Department of Psychology, The Ohio State University, Columbus, OH, USA.
Cogn Behav Ther. 2022 May;51(3):229-242. doi: 10.1080/16506073.2021.1970799. Epub 2021 Nov 9.
Whether and how therapists' delivery of cognitive behavioral therapy (CBT) for depression differs by patients' ethnicity or race remains unclear. In this study, 218 therapists were randomized to clinical vignettes that involved the same text but varied in whether the accompanying image depicted a Black or White patient. Therapists exhibited three key differences in their views of clinical strategies for working with Black as compared to White patients. They viewed cognitive change strategies as less therapeutic and validation strategies as more therapeutic for Black patients. They reported similar differences for the time they would spend on each kind of strategy. When asked to compare the relative importance of cognitive change vs. validation strategies specifically, therapists rated validation as more important for Black than White patients. Among therapists presented with Black patients, positive racial attitudes were associated with viewing cognitive change and validation strategies as more therapeutic. These results suggest therapists tend to believe it is desirable to incorporate cognitive methods more limitedly when working with Black patients. Whether such adaptations enhance or detract from the care of Black patients is an important issue that merits future investigation.
治疗师在为抑郁症患者提供认知行为疗法 (CBT) 时是否以及如何因患者的种族或民族而异尚不清楚。在这项研究中，218 名治疗师被随机分配到临床案例中，这些案例涉及相同的文本，但伴随的图像描绘的是黑皮肤或白皮肤患者。与白人患者相比，治疗师在治疗黑皮肤患者的临床策略方面表现出三个关键差异。他们认为认知改变策略的疗效较差，而验证策略的疗效较好。他们报告说，在每种策略上花费的时间也存在类似的差异。当被要求比较认知改变与验证策略的相对重要性时，治疗师认为验证策略对黑人患者比白人患者更为重要。在接受黑人患者的治疗师中，积极的种族态度与将认知改变和验证策略视为更有效的治疗方法有关。这些结果表明，治疗师倾向于认为在与黑人患者合作时，更希望有限地采用认知方法。这种调整是否增强或削弱了对黑人患者的护理是一个重要的问题，值得进一步研究。
