In this study, we sought to compare racial/ethnic minority participants' preference for racial/ethnic matching in psychotherapy with preferences for other methods of addressing cultural factors in treatment. Using a delay-discounting method, college students (331 racial/ethnic minority students from 2 universities) and a nationwide sample of self-reported clients (n = 77) were asked to indicate their strength of preference for 4 different methods for addressing culturally related variables in psychotherapy, including a desire to (a) work with a therapist whose race/ethnicity matches their own, (b) work with a therapist with a high level of multicultural training and experience, (c) receive a culturally adapted treatment, and (d) receive a therapist who is also a member of a racial/ethnic minority group, but not the same as the participant (i.e., a racial/ethnic minority pairing). We found that participants were willing to make significant sacrifices in treatment efficacy in order to receive each of the variables tested. In both samples, preferences were significantly stronger for therapist multicultural training/experience and use of culturally adapted treatments compared with racial/ethnic matching and racial/ethnic minority pairing. Further analyses indicated that clients expressed stronger preferences for racial/ethnic match and minority pairing than college student participants, and preference strength for 3 of the 4 scenarios was significantly related to strength of minority culture identification. The results of this study have important implications for preference accommodation in psychotherapy with racial/ethnic minority individuals.

Presented herein is a comparative study of group treatments for posttraumatic stress disorder (PTSD). In this study, an emerging intervention, memory specificity training (MeST), was compared with cognitive processing therapy (CPT) using standardized outcome measures of target symptoms (i.e., anxiety and depression from client perspective; memory specificity from independent rater perspective) and global functioning (independent rater perspective), as well as a process measure of expectancy (client perspective). Clients were assessed on 3 separate occasions: at baseline, posttreatment, and 3 months posttreatment. Adherence and treatment fidelity (independent rater perspective) were monitored throughout the course of both treatment conditions. Improvement in PTSD symptoms, depressive symptoms, and global functioning were similar between MeST and CPT; an increase in ability to specify memories upon retrieval was also similar between MeST and CPT. Positive reliable change was observed in both groups on all outcome measures. With respect to the primary target of PTSD symptoms, 88% of participants in both treatment groups moved into the functional distribution by posttreatment and maintained these gains at follow-up. Notably, compared with CPT, MeST required only half the dosage (i.e., number of sessions) to accomplish these gains. Illustrative vignettes from client-therapist exchanges are provided, and results are discussed in terms of the potential mechanisms of action. Implications for both clinical practice and clinical research are also included. (PsycINFO Database Record

Recent investigations have implicated client expectations of psychotherapy as a strong predictor of premature termination; however, there is reason to believe psychotherapist expectations may also impact client outcomes. This study sought to address this gap in the literature by examining the association of psychotherapists' expectations to clients' psychotherapy outcomes, including termination status. Participants were 54 current and recent trainee psychotherapists at a Southern public university, who completed delay discounting measures to assess their expectations of the effectiveness of psychotherapy. Data were also drawn from 300 adult clients who had received at least 2 sessions of individual psychotherapy from the participating psychotherapists of this study, and had previously completed the Outcome Questionnaire 45.2 prior to each individual therapy session. Psychotherapists were found to hold significantly higher expectations for client improvement than anticipated, based on existing literature, and these high expectations were found to be positively correlated with clinically significant change in clients. Moreover, psychotherapists' expectations were found to explain 7.3% of the explainable variance in whether or not clients experienced clinically significant change during psychotherapy. Implications for improving client retention and treatment outcome are discussed.

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