Racial/ethnic disparities in client unilateral termination: The role of therapists' cultural comfort

Psychother Res. 2017 Jan;27(1):102-111. doi: 10.1080/10503307.2015.1078517. Epub 2015 Sep 21.

Abstract

Objective: There is growing evidence highlighting the existence of inequities in mental health treatments that occur on the basis of client race and ethnicity for some therapists. In particular, therapists vary in the degree to which their racial/ethnic minority clients unilaterally terminate as compared to White clients. Although therapists have been shown to be a key source of racial/ethnic mental health treatment disparities, less is known about what predicts which therapists will have larger disparities among their clients.

Method: With this in mind, the current study examined client unilateral termination within therapist caseloads, and then examined therapists' racial/ethnic comfort and general comfort as predictors of client unilateral termination. The sample included 23 counselors who treated 177 clients at a large university counseling center.

Results: The results indicated that therapists' racial/ethnic comfort was significantly associated with racial/ethnic disparities within their caseloads; however, therapists' general comfort was not. Implications for research and practice are offered.

Conclusions: Therapists' racial/ethnic comfort may help explain disparities in unilateral termination.

Keywords: dropout; multicultural competencies; multicultural orientation; racial/ethnic disparities; therapist effects.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Counselors / psychology*
  • Culturally Competent Care*
  • Female
  • Healthcare Disparities*
  • Humans
  • Male
  • Minority Groups*
  • Patient Dropouts / psychology*
  • Professional-Patient Relations*
  • Psychotherapy*
  • Student Health Services