Racial Biases in Therapy: The Effect of Race and Racial-Awareness on Therapeutic Diagnoses

Previous research indicates that therapists express racial biases towards clients of color. Therefore, the present study investigated whether diagnoses vary depending on clients’ race and therapists’ level of racial-awareness. It was hypothesized that therapists with no racial-awareness would rate Black clients differently on psychiatric symptoms compared to White clients. In contrast, therapists with racial-awareness were expected to rate Black clients similar to White clients. Concerning the attribution of causation and solution of the problem the reversed pattern was expected. The final sample included 21 therapists and 13 prospective therapists. Participants were randomly assigned to either a Black or White client vignette, which they had to assess by using the Brief Psychiatric Rating Scale (BPRS) and the Attribution of Causation and Solution Questionnaire. To manipulate awareness of racism, one group received racial-awareness training prior to the assessment task. Results showed that the Black client was rated lower on depression compared to the White client, but only if therapists had no racial-awareness. No differences were found between groups regarding psychotic symptoms. Concerning the attribution of causation and solution it was found that therapists with no racial-awareness rated the Black client equal to the White client. In addition, a trend indicated that therapists with racial-awareness rated the Black client lower compared to the White client. These findings suggest that assessment vary depending on clients’ race. However, racial-awareness seems to reduce biases, thereby facilitating a more accurate assessment of clients of color