Gender-Related Therapist Attributions in Couples Therapy: A Preliminary Multiple Case Study Investigation

By Stabb, Sally D.; Cox, Deborah L. et al. | Journal of Marital and Family Therapy, July 1997 | Go to article overview

Gender-Related Therapist Attributions in Couples Therapy: A Preliminary Multiple Case Study Investigation


Stabb, Sally D., Cox, Deborah L., Harber, Jerry L., Journal of Marital and Family Therapy


Differential treatment by gender has been an ongoing area of concern and uncertainty both in society at large and in clinical research. In this investigation, therapist attributions over the course of therapy for three different couples were coded and analyzed to determine if cause for positive and negative events was assigned differentially to females and males. Additionally, the stability and globality dimensions of the therapist's attributions about the couples were examined for stereotypical gender-related patterns. Results indicate no gender differences in locus of causal attributions but some gender-related patterns in stability and globality dimensions. Implications for both couples therapy and gender bias in couples research are discussed.

The question of therapist gender bias continues to generate controversy, research, and contradictory results. In spite of (or perhaps due to) conflicting findings, most agree that the topic is important and should be further investigated.

Writers on women's psychology consistently note females' tendency to take the lion's share of responsibility for emotional well-being in their relationships (Goodrich, 1991). Gilligan (1982) found women to possess a morality of responsibility toward others over self; women were more concerned with obligation and self-sacrifice than equity. Kaplan (1986) suggested that women assume responsibility for situations in which negative feelings may be aroused in their partners. In other words, when their partners experience some discomfort or anger, women tend to believe that they caused or should alleviate the aversive stimulus. Bradbury and Fincham (1990) reviewed studies of women's depression and marital satisfaction, finding that women's attributions for events in their relationships distinguished between those who were happily married and those who were distressed.

The responsibility ethic becomes especially important as it relates to clinical and therapeutic issues. Clinicians may inadvertantly convey restrictive notions about women's roles in relationships in therapeutic settings with women and couples (Hare-Mustin, 1983). In fact, early naturalistic studies revealed therapists' differential treatment of males and females (Stein, DelGaudio, & Ansley,1976). Women receive more prescriptions for psychotropic medications and are seen for more therapy sessions than are men. Hare-Mustin (1983) suggests that the pathological labels often assigned to women by mental health practitioners actually reflect conditions of society in which females experience prolonged powerlessness and inequality. Hence, clinicians may perpetuate societal assumptions about women's responsibility in relationships by continuing to hold traditional causal views of problems in women's lives.

Additionally, Fitzgerald and Nutt (1986) and the most recent revision of the APA Ethical Principles of Psychologists (1992) strongly emphasize the ethical responsibility of therapists for competent, informed, nondiscriminatory, and respectful treatment/research/theory along gender lines. How gender bias may be reflected specifically through clinician attributions in couples therapy is the focus of this investigation.

The bulk of research to date on therapist gender bias has been conducted in an individual therapy setting. Although results do not always confirm gender bias, a substantial number of studies indicate that stereotyping, diagnostic and treatment biases, sexism, and sexual abuse of women in therapy are prevalent issues (see Nutt, 1992, and Nelson, 1993, for reviews). Feminist critique of family therapy includes concerns regarding the structural/hierarchical placement of males in dominant roles in the family, mother-blaming, assumptions about sharing power and responsibility embedded in the systemic concepts of circularity and complementarity, and assumptions about therapist neutrality (Nutt, 1992). Recently, family therapy has also received scrutiny for its biased treament of men, for example, by reinforcing the socialized limitations of male roles (Brooks, 1991; Deinhart & Avis, 1994). …

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