(PS5-A10) No Gender or Gender Match Differences in Cognitive Processing Therapy Treatment Outcome in a Community Clinic

Prior research demonstrates that gender can interact with PTSD presentation and PTSD treatment outcome. Women are more likely to develop PTSD and have more severe PTSD symptoms when compared with men (Holbrook et al., 2002; Kessler, 1995). Despite this, women are more likely to benefit from and be retained in PTSD treatment (Swift & Greenberg, 2012; Tarrier et al., 2000). Additionally, gender match between therapist and client may be important for treatment factors. For example, male gender match between client and therapist led to higher dropout in a sample of veterans (Shiner et al., 2017).

Participants included 60 clients from a community clinic which specializes in PTSD treatment. Clinicians were comprised of clinical psychology doctoral candidates supervised by a clinical psychologist with expertise in treating PTSD. All clients were treated with Cognitive Processing Therapy and attended at least one treatment session. Changes in PTSD and depressive symptoms as well as session attendance were assessed. T-tests were used to compare means across groups including: client gender (male = 19, female = 41), therapist gender (clients of male therapist = 25, clients of female therapist = 35), and gender match (matched = 32, non-matched = 28). Further, an ANOVA was used to assess specific gender match was also assessed: female match = 24, male match = 8, female client/male therapist = 17, male client/female therapist = 11).

Of these analyses, the only significant finding was differences in initial depressive symptoms in relation to being matched or not matched t(54) = 2.43, p = .019. Specifically, those who were gender matched with their therapist, either male and male or female and female, had lower initial depressive symptoms (M = 28.24, SD = 10.78) compared to those not matched (M = 36.39, SD = 14.37). This significant relationship was not maintained when the specific gender match was assessed using an ANOVA. Due to the number of analyses run, this finding would not survive Bonferroni correction. Further, as gender match requests were not accommodated at the clinic, initial depressive symptom severity based on gender match is a spurious finding rather than relating to gender matching differences. There were no other significant differences in initial PTSD or depressive symptoms, final PTSD or depressive symptoms, percent change in PTSD or depressive symptoms, or session attendance for any gender metric.

Research and clinical experience have showed that a subset of clients may have gender preferences for their therapist. These results suggest that gender match may not relate to therapy retention or outcome in a clinic where these requests cannot be met. Importantly, this was not a randomized controlled trial where individuals were purposefully matched or not matched. However, client assignment was random in that it was based off therapist availability and clients presently on the wait list. These results are contrary to previous research suggesting gender differences in treatment retention and response. Though these analyses were not found to be significant, it is critically important to report and disseminate these null findings to reduce publication bias and to capture a fuller understanding of gender match with respect to PTSD treatment.