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Cognitive Mediators Between Patients' Social Class and Therapists' Evaluations

Barbara Noel Dowds, MA; Alan F. Fontana, PhD; L. Mark Russakoff, MD; Maxine Harris, PhD
Arch Gen Psychiatry. 1977;34(8):917-920. doi:10.1001/archpsyc.1977.01770200055004.
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• Previous research has shown that therapists are more likely to accept middle-class than lower-class persons for psychotherapy and to rate middle-class patients more favorably than lower-class patients. One explanation that has been offered is that lower-class patients may not conceptualize their experiences in a manner compatible with traditional kinds of therapy. This study investigated several cognitive variables that could theoretically serve as mediators between patients' social class and therapists' differential evaluations—specifically, verbal intelligence, psychological differentiation, and locus of control. Therapists evaluated patients after the initial therapy session. Results indicated that psychological differentiation was a mediator for therapists' judgments of both patients' desire for structure and their suitability for psychotherapy. Similarly, a locus of control orientation emphasizing the role of chance functioned as a mediator of therapists' judgments of suitability.

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