Serena Bohn and Dr. Timothy B. Smith, Counseling Psychology and Special Education
The purpose of this research was to conduct a meta-analysis of past and current psychological studies in order to assess what trends have occurred within the field of multi-cultural psychology in regards to the effect on client outcomes through matching clients and therapists based on race or ethnicity. A meta-analysis is the study of the results of other studies. Articles and manuscripts are collected and the data from within is analyzed and converted to a standard statistic, allowing for an overall look at what the collection of data implies. Positive client outcomes were defined in this study as a decrease in symptoms or a higher Global Assessment Functioning (GAF) score after treatment with a matched therapist-client dyad. The field of psychology needs to attend to racial and ethnic factors that affect mental health treatment and through this meta-analysis the researchers have endeavored to further knowledge in this area.
This meta-analysis started with an extensive literature search of electronic databases using PsycInfo-EBSCO accessed through Brigham Young University’s library. The researchers sought quantitative studies investigating ethnic or racial matching of minority ethnic groups with racially or ethnically similar therapists in mental health settings. The articles and dissertations included in the search were written in English and pertained to North America (United States and Canada) from the year 1967 through 2005. Studies that fit the search parameters were coded separately by two pairs of research assistants and then verified by a research pair consisting of one person from each previous pair. This method of collecting and processing data was utilized to ensure minimization of researcher coding error. Fifty-two (K=52) articles and dissertations fulfilled the parameters and were coded in this manner.
The descriptive and demographic information contained in these 52 articles included a total of 117,982 participants. Of these participants, 52% were female, 31% were White, 29% were Black, 20% were Asian American, 16% were Latino/a, less than 1% were American Indian, and 3% identified as “other”.
Results of the meta-analysis indicate a minimally positive difference in client outcomes between racially matched and racially unmatched client-therapist pairs (d= 0.09). These surprising results show that client outcomes are not significantly affected by racial match or mismatch. Variables that did moderate the results included gender and time. Discrepancies between client outcomes from racially or ethnically matched or unmatched pairs slightly increased when the racially dissimilar therapist was male. In addition, discrepancies between client outcomes of the matched and unmatched pairs were shown to have diminished throughout the years of the study.
These results show an optimistic future for the field of multi-cultural psychology. Differences have decreased through the years, perhaps due to more racial sensitivity and education in multi-cultural treatment. Though differences in client outcomes are small, more can be done to make sure ethnic minority groups are receiving racially and culturally sensitive mental health care. Further research needs to be done on the effects of racially similar matching on American Indians especially, since information regarding this group is miniscule. Emphasis on optimum treatment for diverse clients is a necessity, and therapists can seek training in multi-cultural treatment to further improve the client-therapist relationship.
Because of the generous sponsorship of ORCA, this information has been presented in poster format to the conference of American Mormon Counselors and Therapists in Salt Lake City on October 1, 2009. Additionally, thanks to ORCA, presentation of this research will be given during the Utah Conference for Undergraduate Research in February of 2010. Further submission of this information has been received by the American Psychological Association for consideration of presentation to their next conference, permission is pending.
A very special thanks to ORCA whose funding allowed for the preparation, the printing of materials, and the travel to conferences. Thanks to ORCA and to Dr. Tim Smith for this immeasurable experience which has instilled in me hope and confidence in the research field. And of course, a great big thank you for the coders and fellow researchers on Dr. Smith’s team: Heather Stephenson, Jennell Maunder, Kibby Terry, Shelly Gearheart, Josh Kirton, Kirti Potkar, Nikki Armstrong, Mindy Pearson and all you others who came before, who have laughed with me so much and have taught me even more.