Doctoral Dissertation Research: Miserocchi: Therapist White Privilege Attitudes and their Effect on Client Outcomes and the Therapist-Client Therapeutic Relationship

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 (Davidson, Yakushka, & Sanford-Martens, 2004; Kearney, Draper, & Baron, 2005; Sue & Sue, 2008). Additionally, White therapists have been over-represented in professional and training settings (Ancis & Szymanski, 2001; Fouad & Arredondo, 2007; Hays & Chang, 2003; Pack-Brown, 1999). Add to that the fact that therapists have been trained in psychotherapy theories and approaches developed primarily by White men, and later practice counseling with clients based on these theories, and you have a system of counseling that works for some and not all. Thus, White therapists utilizing theories based in Whiteness 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). With these trends in mind, focusing on White therapists’ attitudes toward White privilege and the effect these attitudes could have on their clients of Color could be especially important. The field of counseling psychology has moved toward implementing a social justice and multicultural framework into all aspects of the profession. Crucial to this is a focus on cultural self-awareness in order to better understand one’s own biases. Awareness of White privilege is a form of self-awareness that is an important step to a greater awareness of how others are racially oppressed. Greater awareness may minimize the likelihood of a White therapist reenacting in session the oppression-privilege dynamic that exists in larger society, ultimately leading to more ethical treatment of clients. Most therapists are White, and most clients of Color underutilize mental health services, a sign that the mental health system is not accessible for all. By examining how White privilege attitudes impact the effectiveness of therapy and the therapeutic relationship, this study could shed light on how to improve therapy practice for all clients. With all of this in mind, understanding how therapists’ White privilege attitudes affect clients is crucial to moving toward a social justice and multicultural focus in counseling psychology, and crucial to practicing with all clients in an ethical and appropriate way. With this rationale in mind, I propose the following hypotheses for the proposed study: Hypothesis 1: White therapists will be differentially effective with clients of Color as compared to White clients. Hypothesis 2: Scores on the White Privilege Attitudes Scales (Pinterits, Spanierman, & Poteat, 2009) will be positively correlated with psychotherapy outcomes for clients, as measured by the Outcome Rating Scale (Miller & Duncan, 2000) and the number of attended sessions. Hypothesis 3: Scores on the White Privilege Attitudes Scales (Pinterits et al., 2009) will be positively correlated with client perceptions of the therapeutic relationship, as measured by the Session Rating Scale (Miller, Duncan, & Johnson, 2000). Hypothesis 4: Scores on the White Privilege Attitudes Scales (Pinterits et al., 2009) will be positively correlated with multicultural knowledge and awareness. The results of this study will contribute to multicultural counseling research and further the understanding of how a therapist’s White privilege attitudes may affect the process and outcome of therapy.