A strong therapeutic bond is imperative in order to achieve a successful outcome in psychotherapy. This bond must begin with the initial intake session. Research indicates that clients who feel disconnected from the clinician due to cultural, ethnic, or even religious differences, are more likely to terminate treatment as early as the first session.
To understand what factors influence this dynamic, Daniel C. Rosen of the Counseling and Health Psychology Department at Bastyr University led a study examining race/ethnicity and age among a mixed sample of clients and therapists. He focused his research on complementarity, the level of relational harmony, between the client and therapist, to determine which factors were most significantly related to developing a strong therapeutic bond upon intake.
Rose and his colleagues assessed 114 videos of intake sessions and found, contrary to their hypothesis, that ethnicity did affect complementarity, but only mildly. “Results indicated a significant interaction between Black client and Latino provider, as Affiliation complementarity scores were lower for this pairing compared to their White counterparts,” said Rosen. He also discovered that age impacted complementarity significantly more than race.
Specifically, the researchers found that clients who were matched with therapists close in age developed a stronger bond at intake. This could be due to the fact that people of the same age view life events with a similar perspective and have similar ideals. Additionally, major life concerns, such as growing older, divorce, or health issues, are ones that may be dealt with uniquely based on age. Rosen believes that taking these factors into account during the intake session could benefit the levels of adherence. He suggests that therapists address complementarity when they first meet a client by clearly outlining the purpose of the intake session and the overall plan of treatment. He also feels explaining expectations for future sessions will serve to enrich the relationship between the client and therapist and may help to break down any barriers of race or age.
Reference:
Rosen, D. C., Miller, A. B., Nakash, O., Halpern, L., & Alegría, M. (2012, January 23). Interpersonal Complementarity in the Mental Health Intake: A Mixed-Methods Study. Journal of Counseling Psychology. Advance online publication. doi: 10.1037/a0027045
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