Attitudes of therapists varying in community mental health ideology and democratic values.

Abstract

The purpose of Lhis study was to investigate the relationship between therapists' scores on the Community Mental Health Ideology Scale and the Democratic Values Scale and their ratings of patient ease histories on a number of altitudinal dimensions. Thirty-three therapists rated each of eight case histories of psychiatric outpatients on likabilily, comfort, interest in treating, interest in friendship, and prognosis. Patients' social class, diagnosis, and insight level were systematically varied within the case histories. The results provide support for the contention that previously reported preferences for middle-class, high-insight, and less disturbed patients are related to therapists' degree of adherence to community mental health ideology and democratic values.There arc numerous reports showing that various patient characteristics are related to acceptance into psychotherapy (Garfield,

The politics of clinical judgment: Early empirical returns.

“…In nine (Briar, 1961;Efron, 1970;Haase, 1964;Kurtz et al, 1970;Lee & Temerlin, 1970;Levy & Kahn, 1970;Mintz, 1972;Stein et al, 1972;Trachtman, 1971) of the 14 analogue studies, less favorable clinical judgments were given to lower-as opposed to middle-class patients. Lower-class partisanship was found in three studies (Koscherak & Masling, 1972;Nalven et al, 1969;Routh & King, 1972), and equivocal or null results were obtained in two other studies (Amira et al, in press;Del Gaudio et al, 1976).…”

“…Clinician-subjects have included psychiatrists, clinical and school psychologists, social workers, nurses, psychiatric residents, clinical psychology interns and graduate students, and social work students. In seven (Amira et al, in press;Del Gaudio et al, 1976;Haase, 1964;Koscherak & Masling, 1972;Levy & Kahn, 1970;Nalven et al, 1969;Trachtman, 1971) of the 14 studies, the reported size of the professional (i.e., primarily nonstudent) sample was respectable. Subjects in three studies (Amira et al, in press;Levy & Kahn, 1970;Nalven et al, 1969) were drawn from nationally based professional organizations.…”

“…The first of the 14 analogue studies of social-class effects on clinical judgment (Amira, S. I. Abramowitz, & Gomes, in press;Briar, 1961;Del Gaudio, Stein, Ansley, & Carpenter, 1976;Efron, 1970;Haase, 1964;Koscherak & Masling, 1972;Kurtz, Kurtz, & Hoffnung, 1970;Lee & Temerlin, 1970;Levy & Kahn, 1970;Mintz, 1972;Nalven, Hofmann, & Bierbryer, 1969;Routh & King, 1972;Stein, Green, & Stone, 1972;Trachtman, 1971) was published in 1961, with the bulk appearing in the late sixties and early seventies. Since then, social-class analogues have virtually vanished from the literature.…”

“…Only two studies (Efron, 1970;Lee & Temerlin, 1976) employed another format, an audiotaped interview. The written stimulus contexts have ranged from psychological test scores (Nalven et al, 1969) and adjective descriptions (Mintz, 1972) only to Rorschach protocols (Haase, 1964;Koscherak & Masling, 1972;Levy & Kahn, 1970;Trachtman, 1971) and case reports or interview transcripts (Amira et al, in press;Briar, 1961;Del Gaudio et al, 1976;Kurtz et al, 1970;Routh & King, 1972;Stein et al, 1972).…”

“…This cue may have evoked an "anti-corporate-WASP effect" among the presumably liberal academics in the community-oriented training program from which subjects were recruited. In the Del Gaudio et al (1976) study, patient diagnosis and insight level were varied independently of social-class and proved to be more potent contributors to clinical judgment. The information value of social-class may have been artifactually reduced by the systematic manipulation of two attributes often believed to be inferred roughly from knowledge about socioeconomic status.…”