The role of the designer is changing from the ‘top-down’ creative to the humble designer (Slavin, 2016), fostering collaboration with a range of stakeholders and partnering with other disciplines as the ‘integrative discipline’ (Teal and French, 2016). As such, a new consideration of empathy is required to creatively engage people in co-creation using participatory design approaches. This paper discusses empathy within a participatory design approach, sharing methods and reflections of designing ‘with’ and ‘for’ empathy. The paper considers the role of the designer in engendering empathy in collaborative creativity and illustrates approaches from applied projects in the health and care context.