Inverting the power dynamic: The process of first sessions of psychotherapy with therapists of color and non-latino White patients

Lia Okun, Doris F. Chang, Gregory Kanhai, Jordan Dunn, Hailey Easley

Research output: Contribution to journalArticlepeer-review


The present study is the first to apply Trawalter, Richeson, and Shelton's (2009) stress and coping framework to qualitatively examine interracial interactions in initial sessions of psychotherapy. The sample included 22 dyads: 15 therapists of color administering various treatment modalities to 15 treatment-seeking non-Latino White (NLW) patients and a comparison group of 7 intraracial (NLW-NLW) dyads. In Phase 1, videorecordings of the first session of treatment were analyzed using inductive thematic analysis (TA) to describe patient and therapist behaviors. In Phase 2, a deductive TA approach was used to interpret and cluster those dyadic behaviors according to Trawalter et al.'s (2009) framework. NLW patients paired with therapists of color made more efforts to bridge differences and more often questioned the therapist's professional qualifications compared with those matched with NLW therapists. Therapists of color made more self-disclosures than NLW therapists and maintained a more formal stance, compared with NLW therapists. The deductive TA operationalized 4 of Trawalter and colleagues' (2009) coping responses within a therapeutic framework. Findings highlight the ability of therapists' of color to engage positively with their NLW patients even in the face of challenges to their expertise and credibility. (PsycINFO Database Record

Original languageEnglish (US)
Pages (from-to)443-452
Number of pages10
JournalJournal of Counseling Psychology
Issue number4
StatePublished - Jul 2017


  • Coping responses
  • First sessions
  • Therapists of color
  • White patients
  • Professional-Patient Relations
  • Humans
  • Psychotherapy
  • Male
  • Whites
  • Hispanic or Latino
  • Adult
  • Female
  • Power, Psychological
  • Adaptation, Psychological

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology
  • Social Psychology


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