| Description |
Therapist multicultural competence (MCC) has been utilized as a tool to reduce prevalent health disparities. Numerous MCC theories have been developed and the American Psychological Association has adopted MCC guidelines aimed to infuse multicultural initiatives into psychology training programs. Over the last decade, we have begun to develop a vital empirical base supporting the utility of therapist MCC. There is now strong evidence of the relationship between increased therapist MCC and improved clinical outcomes. However, the meaning of the MCC and outcome correlation remains ambiguous due to issues in interpreting a process-outcome relationship in a dyadic interaction. The present study sought to clarify the therapist MCC and outcome correlation by utilizing multilevel models to (1) measure the amount of variability attributed to the therapist versus the client in client-rated therapist MCC and (2) assess the different sources of MCC variability (client/therapist) in relationship to client outcomes. Using a large repeated measures dataset (n = 1,458 clients; k = 35 therapists; w = 8,497 observations) from a university counseling center, the present study found a small amount of variability in MCC ratings was attributed to the therapist. This small level of variability was consistent across client demographics (race, sexual orientation, and religious affiliation). In examining MCC and outcome, there was a near zero relationship between client-rated therapist MCC and client outcomes. Again, these results were consistent across client demographics. In contrast, ratings of the therapeutic alliance and client treatment satisfaction significantly predicted client outcomes. The implications of these findings, including a discussion of MCC measurement and future research directions, are discussed |
