Enhancing Empathy Through a Creative Writing Program in Elementary School

Education is not only about the transferring of knowledge, but also about the cultivation of strong social and emotional skills, which are necessary for the strengthening of the social competence of students, their positive self-perception and their success in school. Empathy, which refers to the ability to recognize another person‟s emotional state is one of the basic skills of the 21st century, which helps all students grow up to become active and critically aware citizens. The research/intervention program "Creative Writing and Social Learning Skills", implemented by students of the 5th and 6th grade of elementary schools in Thessaloniki, Greece, explores the enhancement of empathy, through the use of creative writing as an educational tool. Activities used were based on literary texts from Balkan countries and countries of Eastern and Southeastern Europe. The research sample consisted of 573 students, who were divided into the Intervention Group, that implemented the program, and the Control Group, that attended its regular curriculum. The analysis of the level of skills in children, and especially the level of empathy, which is of concern to us in the present study, was carried out using a structured improvised questionnaire, the alpha Cronbach coefficients where of range at very high levels. Study results showed that the Intervention Group exhibited statistically greater improvement in the assessment of empathy compared to the Control Group.


Introduction
21st century skills are not only based on cognitive objects but also include information and communication skills, thinking and problem solving, interpersonal and self-managed skills for using 21st century tools, such as information and communication technologies (Koltsiakis, 2018). In fact, in accordance with various bodies and institutions (Casey Life Skills, 2016;McMilan Life Skills, 2016;National Education Association, 2016;WHO, 1997), empathy is included in the skills of the 21st century.
This article explores the enhancement of empathy through creative writing, as creative writing also functions as a form of treatment for various social and emotional problems (Harber and Pennebaker, 1992;Smyth, 1998). More specifically, the enhancement of empathy, which is part of a wider set of social learning skills, is achieved through the research / intervention program "Creative Writing and Social Learning Skills", which includes creative writing activities, based on literary texts from Balkan countries and countries of Eastern and Southeastern Europe. The article is divided into two parts: the theoretical part where we attempt to link creative writing with the enhancement of empathy and the research part where the research/intervention program is described in brief, results are presented and key conclusions are drawn.

Empathy
Empathy is one"s ability to infer another person"s situation and includes an emotional response that matches the other person"s feelings (Wispé, 1986). In fact, empathy is one"s ability to feel exactly what the other person is feeling, rather than simply recognizing their feelings (Hoffman, 2000). According to Siemer and Reisenzein (2007), this may occur when one imagines themselves in someone else"s shoes. Keen (2006) notes that empathy can be defined as the ability to identify another's emotional state and in general to see things from their point of view.
In school, the display of high levels of empathy by teachers has a positive impact on learning (Hattie, 2009;Rogers, 2006). Further, Fonagy et al. (2004) point out that when a child develops a secure bond with the caregiver, the child becomes capable of more effectively "exploring" both itself and others and enhances self-regulation. The affective dimension of teaching is particularly important, as through the recognition and acceptance of emotions students' attention is strengthened, balanced relations are established both between the teacher and the students, but also between the students and, finally, favorable learning conditions are ensured (Lazarescu, 2012 Evernett (2005), defines creative writing as any original piece of work that encourages students to dream and use their imagination. Morley (2007), comments on writing are quite remarkable, as he notes that writing can change people, create new worlds and even universes that exist in parallel to the real one. For Morley creative writing offers life lessons while making an individual feel euphoric. He points out that the writing process is more rewarding than its results, as it is a powerful tool for various types of treatment, from the treatment of depression to social rehabilitation. Creative writing awakens the individual, pushes them beyond their intelligence, helps them think more clearly and gain perspectives about themselves and others.

Creative Writing in School
One of the basic characteristics of creative writing is its role as an effecting tool for the teaching of Literature. Moreover, it promotes the additional exposure of students to language, contributing to their linguistic enrichment, improving their reading and writing skills and helping them choose the right text style based on the occasion and their reading audience (Ghani and Din, 2017). In addition, in accordance with Keeling and Bermudez (2006), creative writing is used to explore and record personal troubled backgrounds, and facilitate internal change. It is a way of understanding personal needs and healing emotional wounds.
It is worth mentioning that for Kenny (2011), there are four reasons why it is necessary to use creative writing in the classroom: a) freedom of expression, b) imagination, c) emotional response and d) connection of the known with the unknown. Additionally, for Maley (2009), some of the benefits of creative writing for students are that it: a) Helps in the development of language at all levels, such as grammar, vocabulary and phonology. b) Encourages students to "play" with the language, experiment and explore it without fear. c) Emphasizes the right side of the brain, emotions, intuition, musicality. d) Enhances students' self-confidence. e) Increases their motivation. f) Improves reading and writing skills.

Empathy and Creative Writing
Social and emotional development may be enhanced through literacy. Literacy is related to reading skills, but also covers other cognitive aspects, such as oral, numeracy and writing skills (United Nations Educational and Scientific and Cultural Organization, 2006). Brill"s study (2004), in school-age children examined the results of four writing tasks, two literary and two non-literary. Text analysis in the above activities included writing style, imagination and empathy of the author/creator. Results showed that in the literary texts imagination and empathy scored higher.
The use of interactive methods in school, as for instance creative writing activities, enhances students' empathy. Faver and Alanis (2012), studied eight families that had children with learning disabilities. The results of their study showed that storytelling helped parents and children see the perspectives of other family members, in other words it helped them develop empathy. In addition, (Upright, 2002) emphasized the use of moral dilemmas to increase empathy. More specifically the above study utilized a variety of activities such as role playing, group work and various writing tasks.
To the above, one must add the study carried out by Partridge (2018), which aimed to investigate the relation between the enhancing of empathy and writing activities within the framework of the interactive program "Shakespeare Can Be Fun". The results of the study showed that narrative writing in the classroom can enhance students' empathy. Another study on empathy by Gair (2012) carried out on 38 second-year social work students, utilized creative writing, specifically the writing of haiku poems. The study showed that through the writing of poems students were encouraged to express conflicting emotional tensions and values, thoughts and feelings, even in cases where empathy can be difficult.

Creative Writing Activities
The creative writing activities used to enhance students' empathy were implemented in three workshops. In fact, their goal was for students to become aware of issues that focus on promoting equality in terms of human dignity. Each creative writing activity consisted of the following stages: a) Preparation, which includes the use of a literary text, in order for students to discover or develop knowledges and writing techniques, b) Invention/ Organization, which includes the stimulus offered by the teacher-animator, in order for students to transform the above knowledge into a new one based on their experiences and feelings and c) Writing/Presentation, which is the stage during which students write their texts and then through their publication, receive feedback, which can lead to a possible rewriting.
In the first workshop an excerpt from Milisav Savic's book "Bread and Fear" is used, which contains incidents of human rights abuses. Students are encouraged to add additional scenes in which the dreams, truth and morals of the heroes are trampled. In the second workshop an excerpt from Qusja Rexhep's book "Death Comes to Me from Such Eyes" is used, which shows the violation of the hero's human rights. Students are urged to use the main character of the above book in a new story thus utilizing the technique of intertextuality. Finally, in the third workshop excerpts from Mehmed Uzun's book "The Well of Destiny" are used, which refer to peace and war. Students are encouraged to collect words and phrases from the above passages and with the help of the "Wheel of Peace" (Compass, 2010) write poems in free verse or rhyme.

Study Participants and Evaluation Scale
573 students of the 5th and 6th grade of elementary schools located in the prefecture of Thessaloniki, Greece, participated in the study. Of these, 382 students formed the Intervention Group that attended the program "Creative Writing and Social Learning Skills" and 191 students formed the Control Group that continued with their regular curriculum.
The "Social Learning Skills Evaluation Scale in the 5th and 6th grade of elementary school" used in the study consists of two parts: The first part includes questions regarding students' demographics and other personal details, while the second includes eleven improvised subscales to evaluate children's social learning skills as they become evident in the school environment. One of the eleven subscales is the empathy subscale.
Their creation was preceded by a study of the following social skills assessment questionnaires: a) "The Walker-McConnell Scale of Social Competence and School Adjustment" by Walker and McConnell (1988), b) "Children's Self-Report Social Skills Scale (CS4)" by Danielson and Phelps (2003) "School Social Behavior Scales, (SSBS)" by Merrell (1993), d) "Social Skills Rating System (SSRS)" by Gresham and Elliott (1990), e) "The Personal and Social Skills Scale for Preschoolers" by Kourmousi (2012).
The scale contains 67 statements in total. In particular, the subscale on empathy includes the following statements: 1. He/She rejoices when another child rejoices. 2. He/She is upset when another child is upset. 3. He/She tolerates the different. 4. He/She respects the views of others. 5. He/She provides assistance to that child who is in a difficult emotional state. 6. He/She encourages other children to express themselves freely. It is also worth noting that the Cronbach's alpha reliability coefficient for the empathy subscale is particularly high, α = 0.970, thus demonstrating the high internal consistency reliability of the questionnaire. The reliability and validity of the scale was tested in a population of 30 teachers with the test-retest process and the Spearman correlation coefficient was calculated for each question separately. Teachers filled in the questionnaires, giving a code to each of their students, in order to maintain their anonymity. In addition, the use of codes was necessary in order to compare the questionnaire for each student with the corresponding questionnaire that was filled in following the intervention, in order to identify any changes in the children's social learning skills.

Data Analysis and Processing
Data processing was performed using IBM SPSS 25.0 (IBM Corp, 2017) and Descriptive and Inferential Statistics methods were applied. Frequency distribution tables were constructed and answers were presented with the respective mean (M), standard deviation (D), median (MD) and range (R) values. Initially, eleven aggregate indicators corresponding to skills were created. These indicators were tested for reliability by calculating Cronbach"s alpha (Cronbach, 1951). The results of the reliability analysis showed that all eleven indicators are extremely reliable and as for the indicator studied herein, its reliability is clearly presented in Table 1:

Initial Evaluation
The statistical comparison between the two groups regarding empathy, showed that there was not a statistically significant difference during the initial evaluation (p>0.05). It should be noted that statistical tests were performed at a 5% significance level (α=0.05). This indicates that the two student groups demonstrated respective skills with similar frequencies at the beginning of the study (Table 2).

Comparison of the Score of the Intervention Group Before and After the Implementation of the Program
Students of the Intervention Group were evaluated with a higher score in the final evaluation compared to the initial evaluation with regard to the skill of empathy which is the skill of interest in this article (Table 3): The score of the Intervention Group in the empathy skill was significantly greater (p <0.001) after the implementation of the program compared to the corresponding value before its implementation.

Comparison of the Final Evaluations of Students of the Intervention Group and the Control Group
According to the results of the statistical analysis, the two students groups do not exhibit a significant difference in the assessment of empathy (p> 0.05), as shown in Table 4.

Change (Improvement) between the Initial and Final Evaluation for the Intervention Group and the Control Group
Results of the statistical comparisons show that both the Intervention Group and the Control Group exhibit a statistically significant change in empathy skills (Z = -2.02, p = 0.04). The change (improvement) between the final and the initial assessment of the students of the Intervention Group, on average, is higher in this skill (Table 5).

Discussion
Replicate measurements before and after the intervention, as well as a comparison between the Intervention and Control Groups were performed in order to investigate the effectiveness of the two programs, namely the program "Creative Writing and Social Learning Skills" on the one hand and the general education program on the other. Indeed, the research findings showed that according to the average values students of the Intervention Group showed a greater improvement (change) in the skill of empathy compared to the students of the Control Group.
Many similar interventions showed similar positive results to those of the assessment study of the program "Creative Writing and Social Learning Skills" regarding the enhancement of empathy. At this point, it should be noted that for Mayer and Salovey (1995), high emotional intelligence is associated with high empathy, and even though research by Mayer et al. (1990) confirms this association, other studies do not identify this connection (Ickes et al., 1990;Levenson and Ruef, 1992). Interventions that examine this skill as "emotional intelligence" and demonstrate similar results to those of the present study are: "Social Decision Making Skills Curriculum" (Hassan and Mouganie, 2014), "Teen Leadership Breakthrough" (Hindes et al., 2008) and "Giant Leap" (Correia and Marques-Pinto, 2016), to name a few. On the other hand, certain interventions did not bring about a statistically significant improvement in the general emotional intelligence of students of the Intervention Group, as for instance the "Living Values" (Hassan and Kahil, 2005), but also the research / intervention program by Hennessey (2007).

Research Limitations
The 39 teachers who took part in the research together with their students expressed from the beginning the desire to join a specific group based on the needs of their class. As a result, the inclusion of students in the Intervention and Control Groups was not carried out in a randomized manner. It is worth noting, however, that the statistical comparison between the two groups for the above skills showed that there was no statistically significant difference during the initial evaluation. Another limitation was that the teachers of the Intervention Group functioned both as observers, and as evaluators; thus, there is a clear subjective element. In conclusion, limiting factors were the implementation of the program mainly in schools in eastern Thessaloniki, the non-evaluation of all students who participated in the research/intervention program, as well as the non-repetition of the evaluation, in order to determine the sustainability of the results.

Conclusions/Suggestions
Findings of the present study show that empathy can be enhanced through creative writing activities, having as basis literary texts from Balkan countries and countries of Eastern and Southeastern Europe. In particular, this skill showed a greater improvement in students of the Intervention Group compared to the students of the Control Group through the implementation of the research/intervention program "Creative Writing and Social Learning Skills".
Certainly, however, the results of the present study need to be verified, as a randomized sample, the assessment of all students and the presence of independent observers / assessors may have yielded more representative results. In addition, the issue of whether students who appear to have acquired or enhanced their empathy skills will retain said skills over time compared to those who did not participate in the program needs to be further examined.
In conclusion, it is worth stressing that school programs aimed at developing children's social and emotional skills have a greater positive impact on children's lives if implemented from early childhood and continue throughout their school and academic career. Although not a solution to all their problems, they are important tools for their social and emotional development.