The Effect of Therapist White Privilege Attitudes on Client Outcomes and the Therapist-Client Relationship
Year of Publication
Doctor of Philosophy (PhD)
Educational, School, and Counseling Psychology
Dr. Robert J. Reese
Dr. Pamela Remer
Counseling Psychology has emphasized the importance of using multicultural and social justice frameworks in psychotherapy to avoid reenacting in session the privilege and oppression dynamics that exist in larger society. People of Color have historically underutilized psychotherapy services and have higher attrition rates when they do attend therapy, even though they have been more likely to face more sources of psychological distress (Kearney, Draper, & Baron, 2005; Sue & Sue, 2008). Additionally, White therapists have been over-represented in professional and training settings (Fouad & Arredondo, 2007; Hays & Chang, 2003). Add to that the fact that therapists have been trained in and practice psychotherapy theories developed primarily by White men and you have a system of counseling that works for some and not all. Thus, White therapists could be at risk for harming their clients of Color, and possibly their White clients as well, because of the utilization of these Euro-centrically biased ways of conceptualizing and treating clients (Mindrup, Spray, & Lamberghini-West, 2011). In this study, I examined the impact of therapist-reported White privilege attitudes on client-reported counseling outcomes and the therapeutic relationship. Participating therapists (N = 36) were recruited from a community mental health agency in the southeast and administered measures of White privilege attitudes, multicultural knowledge and awareness, and motivation to control prejudiced reactions. Outcome and therapeutic relationship data from clients of participating therapists, seen between fall 2012 and fall 2013 semesters, were provided by the agency. Therapist self-reported White privilege attitudes were not directly predictive of therapy outcomes and the therapeutic alliance. Therapists’ willingness to confront White privilege, White privilege remorse, and apprehension about addressing White privilege moderated the effects first session outcome scores and client gender had on number of sessions attended by clients. Client race/ethnicity was not directly predictive of therapy outcome scores or therapeutic alliance scores. However, client race/ethnicity varied significantly across therapists, suggesting that therapists were differentially effective. Results of this study indicate that therapist White privilege awareness has an effect on outcomes and the therapeutic alliance, although the relationship is complicated. Study limitations, strengths, and implication for future research are discussed.
Miserocchi, Kristin M., "The Effect of Therapist White Privilege Attitudes on Client Outcomes and the Therapist-Client Relationship" (2014). Theses and Dissertations--Educational, School, and Counseling Psychology. 17.