Process and Outcome in Cross-Racial Therapeutic Dyads.

Large-scale archival studies of public mental health agencies suggest that patients seeing a therapist of dissimilar race/ethnicity are more likely to drop out of treatment at a higher rate and to attend a fewer number of sessions compared to patients whose therapists share their racial/ethnic background.

However, studies of psychotherapy process provide little evidence that racial/ethnic matching leads to better treatment outcomes or greater satisfaction with therapy. These contradictory findings imply that much that remains unknown about the impact of race and ethnic match/mismatch on the therapy process.

Ongoing Projects

While there are some studies of therapists' experiences addressing race and ethnicity in clinical practice (e.g., Fuertes et al., 2002; Knox et al., 2003), there is very little information regarding clients' subjective experiences of therapy with a racially or ethnically dissimilar therapist.

My students, co-investigator Jonathan Kaplan , and I are in the process of interviewing individuals who have recently terminated therapy with a racially/ethnically different therapist. The purpose of this two-phase, sequential mixed-methods study is to (1) assess, from the client's perspective, how race/ethnicity affects the therapy process, (2) identify therapist behaviors that help or hinder the development of the relationship, and (3) develop and test an intervention designed to improve therapists' ability to establish a strong working relationship with racially/ethnically different clients.