Diagnostic judgments as a function of client and therapist race

Race bias, social class bias, and gender bias in clinical judgment.

“…In all of the studies, different groups of clinicians were given different case histories that were identical except for the designation of race, or they watched videotapes of actors portraying clients and the videotapes were identical except for the race of the actors. When prognostic ratings made by White and Black clinicians were pooled together, prognoses were more favorable for Black clients than for White clients in three studies (Lewis et ah, 1990; Schwartz & Abramow‐itz, 1975; Strickland et al, 1988) and equally favorable for Black clients and White clients in one study (Rabi‐nowitz & Lukoff, 1995). When ratings were analyzed separately for White and Black clinicians, prognoses made by White clinicians were unaffected by client race (Bloch et al, 1980; Franklin, 1985), but Black clinicians tended to make prognoses that were more favorable for Black clients than White clients (Benefee et al, 1976; Franklin, 1985).…”

“…When clinicians made ratings of severity of mental disturbance or level of adjustment, the effect of race was generally not statistically significant (Amira, Abramowitz, & Gomes‐Schwartz, 1977; Bamgbose et al, 1980; Benefee, Abramowitz, Weitz, & Armstrong, 1976; Bloch, Weitz, & Abramowitz, 1980; Franklin, 1985; McLaughlin & Balch, 1980; Schwartz & Abramowitz, 1975; Seligman, 1968; Strickland et al, 1988; Umbenhauer & DeWitte, 1978; also see Merluzzi & Merluzzi, 1978). In all of these studies, clinicians either read case histories or watched videotapes of interviews.…”

“…Ratings were made for African‐American, Mexican‐American, and White patients. When the effect of race was significant (Strickland et al, 1988), White patients were rated as having a more severe mental disturbance than Black patients.…”

“…Client race generally had no effect when judging (a) whether clients were likely to benefit from psychotherapy (Benefee et al, 1976; Blake, 1973; Franklin, 1985; Seligman, 1968; Vail, 1970), (b) whether clients should be seen for short‐term or long‐term psychotherapy (Bloch et al, 1980; McLaughlin & Balch, 1980; Tomlinson‐Clarke & Cheatham, 1993), and (c) whether clients should be seen in individual, couple, group, or family therapy and whether the therapy should be behavioral, nondirective, or insight‐oriented (Franklin, 1985; Lewis et al, 1990; McLaughlin & Balch, 1980; Schwartz & Abramowitz, 1975; Vail, 1970). In the few instances when client race was significant, the treatment recommendations were no more favorable for White clients than for Black clients (Benefee et al, 1976; Franklin, 1985; Strickland et al, 1988). For example, in one of the studies (Strickland et al, 1988), clinical psychology graduate students gave higher ratings of likelihood of successful therapy to Black clients than White clients.…”

“…When Black and White actors followed scripts to portray clients, statistically significant effects were found, but ratings were not consistently more favorable for Black clients or White clients. In the first study (Strickland et al, 1988), actors portrayed normal, neurotic, and psychotic clients. For the normal and neurotic clients, lower ratings of verbal facility were given to Black clients than White clients.…”