Therapist multicultural competency: A study of therapy dyads.

[Correction Notice: An erratum for this article was reported in Vol 44(1) of Psychotherapy: Theory, Research, Practice, Training (see record 2007-04278-014). The fifth author's name should be spelled as follows: Alexa Mislowack.] This study examined the role of therapist multicultural competence (TMC). Fifty-one therapy dyads completed measures of therapist multicultural competency, working alliance, and their satisfaction with therapy. Clients also completed measures of therapist attractiveness, expertness, trustworthiness, and empathy. Results showed strong associations between clients' ratings of TMC and ratings of the working alliance, therapist empathy, and satisfaction. Clients' combined rating of therapist expertness, attractiveness, and trustworthiness were not associated with their TMC ratings but were significantly associated with therapists' self-appraised TMC ratings. Therapists' ratings of their TMC were associated with their ratings of the working alliance and satisfaction with their work. Results are discussed in the context of the relevant literature, as are implications for training and research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Racial microaggressions against African American clients in cross-racial counseling relationships.

This study examined the relationships among African American clients' perceptions of their White counselors with respect to (a) perceived racial microaggressions in cross-racial counseling relationships, (b) the counseling working alliance, (c) their counselors' general and multicultural counseling competence, and (d) their counseling satisfaction. Findings revealed that greater perceived racial microaggressions by African American clients were predictive of a weaker therapeutic alliance with White therapists, which, in turn, predicted lower ratings of general and multicultural counseling competence. Greater perceived racial microaggressions also were predictive of lower counseling satisfaction ratings. In addition, African American clients' perceptions of racial microaggressions had a significant indirect effect on these clients' ratings of White counselors' general and multicultural counseling competence through the therapeutic working alliance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' perceptions of their psychotherapists' multicultural orientation.

The current retrospective study examined whether clients' (N = 176) perceptions of their psychotherapists' multicultural orientation (MCO) were associated with their psychological functioning, working alliance, and real relationship scores. Moreover, we tested whether clients' perceptions of the working alliance and the real relationship mediated the relationship between clients' perceptions of their psychotherapists' MCO and psychological functioning. The results showed that clients' perceptions of their psychotherapists' MCO were positively related to working alliance, real relationship, and psychological functioning. Only clients' ratings of the working alliance mediated the relationship between clients' perceptions of their psychotherapists' MCO and psychological functioning. Thus, because clients perceive their psychotherapists as being more oriented toward cultural issues, they may view the therapist as being more credible and may gain a sense of comfort in the therapeutic process. In turn, clients' strong alliance facilitates improvement in psychological well-being. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effects of metaphors and cognitive complexity on perceived counselor characteristics.

Compared the effects of 3 types of counselor-offered metaphors, varying in levels of complexity, to facilitative responses on tests of perceived empathy, regard, expertness, attractiveness, and trustworthiness. Cognitive complexity was measured with the Paragraph Completion Method, the Intolerance of Ambiguity Scale, and the Intolerance of Trait Inconsistency Scale. Empathy and level of regard were assessed by the Barrett-Leonard Relationship Inventory; perceived counselor expertness, attractiveness, and trustworthiness were measured by the Counselor Rating Form—Short Version. 80 undergraduates, crossed on levels of cognitive complexity, were assigned to 1 of 4 audiotaped treatment conditions: complex metaphor (CM), narrative analogy (NA), cliché (CL), and Level 3 facilitative response (L3). Results indicate that NA and L3 each produced more positive client ratings of empathy, regard, and expertness than CL. Cognitive complexity did not affect client ratings except for CM conditions. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A study of the interpersonal influence process in supervision.

Examined the interpersonal influence process between 20 counselor supervisors (SPs) and 33 trainees (TRs) in an applied setting over 15 wks. Specifically investigated was the relationship between TRs' perceptions of SPs' expertness, attractiveness, and trustworthiness and (a) SPs' and TRs' reported changes in TRs' professional and personal behaviors and attitudes and (b) both groups' perceptions of the supervisory relationship. There was not a significant relationship between the respective ratings of perceived expertness, attractiveness, and trustworthiness and either group's rating of the SPs' impact on TRs' personal and professional development. There was a positive correlation between TRs' perceptions of SP characteristics and both TRs' perceptions of the therapeutic relationship and their satisfaction with supervision. Findings are discussed in terms of S. R. Strong's (1968) 2-stage model of the influence process. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist multicultural competence, Asian American participants' cultural values, and counseling process.

Asian Americans drop out of mental health treatment at a high rate. This problem could be addressed by enhancing therapists' multicultural competence and by examining clients' cultural attitudes that may affect the counseling process. In the present study, we used a video analogue design with a sample of 113 Asian American college students to examine these possibilities. The result from a t test showed that the session containing therapist multicultural competencies received higher ratings than the session without therapist multicultural competence. In addition, correlational analyses showed that participant values acculturation was positively associated with participant ratings of counseling process, while the value of emotional self-control was negatively correlated. The results of a hierarchical multiple regression analysis did not support any interaction effects among the independent variables on counseling process. All of these findings could contribute to the field of multicultural competence research and have implications for therapist practices and training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of a paradoxical intervention on therapeutic relationship measures.

Compared paradoxical (PIs) and nondirective interventions (NDIs) along core therapeutic conditions and therapist–client relationship issues (attractiveness, expertness, trustworthiness) in 2 experiments to explore criticisms that PIs are manipulative and not genuine. In Exp I, 4 advanced doctoral students rated 4 tapes (2 NDIs and 2 PIs with high- and low-core conditions) for levels of warmth, empathy, and genuineness. Results show that although both NDI and PI high-core-condition tapes were rated high in empathy, warmth, and genuineness, the NDI high-core-condition tape was rated higher. In Exp II, 133 undergraduates rated the same tapes for therapist–client relationship variables. Results show that the PI was rated higher than the NDI in counselor expertness. It is suggested that findings challenge criticisms that PI is contraindicated for use in therapy because of properties that might interrupt or undermine the therapeutic process. An excerpt from one tape is included. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impressions of psychotherapists' offices.

For counseling settings, research suggests that softness, personalization, and order might affect the experience and the perceived expertness, trustworthiness, and social attractiveness of the therapist. This article discusses exploratory studies on college students' perception of the counseling office environment and whether the likely client experience was associated with the softness/personalization and order of the office. As stimuli, the studies used 30 color photographs of psychotherapists' offices viewed from the client's perspective. After obtaining ratings of the characteristics of each office, we obtained ratings from different groups of students of the quality of care and comfort expected in each office (Study 1) and how qualified, bold, and friendly the therapist in the office would be (Study 2). Additional studies examined the likelihood of choosing a therapist based on the office, and the first thought or feeling that came to mind about the office, the therapist, and the patient experience. There were strong correlations in response between groups (by whether they had experienced therapy; their level in school; their gender; and their major, location, and school size). The quality of care, comfort, therapist boldness, qualifications of the therapist, and the likelihood that one would choose a therapist based on the office improved with increases in the office's softness/personalization and order. Friendliness improved with increases in softness/personalization. The office choices, open-ended responses, and reported reasons for the ratings confirmed the importance of softness (comfort) and order. Research should test longer term exposure and behavior. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

General and multicultural case conceptualization skills: A cross-sectional analysis of psychotherapy trainees.

The general and multicultural case conceptualization skills of 91 psychotherapy trainees were evaluated for complexity and expertness across 3 case scenarios. The cases varied in the extent to which culture was presented in the demographic information and presenting concerns. Whereas general case conceptualization skills were found to relate to clinical training, multicultural case conceptualization skills were found to relate to multicultural training. Across cases, advanced trainees demonstrated significantly greater complexity and expertness than beginners. Trainees consistently included more culturally relevant ideas when culture was explicitly stated in the case as a presenting problem, versus when culture was implied. Last, consistently significant differences in the case conceptualizations of White trainees and trainees of color were not found. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client and therapist variability in clients' perceptions of their therapists' multicultural competencies.

This study examined therapist differences in their clients' ratings of their therapists' multicultural competencies (MCCs) as well as tested whether therapists' who were rated as exhibiting more MCCs also had clients who had better therapy outcomes (N = 143 clients and 31 therapists). All clients completed at least 3 sessions. Results demonstrated that therapists accounted for less than 1% of the variance in their clients' Cross-Cultural Counseling Inventory–Revised (CCCI-R; T. D. LaFromboise, H. L. K. Coleman, & A. Hernandez, 1991) scores, suggesting that therapists did not differ in terms of how clients rated their MCCs. Therapists accounted for approximately 8.5% of the variance in therapy outcomes. For each therapist, their clients' CCCI-R scores were aggregated to provide an estimate of therapists' MCCs. Therapists' MCCs, based on aggregate CCCI-R scores, did not account for the variability in therapy outcomes that were attributed to them. Additionally, clients' race/ethnicity, therapists' race/ethnicity, or the interaction of clients'–therapists' race/ethnicity were not significantly associated with clients' perceptions of their therapists' MCCs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Salient attributes of two types of helpers: Friends and mental health professionals.

Asked 211 undergraduates to rate the importance of expertness, attractiveness, and trustworthiness for a friend and a mental health professional from whom they might seek help. Three levels of perceived attributes and 2 levels of type of helper were manipulated. Results indicate the salient attributes of a professional were perceived expertness and trustworthiness, whereas the salient attributes of a friend were perceived attractiveness and trustworthiness. The findings are discussed in terms of help-seeking behavior and the perceived credibility of helpers. It is suggested that the perceived credibility of helpers may be dependent upon the perception of trustworthiness in conjunction with the perception of either expertness or attractiveness. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Power of nonverbal cues in counseling interactions: Availability, vividness, or salience?

Tested 3 explanations for the differential impact of verbal and nonverbal cues on perceptions of counselor expertness, attractiveness, and trustworthiness. These explanations involved cue availability (abundance of nonverbal over verbal cues), vividness (concreteness and imagery-provoking nature of nonverbal cues), and salience—vividness (an interaction between the vividness of the cues and the level of arousal of the perceiver). 45 male and 45 female undergraduates were divided into 6 experimental groups to view tapes of counseling interactions. The tapes included 3 expertness tapes representing 3 levels of verbal/nonverbal cues and 3 attractiveness tapes representing the same 3 levels. The independent variables studied were arousal and number of verbal and nonverbal cues. After viewing both an expertness tape and an attractiveness tape, Ss completed an adjective checklist and an instrument designed to measure dimensions of perceived expertness, attractiveness, and trustworthiness. Findings suggest that cue availability is not a compelling explanation for the power of nonverbal communications, that vividness accounts for differential cue effectiveness with certain dependent variables, and that salience is not a prerequisite for the vividness effect to occur. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of counselor qualities: Impact of subjects' self-concepts, counselor gender, and counselor introductions.

Examined the extent to which a counselor quality (reputed expertise) and a client quality (self-concept) were interactive with counselor gender and with each other as determinants of Ss' perceptions of the counselor. 105 male undergraduates were split into high- or low-self-concept groups according to their scores on the Tennessee Self-Concept Scale and listened to an audiotape of a male or female counselor who was introduced as an expert counselor or a nonexpert counselor or who was given no introduction. Ss then used the Counselor Rating Form to rate the counselor. Consistent with previous research, the expertness manipulation affected ratings of the counselor, whereas counselor gender alone did not. No interaction between counselor gender and expertness introduction was obtained, although one interaction (for attractiveness) was obtained for S self-concept by expertness introduction. Three-way interactions were obtained for perceived counselor expertness, attractiveness, and trustworthiness. These results suggest that although S self-concept alone does not determine perceptions of the counselor, it is one recipient characteristic that interacts with the counselor characteristics of gender and ascribed expertise. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Racial and attitudinal factors affecting the perceptions of counselors by Black adolescents.

Presented to 247 Black male and female high school students racial and attitudinal information about a hypothetical male or female counselor and asked them to express their perceptions of the counselor. Attitudinal information about a counselor had a stronger effect than racial information on Ss' perception of the counselor: Counselors portrayed as attitudinally similar were rated significantly higher in attractiveness, trustworthiness, expertness, and social attraction than those portrayed as attitudinally dissimilar. Racial information also influenced perceived attractiveness: White counselors were rated higher than Black ones in attractiveness, although there was no difference in ratings of trustworthiness or expertise. White female counselors were perceived as more expert than their Black female counterparts, whereas the ratings of male counselors were not influenced by the racial variable. Implications for counselor–client relationships and the development of mental health services for minority populations are discussed. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of paradoxical interventions on perceptions of the therapist and ratings of treatment acceptability.

Addressed ethical questions about the manipulative, deceptive nature of paradoxical interventions. Perceptions of the therapist and of the acceptability of paradoxical vs nonparadoxical directives were examined using simulation methodology. Participants (97 undergraduates) took part in a semester-long family simulation of excessive family arguing associated with a rebellious adolescent daughter. Before experimental manipulation, the "families" participated in 4 role-playing exercises and attended a family therapy session. They then received a letter from their therapist containing 1 of the 2 types of directives and, subsequently, responded to the dependent measures. Results indicated (1) paradoxical directives did not negatively influence perceptions of therapist attractiveness, expertness, or trustworthiness; (2) they were judged less acceptable than nonparadoxical directives, although neither was deemed unacceptable. Implications for clinical practice and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference, attachment, and the working alliance: The therapist's contribution.

This study examined the relationship among therapist attachment styles, countertransference behaviors, and working alliance. Fifty therapists in training and their supervisors participated in the study. Therapists completed a self-rated measure of attachment style and a measure of working alliance with 1 of their clients. Supervisors completed measures of working alliance and countertransference behaviors about their supervisee's relationship with the same client. Results indicate that therapist attachment style did not correlate with either countertransference behaviors or working alliance. However, negative countertransference was associated with poorer working alliances, and positive countertransference was related to a weak bond within the working alliance. Additional analyses indicate that disagreement among supervisors and therapists about the bond component was predictive of countertransference behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring the working alliance in advisor–advisee relationships in graduate school.

Drawing from the working alliance literature, the authors constructed the Advisory Working Alliance Inventory (AWAI) to measure the graduate advising relationship from the student's perspective. Two hundred eighty-one counseling psychology doctoral students participated in the 1st study (79% response rate). Three factors (Rapport, Apprenticeship, and Identification-Individuation) were extracted by factor analysis. The AWAI showed very good internal consistency reliability. Scale validity was supported by positive correlations between the AWAI and measures of advisee research self-efficacy and attitudes toward research, as well as the perceived expertness, attractiveness, and trustworthiness of the advisor. Forty-one students participated in the 2nd study, in which the AWAI demonstrated excellent test-retest reliability over a 2-week interval. Implications of the advising working alliance are discussed for doctoral training and areas for future research are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"The association between global and specific measures of the therapeutic relationship": Erratum.

Reports an error in "The association between global and specific measures of the therapeutic relationship" by Nick F. Coady and Elsa Marziali (Psychotherapy: Theory, Research, Practice, Training, 1994[Spr], Vol 31[1], 17-27). This article contained, as Figure 1, an SASB model. The authorship and copyrights for the model were not acknowledged. The following acknowledgement should have been included: "From Benjamin (1983), Intrex User's Manual. Intrex Interpersonal Institute, P.O. Box 581037, Salt Lake City, UT 84158. Reprinted by permission." An apology is offered to the author, Dr. Lorna Smith Benjamin. The particular version used in the article was developed in collaboration with Clinton W. McLemore. (The following abstract of the original article appeared in record 1994-46203-001.) Examined the association between global and specific measures of the therapeutic relationship in Sessions 3, 5, and 15 of 9 cases of time-limited psychodynamic psychotherapy. L. S. Benjamin's (see PA, Vol 53:2991; see also, 1984) structural analysis of social behavior (SASB) model provided the specific measure of relationship. There were more consistent associations between ratings of client contributions to the alliance and SASB ratings of client behaviors than there were for the same therapist variables. Additionally, analyses show that external (i.e., nonself) judgments of client and therapist contributions to the alliance, rather than therapist or client self-ratings of contributions to the alliance, were most frequently associated with the SASB behavior codes. Finally, different therapist and client behaviors seemed to be associated with quality of the therapeutic relationship at different points in the therapeutic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-reported multicultural supervision competence of White predoctoral intern supervisors.

This study assessed the self-reported supervision practices, experiences, and multicultural competence of White intern supervisors (n = 211). White training directors and staff psychologists who were currently supervising predoctoral interns completed a 2-page survey regarding their multicultural supervision. Female supervisors reported higher multicultural supervision competence and spent more time processing cultural differences with their supervisees than male supervisors. Training directors also reported higher multicultural supervision competence than staff psychologists. Further, the number of interns supervised currently and over a career significantly predicted multicultural supervision competence. Recommendations for White intern supervisors include ongoing participation in education and professional practice experiences to improve multicultural supervision competence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)