‘To show or No-show’? Therapist Racial-ethnic Disparities in Clients’ Nonattendance in Therapy

D. Martin Kivlighan, Ae Kyung Jung, Alayna B. Berkowitz, Joseph H. Hammer, Noah M. Collins

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Clients’ nonattendance in therapy poses a significant threat to the effective delivery of mental health services at university counseling centers. As such, researchers have investigated processes related to clients’ nonattendance in an effort to increase treatment utilization and treatment outcomes. However, there is a paucity of research testing the impact of the therapist on clients’ nonattendance patterns. Additionally, it is unknown whether therapists vary in the nonattendance of their racial/ethnic minority (REM) and White clients. Therefore, the present study sought to identify therapist effects in client nonattendance rates, and examine between-therapist disparities in REM and White clients’ nonattendance patterns. Data for this study consisted of 275 REM and 341 White clients seen by 21 therapists at a large university counseling center. Results indicated that therapists accounted for 14% of the variability in clients’ nonattendance. Additionally, therapist effects in nonattendance due to clients’ REM status were identified, suggesting that therapists are a significant source of racial/ethnic disparities in clients’ nonattendance. REM clients’ nonattendance rates were higher compared to White clients for some therapists, but not others. Clinical implications and future research are discussed.

Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalJournal of College Student Psychotherapy
Issue number1
StatePublished - Jan 2 2019

Bibliographical note

Publisher Copyright:
© 2018, © 2018 Taylor & Francis.


  • Nonattendance
  • no show
  • racial/ethnic disparities
  • therapist effects
  • university counseling center

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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