(PS5-B36) A Comparison of Psychotherapy Expectations and Preferences Among Black and White Undergraduate Women

Mental health difficulties are especially prevalent for Black undergraduate women due to the pervasive experience of racism and discrimination on top of an already stressful college schedule (e.g., Cheng et al., 2018). Despite this, Black undergraduate women seek professional mental health care at extremely low rates compared to White women (e.g., Kam et al., 2019). As such, it is necessary to understand factors that may influence help-seeking and treatment-related behaviors in Black women. One fruitful avenue in this vein is an examination of potential differences in psychotherapy preferences and expectations. Examining and considering clients’ preferences and expectations for psychotherapy is related to improved persistence with therapy and positive outcomes (e.g., Swift et al., 2010). A study completed by Charles et al. (2021) elucidated differences in preferences and expectations for therapy between Black and White young adults, and the current study is an attempted replication and extension of these findings with a larger sample of only women.

            The final sample consisted of 369 undergraduate women: 130 Black (35.2%) and 239 White (64.8%). Compared to the Black subsample, a greater proportion of White participants reported engagement with mental health treatment in the past (56.5% of White; 28% of Black) and at the time of the survey (24.7% of White; 7.7% of Black). Participants completed an online questionnaire assessing expectations and preferences for therapist style, demographics, therapeutic activities, and treatment format. They also completed the Psychotherapy Expectancy Inventory-Revised (PEI-R; Bleyen et al., 2001) and Cooper-Norcross Inventory of Preferences (C-NIP; Cooper & Norcross, 2016).

            Mann-Whitney U test results demonstrated several small-sized differences in preferences and expectations for therapists, therapy, and treatment in general across racial groups. For example, a greater proportion of Black women had both expectations and preferences for most or all of therapy to involve venting, getting advice, learning about mental health, learning new skills, and the therapist talking while the client listens. MANCOVA results for the PEI-R indicated no group differences in expectations for seeking approval, seeking advice, initiating conversations, or building a trusting relationship in therapy [F(4, 338)=1.142, p=.337, Wilks’ Λ=.987, partial η²=.013].  Chi-square analyses with the CNIP demonstrated that a significantly higher proportion of White participants (50.5%) have no preference for a therapist to intensely focus on emotion or be emotionally reserved compared to Black participants (34%). Additionally, a greater proportion of Black participants (59.2%) prefer emotional intensity compared to White participants (39.8%).
            While Black women demonstrated less experience with mental health treatment, they reported distinct expectations and preferences. As individuals are more likely to engage with treatment when their preferences are considered (Swift et al., 2011), this information can inform outreach and interventions with Black undergraduate women specifically.