Over a decade of research has validated the common sense intuition that some therapists are better than others at fostering therapeutic change. Hayes, Owen, and Bieschkle (2014) find that this effect is partially explained by the ability of therapists to work effectively with racial and ethnic minority clients. In a sample from a university training clinic, they examined the outcomes of 228 clients, 80 of whom were ethnic minorities (35%), who were treated by 36 graduate student therapists. As expected, some therapists achieved better outcomes than others with their patients. Approximately 9% of the differences in outcomes across patients could be explained by which therapist they were treated. A part of this effect was explained by the ability of therapists to work with racial and ethnic minorities, relative to non-minorities. In this study there were so-called “super shrinks,” therapists who are able to promote substantial amounts of therapeutic change and with different types of clients, as well as “pseudo shrinks,” therapists who could use some improvement with all of the clients. In addition to those types of therapists, there were therapists whose outcomes varied as a function of their ability to work with minority patients. The ability of therapists to work effectively with racial or ethnic minorities in fact accounted for around 20% of the therapist effects on outcomes. Racial and ethnic minorities are at an increased risk of terminating therapy early, have been reported to have more difficulty fostering a therapeutic alliance, and may generally be more hesitant to seek treatment. Thus, the authors conclude that studying the behaviors of the therapists who have better outcomes with minority patients could lead to improvements in training for clinicians who work with diverse populations.
Society for Psychotherapy Research (SPR)
Marna S. Barrett, Ph.D.
Mood & Anxiety Disorders Treatment Research Unit
University of Pennsylvania Perelman School of Medicine
3535 Market St., Suite 670
Philadelphia, PA 19104