Whither the bias: The female client's "edge" in psychotherapy?

Abstract

The literature on gender bias in psychotherapy has been primarily concerned with gender bias against women. Both direct and indirect evidence is reviewed which suggests that along several dimensions women may in fact be favored as clients. This hypothesis was tested by examining ratings of the process-relevant interpersonal characteristics and gross outcome expectancies for 164 new male and female clients. Male clients were ascribed more negative interpersonal characteristics and poorer social skills. They were also rated higher on a composite "controllingness" variable. There was a significant client sex difference in expected duration of treatment, but no differences were found in expectancies regarding premature termination or treatment success.The last 15 years have seen the inception and tremendous growth of research on gender bias in psychotherapy, to the point where reviews and Thanks are due to Michael Russo, for his help with the data collection, and to the therapists and administrative staff who participated in and helped arrange the study. The support of the Computer Center at

Gender-fair psychotherapy in the United States: A possible dream?

“…Anecdotal and survey evidence lead us to believe that such bias continues to exist and it results in less effective therapy (Davidson & Abramovitz, 1980), but to prove it definitively has been more difficult (Heatherington, Mazzarella and Stetts, 1986;Steams et al, 1980). Evidence regarding the measured effects of therapists' attitudes, whether reportedly biased or gender-fair, has been mixed; it is replete with methodological problems as is the evidence for effectiveness of therapy generally (Garfield, 1986;Heatherington, Mazzarella and Stetts, 1986;Orlinsky & Howard, 1980;Smith, 1980;Whiteley, 1979). Some have argued that a therapist's values and expectations do not matter as long as she or he is aware and does not impose them (Smith, 1980;Whiteley, 1979).…”

“…It would seem equally probable based on other evidence, that choice of therapeutic goals and processes can be influenced by the therapist's expectations. Heatherington et al (1986) pointed out that gender bias in psychotherapy has been primarily concerned with gender bias against women. Results of their research indicated that therapists hold different expectations of male and female clients which they purported to be important to the process of therapy.…”

“…However, they present another, more affirming position. Heatherington et al (1986) argued that women are more desired as clients and more likely to become clients because there is a better 'correspondence between therapist's ideas about what client behaviors make for good therapy process and female clients' greater tendency to show these behaviors' (p. 255). They added: 'The implication here is that in addition to how therapists' bias may be operating against women in therapy, we must not overlook the opposite' (p. 255).…”

“…Male counselors surveyed demonstrated greater sex bias, whether by word or deed, and more restricted traditional occupational role conceptualization when working with or talking about female clients (Nickerson, 1978). More recent evidence indicates that both male and female therapists are able to view women and their potentiality in a less stereotypic manner (Heatherington, et al, 1986;O'Malley and Richardson, 1985).…”

Afterword

“…(3) Conclusions at present are often at least superficially contra dictory, e.g., one study may emphasize destructive stereotyping of female patients (see Stiver, 1986), while a second indicates biases operating which favor female patients (Heatherington, Stets and Mazzarella, 1986).…”