Summary articles Exam Compassionate
Technology
Lecture 1: Introduction
eMental Health= web and mobile applications, online counseling (via email, chat or online fora), self-
monitoring and regulation
Why technology?
Cost reduction / Affordability
Efficiency of care
Accessibility of care
Technology is interesting
Compassion - Strauss et al., 2016:
Compassion consists of 5 elements (RUFTA)
1. Recognizing suffering in others
2. Understanding the common humanity of this suffering
3. Feeling emotionally connected with the person who is suffering
4. Tolerating difficult feelings that may arise
5. Acting or being motivated to act to help the person
Compassion is both an attitude or sensitivity to suffering, and taking the expedient action to improve the
human condition
What is technology?
Hierarchical model of Arthur, 2009
Lowest level:
o A way in which people use natural phenomena to address human wants and needs.
o Example: sun, a lens, and the wish to better see really small things
Middle level:
o Technology is a collection of assemblies that together constitutes a functioning system
o Example: smartphone is a system that employ natural phenomena such as
electromagnetism and chemical energy
Complex level:
o The entire collection of devices and engineering practices available to a culture
o The interplay of human needs and solution through technology are part of a complex
system of regulations economies, standards, and social rules
In the system of (mental) health care, there is a dynamic interaction between human needs and
technological solutions, which is influenced by a complex system of:
1
, Regulations
Economies (funding and insurance)
Standards (treatment guidelines)
Social norms (stigma, access to care)
What is compassionate technology?
Compassionate health technology would be a way in which human beings leverage natural phenomena
to facilitate and enable both the recognition and relieving of human suffering
How we can optimally recognize and relieve human suffering through our best human
(engineering and caretaking) efforts.
Compassion, technology, and attitudes of health
professionals
Article 1: Strauss et al. - What is compassion and how can we
measure it? A review of definitions and measures.
Give the definition and element of compassion, and how did we get to this definition. Also explain
why compassion is important.
Key points:
Compassion is recognized as important across many sectors of society
o Religion, healthcare, education and the justice system
Lack of consensus on definition and few self/observer-related measures exist
New compassion definition with 5 elements is proposed
o Recognizing, understanding, feeling, tolerating, acting (RUFTA)
Why is compassion important?
Healthcare Improved clinical outcomes and patient-satisfaction
Mental health: promotes well-being and aids recovery from psychopathology
Professional standards: core value in medical ethics and healthcare systems
Education: growing focus on implementing compassionate-based approaches
Historical context and evolution of compassion
Compassion from Latin: "compati"– to suffer with
Evolutionary perspective: roots in evolutionary theory
o Darwin: communities with more sympathetic members would flourish
o Gilbert: compassion is reproductively advantageous and would benefit communities
o Compassion evolved from adaptive focus (protecting offspring) to broader care on
others
2
,Conceptualization of compassion
Religious perspectives: tenet of Buddhism
o Dalai Lama: "Compassion is an openness to the suffering of others with a commitment
to relieve it"
Emphasized by all religions in the world
Scientific perspectives: Western psychological perspectives
o Kanov et al: compassion consist of three facets: noticing, feeling and responding:
behavioral + cognitive components
1. Noticing= being aware of a person's suffering
Either cognitively recognizing this suffering
Or by experiencing an unconscious physical or affective reaction to it
2. Feeling= responding emotionally to that suffering and experiencing empathetic
concern
3. Responding= having a desire to act to alleviate the person's suffering
o Gilbert: compassion is a motivational system to regulate negative affect
Connected to evolutionary theories: compassion originated from forming
attachment bonds and cooperative behaviors for group survival.
Six attributes:
1. Sensitivity= being responsive to other people emotions and perceiving when
they need help
a. "noticing” facet of Kanov
2. Sympathy= showing concern for other people’s suffering
3. Empathy= putting yourself in other people's shoes
b. Sympathy + empathy= "feeling" facet of Kanov
4. Motivation/caring= motivation to act to relieve the suffering
c. "Responding" facet of Kanov
5. Distress tolerance= the ability to tolerate difficult emotion in oneself when
confronted with someone else's suffering without becoming overwhelmed by
them
a. Not included in Kanov
6. Non-judgement= to remain accepting of and tolerant towards another person
even when faced with difficult feelings in oneself
a. Not included in Kanov
b. Central element to Buddhism
o Neff: Compassion is different than Self-compassion:
Self-compassion is compassion directed towards the self – 3 elements:
1. Kindness= being kind and non-judgmental towards the self – rather than self-critical
2. Mindfulness= holding painful feelings in mindful awareness – rather than over-
identifying with them
a. "Distress tolerance" of Gilbert
3
, 3. Common humanity= seeing one's suffering as part of the human condition – rather
than as isolating
Debate about association between self-compassion and compassion for others
Difference between compassion and empathy
Empathy= putting yourself in other's people shoes - vicarious experience of other's emotion
Similarity: multidimensional construct, consisting of cognitive and behavioral components
Differences:
o It is an essential element of compassion (feeling) - does not include acting
o It includes a broader spectrum, also positive emotions
o Compassion is broader: can be felt for humanity at large, rather than a specific situation
New 5-element definition of compassion
Compassion: (RUFTA)
1. Recognizing suffering
2. Understanding universality of suffering in human experience – common humanity
3. Feeling empathy for the person suffering and connecting with distress (empathy, emotional
resonance)
4. Tolerating uncomfortable feelings aroused in response to the suffering person (e.g. distress,
anger, fear)
5. Acting/Motivation to act to alleviate suffering
Measurement of compassion
All current measures fall short of the 5 elements of compassion, and they don't have good
psychometric properties
Need for a new reliable compassion scale including the 5 elements
Need to balance quantitative measurement with qualitative subtle aspects
Incorporating multiple measurement approaches
o Behavioral observations
o Bio-behavioral measures
o Self-report instruments
Article 2: Van Lotringen et al: The Role of Compassionate
Technology in Blended and Digital Mental Health Interventions:
Systematic Scoping Review.
Canvas:
This article is a literature review, exploring how digital mental health interventions (DMHI’s) have been
connected to compassion and empathy in previous research. Based on the included literature, three
roles are presented in which technology can support compassion in mental health care. You should be
4
Technology
Lecture 1: Introduction
eMental Health= web and mobile applications, online counseling (via email, chat or online fora), self-
monitoring and regulation
Why technology?
Cost reduction / Affordability
Efficiency of care
Accessibility of care
Technology is interesting
Compassion - Strauss et al., 2016:
Compassion consists of 5 elements (RUFTA)
1. Recognizing suffering in others
2. Understanding the common humanity of this suffering
3. Feeling emotionally connected with the person who is suffering
4. Tolerating difficult feelings that may arise
5. Acting or being motivated to act to help the person
Compassion is both an attitude or sensitivity to suffering, and taking the expedient action to improve the
human condition
What is technology?
Hierarchical model of Arthur, 2009
Lowest level:
o A way in which people use natural phenomena to address human wants and needs.
o Example: sun, a lens, and the wish to better see really small things
Middle level:
o Technology is a collection of assemblies that together constitutes a functioning system
o Example: smartphone is a system that employ natural phenomena such as
electromagnetism and chemical energy
Complex level:
o The entire collection of devices and engineering practices available to a culture
o The interplay of human needs and solution through technology are part of a complex
system of regulations economies, standards, and social rules
In the system of (mental) health care, there is a dynamic interaction between human needs and
technological solutions, which is influenced by a complex system of:
1
, Regulations
Economies (funding and insurance)
Standards (treatment guidelines)
Social norms (stigma, access to care)
What is compassionate technology?
Compassionate health technology would be a way in which human beings leverage natural phenomena
to facilitate and enable both the recognition and relieving of human suffering
How we can optimally recognize and relieve human suffering through our best human
(engineering and caretaking) efforts.
Compassion, technology, and attitudes of health
professionals
Article 1: Strauss et al. - What is compassion and how can we
measure it? A review of definitions and measures.
Give the definition and element of compassion, and how did we get to this definition. Also explain
why compassion is important.
Key points:
Compassion is recognized as important across many sectors of society
o Religion, healthcare, education and the justice system
Lack of consensus on definition and few self/observer-related measures exist
New compassion definition with 5 elements is proposed
o Recognizing, understanding, feeling, tolerating, acting (RUFTA)
Why is compassion important?
Healthcare Improved clinical outcomes and patient-satisfaction
Mental health: promotes well-being and aids recovery from psychopathology
Professional standards: core value in medical ethics and healthcare systems
Education: growing focus on implementing compassionate-based approaches
Historical context and evolution of compassion
Compassion from Latin: "compati"– to suffer with
Evolutionary perspective: roots in evolutionary theory
o Darwin: communities with more sympathetic members would flourish
o Gilbert: compassion is reproductively advantageous and would benefit communities
o Compassion evolved from adaptive focus (protecting offspring) to broader care on
others
2
,Conceptualization of compassion
Religious perspectives: tenet of Buddhism
o Dalai Lama: "Compassion is an openness to the suffering of others with a commitment
to relieve it"
Emphasized by all religions in the world
Scientific perspectives: Western psychological perspectives
o Kanov et al: compassion consist of three facets: noticing, feeling and responding:
behavioral + cognitive components
1. Noticing= being aware of a person's suffering
Either cognitively recognizing this suffering
Or by experiencing an unconscious physical or affective reaction to it
2. Feeling= responding emotionally to that suffering and experiencing empathetic
concern
3. Responding= having a desire to act to alleviate the person's suffering
o Gilbert: compassion is a motivational system to regulate negative affect
Connected to evolutionary theories: compassion originated from forming
attachment bonds and cooperative behaviors for group survival.
Six attributes:
1. Sensitivity= being responsive to other people emotions and perceiving when
they need help
a. "noticing” facet of Kanov
2. Sympathy= showing concern for other people’s suffering
3. Empathy= putting yourself in other people's shoes
b. Sympathy + empathy= "feeling" facet of Kanov
4. Motivation/caring= motivation to act to relieve the suffering
c. "Responding" facet of Kanov
5. Distress tolerance= the ability to tolerate difficult emotion in oneself when
confronted with someone else's suffering without becoming overwhelmed by
them
a. Not included in Kanov
6. Non-judgement= to remain accepting of and tolerant towards another person
even when faced with difficult feelings in oneself
a. Not included in Kanov
b. Central element to Buddhism
o Neff: Compassion is different than Self-compassion:
Self-compassion is compassion directed towards the self – 3 elements:
1. Kindness= being kind and non-judgmental towards the self – rather than self-critical
2. Mindfulness= holding painful feelings in mindful awareness – rather than over-
identifying with them
a. "Distress tolerance" of Gilbert
3
, 3. Common humanity= seeing one's suffering as part of the human condition – rather
than as isolating
Debate about association between self-compassion and compassion for others
Difference between compassion and empathy
Empathy= putting yourself in other's people shoes - vicarious experience of other's emotion
Similarity: multidimensional construct, consisting of cognitive and behavioral components
Differences:
o It is an essential element of compassion (feeling) - does not include acting
o It includes a broader spectrum, also positive emotions
o Compassion is broader: can be felt for humanity at large, rather than a specific situation
New 5-element definition of compassion
Compassion: (RUFTA)
1. Recognizing suffering
2. Understanding universality of suffering in human experience – common humanity
3. Feeling empathy for the person suffering and connecting with distress (empathy, emotional
resonance)
4. Tolerating uncomfortable feelings aroused in response to the suffering person (e.g. distress,
anger, fear)
5. Acting/Motivation to act to alleviate suffering
Measurement of compassion
All current measures fall short of the 5 elements of compassion, and they don't have good
psychometric properties
Need for a new reliable compassion scale including the 5 elements
Need to balance quantitative measurement with qualitative subtle aspects
Incorporating multiple measurement approaches
o Behavioral observations
o Bio-behavioral measures
o Self-report instruments
Article 2: Van Lotringen et al: The Role of Compassionate
Technology in Blended and Digital Mental Health Interventions:
Systematic Scoping Review.
Canvas:
This article is a literature review, exploring how digital mental health interventions (DMHI’s) have been
connected to compassion and empathy in previous research. Based on the included literature, three
roles are presented in which technology can support compassion in mental health care. You should be
4
