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Their Relation to Preferred Therapist Characteristics in Clinical Subjects Sex Ro1es, PsychoLogica]- Àdjustment, and Presenting Problems: Their Relation to Preferred Therapist Characteristics in Clinical Subjects by Cheryl B. Lankt ree À thesis presented to the University of Manitoba in partiaJ. fulfil-1ment of the requirements for the degree of Ðoctor of Ph i losophy in Ðepartment of PsychoLogy I.7í nn i peg , Manitoba (c) cheryl B. Lanktree, 1984 SEX ROLES, PSYCHOLOGICAL ADJUSTMENT, AND PRXSENTING PROBI,EMS: THEIR REI.ATION TO PREFERRED THERAPIST CHARACTERTSTICS IN CLINTCAL SUBJECTS BY CHERYL B. LANKTREE A thesis submitted to the Facu¡ty of Craduate Studies of the University of Manitoba ¡n part¡al fulf¡tlment of the requircments of the degree of DOCTOR OF PHILOSOPHY @ v 1984 Permision has been granted to the LIBRARy OF THE UNMR- SITY OF MAN¡TOBA to lend or sell copies of this thesis. to the NATIONAL LIBRARY OF CANADA to microfilm this theiis and to tend or scll copies of the film, and UNIVERS¡TY MICROF¡LMS to publish an abstract of this thesis. The author reserves other publication rights, and neither, the thesis nor extensivc extracts from it may bc printed or other- wisc rcproduced without the author's written permission. ÀBSTRACT Despite the crucial roLe of the therapist-client relationship in therapeutic improvement/ the nature of client preferences and expectations upon entry into psychotherapy has yet to be fu1ly understood. MosÈ notabfy I the effects of subject gender, sex-role orientation, sex- role attitudes, presenting problems, and psychological adjustment on preferences for type and gender of therapist have been studied infrequently. Moreover ranalogue research has dominated this field, limiting the reLevance of such findings for cIinicaJ. practice. The few cLinical studies available have often relied upon small samples and methodologically flawed designs. Further, correlates of psychoJ.ogical adjustment and presenting problems incLuding subject gender and sex-rol-e orientation have seldom been studied with clinical subjects. Two hundred and sixteen men and women participated in this study âs they entered psychotherapy at a university- based clinic. Variables examined were: preference for therapist gender prior to the first intervieu, subject gender, previous therapy experience, sex-ro1e orientation (Personal Attributes Questionnaire), sex-role attitudes (ettitudes Toward women-Short Form), psychological 1\' - adjustment factors (california Psychological Inventory-short Form), presenting problem factors (Personal Problens Rating Scale created by the author), and "ideal" therapist trait factors (CounselLor Rating F'orm). Multivariate analyses of variance revealed several sign i f icant findings: liberal-undifferenÈiated subjects reported the strongest preference for a female therapist while conservative-undifferentiated subjects reported the strongest preference for a male therapist.i subjects with more anxiety-related and identity-depression problems expressed a stronger preference i.n generali and a female therapist was more freguently preferred than a mafe therapisl at a rate exceeding previous findings. Feminine subjects preferring a male therapíst rated their ideal therapist as significantly more agentic but mascuLine subjects preferring a female therapist rated communal.- expressive skiIls highest. Androgyny as a model of mental health was supported for women and men in relation to general psychological adjustment. Àndrogyny and rnasculinity aLone reduced the risk of psychological problems. Feminine and undifferentiated subjects were least. adjusted and reported more problems. Sex differences found were: r{omen were generally better adjusted and more other-oriented but men scored higher on confident-outgoing traits. Nevertheless, sex-role orientation emerged as a rnore potent predictor of mental health and therapist preferences than did sex aLone. ÀCKNOWI,EDGEMENTS The completion of this dissertation and ny Ph.D. narhs the culmination of several years of learning, growth, and challenge. The satisfaction that I feel, at this time' is surpassed on).y by the gratitude that I owe to sone people who have enhanced this adventure. To John Schallow, my advisor, I wish to extend my gratitude for his thoughtful guidance ' support, imagination, and friendship, throughout all the stages of this project, as well as during those years spent in the clinical progran. His inimitable ¡rit and good humour made the experience nore pleasant and often, quite enjoyabte. I am also grateful for the guidance and. assístance provided by rny thesis connittee: Nina Colwill, Neena Chappelt, and Ross Hartsough, in preparing this dissertation. To Denise, Àudrey, Marsha, Robin, and Pat, I wish to express my appreciation for their extensive assistance and energy in ímplementing this research in the day-by-day process of data collection. I am indebted to very dear friends who have, at different times, provided me with the social diversions and the caring necessary to continue. Thank you' Mindy' Dick, Cornelia' Chris, Li11ían' Jaye' and Pat! - vl To my family and especiafly, my parents' I am grateful for theír encouragement to pursue ambiLious goa1s, theír patience, and love throughout the years. With particular fondness, I wish to acknowledge ny husband, John' for providing me with the love ' the humour, and above aII' the unconditional support to sustain ne. Sharing this entire experience so completety with him has given ít a special nean ing. Finally, I owe my appreciation to the Manitoba Mental Health Research Foundation for providing me wíth the funding to support thi s research. - vll LI ST OF TABI.,,E S pa ge Table 1 Factor structure following va r imax rotation of four factors of the Counseflor Rating Form 112 Tabl-e 2 Factor structure following Var imax rotation of three factors of the counsellor Rating Form 113 TabIe 2 Mean likelihood of reporting problems of the Personal Problems Rating Scale 116 Tabl e 4 Factor strucLure following var imax rotation of the Personal Problems Rating Scale factors 117 Table Factor structure following va r imax rotation of the Calif orni.a Psychological Inventory factors 121 Table 6 Mean Cal i fornia Psychological lnventory factor scores according to sex-role orientation 124 TabIe 7 Mean Personal Problems Rating Scale factor scores according to sex-role orientation 127 Table I Summary tabte of analysis of variance preferred of effects of sex of subject ' sex of therapist, sex-rofe orientation, and - víii - sex-ro1e attitudes on TPF reason 1 133 Tabl e 9 summary table of analysis of variance of effects of sex of subjects, preferred sex of therapist, sex-role orientation, and sex-role attitudes on TPF reason 2 134 TabIe 10 Summary table of analysis of variance of effects of sex of subject, preferred sex of therapist, sex-role orientation, and sex-role attitudes on TPF reason 3 135 Tabl e 11 Summary tabLe of analysis of variance of effects of sex of subject, preferred sex of therapist, sex-rol-e orientation, and sex-roLe attitudes on TPF reason 4 138 Tabl e 12 Summary table of analysis of variance of effects of sex of subject, preferred sex of therapist, sex-role orientation, and sex-role attitudes on TPF reason 5 139 Ta bl- e t5 Summary table of analysis of variance of effects of sex of subject, preferred sex of therapist, sex-r'ole orientation' and sex-rol-e attitudes on TPF reason 6 140 TabIe 14 Summary table of analysis of variance of effects of sex of subject, preferred sex of therapist, sex-role orientation, and sex-role attitudes on TPF reason 7 141 TabL e t5 sunmary tabfe of analysis of variance of effects of sex of subject, preferred sex of therapist, sex-ro1e orientation ' and ix - sex-roLe attitudes on TPF reason I 147 Tab1e 16 Reasons provided by subjects for stating preference for gender of therapist 148 Tab]e 17 Mean PersonaL Problems Rating Scal-e factor scores according to preference or ]ack of preference for therapist's gender 1s0 Tab1e 18 Mean Cal i fornia Psychological Inventory factor scores according to sex of subj ec t 1È) Table 19 Mean Counsellor Rating Form factor scores according to sex-roLe orientation and therapi st preference 161 -x- LI ST OF F I GURES pa9e F i gure 1 Mean Therapist Preference Form Score as a function of sex-role orientation and sex-rolê attitudes 129 F i gure Mean rate of responding to TPF reason 3 as a function of sex of subject and preferred sex of therapist 136 F i gure ) Mean rate of responding to TPF reason 7 as a function of sex-rofe orientation and preferred sex of therapist 142 F i gure 4 Mean rate of responding to TPF reason 7 as a function of sex-roLe orientation and preferred sex of therapist 143 E i gure Mean rate of responding to TPF reason 7 as a function of sex-role attitudes and preferred sex of therapist 144 F i gure 6 Mean General Adjustnent score as a function of sex of subject and sex-role orientation 154 F i gure 7 Mean Confident-Outgoing score as a function of sex of subject and sex-ro1e orientation 155 Figure Ë Mean Agentic Interpersonal SkiIIs score as a function of sex-roIe orientation and preferred sex of lherapist 159 - xI CONTENTS ÀBSTRACT . IV ÀCKNOWI,EDGEMENTS . v1 I.I ST OF TABLES v111 I.I ST OF F I GURES . x1 Þaqe I NTRODUCTT ON Sex of Therapist: client Percep!ions and Preferences 7 Process and Outcome Li terature 9 Therapist Preference Research 7 Ctient Expectations in Relation to Sex of Therapist Evaluation of Competence and Àttributed Characteristics Attributed Characteristics of the Ideal Therapi st 39 Preferences for Sex of Therapist and Presenting Problems 45 Sex Roles, and Attitudes Toward Wornen in Re1at ion to Therapist Preferences' Adjustment, and PsychologícaI Problems 4 I Sex Rofes and the Concept. of Androgyny . 49 Measurenent of Masculinity, Femininity, and Androgyny 50 The Personality Attributes Questionnaire Attit.udes Toward women Scale-Short Form .
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