Effect of Client-Therapist Gender Match on the Therapeutic Relationship: An Exploratory Analysis

Abstract

Matching clients and counselors on the basis of heuristics, such as gender, is common in clinical practice. Considerable research has examined the effect of gender matching on the therapeutic alliance with equivocal results. Researchers have offered various hypotheses to explain these findings without consensus. This study sought to examine gender matching in a naturalistic setting and proposed that gender matching varies in importance depending upon the stage of the therapeutic relationship. It was hypothesized that gender matching affects the therapeutic alliance initially and then becomes less important as other factors come into play. Results did not support the hypothesis but showed a general "female effect." Across all stages of therapy, female clients matched with female therapists reported therapeutic alliance ratings higher than dyads with a male therapist. Dyads with a female therapist and male client also reported alliance higher than male gender matched dyads. Implications of these results, limitations, and future directions are discussed.

Client and therapist match on gender, age, and income: Does match within the therapeutic dyad predict early growth in the therapeutic alliance?

“…This particular level of gender match appears to be associated with significant initial downturns in alliance ratings, but that seem to rectify in a positive direction from the fourth session onward. These results provide an additional source of data to discuss the so-called "female effect" outlined by Bhati (2014), and that refers to a general finding of more positive therapeutic alliance ratings for female therapist matched with female clients. Our findings do not support this effect when the session-to-session growth of the alliance is modeled and initial severity of clients is controlled.…”

“…The literature is far more equivocal when it comes to the influence of client–therapist gender match on treatment outcome in general and on the therapeutic alliance specifically (Flaskerud & Liu, ; Bhati, ). Regarding the effects of dyad gender‐match on treatment outcome the literature is vast, with multiple studies reporting mixed findings (Blow, Timm, & Cox, ; Fowler, Wagner, Iachini, & Johnson, ; Wintersteen, Mensinger, & Diamond, ; Johnson & Cladwell, ; Bhati, ). It is likely that equivocal results can be attributed to sampling and design disparities between studies (Bhati, ; Flaskerud, ).…”

“…Regarding the effects of dyad gender‐match on treatment outcome the literature is vast, with multiple studies reporting mixed findings (Blow, Timm, & Cox, ; Fowler, Wagner, Iachini, & Johnson, ; Wintersteen, Mensinger, & Diamond, ; Johnson & Cladwell, ; Bhati, ). It is likely that equivocal results can be attributed to sampling and design disparities between studies (Bhati, ; Flaskerud, ). Regarding specific effects of gender match on the alliance, results are also equivocal.…”

“…Given these findings, it is reasonable to wonder whether salient similarities between participants, such as age, gender, and socioeconomic status, may affect the development of the therapeutic alliance, particularly at the beginning of the treatment, when other deeper and more complex personal attributes of client and therapists may not yet be available. In clinical practice settings, case assignment based on demographic similarities between clients and therapists may contribute to the early development of positive therapeutic alliances and may thus constitute a relevant and practical case assignment heuristic across treatment settings (Wintersteen, Mesinger, & Diamond, , Bhati, ).…”

“…In clinical practice settings, case assignment based on demographic similarities between clients and therapists may contribute to the early development of positive therapeutic alliances and may thus constitute a relevant and practical case assignment heuristic across treatment settings (Wintersteen, Mesinger, & Diamond, 2005, Bhati, 2014. PREVIOUS RESEARCH ON DEMOGRAPHIC ATTRIBUTE MATCHING…”