A comparison of German and British therapists’ explicit and implicit reasoning about white and non-white clients – a vignette study

Abstract

Objectives – This doctoral study explored the impact of a client’s ethnic background on the perception and chosen therapeutic approach of UK and German therapists. This study sought to identify how a therapist’s held explicit and implicit biases influence their practise with clients of various ethnic backgrounds. Methodology – A sample of 51 therapists from the UK and Germany was recruited to take part in this online study. Participants were randomly allocated to either ‘Condition Caucasian’ or ‘Condition Diverse’ and first presented with three vignettes accompanied either by a photo of a person with European ethnic background or a person with African or South-Asian ethnic background. The participants then answered nine questions about their potential approach with each presented client, which were designed to identify explicit bias. In the second step, all completed a modified race implicit association test (IAT) that further quantified the therapists’ implicit and explicit bias towards individuals of various ethnicities. Results – Multivariate Analysis of the vignette data found no statistically significant differences between the two conditions; thus, no explicit bias was found within this sample. A subsequent comparison between the two nationalities was impaired due to uneven sample sizes, yet differences between the scores became visible. The analysis of the IAT data found slight implicit pro-white bias in the complete sample, as well as indicators for a priming effect in participants assigned to ‘Condition Caucasian’. The IAT study replicated previous research findings of implicit pro-white bias and the inconsistency between the tested implicit and the self-reported explicit bias within a therapist sample. Discussion – While explicit bias could not be identified within this sample, implicit pro-white bias was uncovered. It was concluded that therapists are as fallible to implicit bias as other healthcare workers, though they may be better at masking its conscious impact. Steps towards a less biased practise were outlined. Follow-up research will have to determine whether all findings, and in particular the cross-cultural comparison, can be replicated with a larger sample.