Fit of the Horizontal–Vertical Individualism–Collectivism Model with Empathy in Mental Health Therapists: The Mediating Role of Mentalization
DOI:
https://doi.org/10.61838/kman.pdmd.731Keywords:
Horizontal–vertical individualism–collectivism, mentalization, empathy, mental health therapists, structural equation modelingAbstract
Objective: The aim of this study was to examine the structural fit of the relationship between horizontal–vertical individualism–collectivism and empathy in mental health therapists with the mediating role of mentalization.
Methodology: This study was fundamental in purpose and descriptive–correlational in method using structural equation modeling. The statistical population included 991 mental health therapists in Tehran, from which 280 participants were selected through systematic random sampling. Data were collected using the Jolliffe and Farrington Empathy Questionnaire (2006), the Horizontal–Vertical Individualism–Collectivism Scale by Sivadas et al. (2008), and the Fonagy Mentalization Questionnaire (2018). Data analysis was conducted using descriptive statistics and structural equation modeling techniques.
Findings: The results indicated that horizontal–vertical individualism–collectivism had a positive and significant direct effect on empathy (β=0.45, p=0.001). Mentalization also showed a positive and significant direct effect on empathy (β=0.36, p=0.001). Additionally, individualism–collectivism had a significant direct effect on mentalization (β=0.58, p=0.001). Bootstrap analysis revealed a positive and significant mediating effect of mentalization in the relationship between cultural orientations and empathy (B=0.128, p=0.021). Model fit indices (χ²/df=2.29, RMSEA=0.053, GFI=0.96, CFI=0.99, AGFI=0.88) indicated a good model fit.
Conclusion: The findings demonstrate that horizontal–vertical individualism–collectivism influences therapists’ empathy both directly and indirectly through mentalization, highlighting the critical role of mentalization in transforming cultural orientations into empathic professional behavior.
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References
Aafjes-van Doorn, K., Cicconet, M., Bate, J., Cohn, J. F., & Aafjes, M. (2025). Development of an artificial intelligence-based measure of therapists' skills: A multimodal proof of concept. Psychotherapy. https://doi.org/10.1037/pst0000561
Appelbaum, A. J. B. (2024). Meaning-Centered Psychotherapy for Cancer Caregivers: Therapist Manual and Caregiver Workbook. Oxford University Press. https://doi.org/10.1093/med/9780197640777.001.0001
Basha, S. M. T., Margret, S. N., & Divya, N. S. (2025). An Understanding of Active Listening as a Significant Soft Skill: A Study. https://doi.org/10.47311/IJOES.2025.7.04.37
Baskin-Sommers, A., Krusemark, E., & Ronningstam, E. (2014). Empathy in narcissistic personality disorder: From clinical and empirical perspectives. Personality Disorders: Theory, Research, and Treatment, 5(3), 323-333. https://doi.org/10.1037/per0000061
Cirasola, A., & Fonagy, P. (2025). Relate-Youth (Relate-Y): An Integrative, Relationship Focused Training to Strengthen the Youth-Therapist Alliance-Background and Development. Journal of Infant, Child, and Adolescent Psychotherapy, 24(1), 34-53. https://doi.org/10.1080/15289168.2025.2473326
de Sousa, R. R. A. (2024). A Miseria do Mundo: Como a Obra de Pierre Bourdieu Continua a Influenciar a Sociedade Atual. Revista Intersecao, 6(1), 6-23. https://doi.org/10.48178/intersecao.v6i1.493
Diener, M. J., Hilsenroth, M. J., & Giannopoulos, E. (2025). Therapist affect focus and patient outcomes in psychodynamic therapy: An updated systematic review and meta-analysis. Psychotherapy. https://doi.org/10.1037/pst0000568
Field, N. H., Balkind, E., Burnell, K., Fox, K. A., Feldman, M. J., Nick, E. A., Telzer, E. H., Lindquist, K. A., & Prinstein, M. J. (2025). Popularity, but Not Likability, as a Risk Factor for Low Empathy: A Longitudinal Examination of Within- and Between-Person Effects of Peer Status and Empathy in Adolescence. Developmental Psychology. https://doi.org/10.1037/dev0001914
Fischman, L. (2025). My Bad, You Got This: Witnessing, Therapist Attitude and the Synergy Between Psychedelics and Inner Healing Intelligence in the Treatment of Trauma. Frontiers in psychology, 16. https://doi.org/10.3389/fpsyg.2025.1469559
Franco, P., Tesio, V., Bertholet, J., Gasnier, A., Portillo, E. G., Spałek, M., Bibault, J. E., Borst, G. R., Elmpt, W. v., Thorwarth, D., Mullaney, L., Redalen, K. R., Dubois, L., Chargari, C., Perryck, S., Heukelom, J., Petit, S., Lybeer, M., & Castelli, L. (2020). The Role of Alexithymia and Empathy on Radiation Therapists’ Professional Quality of Life. Technical Innovations & Patient Support in Radiation Oncology, 15, 29-36. https://doi.org/10.1016/j.tipsro.2020.07.001
Ginalska, K., & Cichopek, A. (2024). Exploring Links Between Attachment and Mental Health. Kwartalnik Naukowy Fides et Ratio, 59(3), 73-83. https://doi.org/10.34766/fer.v59i3.1299
Hijriyah, A. L., Putri, A. H., Setiyawan, A., & Badrisya, A. H. (2024). The Social Cognitive Theory by Albert Bandura and Its Implementation in Arabic Language Learning. Mantiqu Tayr: Journal of Arabic Language, 4(2), 626-639. https://doi.org/10.25217/mantiqutayr.v4i2.4564
Khan, D. A. A., Altaf, R., Khan, G. N., Jamil, B., Fatima, U., Khalil, A., & Ikram, A. (2025). Exploring the Link Between Attachment Styles, Empathy Development, and Moral Decision-Making in Adolescents: A Comparative Study of Rural and Urban Areas of Punjab. South Eastern European Journal of Public Health, 1439-1447. https://doi.org/10.70135/seejph.vi.3947
Kielt, W., Kozlowska, J., Broniec, G., Wajdowicz, B., Kudla, A., Czapiewska, R., & Kowalska, K. (2024). The Role of Mirror Neurons in Empathy, with a Focus on Their Relevance in Autism Spectrum Disorder and Other Clinical Implications. Journal of Education, Health and Sport, 69, 55758-55758. https://doi.org/10.12775/JEHS.2024.69.55758
Lachance, V., Laverdière, O., Kealy, D., & Ogrodniczuk, J. S. (2024). Dispositional Empathy Among Psychotherapists: A Latent Profile Analysis. Clinical Psychology & Psychotherapy, 31(3). https://doi.org/10.1002/cpp.3016
Levitt, H. M., Collins, K. M., Rizo, J., & Hand, A. B. (2022). Rethinking Therapists’ Responsiveness to Center Clients’ Experiences of Psychotherapy. 265-294. https://doi.org/10.1037/0000303-010
Li, Z. (2024). Unseen Scars: The Intersection of School Bullying, Individualism, and Collectivism. Lecture Notes in Education Psychology and Public Media, 38, 172-179. https://doi.org/10.54254/2753-7048/38/20240629
Lindegaard, T., Persson, L., Thorängen, M., & Rozental, A. (2024). Therapists' experiences of negative effects in intensive short-term dynamic psychotherapy: A qualitative interview study. Psychotherapy Research, 1-13. https://doi.org/10.1080/10503307.2024.2420717
Lindegaard, T., Persson, L., Thorängen, M., & Rozental, A. (2025). Therapists' Experiences of Negative Effects in Intensive Short-Term Dynamic Psychotherapy: A Qualitative Interview Study. Psychotherapy Research, 35(8), 1300-1312. https://doi.org/10.1080/10503307.2024.2420717
Moyers, T. B., & Miller, W. R. (2013). Is low therapist empathy toxic? Psychology of Addictive Behaviors, 27(3), 878. https://doi.org/10.1037/a0030274
Nezlek, J. B., & Humphrey, A. (2023). Individualism, Collectivism, and Well-Being Among a Sample of Emerging Adults in the United States. Emerging Adulthood, 11(2), 520-524. https://doi.org/10.1177/21676968211054596
Nissen‐Lie, H. A., Heinonen, E., & Delgadillo, J. (2023). Therapist Factors. 79-106. https://doi.org/10.1037/0000358-005
Pham, M. D., Chaney, K. E., & Lin, M. (2024). Our Wars Are the Same: Horizontal Collectivism Is Associated With Lay Theory of Generalized Prejudice. Personality and Social Psychology Bulletin. https://doi.org/10.1177/01461672241273274
Searight, R. (2024). Challenging Mental Health Professionals to Look Beyond the Consulting Room: A Review of Becoming a Citizen Therapist: Integrating Community Problem-Solving into Your Role as a Healer. Journal for Social Action in Counseling and Psychology, 16(2), 61-71. https://doi.org/10.33043/4a6a157364
Shanbour-Srour, K., Goldberg, T., & Kurman, J. (2025). Exploring the Relationship Between Cultural Orientations and Empathy Among Arab-Palestinian Teachers in Israel: A Mixed-Method Study. Journal of Cross-Cultural Psychology. https://doi.org/10.1177/00220221251320354
Søndergaard, A. A., Juul, S., Poulsen, S., & Simonsen, S. (2023). Mentalizing the therapist - Therapist experiences with short-term Mentalization-based therapy for borderline personality disorder: A qualitative study. Frontiers in Psychiatry, 14, 1088865. https://doi.org/10.3389/fpsyt.2023.1088865
Steindl, J., Gilbert, P., & McEwan, K. (2023). Therapists' perspectives on Compassion-Focused Therapy: Addressing resistance and emotional barriers in treatment. Clinical Psychology & Psychotherapy, 30(1), 72-86. https://onlinelibrary.wiley.com/doi/abs/10.1002/capr.12530
Stiegler, J. R., Schanche, E., Danielsen, Y. S., & Hjeltnes, A. (2024). Growth in challenging situations: A qualitative investigation of therapists' experience of delivering emotion-focused therapy. Psychotherapy Research, 1-13. https://doi.org/10.1080/10503307.2024.2432680
Wei, B., Zhang, X., Cui, D., & Li, Y. (2023). Linking Objective and Subjective Social Status to Altruistic Sharing in China: The Role of Empathy. Current Psychology, 42(31), 27401-27414. https://doi.org/10.1007/s12144-022-03675-x
Zhang, A., Kazazi, F., Tang, K., & Howell, P. (2024). Interplay of Mental State, Personality, and Popularity Among Peers in Shaping Belongingness of First-Year Students: A Cross-Sectional Study. PLOS Mental Health, 1(2), e0000019. https://doi.org/10.1371/journal.pmen.0000019
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