupturing this neoliberal reality of carelessness. By affectively sharing emotions with their clients, these workers resist the neoliberal logic of their workplaces and the modes in which their disciplines, the State, policymakers, non-governmental organization (NGOs), and society have organized care.

Empathy can be a deep and intense relationship with another human being; however, the ideologically shaped labor conditions under which it is performed (neoliberal economic structures and the related ideal-typical clinical empathy framework) militate against the spontaneity and emotional intensity that this relationship evokes in the studied context. For example, Daniel discarded the expectations of traditional clinical practice when he merged with the empathy affect that connected him to his client. Opposing the script of clinical empathy, both the client’s and worker’s bodies were embedded in an empathic relationship mediated by a cigarette and the practice of smoking. As noted, establishing therapeutic distance and omitting personal experience and practical and embodied knowledge are very hard in the scenario described by Daniel, characterized by heightened affective intensity.

Indeed, the societal expectation for performing clinical empathy forces the child welfare worker to hide behind a mask while the clients can express themselves freely and spontaneously. This framework prevents workers from fully feeling and connecting with others, as they cannot share their emotions and experiences. How can they share a worldview if they cannot speak their minds and feel their feelings when empathizing? Most importantly, how can they be fully present with the other under the exploitative structural conditions in which they perform their labor?

The implications of these findings for clinical and social work practice and policy are worth noting. First, the labor conditions under which these workers perform their jobs are characterized by economic precarity with constant procedural demands alongside high workloads. These workload requirements are not sustainable. Without a reasonable workload, these workers encounter ‘burnout’ and the risk of ‘opting out’ from the system. Future changes to the child welfare system should address these constraining and exploitative conditions, reduce expectations for high workloads, and monitor that the maximums are being met and not surpassed. Second, the clinical framework of empathy dominant in counseling and social work practice must be revised. This investigation found that child welfare workers aim to achieve affective closeness by providing empathic, caring relationships to their clients. However, given the circumstances described, they often find themselves unable to cope and, as a result, experience low self-efficacy while performing their jobs. Educational and instructional models in counseling and social work practice promoting the previously mentioned clinical framework assume that workers have the emotional resources to tackle the cases and the workload.

Indeed, this study reveals that the clinical framework is imperfect and, most importantly, sometimes counterproductive. This is because workers and clients, if following the dictates of this script, can fall into what we can term affective precarity – a precarity of affect built when empathy affect does not flow between workers and clients, thus preventing workers and clients from forming deeper empathic relationships. Of course, workers and clients can counteract this affective precarity by seeking to ignore this framework, as we have discussed. The affective closeness they create can begin to heal the emotional harm that the clients experience. Nevertheless, even the latter cannot ‘fix’ the social harms these clients suffer due to their economically marginalized position and their life circumstances.

The limitations of this study are as follows. First, the type of research design did not permit to establish generalizability. Second, with this research design, the client’s perspective could only be indirectly accessed through the workers’ narratives. It would be important to conduct studies that examine and analyze empathy, comparing the perspective of clients vis-à-vis the perspective of the child welfare workers they work with. To advance this article’s objectives, future research could also examine the type of relationships workers and clients would choose if precarious labor conditions and established frameworks of clinical practice were not an issue. What type of nurturing and healing relationships could be possible in the professional contexts under study? Mapping out the realities of affect, this study asks for more inquiry into these types of relationships and their potential.

Footnotes

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Javiera Garcia-Meneses

Notes

Author biographies

Natalia Ruiz-Junco is an Associate Professor at Auburn University. Her work focuses on social theory, social psychology, sociology of emotions, social movements, and qualitative methodology.

Javiera Garcia-Meneses is a Doctor in Psychology from the Pontificia Universidad Católica de Valparaíso, Chile. Her research interests are affect theory and labor subjectivity.

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