Interaction of client class and gender in biasing clinical judgment.

Abstract

Class and gender and determinants of therapists' perceptions of clients were investigated in a survey of 418 psychologists presented with a case history that manipulated all possible combinations of client class (working/middle) and gender (male/female). Findings suggest that among male clients, the higher the social class, the more favorable the therapists' attitude; among female clients, the trend is in the opposite direction. Results are discussed in the context of the sexual division of labor and differential expectations for male and female clients in therapy.

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

“…Middle‐class individuals were more likely to be recommended for psychotherapy and were expected to do better in psychotherapy than were lower‐class individuals, and when psychotherapy was recommended, the lower‐class individuals were more likely to be referred for supportive psychotherapy and the middle‐class individuals were more likely to be referred for insight‐oriented therapy (Franklin, 1985; Levy & Kahn, 1970; Neumann, Salganik, Rabinowitz, Bauer, & Kastner, 1990; Rabinowitz & Lukoff, 1995; Routh & King, 1972; Rowden, Michel, Dillehay, & Martin, 1970; Sutton & Kessler, 1986; Umbenhauer & DeWitte, 1978). [However, in one study, Settin & Bramel (1981), the difference was not statistically significant, and in another study, Hardy & Johnson (1992), the difference was not statistically significant and the direction of the difference was not described though even in this study there was a tendency for clinicians to say that they were less attracted to the lower‐class clients.] In all of the studies except one (Neumann et al, 1990), different groups of clinicians were given case vignettes that were identical except for the designation of social class.…”

“…Stearns et al (1980) also reported that the effect of client gender was not statistically significant when clinicians made ratings for 20 other personality traits. Finally, a female actor portraying a client was rated as being more aggressive, ambitious, and independent than a male actor following the same script (Hayes & Wolleat, 1978), but nonsignificant results were obtained for ratings of these personality traits when clinicians read case histories that were identical except for the designation of gender (Agell & Rothblum, 1991; Garfinkle & Morin, 1978; Settin & Bramel, 1981).…”

“…Prognostic ratings were never more favorable for lower‐class clients than for middle‐class or upper‐class clients. In several studies, prognostic ratings did not vary as a function of social class when different groups of clinicians were given identical case histories except for the designation of social class (Foon, 1989; Settin & Bramel, 1981) or when they were given identical Rorschach test results except for the designation of social class (Koscherak & Masling, 1972). Similarly, prognostic ratings did not vary as a function of social class when clinicians interviewed actors who portrayed clients (Wright & Hutton, 1977).…”

“…Females were rated as being more emotionally mature and intelligent than males in one study (Fischer et al, 1976), but equally emotionally mature and less intelligent in a replication study (Dailey, 1980). Similarly, females were rated as being less competent than males in one study (Settin & Bramel, 1981), but more competent in a second study (Stearns, Penner, & Kim‐mel, 1980). Stearns et al (1980) also reported that the effect of client gender was not statistically significant when clinicians made ratings for 20 other personality traits.…”

Gender Differences in Living Skills and Global Assessment of Functioning Among Outpatients with Schizophrenia

“…It may be that the clinician raters give lower GAF scores to women as compared to men because they expect that all women, whether suffering from mental illness or not, should be able to do housework which expectation they do not have for men. Some previous studies have also suggested that gender-role values and attitudes of treatment personnel may influence their clinical judgements [20, [21], [22]].…”