Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Arts (MA)


Clinical Psychology

First Advisor

Lizabeth Roemer

Second Advisor

Tahirah Abdullah

Third Advisor

Abbey Eisenhower


Mental health disparities for Black people of diverse ethnicities compared to people of other racial identities has been well-documented (Alegría et al., 2008; Maura & Weisman de Mamani, 2017). Research addressing this pervasive systemic and interpersonal problem often focuses on client-related factors that create or intensify barriers to care. However clinician-related factors (i.e., racial identity, multicultural training, implicit biases, behavior, etc.) also have a significant impact on barriers to care, retention in therapy, and clinical outcomes for people of African descent (Larrison & Schoppelrey, 2011; Owen, Imel, Adelson, & Rodolfa, 2012). Researchers suggest that the favoring of historically white perspectives, enactment of overt discrimination and bias in therapy, and the prevalence of microaggressions committed even by well-meaning therapists contribute to stigma about mental health care, attrition, and disruption of the therapeutic alliance for clients of African descent (Constantine, 2007; Gómez, 2015; Owen et al., 2012).

The current study sought to understand what types of behavior from therapists are most likely to lead to positive outcomes for Black clients with a variety of cultures and ethnicities. Responses to three categories of therapist behavior were examined: 1) Culturally Sensitive behaviors, which exemplify methods encouraged by common multicultural training, 2) Counterstereotypical behaviors, involving particular attention to the impact of a context of racial stereotypes, and 3) Well-Intentioned but Harmful Approaches or Methods (WHAMs), which include microaggressive behaviors common to well-meaning therapists. Participants responded using four variables associated with positive mental health outcomes: trust, belief in genuine investment, disclosing deeper feelings, and likelihood to return.

Results indicated that the three therapeutic behavior categories were not psychometrically distinct; however, Culturally Sensitive and Counterstereotypical behaviors generally received significantly higher ratings of likelihood to return, trust, belief in genuine investment, and likelihood of disclosing deeper feelings than WHAM behaviors. Complex patterns of responses were found related to participant ethnicity.

This research indicates a positive effect of understanding, acknowledging, and addressing the context of negative and seemingly positive stereotypes that people of African descent are forced to navigate. Future studies could improve upon this one by further qualitatively investigating how Black people perceive each specific behavior included in the vignettes.