Behavior therapy for non-White, non-YAVIS clients: Myth or panacea?

Abstract

In response to research in the last two decades which increasingly has pointed to a lack of congruence between traditional aspects of insight-oriented therapy and the social facts and realities of non-white and non-YAVIS populations, a number of mental-health professionals have championed a move to more behaviorally oriented modalities as more appropriate and potentially prescriptive for these clients. This article points out the weak empirical bases for such claims and questions the failure of behaviorally oriented researchers to systematically examine either the relative utility of behavior therapy with poor and minority clients or its actual congruence with their life-styles and experiences.The mental-health field has traditionally, and often unsuccessfully, attempted to transfer concepts and techniques developed with white, middle-class, "young, attractive, verbal, intelligent, and successful" (YAVIS) clients (Schofield, 1964) in toto to populations which differ ethnically, socially, culturally, or economically (Jones, 1974;Lorion, 1974;Sue & Sue, 1977). Such undifferentiated use of insight-oriented approaches to psychotherapy and counseling has been found to result in therapists rejecting non-white, non-YAVIS clients for treatment, and in a high rate of premature termination Requests for reprints should be sent to

Psychotherapy, Classism, and the Poor: Conspicuous by Their Absence.

“…According to Siassi and Messer (1976), alternative “modalities of care suggested as appropriate for the lower classes may turn out to be inadvertent discrimination in disguise” (p. 32). Smith and Dejoie-Smith (1984) made a similar case with regard to the prescriptive use of behavioral therapy among poor and/or ethnically diverse populations. They demonstrated that claims of its greater effectiveness among such clients lacked empirical validation and cautioned that therapists who made use of such a “cookbook approach” (Smith & Dejoie-Smith, 1984, p. 528) could be perpetuating unsubstantiated generalizations about poor clients.…”

Why you hide what you know: Neuroscience behind knowledge hiding

“…The term YAVIS, which was coined by William Schofield of the University of Minnesota, essentially made it an acronym for “young, attractive, verbal, intelligent and successful.” Schofield underlined the typical soft treatment and the extra‐element of support towards these types of patients by the mental health professionals. Without any external intervention, these segments of individuals can form a very positive therapeutic relationship (Smith & Dejoie‐Smith, 1984; Tryon, 1981). The positive bias of the mental health professionals towards the YAVIS people often facilitates ways of knowledge hiding.…”

Middle class sprawl: Locating the psychologesque in the history of psychology.

“…Other evidence that a class may be involved is suggested by implicit class biases, presumably stemming from counselors’ and therapists’ own class prerogatives and worldviews, that are a persistent feature of the clinical and counseling landscape. Beginning at least with the coinage of “YAVIS” (young/affluent/verbal/intelligent/successful) in William Schofield’s (1964) Psychotherapy: The Purchase of Friendship , anxieties about discrimination based on class have never been far from the surface in counseling and psychotherapy (Smith & DeJoie-Smith, 1984; Kugelmass, 2016; McEvoy, 2020).…”