Date of Graduation

12-2019

Document Type

Thesis

Degree Name

Master of Arts in Psychology (MA)

Degree Level

Graduate

Department

Psychological Science

Advisor

Ana J. Bridges

Committee Member

Lindsay S. Ham

Second Committee Member

Denise R. Beike

Keywords

Alliance, Biases, Cultural Humility, Microaggressions, Psychotherapy, Social Privilege, Treatment Engagement

Abstract

Strengthening therapeutic alliance through social identity matching has been a strategy used to reduce psychotherapy dropout among racial/ethnic and sexual minority clients. Limited research has examined social identity match by manipulating social identity (e.g., race/ethnicity, sexual orientation) in an analogue therapy setting. This study (1) assessed whether self-reported alliance was positively associated with theoretical proxies of alliance and (2) examined the effects of racial/ethnic and sexual orientation match on therapeutic alliance (self-reported) and proxies of alliance (perceived similarity, liking, blame, empathy, closeness, microaggression proxies, verbal validation, and open body language). Participants (N = 71) were heterosexual White women interested in a mental health career. They were recruited for a study that ostensibly involved evaluating the impact of a brief training on clinical interviewing skills. All participants conducted a pre-training interview with a confederate who identified as either White (racial/ethnic match) or Latinx (racial/ethnic mismatch) and either heterosexual (sexual orientation match) or lesbian (sexual orientation mismatch). After the interview, participants completed self-report measures assessing perceived similarity, liking, therapeutic alliance, blame, empathy, and closeness. All interviews were video recorded, transcribed, and coded for participant behaviors (microaggression proxies, validation, and open body language). Results revealed only liking and empathy were associated with self-reported therapeutic alliance. There was a significant main effect of racial/ethnic match for three of nine analyses. Participants validated the confederate’s problems and demonstrated more open body language when the confederate identified as White instead of Latinx. Participants asked the confederate, “Where are you from?” more often when she identified as Latinx instead of White. There was also a main effect of sexual orientation match for three of nine analyses. Specifically, participants perceived the confederate as more similar and liked her more when she identified as heterosexual instead of lesbian. Participants discussed the confederate’s romantic relationship more when she identified as lesbian instead of heterosexual. There were no statistically significant interaction effects to suggest endorsing two unmatched identities was worse for therapeutic alliance than one unmatched identity. Findings suggest therapists may be engaging in biased behaviors when they interact with clients of diverse social identities.

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