Pairing ethnic minority clients seeking mental health treatment with therapists that share the same ethnic background has been demonstrated to increase treatment utilization and lower rates of drop out. Considerably less research has explored the active ingredient in ethnic match and what about it is causing these changes. this study proposes that ethnic match is actually a proxy for cultural match, in which clients and therapists from a shared cultural background share similar attitudes, values, and cultural beliefs about different mental health topics. this assumed shared belief can influence session content which then serves as a moderator for treatment utilization. in a sample of 4,924 clients seen at a university counseling center, ethnic match significantly increased treatment stays for ethnic minority patients. it also reduced one-session attrition rates. hierarchical logistic regressions revealed that the odds of certain issues being discussed in therapy changed depending on the presence of an ethnic match and that these patterns were not consistent across ethnic groups. African American clients were significantly more likely to discuss substance use when paired with an ethnically matched therapist, but Asian American clients were significantly less likely to do so. latino/a clients were more likely to discuss sexual identity when ethnically matched. A moderation analysis also examined which issues were associated with longer treatment stays. For Asian Americans, the issues associated with increased utilization were sexual identity and academic concerns. in latino/as these issues were sexual identity, drug use, sexual abuse, racism, and academic problems.