Date of Award

Summer 1991

Document Type


Degree Name

Doctor of Psychology (PsyD)




Virginia Consortium Program in Clinical Psychology

Committee Director

Barbara A. Winstead

Committee Member

Michael Stutts

Committee Member

Robin J. Lewis

Committee Member

J. D. Ball

Committee Member

Deanna Krauss-Zeilmann


This study investigated the effect of client gender on several aspects of clinical decision-making processes and clinical judgement when a client presented with a combination of depressive and alcohol-dependent symptoms. Forty-four male and 44 female clinicians, who came from various mental health disciplines (i.e., psychology, social work, counseling, nursing, and psychiatry), volunteered to participate as subjects.

The subjects were assigned to hear one of four audiotapes (two male tapes and two female tapes) in which mock clients gave the same initial presentation of symptoms and problems. After listening to the tapes, the clinicians were asked to engage in a number of tasks related to clinical judgement including the following: recall, question generation, diagnosis, attribution of etiological factors, prognostic judgements, and therapeutic recommendations of modality, style and length of treatment.

These results revealed that there were only significant client gender main effects for recommendations for therapeutic modality. Those clinicians who did not recommend individual therapy were most likely to recommend the male clients for group therapy and to recommend the female clients for marital therapy or medication evaluation. Also, there were significant interactions involving client gender by tape version and clinician gender by tape version.

It seems that client gender may not be a predominating influence for the clinical decision-making processes of recall, question generation, and diagnosis when a client presents with objective and behaviorally-anchored symptoms. However, client gender may play a significant role in the outcome decision of recommended therapeutic intervention. The complex interactions between client gender and clinician gender with the tape version suggest that subtle, vocal differences between the four actors influenced clinicians' judgements, and this phenomenon needs further investigation.


A Dissertation Submitted to the Faculties of The College of William and Mary, Eastern Virginia Medical School, Norfolk State University, Old Dominion University in Partial Fulfillment of the Requirements for the Degree of Doctor of Psychology in Clinical Psychology through the Virginia Consortium Program in Clinical Psychology.


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