Advancing the understanding of factors that influence client preferences for race and gender matching in psychotherapy

ABSTRACT

Although clients sometimes prefer having a counselor of their same race or gender, research generally does not show that racial/gender matching improves outcomes. Two studies explored matching preferences as a function of being informed (or not) about the lack of evidence for its efficacy, and the role of two individual difference variables, systemizing and strength of cultural identification. Studies 1 (n = 129) and 2 (n = 172) investigated preferences for racial and gender matching, respectively. Participants were randomly assigned to be “Informed” that research shows matching does not lead to superior outcomes, or “Uninformed.” Using a discounting paradigm, they indicated their preference between more effective, unmatched therapy, or less effective, matched therapy; then between unmatched in-person therapy or matched teletherapy. Across studies, being informed did not affect preferences, and participants preferred unmatched in-person treatment to matched teletherapy. Lower systemizing and stronger identification with a culture other than White/European American were associated with stronger race/gender matching preferences. Black/African American participants had higher racial matching preferences compared to others, and Asian/Asian American participants (largely male) had higher gender matching preferences. This suggests clients may disregard information about the effectiveness of race/gender matching on outcomes, and they value in-person treatment over teletherapy.

KEYWORDS:

• Client preferences
• race matching
• gender matching
• psychotherapy
• teletherapy

Acknowledgments

We would like to thank Research Assistant April Su for her excellent help in preparing the Qualtrics survey and running the study on Mturk; Kris Kirby, Ph.D., for his valuable consultation on specifics of the analysis of discounting data; and Joel Ginn, MA, for statistical consultation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. In using the log-transformed outcome variable, this effect became statistically significant (p = .012).

Additional information

Notes on contributors

Gabrielle S. Ilagan

Gabrielle (Gabs) Ilagan is an incoming PhD student in the Clinical Psychology program at Fordham University, to be advised by Dr. Christopher Conway. Gabs' research interests broadly include access to mental health care, psychotherapy, and personality disorders. Before joining the Conway Lab, Gabs graduated from Williams College then worked at McLean Hospital's Gunderson Personality Disorders Institute researching treatments for borderline personality disorder and coordinating clinician trainings in these treatments.

Laurie Heatherington

Laurie Heatherington is the Edward Dorr Griffin Professor of Psychology at Williams College. Her areas of expertise is in clinical psychology, with research in family therapy change processes, the therapeutic alliance, cognition in family relationships and psychotherapy. Additional research interests include outcomes evaluation of mental health interventions in diverse settings and global mental health.