Abstract
Several studies have examined whether therapist-client match on ethnicity and other demographic variables (e.g., gender, sexual orientation) influences treatment efficacy and satisfaction (e.g., Bhati, 2014; Presnell, Harris, & Scogin, 2012) with psychotherapy. While some suggest that matching on demographic variables may improve attrition rates, most studies do not support the view that matching on ethnicity and related variables enhances treatment efficacy. For example, two recent studies, tested a newly developed, family focused, culturally informed therapy for schizophrenia (CIT-S), and found that while the treatment is effective for reducing patient symptoms (Weisman de Mamani, Weintraub, Gurak, & Maura, 2014) and caregiver burden (Weisman de Mamani & Suro, 2015), no differences were found in treatment efficacy or on consumer satisfaction with treatment at termination when patients and therapists were matched versus mismatched on ethnicity. In this study, we examined the effect of therapist-client similarity on variables that go behind surface level demographic characteristics. Specifically, we proposed to examine therapist-client similarity in two key areas, religiosity/spirituality and interdependence, in a sample of 48 key family members and 36 patients with schizophrenia who were enrolled in CIT-S or a psycho-education only comparison condition (PSY-ED). We chose to examine these two areas because CIT-S specifically targets these values and practices. Discrepancy values from the 14-item Intrinsic/Extrinsic Revised Scale (I/E) and the 12-item Interdependent Subscale from the Self-Construal Scale (SCS) were calculated by taking the absolute value of the differences between client scores and their therapist scores. Contrary to hypotheses, therapist-client similarity in religious beliefs and values, as well as family collectivistic values, was not predictive of any outcome variable for neither patients nor family members, in either condition. Results suggest that having similar religious or family backgrounds offers no advantage in improving religious and family based treatments for schizophrenia. It may be that therapist personal characteristics, such as flexibility, honesty and openness, may be more important than actual matched values. This is encouraging because results suggest that treatment can be satisfying and efficacious regardless of therapist-client match. In other words, therapists can be competent and successful without holding values that are highly similar to those of the clients that they serve. A content analysis of sessions with the most and least discrepant therapist-client dyads was also conducted to help clarify results. Insights from these analyses are examined in the discussion section.