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Racial/ethnic matching of clients and therapists in mental health services: A meta-analytic review of preferences, perceptions, and outcomes.

Cabral, Raquel R., Smith, Timothy B.·2011·Journal of Counseling Psychology

DOI 10.1037/a0025266

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Abstract

Across several decades the effects of matching clients with therapists of the same race/ethnicity have been explored using a variety of approaches. We conducted a meta-analysis of 3 variables frequently used in research on racial/ethnic matching: individuals' preferences for a therapist of their own race/ethnicity, clients' perceptions of therapists across racial/ethnic match, and therapeutic outcomes across racial/ethnic match. Across 52 studies of preferences, the average effect size (Cohen's d) was 0.63, indicating a moderately strong preference for a therapist of one's own race/ethnicity. Across 81 studies of individuals' perceptions of therapists, the average effect size was 0.32, indicating a tendency to perceive therapists of one's own race/ethnicity somewhat more positively than other therapists. Across 53 studies of client outcomes in mental health treatment, the average effect size was 0.09, indicating almost no benefit to treatment outcomes from racial/ethnic matching of clients with therapists. These 3 averaged effect sizes were characterized by substantial heterogeneity: The effects of racial/ethnic matching are highly variable. Studies involving African American participants demonstrated the highest effect sizes across all 3 types of evaluations: preferences, perceptions, and outcomes.

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“Despite clients expressing a preference for a therapist matching their own background or identity, the benefits of matching clients with therapists have been inconsistent [2,11].”
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“However, research shows the effects of ethnic matching to be highly variable (Cabral & Smith, 2011).”
Background
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“…with seeking mental health care (Mays et al., 2017); on the other hand, ethnic-racial identity (Rivas-Drake et al., 2014), ethnic matching (Cabral & Smith, 2011) and cultural respect (Liu et al., 2018) have widely been recognized as protective, contributing to positive mental health,…”
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“This perhaps explains why simple ethnic matching of clients and therapists only has a very minor impact on treatment outcomes (Cabral & Smith, 2011).”
BackgroundResult
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“It is well-established that people of color prefer therapists from their group (Cabral & Smith, 2011), and both mainstream and the culturally adapted interventions work with individuals of color (e.g., Escobar & Gorey, 2018).”
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“Although research on race-matched therapeutic dyads has been inconclusive [65–68] many leaders indicated a preference for Black, Indigenous, and People of Color (BIPOC) therapists, and described their beliefs on the benefits of entering a race-matched or race concordant therapeutic dyads.”
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“Research has found that clients prefer mental health therapists who are similar in race, culture, and gender (Cabral & Smith, 2011; Landes et al., 2013).”
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“Our race/ethnicity finding is consistent with research on preferences for a match between client and therapist on race/ethnicity (Cabral & Smith, 2011; López et al., 1991; Shin et al., 2005).”
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“Thus, it is widely recommended to match therapists and clients based on race and gender as individuals are socialized to engage in behaviors and interactional styles according to race and gender (Cabral et al., 2011; Ferguson et al., 2008; Townes et al., 2009).”
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“Prior work has also demonstrated that culturally relevant services, including racial/ethnic matching, improve the client – therapist alliance (Cabral & Smith, 2011; Hamilton, 2024), which is related to improved outcomes (Kim & Kang, 2018).”
Crisis Line Use Among Undergraduate Men of Color: A Qualitative Inquiry
Shaikh, A. N., Westcott, J. B., Dosal‐Terminel, D., Loury, J. A., & Gueh, B. B. (2026) · The Counseling Psychologist · doi:10.1177/00110000251352569 · Cited by 2
“These ﬁ ndings emphasize the need for crisis counselors who are also men of color in order to combat potential barriers to emotional disclosure (Cabral & Smith, 2011).”
Exploring Social Perceptions of Queer and Trans Music Therapists and Clients
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“(20TQMT) “Matching” or shared identities has been widely discussed within the psychotherapy literature (e.g., Cabral & Smith, 2011).”
LEARNING FROM BRISBANE: THE POLITICS OF IDENTITY AND THE PROMISE OF EMPATHY
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“The study concluded that “across 53 studies of client outcomes in mental health treatment, the average effect size was 0.09, indicating almost no benefit to treatment outcomes from racial/ethnic matching of clients with “therapists” (Cabral & Smith, 2011).”
BackgroundInfluential

Authors: Cabral, R. R., & Smith, T. B.
Affiliations: Brigham Young University (US)
ORCID: Smith, Timothy B.
Venue: Journal of Counseling Psychology
Publisher: American Psychological Association (APA)
Published: 2011
Volume: 58
Issue: 4
Pages: 537-554
ISSN: 0022-0167 (ISSN-L)
1939-2168
DOI: 10.1037/a0025266
OpenAlex: W2082304096
Cited by: 651
References: 228
Citations by year: 2026: 41 · 2025: 51 · 2024: 83 · 2023: 44 · 2022: 54 · 2021: 50 · 2020: 52 · 2019: 34 · 2018: 40 · 2017: 61 · 2016: 35 · 2015: 43 · 2014: 26 · 2013: 22 · 2012: 13
FWCI: 21.35
Type: journal article
Language: en
Open access: closed
Locations: Journal of Counseling Psychology (publishedVersion)
PubMed (publishedVersion)
ScholarsArchive (Brigham Young University) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Clinical Psychology › Counseling Practices and Supervision
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: therapist preferences, client perceptions of therapists, treatment outcomes, mental health services, African American clients
MeSH terms: Mental Disorders, Ethnicity, Health Personnel, Humans, Mental Health Services, Professional-Patient Relations, Psychotherapy, Treatment Outcome, Patient Satisfaction, Racial Groups, Cultural Competency

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Racial/ethnic matching of clients and therapists in mental health services: A meta-analytic review of preferences, perceptions, and outcomes.

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