Paige

Impact of Client-Therapist Match on Treatment Outcome for African American Clients Presenting with Depression and Anxiety

Lynn Paige

Abstract

While African- American comprise of 13% of the United States Population (United States Census Bureau, 2010), Shin (2005) argues that individuals from the African-American population have been found to have less access to mental health services, a lower probability of receiving needed services, and a greater likelihood of receiving poor quality of care, thus influencing retention during treatment and the efficacy of counseling. One reason for this might be an issue related to being seen by someone who is not an African-American and thus the therapeutic alliance, a key to successful therapy, is weakened.

Research is showing how vital therapeutic alliance is to outcome in counseling, so tracking the outcome of counseling with African-Americans based on the ethnic match of their counselors could give insight into the role match plays in making counseling effects (Duncan, Miller, Wampold, & Hubble, 2011).

The present study examines the relationship of client-therapist match during treatment to therapeutic alliance, treatment outcome, and change in depressive and anxious symptoms. There was a total sample of 1286 clients from Richmont Graduate University (RGU)’s network of counseling centers in the Atlanta and Chattanooga areas. The subjects included 60 therapists, 9 were African-American and 51 Caucasian. There were 28 African American clients. The study found that Caucasian therapists have significantly better alliances with Caucasian than with African-American clients (p<.001), African American clients matched with Caucasian therapists showed a stronger therapeutic alliance than with African American therapists (p<.05), and client-therapist match did not relate to change in anxious and depressed symptoms.

Keywords: Counseling outcomes; depression; anxiety; therapeutic alliance; minorities; race