Therapist behavior in gender-sensitive clinical assessment: Development of an observational coding system

Clinical assessment may overlook the cultural and systemic contingencies involved in the development and maintenance of clients’ difficulties. This study aimed to develop an observational coding system for identifying and classifying therapist verbal responses related to gender contingencies during psychological assessment. The System for the Categorization of Gender Sensitivity during Evaluation (SCISG-E) was developed through a theory-informed and iterative process drawing on behavior-analytic feminist literature, research on gender-sensitive clinical practice, and observations of recorded clinical assessment sessions. The final system comprised five main categories and 11 subcategories addressing invalidation, sexism and segregation, power abuse and violence, vulnerability, and power imbalances within the clinical context. Preliminary interobserver agreement was examined using percentage agreement and Cohen’s kappa. Across the reliability dataset, 93 distinct codable-event opportunities were identified. Overall percentage agreement was 60.22%, with a Cohen’s kappa of .503. Agreement varied across categories, and 78.4% of the observed errors involved omission or commission rather than disagreement about category assignment. These findings indicate that the main challenge lies in determining whether a therapist verbalization constitutes a gender-related codable event. The SCISG-E provides a preliminary method for examining observable therapist behavior related to culturally organized gender contingencies, although further refinement of event-detection criteria, observer training, content validity, and reliability is required.