Bias, multicultural counseling competencies, and clinical judgment

Aaron Matthew Ramirez (2008)

This study examined the relationship between clinician propensity to diagnose a Black client with schizophrenia, based on a clinical vignette, the degree of racial bias, as measured by the Attitudes Toward Blacks (Brigham, 1993) self-inventory and self-perceived multicultural competence, as measured by the Multicultural Counseling Inventory (Sodowsky, Taffe, Gutkin, & Wise, 1994). A total of fifty-five female and male mental health clinicians, mostly at the master's level and mostly White, participated in the study. Based on the extant literature, it was hypothesized that there would be a significant positive relationship between racial bias toward Blacks and the likelihood of making a diagnosis of schizophrenia. It was also predicted that there would be a significant inverse relationship between self-perceived multicultural competence and the likelihood of a diagnosis of schizophrenia. Finally, it was hypothesized that a diagnosis of a major affective disorder would be positively correlated with racial bias and negatively correlated with self-perceived multicultural competence. None of the main hypotheses were supported by the data. Contrary to hypothesis, there were statistically significant positive relationships between self-perceived multicultural competence and clinician judgment of blunted affect, as well as race bias and blunted affect. Based on the vignette, there were trends that suggested positive but not statistically significant relationships among racial bias, MCCs, and the propensity to assign a diagnosis of a Major Affective Disorder.