502 Ethnic Minorities
Of particular interest was the likelihood of ethnic minori-
ties being treated by white therapists in comparison to clients
treated by ethnic minority therapists. Non-white therapists in
both years reported treating more ethnic minority clients than
white therapists, based on those reporting 60% or above of
their client population by ethnicity.
Some research indicates preferences for therapists from
similar ethnic backgrounds and SES, but studies are incon-
clusive (Sue, Zane, & Young, 1994). What these increased
numbers may represent is the increased utilization of mental
health services by ethnic minority clients due to enhanced
services and access of more trained ethnic minority psychol-
ogists in 1992.
THERAPISTS’ REPORTED LEVELS OF COMFORT
Further results of the survey suggested a decrease from 1986 to
1992 in the number of respondents who reported “feeling com-
pletely comfortable” in working with any ethnic group. The
percent of respondents reporting feeling completely comfort-
able with white clients decreased from 1986 to 1992, 88.8% to
85.2%, respectively. Therapists with Native American clients
showed the least comfort with that population.
The shifts in reported levels of comfort from 1986 to 1992
suggested that both white and ethnic minority therapists were
moving away from generalized views of all clients being
inherently the same and were more closely scrutinizing them-
selves, their abilities, and their preparation for clinical work
with clients from various ethnic and cultural groups.
The release of the 1990 APA Guidelines for Providers of
Psychological Services to Ethnic, Linguistic, and Culturally
Diverse Populations challenged psychologists’ level of
knowledge and skill in working with the ethnically diverse,
thus creating uncertainties and discomfort. Even though re-
spondents reported higher levels of discomfort, they were
in fact becoming better prepared as they anticipated ethnic
and cultural issues in their clinical work, and the numerous
considerations required for applying a sociocultural frame-
work to diagnosis, assessment, and treatment of the culturally
diverse.
CLINICAL PROBLEMS FREQUENTLY PRESENTED
IN THERAPY
Our survey asked respondents how frequently 11 clinical
problems were presented by clients representing five ethnic
groups. A significant increase from 1986 to 1992 was re-
ported among African American clients for the following
four clinical problems: alcoholism, anxiety, health-related
problems, and work-related problems. For Latinos, alco-
holism was the only clinical problem showing a significant
increase. Significant increases in the reporting of health-
related problems and work-related problems were found for
Asian American clients. For Native American clients, signif-
icant increases were found on 5 of the 11 commonly reported
clinical problems: health-related problems, marital/family
related problems, stress-related problems, and work-related
problems. No significant differences were found for clinical
problems reported to white versus non-white therapists.
There is a considerable body of literature (Turner, 1996)
on ethnic/cultural differences in symptomatology for depres-
sion as well as on treatment considerations for anxiety disor-
ders and associated stress-related conditions. Asian American
clients most frequently presented marital/family problems in
therapy, which may be associated with cultural traditions that
place a high value on respecting one’s elders and a collective
approach to decision making that emphasizes the good of the
family versus the well being of the individual.CLIENT RESISTANCE AND TREATMENT
EFFECTIVENESSThere were significantly fewer reported sources of resistance
in 1992 than in 1986, (i.e., 39% versus 61%, respectively;
n159). For example, attendance was one of the categories
reported less frequently in 1986. Client dropout rates and
length of treatment have been commonly reported problems
by both white and non-white therapists working with ethnic
minority clients (Sue, Zane, & Young, 1994). Based on our
results, it appears that therapists in 1992 were better prepared
to deal with resistance than those responding in 1986.
Training significantly contributed to the work of therapists
in 1992. Half of those surveyed (n87) indicated that they
had received training that was helpful in understanding the
therapeutic needs of ethnic minorities.CONCLUSIONSWhen comparing delivery services to ethnic minorities in
the decade of the 1980s, it appears that our preparation has
advanced. Both white and ethnic minority therapists have
positively responded to the call for increased cultural sensi-
tivity in their work with ethnically and culturally different
clients. Increased expectations for more sensitivity to cultural
and ethnic diversity, coupled with the increased number of
ethnic minorities in the field, appear to have laid a foundation
for the progress over the last decade.