A Systematic Review of Interventions for Teaching Empathy in Child and Adolescent Samples

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Introduction: Escalating levels of youth violence and aggression is today a major global concern and is notably apparent in South Africa. Despite the deleterious consequences associated with these acts, a long-term, efficacious intervention is still lacking. Furthermore, early onset aggression has repeatedly been linked to later aggression, which underscores the need for intervention in a younger cohort of the population. Various international studies have positioned empathy as a notable correlate of violence and aggression, associating increased empathy with a decreased risk of presenting with violent and aggressive behaviour. Research has also demonstrated the potential to enhance child and adolescent empathic behaviour using various interventions. These findings lend themselves to the possibility of using empathy enhancing interventions to counteract youth violent and aggressive behaviours. Method: To this end, a PRISMA-P compliant systematic review of randomised pre-/post-test experimental studies was conducted to assess the efficacy of interventions that have been used to enhance empathic behaviour among child and adolescent samples. Eight journal databases were searched, using key terms relating to teaching, empathy, children/adolescents, and interventions. Results: Of the 1,656 articles found, the authors reviewed the full texts of 161 articles. A total of 38 articles were included in the final analysis (ten randomised control trials, 18 cluster randomised control trials, one class randomised cross over design and nine pre-/post-test randomised experimental designs). Included interventions were classified according to eight categories: classroom-based social emotional learning (SEL) interventions (N=10), narrative/conversation-based interventions (N=8), game-based interventions (N=3), physical education (PE) interventions (N=2), mindfulnessbased interventions (MBIs; N=3), home-based, caregiver-administered interventions (N=2), role play interventions (N=1) and other (N=9). Conclusion: Evidence from the review indicates that empathic behaviour can be enhanced in children and adolescents. Notably, this review is the first of its kind to assess the efficacy of these interventions in an all-inclusive, universally applicable manner and in neurotypical child and adolescent samples. However, the review also highlights the need for a concrete, unanimously accepted definition of empathy so that future research can make more definitive conclusions and more accurate comparisons.