Therapist differences in symptom change with racial/ethnic minority clients

Some psychotherapists produce better outcomes than others (Crits-Christoph & Mintz, 1991; Kraus, Castonguay, Boswell, Nordberg, & Hayes, 2011), although it has not been established whether therapists vary in their effectiveness with racial/ethnic minority (REM) clients. The importance of identifying therapist factors associated with successful outcomes for REM clients is underscored by imperatives regarding the provision of culturally competent psychotherapy (American Psychological Association, 2003; Smith, Rodriguez, & Bernal, 2011) and by research demonstrating the existence of ethnic disparities in mental health problems (Hayes, Chun-Kennedy, Edens, & Locke, 2011a) and their treatment (Harris, Edlund, & Larson, 2005). In this study, we investigated 36 therapists and 228 clients seen at a university training clinic to investigate whether differences in therapist effectiveness were a function of client ethnicity. Clients completed the Outcome Questionnaire-45 prior to each session. Multilevel modeling analyses indicated that (a) outcomes for REM and non-REM clients did not differ, (b) some therapists produced better outcomes than others, and (c) this variability was due in part to client REM status. Thus, it appears that therapists vary in their effectiveness at reducing symptoms with REM clients. Implications for training, multicultural theory, and future research are discussed.