Effects of race on psychotherapy process and outcome: An exploratory investigation.

This study examined the effects of the race of therapist and client on the process and short-term outcome of psychotherapy. Fourteen female clients, evenly divided by race, and carefully matched in age and education were seen in individual, psychodynamically oriented psychotherapy by black and white therapists. All four possible therapist-client racial matches were represented (black-black, black-white, white-black, and whitewhite). Outcome was measured by both therapist and client responses to questionnaires concerning their impressions of therapy after ten sessions. Process data consisted of therapists' tape recordings and process notes of approximately the first ten therapy hours with each of their clients, and were rated with a specially designed Q-sort, constructed to be descriptive both of the therapeutic process in general as well as issues pertaining to race. Results indicated there were no differences in outcome as a function of racial matching; however, there were clear differences in therapy process. A cluster analysis produced seven dimensions of psychotherapy process, four of which varied significantly across racial match. A subsequent analysis of Q-sort items demonstrated significant changes in therapy process over time, many of them occurring between the first therapy hour and subsequent sessions. This finding raises serious questions about the generalizability of the results of previous studies on the effects of race in psychotherapy that base their conclusions on data acquired solely in an initial interview.