Date of Award

2025

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

Lauren Lipner, PhD

Second Advisor

Michael Katz, PhD

Third Advisor

Ki Eun (Kay) Shin, PhD

Abstract

Patient preferences are defined as a patient’s desire for specific behaviors or attributes of the therapist or therapy (Arnkoff et al., 2002). Psychotherapy patients may hold a preference for a same-race therapist due to their perception that the therapist is similar to themselves, which may positively affect the therapeutic alliance (Cabral & Smith, 2011). However, since previous research has found mixed results on the positive effects of racial matching in psychotherapy (Cheng et al., 2023), another possible angle to examine the effects of racial matching on the therapeutic alliance is by taking patient preference into account. While data is limited on many racial groups in the literature, there is particularly scarce data on the Indian immigrant population (Misra et al., 2000). Therefore, this study examined the effects of racial match on the therapeutic alliance as moderated by preference among Indian immigrants living in the United States, as well as the reasons behind these preferences. It was hypothesized that when an Indian immigrant patient in psychotherapy was treated by a therapist perceived to be of their stated preference, they would exhibit a stronger therapeutic alliance than those who were not treated by a therapist perceived to be of their stated preference. 280 Indian immigrants currently in psychotherapy completed a three-part survey assessing their demographic information, therapeutic alliance, and preference for race of therapist. A regression analysis was used to examine the differences on WAI-SR scores between patients who perceived a racial match and a non-racial match, with preference as a moderator. The results of this study found that Indian immigrants who perceived a racial match with an Indian therapist had significantly higher WAI scores than Indian immigrants who perceived a non-racial match. Further, Indian immigrants who had no specific preference for the race of their therapist had significantly higher WAI scores than those who preferred an Indian therapist and those who did not prefer an Indian therapist. Participants who preferred an Indian therapist cited a greater understanding of cultural issues, easier communication, and possible discrimination from non-Indian therapists as reasons for this preference, while those who preferred a non-Indian therapist cited reasons such as more objective and alternative perspectives on cultural topics, more focus on individuality, and the perception that non-Indian therapists were more advanced practitioners and more accepting of diversity. The results of the study support previous literature stating that racial match may positively impact the therapeutic alliance.

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