Date of Award

12-2019

Document Type

Campus Access Thesis

Degree Name

Master of Arts (MA)

Department

Clinical Psychology

First Advisor

Sarah A. Hayes-Skelton

Second Advisor

Lizabeth Roemer

Third Advisor

Alice Carter

Abstract

The goal of the present study was to investigate how client appraisals of therapist attributes influence the client’s propensity to trust a particular therapist and how client trust in the therapist may impact client retention after a first session of therapy. The proposed model of trust development in the therapist-client relationship may provide insight on how client appraisals of therapist attributes (operationalized as ability, empathy, congruence, level of regard, and unconditionality) influence client trust in their therapist during the first session of therapy. The current study assessed participants for their propensity to trust at baseline and then presented them with a vignette of a multiculturally informed, hypothetical first session of therapy. Role induction was used to prompt participants to imagine themselves as the client in a dialogue with a therapist, who was randomized to either be perceived to be from the same (racial match) or from a different (racial mismatch) racial and ethnic group as the therapist. Participants then completed a survey assessing their attributions of trust in the vignette therapist, based on their appraisals of therapist attributes. The sample consisted of 162 participants (mean age= 20.29) from various racial and ethnic identities. The results indicated that client propensity to trust and appraisals of therapist ability, congruence, empathy, level of regard, and unconditionality were associated with trust development in a hypothetical first session of therapy; however, only therapist ability, empathy, and level of regard uniquely predicted trust development. In addition, the level of regard significantly moderated the relation between client propensity to trust and trust development. Participants’ appraisals of trust development in a therapist-client relationship was associated with expectations of client retention. Lastly, among participants of color, racial match and mismatch significantly moderated the relation between client propensity to trust and trust development in the therapist-client relationship in a hypothetical first session of therapy. Overall, our findings may inform the mechanisms underlying trust development in the therapist-client relationship, which may hold important implications for clients of color, who face an increased risk for psychotherapy dropout. This research may start to address the severe lack of research on therapy retention and engagement for People of Color and, subsequently, empirically supported treatments for these populations.

Comments

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