race, ethnicity, culture, psychotherapy, therapeutic alliance


The effects of matching clients with therapists of the same race/ethnicity have been explored using a variety of approaches across several decades. We conducted a meta-analysis of three variables frequently used in research on racial/ethnic matching: Clients' preferences for a therapist of their own race/ethnicity, clients' perceptions of therapists, and therapeutic outcomes. Across 52 studies of preferences, the average effect size was d = .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 d = .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 d = .09, indicating almost no benefit to treatment outcomes from racial/ethnic matching of clients with therapists. These three 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 three types of evaluations: preferences, perceptions, and outcomes.

Original Publication Citation

Cabral, R., & Smith, T. B. (in press). Racial/ethnic matching of clients and therapists in mental health services: A meta-analytic review of preferences, perceptions, and outcomes. Journal of Counseling Psychology.

Document Type

Peer-Reviewed Article

Publication Date


Permanent URL


American Psychological Association




David O. McKay School of Education


Counseling Psychology and Special Education