Abstract
This study explored the effects of ethnic/racial matching on psychotherapy outcomes via the number of counseling sessions attended by clients, using clinical data collected from a university’s counseling center. A total sample of 644 clients (193 men, 448 women) was selected and the ethnic/racial distribution of the sample comprised 499 White/European American (77.5%), 81 African American (12.6%), 33 Asian American (5.1%), and 31 Hispanic clients (4.8%). As a result of a multilevel mediation analysis, it was found that the clients working with counselors of matching ethnicity/race attended more number of counseling sessions than those with counselors of different ethnicity/race. Moreover, the ethnic/racial matching between clients and counselors led to a higher improvement of global assessment of function (GAF). The analysis also revealed that the client–counselor ethic/racial matching showed significant, direct effects on the improvement of GAF. The effects of ethnic/racial matching on the number of counseling sessions and GAF improvement significantly differed at the counselor-level. Clinical implications to multicultural counseling and training are provided.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Change history
09 March 2018
The original version of this article was published with the following error. This has been corrected with this erratum.
09 March 2018
The original version of this article was published with the following error. This has been corrected with this erratum.
09 March 2018
The original version of this article was published with the following error. This has been corrected with this erratum.
References
Alladin, W. J. (1994). Ethnic matching in counselling: How important is it to ethnically match clients and counsellors? Counselling Psychology Review, 9(3), 13–17.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th edn.). Washington, DC: American Psychiatric Association.
American Psychological Association. (2003). Guidelines on multicultural education, training, research, practice, and organizational change for psychologists. American Psychologist, 58, 377–402.
Atkinson, D., R. & Matsushita, Y. J. (1991). Japanese-American acculturation, counseling style, counselor ethnicity, and perceived counselor credibility. Journal of Counseling Psychology, 38(4), 473–478.
Banks, N. (1999). White counselors-Black clients: Theory, research and practice. Brookfield, VT: Ashgate Publishing.
Bowers, T. G., & Clum, G. A. (1988). Relative contribution of specific and nonspecific treatment effects: Meta-analysis of placebo-controlled behavior therapy research. Psychological Bulletin, 103, 315–323.
Cabral, R. R., & Smith, T. B. (2011). Racial/ethnic matching of clients and therapists in mental health services: A meta-analytic review of preferences, perceptions, and outcomes. Journal of Counseling Psychology, 58, 537–554.
Cottone, J. G., Drucker, P., & Javier, R. A. (2002). Gender differences in psychotherapy dyads: Changes in psychological symptoms and responsiveness to treatment during 3 months of therapy. Psychotherapy: Theory, Research, Practice, Training, 39, 297–308.
Erdur, O., Rude, S. S., & Baron, A. (2003). Symptom improvement and length of treatment in ethically similar and dissimilar client-therapist pairings. Journal of Counseling Psychology, 50, 52–58.
Flicker, S. M., Waldron, H. B., Turner, C. W., Brody, J. L., & Hops, H. (2008). Ethnic matching and treatment outcome with Hispanic and Anglo substance-abusing adolescents in family therapy. Journal of Family Psychology, 22(3), 439–447.
Fuertes, J. N., Bartolomeo, M., & Nichols, M. (2001). Future research directions in the study of counselor multicultural competency. Journal of Multicultural Counseling and Development, 29, 3–12.
Fujino, D. C., Okazaki, S., & Young, K. (1994). Asian-American women in the mental health system: An examination of ethnic and gender match between therapist and client. Journal of Community Psychology, 22(2), 164–176.
Hayes, J. A., McAleavey, A. A., Gastonguay, L. G., & Locke, B. D. (2016). Psychotherapists’ outcome with white and racial/ethnic minority clients: First, the good news. Journal of Counseling Psychology, 63(3), 261–268. https://doi.org/10.1037/cou0000098.
Jones, E. E., & Zoppel, C. L. (1982). Impact of client and therapist gender on psychotherapy process and outcome. Journal of Consulting and Clinical Psychology, 50, 259–272.
Jones, S. H., Thornicroft, G., Coffey, M., & Dunn, G. (1995). A brief mental health outcome scale: Reliability and validity of the Global Assessment of Functioning (GAF). The British Journal of Psychiatry, 166, 654–659.
Jose, P. E. (2013). Doing statistical mediation and moderation. New York, NY: The Guilford Press.
Karlsson, R. (2005). Ethnic Matching Between Therapist and Patient in Psychotherapy: An Overview of Findings, Together With Methodological and Conceptual Issues. Cultural Diversity and Ethnic Minority Psychology, 11, 113–129.
Kenny, D. A., Korchmaros, J. D., & Bolger, N. (2003). Lower level mediation in multilevel model. Psychological Methods, 8(2), 115–128.
Lambert, M. J., Smart, D. W., Campbell, M. P., Hawkins, E. J., Harmon, C., & Slade, K. L. (2006). Psychotherapy outcome, as measured by the OQ-45, in African American, Asian/Pacific Islander, Latino/a, and Native American clients compared with matched Caucasian clients. Journal of College Student Psychotherapy, 20, 17–29.
MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. Mahwah, NY: Erlbaum.
Maramba, G. G., & Nagayama-Hall, G. C. (2002). Meta-analyses of ethnic match as a predictor of dropout, utilization, and level of functioning. Cultural Diversity and Ethnic Minority Psychology, 8, 290–297.
Minami, T., Davies, D. R., Tierney, S. C., Bettmann, J. E., McAward, S. M., Averill, L. A., et al. (2009). Preliminary evidence on the effectiveness of psychological treatments delivered at a university counseling center. Journal of Counseling Psychology, 56, 309–320.
Murphy, M. J., Faulkner, R. A., & Behrens, C. (2004). The effect of therapist-client racial similarity on client satisfaction and therapist evaluation of treatment. Contemporary Family Therapy, 26(3), 279–292.
Raudenbush, S., & Bryk, A. S. (2002).). Hierarchical Linear Model: Applications and data analysis methods (2nd edn.). Thousand Oaks, CA: Sage Publications.
Satel, S. (2002). Politically correct M.D.: How political correctness is corrupting medicine. New York, NY: Basic Books.
Sharf, J., Primavera, L. H., & Diener, M. J. (2010). Dropout and therapeutic alliance: A meta-analysis of adult individual psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 47, 637–645.
Shin, S., Chow, C., Camacho-Gonsalves, T., Levy, R. J., Allen, I. E., & Leff, H. S. (2005). A meta-analytic review of racial-ethnic matching of African American and Caucasian American clients and clinicians. Journal of Counseling Psychology, 52, 45–56.
Smith, M. L., Glass, G. V., & Miller, T. L. (1980). The benefits of psychotherapy. Baltimore, MD: Johns Hopkins University Press.
Söderberg, P., Tungström, S., & Armelius, B. (2005). Special Section on the GAF: Reliability of Global Assessment of Functioning Ratings Made by Clinical Psychiatric Staff. Psychiatric Services, 56(4), 434–438.
Sue, D. W., & Sue, D. (1977). Barriers to effective cross-cultural counseling. Journal of Counseling Psychology, 24, 420–429.
Sue, S. (1991). Ethnicity and culture in psychological research and practice. In J. D. Goodchilds (Ed.), Psychological perspectives on human diversity in America (pp. 47–85). Washington, DC: American Psychological Association.
Sue, S. (1998). In search of cultural competence in psychotherapy and counseling. American Psychologist, 53, 440–448.
Sue, S. (2003). In defense of cultural competency in psychotherapy and treatment. American Psychologist, 58, 964–970.
Sue, S., Fujino, D. C., Hu, L. T., Tackeuchi, D. T., & Zane, N. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Consulting and Clinical Psychology, 59, 533–540.
Sue, S., & Zane, N. (1987). The role of culture and cultural techniques in psychotherapy: A critique and reformulation. American Psychologist, 42, 37–45.
Tucker, C. M., Herman, K. C., Pedersen, T. R., Higley, B., Montrichard, M., & Ivery, P. (2003). Cultural sensitivity in physician-patient relationships: Perspectives of an ethnically diverse sample of low-income primary care patients. Medical Care, 41, 859–870.
Wang, J., & Wang, X. (2012). Structural equation modeling: Applications using Mplus. West Sussex: Wiley.
Wintersteen, M. B., Mensinger, J. L., & Diamond, G. S. (2005). Do gender and racial differences between patient and therapist affect therapeutic alliance and treatment retention in adolescents? Professional Psychology: Research and Practice, 36(4), 400–408.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kim, E., Kang, M. The effects of client–counselor racial matching on therapeutic outcome. Asia Pacific Educ. Rev. 19, 103–110 (2018). https://doi.org/10.1007/s12564-018-9518-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12564-018-9518-9