Gender Issues in Psychotherapy

The latest Psychotherapy (APA Div 29 journal, March 2011) is an interesting special issue on evidence-based psychotherapy relationships. Separate articles address various dimensions of psychotherapy including  alliance, empathy, positive regard, congruence, conter-tertransference, etc. Each article follows a fixed reporting format for the evidence base for the category, including “therapist variables” and “patient factors.” Gender as moderating therapist variable or patient factor was not included in the analyses.  

As usual, in my relentless effort to understand the factors that shape and condition out individual and collective existence, I started looking into the matter. In psychotherapy research, the pertinent terms would be gender, gender matching, and gender matching preference  as factors in process and outcome. The literature is very sparse.  In fact there does not appear to be a definitive study which addresses this issue, only a general consensus.

I contacted several of the authors — all prominent and well recognized in the field — and their responses were mostly equivocal, all stating the general consensus that gender is a non-issue in process or outcome. They could not point to research which definitively addresses the issue, however.

I did receive a fine, large unpublished study from a university counseling center which reviews the sparse lit, citing the position that “therapist sex is a poor predictor of outcome in therapy.” Although the findings report small effect sizes for duration, “the overall conclusion is that gender of the client or therapist, or the gender match between the client and the therapist has negligible impact on therapy outcome or duration of therapy for the average client.”

They note further “the assumption of some therapists that gender matching is broadly influential on therapy outcome and the most preferred form of treatment by clients does not appear ot have strong support in the research literature or the findings of this study.”

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