The Effects Of Sexual Stereotypes In Clinical Practice

Psychotherapists are not immune to prejudice and stereotypes against homosexual people, although nothing is known about their direct impact on the clinical process. Objectives: The aim of the present study is to analyze the impact of homophobic prejudice on clinical formulation, and its influence on diagnosis and assessment of severity and prognosis of a fictitious patient. Methods: We recruited a sample of 152 heterosexual male psychotherapists (psychologists or psychiatrists) (Mean age = 46.04; SD = ±11.26; range: 29–71), through an online survey which was advertised by contacting the boards of psychologists and psychiatrists throughout the country. Participants were asked to read a fictitious clinical vignette and formulate an impression of the patient. We used a 2 (Sexual Orientation of the Client: heterosexual vs. homosexual) × 2 (Diagnosis: difficulties in controlling sexual urges vs. anger). Participants were randomly exposed to one of four experimental conditions, thus they read about a heterosexual (vs. homosexual) patient with difficulties in controlling rage (vs. sexual urges). The two diagnostic profiles were considered as stereotypical of heterosexuals and homosexuals respectively (Boysen et al., 2006). After reading the vignette, participants were asked to rate the patient’s: – Psychopathological severity; – Amenability to psychotherapy; – Level of functioning using the Global Assessment of Functioning (GAF). Results: Results showed that stereotypes influence clinical practice, most of all in prognosis: in particular (a) therapists believe that homosexual patients can benefit less from psychotherapy when their disorder is stereotypical of their sexual orientation, and that (b) the patient’s sexual orientation has more impact on diagnosis when his disorder is stereotypical of the sexual orientation, both in homosexual and heterosexual patients. Conclusions: Our results show that psychotherapists can be biased by prejudice against homosexuals and therefore, specific training should be offered.