This article was downloaded by: [Memorial University of Newfoundland] On: 29 January 2015, At: 19:47 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of Homosexuality Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/wjhm20
The Effects of Social Sex-Role Stereotypes and Sexual Orientation on Psychotherapeutic Outcomes Petra Liljestrand MA , Ernest Gerling & Patricia A. Saliba Published online: 26 Oct 2008.
To cite this article: Petra Liljestrand MA , Ernest Gerling & Patricia A. Saliba (1978) The Effects of Social Sex-Role Stereotypes and Sexual Orientation on Psychotherapeutic Outcomes, Journal of Homosexuality, 3:4, 361-372, DOI: 10.1300/J082v03n04_04 To link to this article: http://dx.doi.org/10.1300/J082v03n04_04
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/ terms-and-conditions
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
THE EFFECTS OF SOCIAL SEX-ROLE STEREOTYPES AND SEXUAL ORIENTATION O N PSYCHOTHERAPEUTIC OUTCOMES Petra Liljestrand, MA Ernest Gerling Patricia A. Sdiba
ABSTRACT: This paper examines &e rehamship of bi&&al sex, s&l sa-r& s&e*es, a d s w L o r k h t i r n of c1imi a d herapkt ta Bsyda&ape&c outcomes. It uws hypothesized .that w t a l o p bihgkal sa,dqbartures in s o d sm-role, a d s d otht&on of e l k t and admpkt d have pm'tivc effects on pqchdmapeu& mtcmes. T w & f w u c h and 16 dkarapts, ilecldngfwe cld-ther+wt Ms, were inm'md on how issues Of s o d sex-role s&r+ng and sexud &basion arose and ume ded6 wn'sh tn hwnpy. Tb r m h i d k a k d (a) a trmd bward more paceaCeti~s &oms d e n c l i d and ihsrapiss were of the same SEX> and (b) & sinbihiQ qf s d &n&hwz of r l i w and thmapui k r e b d lo positive psyck&aputic ou!zms. The rwbtr for dqbartarref ~ a msoda/ sex-r& Stfleolypar wt anconchue.
This study focused on the following research question: What is the relationship of biological sex, social sex-role stereotypes. and sexual orientation of cIients and therapists to psychotherapeutic outcomes? The major variables in this research question were defined as follows: Biologicai sex refers to clients and therapists being female or male. S o c d sex-rode refers to characteristics that 'are culturally associated with men and women. S o c d sex-role st.ereotrpa refer to perceptions of these characteristics as feminine or masculine. Sexual mi&tion refers to the individual's physical: and affectional preference for individuals of the opposite or the same sex. There* refers to professional and paraprofessional clinicians providing treatment. Cla'eni refers to men and women who volunteer for treatment. Successful p~hothwapmticonstcmes are identified in terms of (a) self-knowledge, which indudes self-awareness and self-acceptance; (b) self-acrualization, which includes the abiIity to use self-knowledge: and (c) sarisfaction with the experience of selfactualizing in the areas of social sex-role and sexual orientation. LITERATURE REVIEW A review of perdnent literature reveals that the pairing of &nt and therapist with particular characteristia is an important factor for positive Thr adtors are research mista~tsa6 tk Cpla6erfor H m e m a l Educdm, E v a h i m and Research, San Fmnckco Stale Univm+ty,San FranEisco, C a l $ h k 94132. J o u d OI Homcscxuality. Val. 3(4), Summer 1978
@ 1978 by Tht Hmwnh Prcss. AU
+ S I
rcurvtd.
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
JOURNAL OF HOMOSEXUALITY psychotherapeutic outcomes. Cutler (1958) obtained findings that suggested that a therapist paired with a patient who had similar internal conflicts would perform less skillfully than a therapist and a patient who had dissimilar conflick. Bergin and Strupp (1972) reviewed several studies &at indicate that there must be some complementarity of dominance and submission of dient and therapist. Several studies have shown that the pairing of client and therapist by biological sex can be an important factor for psychotherapeutic outcomes. Howard, OrIinsky, and Hill (1970) found that female clients were more satisfied with female than with male therapists. In one study more success was reported when client and therapist were of the same, rather than opposite, biological sex (Bleckner,Note 1; Cleveland, Note 2). The combination of femaIe client and female therapist was more successful than the combination of male client and male therapist. Furthermore. the study showed that female therapists had more success with male clients than male therapists had with female clients. Hill ( 1973) studied the relationship of biological sex of clients and of inexperienced and experienced therapists to the psychotherapeutic process. She found that same-sex compared with opposite-sex pairs yielded more emotive responses that were relevant to the psychotherapeutic issues. There have been a series of studies on rhe relationships of the social sex-roles of therapists to psychotherapy. In three s~udiesit was found that both female and male therapists conceptualized the healthy individual by using more characteristics of the masculine stereotvpe for men than characteristics of the feminine stereotype for women (D. bl. Broverman, Klaiber, Kobayashi, & Vogel, 1968; I. Broverman, Broverman, Clarkson, Rosenkranu, & Vogel, 1970; I. Broverman et al.. 1972). Steinmann (1974) studied how individuals of each biolopcal sex (a} conceptualized the "ideal man" and "ideal woman" and (b) predicted how &e opposite sex conceived of the ideal man and ideal woman. She found that males and females had similar conceptions of the ideal woman. She also discovered that females incorrectly guessed how males described the ideal woman. Females thought the males expected characteristics for the ideal woman that were more stereotypic than the characteristics that the males actually listed. In addition she used her research findings successfully in psychotherapy to help clients identify areas of conflict around sex-role ambiguities. There has been little research done specifically on the effects of pairing sexual orientation of client and therapist. In fact, it has been assumed in clinical research chat a heterosexual orientation is the only suitable orientation for therapisa (Bergin & Strupp, 1952). Saghir and Robins (1973) reported that about one-third of the homosexual clients they interviewed had negative feelings about their psychotherapy. The homosexual clients indicated h t their therapists were personally prejudiced agaiist the hornovexual orientation and life-styIe. Wandrei (Note
.
3) studied the attitudes of 36 homt>sexualwomen dients toward their therapists. She concluded that the dients with homosexual therapists as compared to dients with heterosexual therapists felt (a) more favorable toward their psychotherapy and (b)that their therapists had more positive attitudes toward their homosexual feelings and were more effective Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
as therapists.
HYPOTHESES There were four hypotheses for the study: 1. Clients and therapists of the same sexual orientation, as compared with dents and therapists of different sexud orientations, will re-
port more successful therapeutic outcomes.
2. Female clients and therapists, one or both of whom depart from the feminine stereotype, as compared with those who both conform, will report more successful therapeutic outcomes. 3. Male clients and therapists, one or both of whom depart from the mascuIine stereotype, as compared with those who both conform, wiIl report more succ~ssfultherapeutic outcomes. 4. Clients and therapists of the same biological sex, as compared with dients and therapists of opposite biologial sexes, will report more satisfying outcomes. SAMPLE
The respondents included 24 men and women who had been in psychotherapy and 16 therapists. Included in the sample were five client-therapist pairs. Most respondents were obtained through professional and friendship networks in the San Francisco Bay Area. The majority of respondents indicated that they received or provided individual rather than group or couples treatment.
Twelve maIe and I2 female dients were interviewed. Their ages at the time of therapy ranged from 14 to 49 years, with a modal age of 23 and a median age of 26. Eighty-three percent of the dients were white. Fifty-eight percent were Protestant, 2 1% were Catholic, and 2 1% had other religious affiliations or no affiIiation. All the dients had an educational level of some college or higher. The larger percentage were students or employed at professional leveb. Table 1 shows the sexual orientation of the dients at the time of psychotherapy. Sexual orientation is shown on three dimensions of
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
JOURNAL OF HOMOSEXUALITY (a)physicalsexual activity, (b) dose relationships, and (c) erotic fantasies. Each respondent rated herselfhimself on each dimension using the CHEER &point Sexual Orientation Scale (DeCecco et a]., 1977). Clients who indicated that they were exclusiveIy or predominant1y heterosexual were mtegorized as heterosexual. Clients who indicated that they were equally heterosexual and homosexual were categorized as bisexual. CIients who indicated that they were exciusively or predominantly homosexual were categorized as homosexual. Clients who indicated that the); had physical sexuaI activity, close relationships, or erotic fantasies with or about no one, were categorized on the basis of their previous experiences. Table 1 shows chat the percentage of clients with a particular sexual orientation varies with the dimension used as a basic indicator. When physical sexual activity is used, 54.2% of the clients were homosexual. When cIose rehrionships is used, 45.8% of the clients were homosexual. When erotic fantasies is used, 34.2% of the clients were homosexual. To determine to what extent respondents conformed to or departed from the social sex-rolestereotypes. respondents were asked to rate themselves lor femininity on one scale and for masculinity on another scale using the CHEER 4-point rating scales (Shively 9c De Cecco, 1977). M e n and women who rated themselves 1 (notat all feminine) and 2 (somewhat feminine) on the femininity sale were classified as departing from the femhine stereotype. Those who rated themselves 3 (moderarely Feminine) and 4 (very feminine) on the femininity scale were classified as conforming to the feminine stereotype. Departure from and conformance to the masculine stereotype were determined in the same way as departure from and conformance to the feminine stereorvpe. In this report neither conformance to nor depanure from one stereotype is interpreted as conformance to or departure from the other stereotype. TABLE 1
Serua.1
Physical Sexual A c t i v i t y
Close Relatfonshf ps
-
Erotic
Fantastes
Orientation
a
Wanosexual
13
54.2
11
45.8
13
54.2
Bisexual
2
8.3
10
41.7
2
8.3
Heterosexual
9
37.5
3
12.5
9
37.5
P
I n the anatysjs of data. physical sexual aetivSty was used as e. basis for classifying clients' sexual orlentation-
the
Of the men dients, 8.3% departed from both stereotypes, and 83.35% were conformed to the masculine stereotype. Of the women dients, 35 3%departed from both,the feminine and masculine stereotypes and 98.3% conformed to the feminine stereotype.
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
Therapists Ten female and six male therapists were interviewed. Their ages ranged from 22 to 31 years, with a modal age of 28 and a median age of 33.5 years. Fifteen therapists were white and one was black. Fifty percent were Protestant, 19% were Catholic, 13% were Jewish, and 18% had other religious affiliations or no affiliation. The larger percentage of therapists had an educational level of a master's degree or higher. Of those who had obtained doctorates, two were psychiatrists and three were psychologists. Table 2 shows the sexual orientation of the therapists. When physical sexual activity is used as the basic indicator of sexual orientation,68.7% of the therapiss were homosexual. When dose relationships is used, 31.3% were homosexual. When erotic fantasies is used, 56.3% were homosexual. In rating themselves on the masculinity and femininity sales, 10%of the female therapists indicated that they departed from both the feminine and masculine stereotypes, and 80% indiated that they conformed to the feminine stereotype. Of the male therapists, 16.7%departed from both stereotypes, and 83.3% conformed to the masculine stereotype.
Clzents a d Thmprits
In comparing the results of the ratings for the soda1 sex-role stereotypes it was
found that: (a) more female dients than female therapists deTABLE 2 SparaZ Odmbtion of Thowpists
Sexual Orientat4 on
Physical Sexual Ac.tfvity
f
'%
Close Relationships F
5:
Erotic
Fantasies C J
%
11
68.7
5
31.3
9
56.3
Btsexual
0
0.0
10
62.4
3
18.7
Heterosexual
5
31.3
1
6.3
4
25.0
16
100.0
16
100.0
16
190.0
Homosexual
Total
JOURNAL OF HOMOSEXUALllY parted from both stereotypes; (b) more female therapists than female clients conformed to the feminine stereotype; (c) more male therapists than male clients departed from both stereotypes; and (dl equal percentages of male therapists and male dicnts conformed to the masculine stereotype. Five pairs of clients and therapists were separately interviewed. Trvo pairs were female and Ehree were male. Four pairs contained individuals who had the same sexual orientation: T w o were heterosexual.and two were homosexua1.
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
METHODOLOGY T w o interview schedules were develop&ne for clients and one for therapists. T h e uestions asked covered the following: (a) background data on the diem and t e therapist: (b) data on previous therapeutic contacrs and prescrlr therapeutic setting; (c) the respondent's perceptions of issues and procedut-esin therapy; ( d ) data on the sex-roIe stereatvpes and sexual orientation of the respondent and of hidher client or therapist; (e) description of a session that cy ifred the working relationship; and ( f ) assessment of therapeutic outcomes. A data were c d e d by at least two coders in order to establish coding reliabilin. For the purposes of this report analysis of dam was restricted to the follurving variables: age, biological sex, education, occupation. raciauethnic background. religion, sexual orientation, femininity and masculinity, and assessment of therapeutic outcomes. Four categories of therapeutic outcomes were analyzed: (a) social sex-roles. including femininity and masculinity; (b) sexual orientation. including physical sexual activity, close relationships, and erotic fantask; (c} general outcomes. self-actualization, self-control. inincluding self-knowledgeand ~el~acceptance. terpersonal communicarion, relief of pain, and M ~ u ~ ~ o Iof I problems: and (d) other outcomes considered to be negative by the respondent. -111 outcomes were coded for (a) gains or successful therapeudc achievements and (b) losses or faiIures and no change. For this report, only data on successful psvchorherapeutic outcomes were analyzed.
1
R
RESULTS
The results were determined on four dimensions: (a) sexual orientadon: (b) social sex-roles; (c) general autcornes; and (d) overall outcomes. Overall outcomes was a total of the outcomes for the three specific dimensions. The first hypothesis was: Clients and therapists of the same sexual orientation, as compared with clients and therapisa of differenr sexual orientations, wi1I report m w e successful therapeutic outcomes. Table 3 shows the means of successful outcomes for dealing with issues of sexual orientation. T h e results of the t test (t = 1.989,p < .05) indicated that the dif-
Petm Lijeswnd, Ernest Gding, rsad Patricia A. S d b a TABLE 3 O
u
~ for s DeaZing u i t h Issues of S-b OrLentatCm
Gains
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
Sexual Orientation of Client and
Losses,
Failures,
Therapist
-
D i f f arent (n * 16)
.750
-
Na Chanoe -
-
1.688
No Data
-
,563
ference in outcomes for dealing with issues of sexual orientation in therapy was significant. T h e t test for outcomes dealing with issues of social sex-role (t = .170) and for general outcomes (t = .929) indicated that the differences were not signifimnt. The results of the t test for overaIl outcomes (t = 1.736, p< .05) indimted that the difference was significant. The results support the hypothesis. The second hypothesis was: Female dients and therapists, one or both of whom depart from the feminine stereotype, as compared with those who both conform, wiIl report more successful therapeutic outcomes. T tests were performed comparing the subsamples of: (a) both conformed (n = 7) versus one departedlone conformed (n = 41, and (b) both conformed versus both departed (n = 5). A comparison of the results revealed that: (a) in three out of the four dimensions of outcomes the highest mean was for clients and therapists who both confarmed to the feminine stereotype,and (b) the only difference found to be significant (6 = 3.384, $ < -005) was for dealing with issues of social sex-roles, where they reported significantly better outcomes than situations where one conformed to and the other departed from the stereotype. The results do not support the stated hypothesis. T h e third hypothesis was: Male dients and therapists, one or both of whom depart from the masculine stereotype, as compared with those who both conform, will report more successful therapeuric outcomes. T tests were performed between the subsampks of both conformed (n = 10) versus one departedlone conformed (n = 5). The subsample of male clients and therapists who both departed from the masculine stereotype (n = I) was not large enough to be analyzed. A comparison of the results revealed that: (a) in three out of four dimensions, the highest mean for successfuL outcomes was where one departed from and the other conformed to the mascuIine stereotype, and (b) the only difference found to
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
JOURNAL OF HOMOSEXUALITY be significant (t = 1.866, p < .05) was for dealing with issues of social sex-roles. The results partly supported the hypothesis. The fourth hypothesis was: Clients and therapists of the same biological sex, as compared with clients and therapists of apposite biological sexes, will rcpurt more satisfying outcomes. T tests were performed between the subsamples of same Era = 32)and opposite biological sex (n = 8). Cherall, the highest mean of successful outcomes was for client and therapist of the same biological sex. However, none of the differences was statistically significant for any of the four dimensions of outcomes. These results do not support the hypothesis. Respondents sometimes provided negative comments that were not included in the three general classes of outcomes. Most of these statements were made by clients and were more concerned with the therapeutic process than with the outcomes. The most frequently made complaint was that the therapist did not participate enough y' = 6 ) . Cmparism of Paired Clients and Therapists
The outcomes of the five client-herapist pairs were anafvzed in relation to the amount of agreement on indicated outcomes within each pair. The amount of agreement was analyzed. For each dimension of outcomes, each client-therapist pair could have: (a) "disagreement" (one respondent indicated a negative outcome, while the other indicated a positive outcome); (b) "imperfect disagreement" (mention of a positive or a negative outcome by one respondent and no mention of the outcome by the other respondent); or (c) "agreement" (both respondents mentioned either a positive or a negative outcome). h two-tailed r test was performed (between "agreement" and the two types of "disagreement") for each dimension. Table 4 presents the t values for each of the four dimensions. The table shows that overa~,there was disagreement concerning successful outcomes as reported by client and therapist. This difference in reported outcomes was shown tci be significant.
The first hypothesis,comparing the effect of same or different sexual orientation for client and therapist, was supported by the findings in this study, mainly by the outcomes for dealing with issues of sexual orientation. One reason for this positive result may be the initial basis of trust in the therapeutic relationship that is created when client and therapist are of the same sexual orientarion and are mutually disclosed. This simiIaritv of sexual orientation may enhance the personal qualities of rhtrapist and client which have been found related to successful outcomes, For therapists some of these qualities are empathy, warmth, interest, atten-
P e w Liljestrand, Ernest sterling, and Pm'ciQ A. SaEibo TABLE 4
Stgnificance
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
Dimnston o f O u t e m
Sexual or1entatf on Social sex-roles
Generil 01$agreement"
"Imperfect
d i sagrwnent"
herezl
Df s a g r e m t "
"lr~perf ect d i sagreenent"
2.449
p c .Ol
12.649
p < .01
riveness, understanding, recognition [that the problems are real and not imaginary), respect, and being a good listener (Katzenelbagen, 1958; Strupp, Fox, & Lessler, 1969). For dients some of the qualities are motivation, confidence in the therapist, and degree of voluntariness (Kauenelbogen, 1958; Suupp, Fox,& Lessler, 1969). For the homosexual dient and therapist these personal qualities would be enhanced when dealing specifically with issues of sexual orientation because of their sharing of very personal experiences [being "different" and "coming out"). The dient may feel more confidence and be more willing to take risks in therapy. The second hypothesis, comparing social sex-role stereotypes of female dients and therapists, was not supported by the fmdings. In fact, the resulrs show a trend in the opposite direction. T h e most satisfying outcomes are achieved when dient and therapist both conform ro the feminine stereotype, A possible explanation may be that congruency in the dients' and therapists' expectations of the therapy is positively related to the psychotherapeutic process (Bergin & Strupp, 1972). These expectations would be particularly relevant in the area of social sex-roles. I t is conceivable that when both the female dient and the therapist conform to the feminine stereotype, the expectations of the therapeutic relationship are dearer and more consistent than where one or both depart. Departure from the feminine stereotype may indicate experimentation with nontraditional behavior, and as such could include ambiguous values and expectations. Departure may also provide more options for dients in developing both their femininity and masculinity. The structure of the sample may also explain the results for the hypothesis. Only the clients' and therapists' ratings on the scale for the
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
JOURNAL OF HOMOSEXUAUTY feminine stereotype were analyzed for this report. However, analysis of their ratings on the scale for the masculine stereotype couId give different results. A high rating on one scale can occur with either a high or a low rating on the other scale. An analysis oE the ratings on both scales for both the client and the therapist could give several additional sexrole combinations. These combinations may be relevant for the outcome in regard to similarity of internal conflict and complementarity of dominance and submission of dient and therapist. A third explanation for the results may be found in how interviews were conducted, and in the composition of the sample. Some of the women who were interviewed, mainly feminists and lesbians, resisted responding to the questions about social sex-roles.They perceived social sex-roles to be restraints and had consciously tried to rid themselves of thinking in terms of stereotypes, but dso consciously attached new values to the old stereotypes. When requested to rate themselves and the other person, they may have confused values and stereotypes. Possibly these women responded more in terms of how they approve or disapprove of the stereotypes per se, and rated themselves and the orher person using their own personal values instead of the stereotvpes as they exist for the general population. The third hypothesis, comparing social sex-role stereotypes of male clients and therapists, was pardy supported. There is a trend toward more successful outcomes when either the male client or therapist depare from the masculine stereotype, compared with when they both conform. It is possible &at when one individual in the relationship departs from the masculine stereotype, an interpersonal climate that is more conducive to psychotherapy is created. In comparing the results for hypotheses 2 and 3 it appears that women achieve more satisfying outcomes when they both conform to the feminine stereotype. whereas men achieve better outcomes when one conforms to and the other departs from the masculine stereotvpe. .A possible explanation could be differences in the struggle in overcoming social sex-role stereotypes for men and women. Research by I. Broverman et 4.(1970) shows that "masculine" qualities are culturallv more highly valued than "feminine" qualities. Women who struggle to get away from the limitations of t h e social sex-role stereotvpes rvould have not only to integrate "masculine" qualities but also to rid themselves of negative attitudes toward "Feminine" qualities. .Men wot~ldpredominantly spend heir energy on developing as well as integrating "feminine" qualities. Dealing with the issue of social sex-roles in therapy may be of a more complex nature for women than for men as reflected in the differing results in this report. T h e fourth hypothesis comparing biological sex of client and therapist was not supported. It is possibk that the biological sex of clients and therapists only has an effect on the treatment outcomes to the extent thar
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
Petra Lijestrand, E m s t Gmling, and Pahcia A. Saliba sex differences manifest themselves through departures from and conformances to the social sex-role stereotypes. Previous research attributing different outcomes to the variable of biologid sex alone probably has confounded the effects of biological sex with those of social sex-role stereotypes. The personaiity qualities associated with an individual's biological sex, and conceived as affecting the treatment outcomes, could be attributed to the social sex-roleslearned by men and women. A wealth of data on psychotherapeutic variables (type of therapy, particuIar therapeutic issues, basis of referral, and choice of therapist) was collected but not analyzed for this paper. Current data analysis will explore some of these variables and their relationship to treatment outcomes. Fumre research could investigate the impact of the therapy with regard to changes in the client's sexual orientation taking place during therapy or after it was terminated. Particular changes could be related to how issues of sexual orientation and social sex-role were dealt with in the client's previous therapy. Attention could also be given to changes reported by therapists in their own sexual orientation,and in their departures from and conformances to the social sex-role stereotypes. The analysis of agreement between clients and therapists in rating outcomes of therapy was a minor focus of this study. T h e results, however, are of major importance. The finding of signifiant differenms in the pairs' ratings of the outcomes implies that research on ooutcomes of psychotherapy should include an evaluation by both client and therapist.
CONCLUSION This study has examined the relationship of biological sex, social sex-role stereotypes, and sexual orientation to successful outcomes in psvchotherapy. The findings suggest that the variable of social sex-role stereotypes is the most signifimnt and'complex factor contributing to successful outcomes. REFERENCE NOTES 1. Bleckner. J. Personal communicadon, 1977. 2. Clcvel~nd.P. Personal communication. 1977. 3. Wandrei, K. Lesbiatns' experience in therapy. Submitted as a paper for Seniors' Honors Program in Psychology, University of Caliiomia at Berkeley, 1975.
REFERENCES Bergin. A. E., & Strupp, H. H.C-ng AldinelAtherwn, 1972.
frmttkn in I/tr h
e
ofPsgJl&q~.
Chicago:
Brovwman, D. M.. Klaibcr. E. L., Kohyashi, Y.,& Vogel, W. Rdes of activation and inhibition in sex d i f f e r e m in cognitive abilities. Pqchologital R&, I968,75, 23-50.
JOURNAL OF HOMOSEXUAWTY Broverman, I., &roverman. D., Clarkson. F.. Rosenkranre, P.. & Vogtl. S. Sex-role stereotypes and clinical judgments of mental health-Journal of Cmuulting and CIinical P ~ h d o g y ,1970,34 (I). 1-7. Broverman. I., et al. Sex-role stereotypes: A current appraisal.J w m d ofSocial Issues, 1912. 28. 59-79. ~ u d e rR . L. Countertransfcrencc effects in psychotherapy.Journal $ConiulLing P - y h o l o s . 1958,22, 949-356. De Cecco, j.P.. Minnigerodc, F. X., Adelman. U. R.. Shively, M. G.. rG Knurson. D. C. Research on the violations of civil E k n i e s of homosexual men and women. Juurnal of H M A Q T 1977.2(4), ~ ~ ~ . 315-942. Hill, C.Sex of dient and sex experience twel of counselor.Journal $Cowulting Psycholog)', 1975,22(1),6-1 1. Howard, K.,Orlinsky, D.,& Hill J. Patient's satisfaction in psychorherapy as a function a l patient-therapist pairings. Psychotherapy: Tho?, Research and Practtce. 1 970.7, 130-1 34. Katzenelbogen, S. Anabzing p.sychothe~apr.Xew York: Philosophical Libiarv, 1958. Saghir, M., & Robins. E. .WaL and female h o ~ ~ l ~ c m Baltimore: lit~. Wiltiams L Wilkins.
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
1973. -- - - -
Shivrly, M. C..& De Cecco, J. P.Components of se?rual idenrity.juurna1 aJ'Hmlut.t.slrr~lit~. 1977.3(1), 4 1 4 8 . Steinrnann, A. Culrural values. female rote expecrancies and therapeutic goals: RescarcI~ and interpretadon. In V. Franks & V. Burde (Eds.),Wmmm in tlm(ip:.Vrul purhuthrrup1p.r /or a chmaging rocieq. New York: Brunner/Mazel, 1974. Suupp, H. H.,Fox, R. E., k Lcssler. K. Paitmu v ~ r wthrir p ~ r h h ~ r a p pBaltimore: . Johns Hopkins Press, 1969.
Journal of Homosexuality Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/wjhm20
The Effects of Social Sex-Role Stereotypes and Sexual Orientation on Psychotherapeutic Outcomes Petra Liljestrand MA , Ernest Gerling & Patricia A. Saliba Published online: 26 Oct 2008.
To cite this article: Petra Liljestrand MA , Ernest Gerling & Patricia A. Saliba (1978) The Effects of Social Sex-Role Stereotypes and Sexual Orientation on Psychotherapeutic Outcomes, Journal of Homosexuality, 3:4, 361-372, DOI: 10.1300/J082v03n04_04 To link to this article: http://dx.doi.org/10.1300/J082v03n04_04
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/ terms-and-conditions
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
THE EFFECTS OF SOCIAL SEX-ROLE STEREOTYPES AND SEXUAL ORIENTATION O N PSYCHOTHERAPEUTIC OUTCOMES Petra Liljestrand, MA Ernest Gerling Patricia A. Sdiba
ABSTRACT: This paper examines &e rehamship of bi&&al sex, s&l sa-r& s&e*es, a d s w L o r k h t i r n of c1imi a d herapkt ta Bsyda&ape&c outcomes. It uws hypothesized .that w t a l o p bihgkal sa,dqbartures in s o d sm-role, a d s d otht&on of e l k t and admpkt d have pm'tivc effects on pqchdmapeu& mtcmes. T w & f w u c h and 16 dkarapts, ilecldngfwe cld-ther+wt Ms, were inm'md on how issues Of s o d sex-role s&r+ng and sexud &basion arose and ume ded6 wn'sh tn hwnpy. Tb r m h i d k a k d (a) a trmd bward more paceaCeti~s &oms d e n c l i d and ihsrapiss were of the same SEX> and (b) & sinbihiQ qf s d &n&hwz of r l i w and thmapui k r e b d lo positive psyck&aputic ou!zms. The rwbtr for dqbartarref ~ a msoda/ sex-r& Stfleolypar wt anconchue.
This study focused on the following research question: What is the relationship of biological sex, social sex-role stereotypes. and sexual orientation of cIients and therapists to psychotherapeutic outcomes? The major variables in this research question were defined as follows: Biologicai sex refers to clients and therapists being female or male. S o c d sex-rode refers to characteristics that 'are culturally associated with men and women. S o c d sex-role st.ereotrpa refer to perceptions of these characteristics as feminine or masculine. Sexual mi&tion refers to the individual's physical: and affectional preference for individuals of the opposite or the same sex. There* refers to professional and paraprofessional clinicians providing treatment. Cla'eni refers to men and women who volunteer for treatment. Successful p~hothwapmticonstcmes are identified in terms of (a) self-knowledge, which indudes self-awareness and self-acceptance; (b) self-acrualization, which includes the abiIity to use self-knowledge: and (c) sarisfaction with the experience of selfactualizing in the areas of social sex-role and sexual orientation. LITERATURE REVIEW A review of perdnent literature reveals that the pairing of &nt and therapist with particular characteristia is an important factor for positive Thr adtors are research mista~tsa6 tk Cpla6erfor H m e m a l Educdm, E v a h i m and Research, San Fmnckco Stale Univm+ty,San FranEisco, C a l $ h k 94132. J o u d OI Homcscxuality. Val. 3(4), Summer 1978
@ 1978 by Tht Hmwnh Prcss. AU
+ S I
rcurvtd.
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
JOURNAL OF HOMOSEXUALITY psychotherapeutic outcomes. Cutler (1958) obtained findings that suggested that a therapist paired with a patient who had similar internal conflicts would perform less skillfully than a therapist and a patient who had dissimilar conflick. Bergin and Strupp (1972) reviewed several studies &at indicate that there must be some complementarity of dominance and submission of dient and therapist. Several studies have shown that the pairing of client and therapist by biological sex can be an important factor for psychotherapeutic outcomes. Howard, OrIinsky, and Hill (1970) found that female clients were more satisfied with female than with male therapists. In one study more success was reported when client and therapist were of the same, rather than opposite, biological sex (Bleckner,Note 1; Cleveland, Note 2). The combination of femaIe client and female therapist was more successful than the combination of male client and male therapist. Furthermore. the study showed that female therapists had more success with male clients than male therapists had with female clients. Hill ( 1973) studied the relationship of biological sex of clients and of inexperienced and experienced therapists to the psychotherapeutic process. She found that same-sex compared with opposite-sex pairs yielded more emotive responses that were relevant to the psychotherapeutic issues. There have been a series of studies on rhe relationships of the social sex-roles of therapists to psychotherapy. In three s~udiesit was found that both female and male therapists conceptualized the healthy individual by using more characteristics of the masculine stereotvpe for men than characteristics of the feminine stereotype for women (D. bl. Broverman, Klaiber, Kobayashi, & Vogel, 1968; I. Broverman, Broverman, Clarkson, Rosenkranu, & Vogel, 1970; I. Broverman et al.. 1972). Steinmann (1974) studied how individuals of each biolopcal sex (a} conceptualized the "ideal man" and "ideal woman" and (b) predicted how &e opposite sex conceived of the ideal man and ideal woman. She found that males and females had similar conceptions of the ideal woman. She also discovered that females incorrectly guessed how males described the ideal woman. Females thought the males expected characteristics for the ideal woman that were more stereotypic than the characteristics that the males actually listed. In addition she used her research findings successfully in psychotherapy to help clients identify areas of conflict around sex-role ambiguities. There has been little research done specifically on the effects of pairing sexual orientation of client and therapist. In fact, it has been assumed in clinical research chat a heterosexual orientation is the only suitable orientation for therapisa (Bergin & Strupp, 1952). Saghir and Robins (1973) reported that about one-third of the homosexual clients they interviewed had negative feelings about their psychotherapy. The homosexual clients indicated h t their therapists were personally prejudiced agaiist the hornovexual orientation and life-styIe. Wandrei (Note
.
3) studied the attitudes of 36 homt>sexualwomen dients toward their therapists. She concluded that the dients with homosexual therapists as compared to dients with heterosexual therapists felt (a) more favorable toward their psychotherapy and (b)that their therapists had more positive attitudes toward their homosexual feelings and were more effective Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
as therapists.
HYPOTHESES There were four hypotheses for the study: 1. Clients and therapists of the same sexual orientation, as compared with dents and therapists of different sexud orientations, will re-
port more successful therapeutic outcomes.
2. Female clients and therapists, one or both of whom depart from the feminine stereotype, as compared with those who both conform, will report more successful therapeutic outcomes. 3. Male clients and therapists, one or both of whom depart from the mascuIine stereotype, as compared with those who both conform, wiIl report more succ~ssfultherapeutic outcomes. 4. Clients and therapists of the same biological sex, as compared with dients and therapists of opposite biologial sexes, will report more satisfying outcomes. SAMPLE
The respondents included 24 men and women who had been in psychotherapy and 16 therapists. Included in the sample were five client-therapist pairs. Most respondents were obtained through professional and friendship networks in the San Francisco Bay Area. The majority of respondents indicated that they received or provided individual rather than group or couples treatment.
Twelve maIe and I2 female dients were interviewed. Their ages at the time of therapy ranged from 14 to 49 years, with a modal age of 23 and a median age of 26. Eighty-three percent of the dients were white. Fifty-eight percent were Protestant, 2 1% were Catholic, and 2 1% had other religious affiliations or no affiIiation. All the dients had an educational level of some college or higher. The larger percentage were students or employed at professional leveb. Table 1 shows the sexual orientation of the dients at the time of psychotherapy. Sexual orientation is shown on three dimensions of
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
JOURNAL OF HOMOSEXUALITY (a)physicalsexual activity, (b) dose relationships, and (c) erotic fantasies. Each respondent rated herselfhimself on each dimension using the CHEER &point Sexual Orientation Scale (DeCecco et a]., 1977). Clients who indicated that they were exclusiveIy or predominant1y heterosexual were mtegorized as heterosexual. Clients who indicated that they were equally heterosexual and homosexual were categorized as bisexual. CIients who indicated that they were exciusively or predominantly homosexual were categorized as homosexual. Clients who indicated that the); had physical sexuaI activity, close relationships, or erotic fantasies with or about no one, were categorized on the basis of their previous experiences. Table 1 shows chat the percentage of clients with a particular sexual orientation varies with the dimension used as a basic indicator. When physical sexual activity is used, 54.2% of the clients were homosexual. When cIose rehrionships is used, 45.8% of the clients were homosexual. When erotic fantasies is used, 34.2% of the clients were homosexual. To determine to what extent respondents conformed to or departed from the social sex-rolestereotypes. respondents were asked to rate themselves lor femininity on one scale and for masculinity on another scale using the CHEER 4-point rating scales (Shively 9c De Cecco, 1977). M e n and women who rated themselves 1 (notat all feminine) and 2 (somewhat feminine) on the femininity sale were classified as departing from the femhine stereotype. Those who rated themselves 3 (moderarely Feminine) and 4 (very feminine) on the femininity scale were classified as conforming to the feminine stereotype. Departure from and conformance to the masculine stereotype were determined in the same way as departure from and conformance to the feminine stereorvpe. In this report neither conformance to nor depanure from one stereotype is interpreted as conformance to or departure from the other stereotype. TABLE 1
Serua.1
Physical Sexual A c t i v i t y
Close Relatfonshf ps
-
Erotic
Fantastes
Orientation
a
Wanosexual
13
54.2
11
45.8
13
54.2
Bisexual
2
8.3
10
41.7
2
8.3
Heterosexual
9
37.5
3
12.5
9
37.5
P
I n the anatysjs of data. physical sexual aetivSty was used as e. basis for classifying clients' sexual orlentation-
the
Of the men dients, 8.3% departed from both stereotypes, and 83.35% were conformed to the masculine stereotype. Of the women dients, 35 3%departed from both,the feminine and masculine stereotypes and 98.3% conformed to the feminine stereotype.
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
Therapists Ten female and six male therapists were interviewed. Their ages ranged from 22 to 31 years, with a modal age of 28 and a median age of 33.5 years. Fifteen therapists were white and one was black. Fifty percent were Protestant, 19% were Catholic, 13% were Jewish, and 18% had other religious affiliations or no affiliation. The larger percentage of therapists had an educational level of a master's degree or higher. Of those who had obtained doctorates, two were psychiatrists and three were psychologists. Table 2 shows the sexual orientation of the therapists. When physical sexual activity is used as the basic indicator of sexual orientation,68.7% of the therapiss were homosexual. When dose relationships is used, 31.3% were homosexual. When erotic fantasies is used, 56.3% were homosexual. In rating themselves on the masculinity and femininity sales, 10%of the female therapists indicated that they departed from both the feminine and masculine stereotypes, and 80% indiated that they conformed to the feminine stereotype. Of the male therapists, 16.7%departed from both stereotypes, and 83.3% conformed to the masculine stereotype.
Clzents a d Thmprits
In comparing the results of the ratings for the soda1 sex-role stereotypes it was
found that: (a) more female dients than female therapists deTABLE 2 SparaZ Odmbtion of Thowpists
Sexual Orientat4 on
Physical Sexual Ac.tfvity
f
'%
Close Relationships F
5:
Erotic
Fantasies C J
%
11
68.7
5
31.3
9
56.3
Btsexual
0
0.0
10
62.4
3
18.7
Heterosexual
5
31.3
1
6.3
4
25.0
16
100.0
16
100.0
16
190.0
Homosexual
Total
JOURNAL OF HOMOSEXUALllY parted from both stereotypes; (b) more female therapists than female clients conformed to the feminine stereotype; (c) more male therapists than male clients departed from both stereotypes; and (dl equal percentages of male therapists and male dicnts conformed to the masculine stereotype. Five pairs of clients and therapists were separately interviewed. Trvo pairs were female and Ehree were male. Four pairs contained individuals who had the same sexual orientation: T w o were heterosexual.and two were homosexua1.
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
METHODOLOGY T w o interview schedules were develop&ne for clients and one for therapists. T h e uestions asked covered the following: (a) background data on the diem and t e therapist: (b) data on previous therapeutic contacrs and prescrlr therapeutic setting; (c) the respondent's perceptions of issues and procedut-esin therapy; ( d ) data on the sex-roIe stereatvpes and sexual orientation of the respondent and of hidher client or therapist; (e) description of a session that cy ifred the working relationship; and ( f ) assessment of therapeutic outcomes. A data were c d e d by at least two coders in order to establish coding reliabilin. For the purposes of this report analysis of dam was restricted to the follurving variables: age, biological sex, education, occupation. raciauethnic background. religion, sexual orientation, femininity and masculinity, and assessment of therapeutic outcomes. Four categories of therapeutic outcomes were analyzed: (a) social sex-roles. including femininity and masculinity; (b) sexual orientation. including physical sexual activity, close relationships, and erotic fantask; (c} general outcomes. self-actualization, self-control. inincluding self-knowledgeand ~el~acceptance. terpersonal communicarion, relief of pain, and M ~ u ~ ~ o Iof I problems: and (d) other outcomes considered to be negative by the respondent. -111 outcomes were coded for (a) gains or successful therapeudc achievements and (b) losses or faiIures and no change. For this report, only data on successful psvchorherapeutic outcomes were analyzed.
1
R
RESULTS
The results were determined on four dimensions: (a) sexual orientadon: (b) social sex-roles; (c) general autcornes; and (d) overall outcomes. Overall outcomes was a total of the outcomes for the three specific dimensions. The first hypothesis was: Clients and therapists of the same sexual orientation, as compared with clients and therapisa of differenr sexual orientations, wi1I report m w e successful therapeutic outcomes. Table 3 shows the means of successful outcomes for dealing with issues of sexual orientation. T h e results of the t test (t = 1.989,p < .05) indicated that the dif-
Petm Lijeswnd, Ernest Gding, rsad Patricia A. S d b a TABLE 3 O
u
~ for s DeaZing u i t h Issues of S-b OrLentatCm
Gains
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
Sexual Orientation of Client and
Losses,
Failures,
Therapist
-
D i f f arent (n * 16)
.750
-
Na Chanoe -
-
1.688
No Data
-
,563
ference in outcomes for dealing with issues of sexual orientation in therapy was significant. T h e t test for outcomes dealing with issues of social sex-role (t = .170) and for general outcomes (t = .929) indicated that the differences were not signifimnt. The results of the t test for overaIl outcomes (t = 1.736, p< .05) indimted that the difference was significant. The results support the hypothesis. The second hypothesis was: Female dients and therapists, one or both of whom depart from the feminine stereotype, as compared with those who both conform, wiIl report more successful therapeutic outcomes. T tests were performed comparing the subsamples of: (a) both conformed (n = 7) versus one departedlone conformed (n = 41, and (b) both conformed versus both departed (n = 5). A comparison of the results revealed that: (a) in three out of the four dimensions of outcomes the highest mean was for clients and therapists who both confarmed to the feminine stereotype,and (b) the only difference found to be significant (6 = 3.384, $ < -005) was for dealing with issues of social sex-roles, where they reported significantly better outcomes than situations where one conformed to and the other departed from the stereotype. The results do not support the stated hypothesis. T h e third hypothesis was: Male dients and therapists, one or both of whom depart from the masculine stereotype, as compared with those who both conform, will report more successful therapeuric outcomes. T tests were performed between the subsampks of both conformed (n = 10) versus one departedlone conformed (n = 5). The subsample of male clients and therapists who both departed from the masculine stereotype (n = I) was not large enough to be analyzed. A comparison of the results revealed that: (a) in three out of four dimensions, the highest mean for successfuL outcomes was where one departed from and the other conformed to the mascuIine stereotype, and (b) the only difference found to
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
JOURNAL OF HOMOSEXUALITY be significant (t = 1.866, p < .05) was for dealing with issues of social sex-roles. The results partly supported the hypothesis. The fourth hypothesis was: Clients and therapists of the same biological sex, as compared with clients and therapists of apposite biological sexes, will rcpurt more satisfying outcomes. T tests were performed between the subsamples of same Era = 32)and opposite biological sex (n = 8). Cherall, the highest mean of successful outcomes was for client and therapist of the same biological sex. However, none of the differences was statistically significant for any of the four dimensions of outcomes. These results do not support the hypothesis. Respondents sometimes provided negative comments that were not included in the three general classes of outcomes. Most of these statements were made by clients and were more concerned with the therapeutic process than with the outcomes. The most frequently made complaint was that the therapist did not participate enough y' = 6 ) . Cmparism of Paired Clients and Therapists
The outcomes of the five client-herapist pairs were anafvzed in relation to the amount of agreement on indicated outcomes within each pair. The amount of agreement was analyzed. For each dimension of outcomes, each client-therapist pair could have: (a) "disagreement" (one respondent indicated a negative outcome, while the other indicated a positive outcome); (b) "imperfect disagreement" (mention of a positive or a negative outcome by one respondent and no mention of the outcome by the other respondent); or (c) "agreement" (both respondents mentioned either a positive or a negative outcome). h two-tailed r test was performed (between "agreement" and the two types of "disagreement") for each dimension. Table 4 presents the t values for each of the four dimensions. The table shows that overa~,there was disagreement concerning successful outcomes as reported by client and therapist. This difference in reported outcomes was shown tci be significant.
The first hypothesis,comparing the effect of same or different sexual orientation for client and therapist, was supported by the findings in this study, mainly by the outcomes for dealing with issues of sexual orientation. One reason for this positive result may be the initial basis of trust in the therapeutic relationship that is created when client and therapist are of the same sexual orientarion and are mutually disclosed. This simiIaritv of sexual orientation may enhance the personal qualities of rhtrapist and client which have been found related to successful outcomes, For therapists some of these qualities are empathy, warmth, interest, atten-
P e w Liljestrand, Ernest sterling, and Pm'ciQ A. SaEibo TABLE 4
Stgnificance
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
Dimnston o f O u t e m
Sexual or1entatf on Social sex-roles
Generil 01$agreement"
"Imperfect
d i sagrwnent"
herezl
Df s a g r e m t "
"lr~perf ect d i sagreenent"
2.449
p c .Ol
12.649
p < .01
riveness, understanding, recognition [that the problems are real and not imaginary), respect, and being a good listener (Katzenelbagen, 1958; Strupp, Fox, & Lessler, 1969). For dients some of the qualities are motivation, confidence in the therapist, and degree of voluntariness (Kauenelbogen, 1958; Suupp, Fox,& Lessler, 1969). For the homosexual dient and therapist these personal qualities would be enhanced when dealing specifically with issues of sexual orientation because of their sharing of very personal experiences [being "different" and "coming out"). The dient may feel more confidence and be more willing to take risks in therapy. The second hypothesis, comparing social sex-role stereotypes of female dients and therapists, was not supported by the fmdings. In fact, the resulrs show a trend in the opposite direction. T h e most satisfying outcomes are achieved when dient and therapist both conform ro the feminine stereotype, A possible explanation may be that congruency in the dients' and therapists' expectations of the therapy is positively related to the psychotherapeutic process (Bergin & Strupp, 1972). These expectations would be particularly relevant in the area of social sex-roles. I t is conceivable that when both the female dient and the therapist conform to the feminine stereotype, the expectations of the therapeutic relationship are dearer and more consistent than where one or both depart. Departure from the feminine stereotype may indicate experimentation with nontraditional behavior, and as such could include ambiguous values and expectations. Departure may also provide more options for dients in developing both their femininity and masculinity. The structure of the sample may also explain the results for the hypothesis. Only the clients' and therapists' ratings on the scale for the
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
JOURNAL OF HOMOSEXUAUTY feminine stereotype were analyzed for this report. However, analysis of their ratings on the scale for the masculine stereotype couId give different results. A high rating on one scale can occur with either a high or a low rating on the other scale. An analysis oE the ratings on both scales for both the client and the therapist could give several additional sexrole combinations. These combinations may be relevant for the outcome in regard to similarity of internal conflict and complementarity of dominance and submission of dient and therapist. A third explanation for the results may be found in how interviews were conducted, and in the composition of the sample. Some of the women who were interviewed, mainly feminists and lesbians, resisted responding to the questions about social sex-roles.They perceived social sex-roles to be restraints and had consciously tried to rid themselves of thinking in terms of stereotypes, but dso consciously attached new values to the old stereotypes. When requested to rate themselves and the other person, they may have confused values and stereotypes. Possibly these women responded more in terms of how they approve or disapprove of the stereotypes per se, and rated themselves and the orher person using their own personal values instead of the stereotvpes as they exist for the general population. The third hypothesis, comparing social sex-role stereotypes of male clients and therapists, was pardy supported. There is a trend toward more successful outcomes when either the male client or therapist depare from the masculine stereotype, compared with when they both conform. It is possible &at when one individual in the relationship departs from the masculine stereotype, an interpersonal climate that is more conducive to psychotherapy is created. In comparing the results for hypotheses 2 and 3 it appears that women achieve more satisfying outcomes when they both conform to the feminine stereotype. whereas men achieve better outcomes when one conforms to and the other departs from the masculine stereotvpe. .A possible explanation could be differences in the struggle in overcoming social sex-role stereotypes for men and women. Research by I. Broverman et 4.(1970) shows that "masculine" qualities are culturallv more highly valued than "feminine" qualities. Women who struggle to get away from the limitations of t h e social sex-role stereotvpes rvould have not only to integrate "masculine" qualities but also to rid themselves of negative attitudes toward "Feminine" qualities. .Men wot~ldpredominantly spend heir energy on developing as well as integrating "feminine" qualities. Dealing with the issue of social sex-roles in therapy may be of a more complex nature for women than for men as reflected in the differing results in this report. T h e fourth hypothesis comparing biological sex of client and therapist was not supported. It is possibk that the biological sex of clients and therapists only has an effect on the treatment outcomes to the extent thar
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
Petra Lijestrand, E m s t Gmling, and Pahcia A. Saliba sex differences manifest themselves through departures from and conformances to the social sex-role stereotypes. Previous research attributing different outcomes to the variable of biologid sex alone probably has confounded the effects of biological sex with those of social sex-role stereotypes. The personaiity qualities associated with an individual's biological sex, and conceived as affecting the treatment outcomes, could be attributed to the social sex-roleslearned by men and women. A wealth of data on psychotherapeutic variables (type of therapy, particuIar therapeutic issues, basis of referral, and choice of therapist) was collected but not analyzed for this paper. Current data analysis will explore some of these variables and their relationship to treatment outcomes. Fumre research could investigate the impact of the therapy with regard to changes in the client's sexual orientation taking place during therapy or after it was terminated. Particular changes could be related to how issues of sexual orientation and social sex-role were dealt with in the client's previous therapy. Attention could also be given to changes reported by therapists in their own sexual orientation,and in their departures from and conformances to the social sex-role stereotypes. The analysis of agreement between clients and therapists in rating outcomes of therapy was a minor focus of this study. T h e results, however, are of major importance. The finding of signifiant differenms in the pairs' ratings of the outcomes implies that research on ooutcomes of psychotherapy should include an evaluation by both client and therapist.
CONCLUSION This study has examined the relationship of biological sex, social sex-role stereotypes, and sexual orientation to successful outcomes in psvchotherapy. The findings suggest that the variable of social sex-role stereotypes is the most signifimnt and'complex factor contributing to successful outcomes. REFERENCE NOTES 1. Bleckner. J. Personal communicadon, 1977. 2. Clcvel~nd.P. Personal communication. 1977. 3. Wandrei, K. Lesbiatns' experience in therapy. Submitted as a paper for Seniors' Honors Program in Psychology, University of Caliiomia at Berkeley, 1975.
REFERENCES Bergin. A. E., & Strupp, H. H.C-ng AldinelAtherwn, 1972.
frmttkn in I/tr h
e
ofPsgJl&q~.
Chicago:
Brovwman, D. M.. Klaibcr. E. L., Kohyashi, Y.,& Vogel, W. Rdes of activation and inhibition in sex d i f f e r e m in cognitive abilities. Pqchologital R&, I968,75, 23-50.
JOURNAL OF HOMOSEXUAWTY Broverman, I., &roverman. D., Clarkson. F.. Rosenkranre, P.. & Vogtl. S. Sex-role stereotypes and clinical judgments of mental health-Journal of Cmuulting and CIinical P ~ h d o g y ,1970,34 (I). 1-7. Broverman. I., et al. Sex-role stereotypes: A current appraisal.J w m d ofSocial Issues, 1912. 28. 59-79. ~ u d e rR . L. Countertransfcrencc effects in psychotherapy.Journal $ConiulLing P - y h o l o s . 1958,22, 949-356. De Cecco, j.P.. Minnigerodc, F. X., Adelman. U. R.. Shively, M. G.. rG Knurson. D. C. Research on the violations of civil E k n i e s of homosexual men and women. Juurnal of H M A Q T 1977.2(4), ~ ~ ~ . 315-942. Hill, C.Sex of dient and sex experience twel of counselor.Journal $Cowulting Psycholog)', 1975,22(1),6-1 1. Howard, K.,Orlinsky, D.,& Hill J. Patient's satisfaction in psychorherapy as a function a l patient-therapist pairings. Psychotherapy: Tho?, Research and Practtce. 1 970.7, 130-1 34. Katzenelbogen, S. Anabzing p.sychothe~apr.Xew York: Philosophical Libiarv, 1958. Saghir, M., & Robins. E. .WaL and female h o ~ ~ l ~ c m Baltimore: lit~. Wiltiams L Wilkins.
Downloaded by [Memorial University of Newfoundland] at 19:47 29 January 2015
1973. -- - - -
Shivrly, M. C..& De Cecco, J. P.Components of se?rual idenrity.juurna1 aJ'Hmlut.t.slrr~lit~. 1977.3(1), 4 1 4 8 . Steinrnann, A. Culrural values. female rote expecrancies and therapeutic goals: RescarcI~ and interpretadon. In V. Franks & V. Burde (Eds.),Wmmm in tlm(ip:.Vrul purhuthrrup1p.r /or a chmaging rocieq. New York: Brunner/Mazel, 1974. Suupp, H. H.,Fox, R. E., k Lcssler. K. Paitmu v ~ r wthrir p ~ r h h ~ r a p pBaltimore: . Johns Hopkins Press, 1969.
