Toronto Empathy Questionnaire (TEQ): scoring guide and free template

Key Takeaways

The Toronto Empathy Questionnaire (TEQ) is a validated 16-item self-report scale measuring emotional empathy using a 5-point Likert scale with scores ranging 0-64.

Internal consistency (Cronbach’s alpha = .85) and significant correlation with established empathy measures (IRI, EQ) confirm strong reliability and validity.

The TEQ’s emphasis on emotional rather than cognitive empathy makes it distinct from other scales and ideal for therapy and counseling assessment.

Practice management software like Pabau enables TEQ administration, automatic scoring, and secure storage within patient records, streamlining assessment workflows for mental health practitioners.

Mental health practitioners working in therapy, counseling, and psychology settings often need a reliable, brief measure to assess a client’s capacity for empathy. The mental health EMR systems that many practices use now support digital assessment tools, making it easier to integrate standardized questionnaires into patient intake workflows.

This guide covers how to administer, score, and interpret the Toronto Empathy Questionnaire (TEQ), plus how to apply the results in practice. The TEQ is one of the most validated instruments for measuring emotional empathy in clinical and research settings.

What is the Toronto Empathy Questionnaire?

The Toronto Empathy Questionnaire (TEQ) is a validated, self-report measure of emotional empathy developed by Spreng et al. (2009). It consists of 16 items rated on a 5-point Likert scale, with total scores ranging from 0 to 64.

Unlike broader empathy measures that assess both cognitive (understanding others’ perspectives) and emotional (feeling what others feel) components, the TEQ focuses specifically on emotional empathy. It captures the ability to recognize and resonate with others’ feelings. This distinction makes it particularly useful in therapy and counseling, where practitioners need to evaluate a client’s emotional responsiveness and relational capacity.

The instrument was developed to meet a specific need in psychological assessment: a brief, psychometrically sound tool that could measure empathy without the length or cognitive-load demands of earlier instruments.

The 16 TEQ items and response options

The Toronto Empathy Questionnaire contains 16 statements that respondents rate on a 5-point Likert scale. Each response corresponds to a specific value:

• Never = 0 points
• Rarely = 1 point
• Sometimes = 2 points
• Often = 3 points
• Always = 4 points

Sample items include statements such as “It upsets me to see someone being treated disrespectfully,” “I have tender, concerned feelings for people less fortunate than me,” and “Other people’s misfortunes do not disturb me a great deal” (a reverse-scored item).

Digital forms platforms can now store these items and guide respondents through the questionnaire electronically. This eliminates transcription errors and speeds up data entry into patient records.

The TEQ items are intentionally brief and non-technical, making them accessible to diverse respondent populations without requiring specialized psychological knowledge.

How to score the Toronto Empathy Questionnaire

Scoring the TEQ is straightforward but requires careful attention to reverse-scored items. Follow these steps:

1. Identify reverse-scored items. Items 2, 4, 7, 10, 11, 12, 14, and 15 are reverse-scored. For these items, flip the respondent’s answer: if they selected “Always” (4), score it as 0; if “Often” (3), score as 1; if “Sometimes” (2), score as 2; if “Rarely” (1), score as 3; if “Never” (0), score as 4.
2. Score all other items normally. For items 1, 3, 5, 6, 8, 9, 13, and 16, use the respondent’s answer directly without reversing.
3. Sum all 16 item scores. Add the scores from all items (including reverse-scored) to calculate the total TEQ score.
4. Record the total. The final score will range from 0 to 64, with higher scores indicating greater emotional empathy.

Best practice: encourage clients to complete the questionnaire in a quiet, distraction-free environment to ensure thoughtful responses and support patient compliance. Some practitioners administer it during an intake appointment, while others send it via secure digital forms before the first session.

Interpreting Toronto Empathy Questionnaire scores

TEQ scores provide a quantitative snapshot of emotional empathy. While the original validation study did not establish formal clinical cutoff points, general interpretation guidelines have emerged from research:

Measuring patient satisfaction is central to quality mental health care. TEQ scores at baseline and follow-up can help practitioners track shifts in empathic capacity, especially in therapeutic modalities like compassion-focused therapy or emotion-focused therapy.

Reliability and validity of the Toronto Empathy Questionnaire

The TEQ’s psychometric credentials are strong. The original validation study reported Cronbach’s alpha of .85, indicating good internal consistency. A principal components analysis identified a single-factor solution with an eigenvalue of 5.23, roughly a third of total item variance. This confirms that the 16 items cohere around one underlying construct: emotional empathy.

Convergent validity studies show the TEQ correlates significantly with other established empathy measures, including the Interpersonal Reactivity Index (IRI) and Baron-Cohen’s Empathy Quotient (EQ). However, the TEQ’s correlation with the cognitive empathy subscales of the IRI is modest, confirming its distinct focus on emotional rather than cognitive empathy.

Test-retest reliability over a mean interval of about 66 days (roughly nine to ten weeks) was reported at r = .81, supporting its use in longitudinal clinical settings. These properties make the Toronto Empathy Questionnaire suitable for both research and routine clinical assessment.

How clinicians use the Toronto Empathy Questionnaire in practice

Mental health practitioners administer the TEQ in several clinical contexts:

• Intake assessment. As part of a biopsychosocial history or psychiatric evaluation, the TEQ provides baseline data on the client’s emotional empathy. This is relevant for understanding interpersonal patterns and relationship difficulties.
• Treatment planning. Low TEQ scores may indicate a target for therapeutic work, especially in therapy modalities addressing relational skills, emotional awareness, or social connection. A structured asking for help worksheet can support clients building those relational skills between sessions.
• Outcome measurement. Practitioners can readminister the TEQ periodically to track therapeutic progress and patient engagement in interventions designed to enhance emotional awareness or interpersonal capacity.
• Research. Academic researchers studying empathy, personality, or mental health conditions frequently use the TEQ as a validated outcome measure.

Administering the TEQ digitally via telehealth platforms or secure online forms streamlines workflows. Responses can be automatically scored and attached to the client’s record, eliminating manual transcription and improving documentation quality.

Toronto Empathy Questionnaire vs other empathy measures

Several validated empathy assessment tools exist. Understanding how the TEQ differs helps practitioners select the right instrument for their assessment needs.

The Toronto Empathy Questionnaire stands out for its brevity (16 items) and singular focus on emotional empathy. If you need a quick, validated measure of emotional responsiveness without assessing cognitive empathy separately, the TEQ is an excellent choice. Improving patient engagement through efficient assessment is a key benefit of using brief, focused instruments like the TEQ.

Ethical and legal considerations for using the TEQ

The Toronto Empathy Questionnaire is a published research instrument. When administering it clinically, practitioners should be aware of the following considerations:

• Proper citation. When using the TEQ, cite the original publication: Spreng, R. N., McKinnon, M. C., Mar, R. A., & Levine, B. (2009). The Toronto Empathy Questionnaire: Scale development and initial validation. Journal of Personality Assessment, 91(1), 62-71.
• Patient consent. Ensure clients understand the purpose of the assessment and consent to its administration. Store results securely in compliance with HIPAA compliance standards (US) or GDPR (UK/EU) rules.
• Informed interpretation. The TEQ measures only emotional empathy, one dimension of interpersonal capacity. Avoid over-interpreting low scores as pathology. Empathy exists on a spectrum and is shaped by neurobiology, culture, and context. Where documentation calls for a placeholder mental health code, coders sometimes use F09 pending further evaluation.
• Clinical judgment. Use TEQ results alongside clinical interview, observation, and other assessment data. No single questionnaire should drive diagnostic or treatment decisions alone.

Administering the Toronto Empathy Questionnaire digitally

Modern practice management systems now allow practitioners to administer the Toronto Empathy Questionnaire via secure client record systems that automatically calculate scores and store results. This digital approach has several advantages: reduced data-entry errors, immediate availability of scores during the session, and a complete audit trail for compliance documentation.

Best practice: send the questionnaire to clients before their intake appointment via a secure online portal. This gives them time to reflect on responses and allows you to review scores before the session begins, directing clinical focus toward areas revealed by the assessment.

Putting the Toronto Empathy Questionnaire into practice

The Toronto Empathy Questionnaire is a scientifically validated, brief, and practical tool for assessing emotional empathy in mental health practice. Its strong psychometric properties, ease of administration, and clear interpretation guidelines make it suitable for intake assessments, treatment planning, and outcome tracking in therapy, counseling, and psychological research.

Using the TEQ alongside modern psychology practice management software enables practitioners to capture, score, and store assessments securely within patient records. This improves documentation quality and allows longitudinal tracking of empathic capacity during therapy. Book a demo to see how Pabau streamlines clinical assessment workflows for mental health practices.

Continue your research

Need a fuller intake picture before scoring the TEQ? Comprehensive biopsychosocial assessment template gives you the wider intake context to pair with an empathy measure.

Want a tool for building emotional vocabulary in session? Emotion wheel worksheet helps clients name and articulate feelings during therapy.

Planning next steps after a low empathy score? Stages of change worksheet supports structured treatment planning for clients working on relational skills.

Frequently Asked Questions