Low-income blacks in community mental health: forming a treatment relationship

Sociodemographics, psychological symptom distress, and global adjustment were related to perceived quality of the therapeutic relationship at a community mental health center serving a predominantly low-income and black clientele. Data were collected at intake describing 56 clients; additional data were collected after two sessions of treatment, recording therapist perceived quality of the therapeutic relationship. Results indicated that with all else controlled, three factors predicted a favorable therapist evaluation: having ever been married; reporting more symptoms of psychological distress; having been rated as better adjusted. Apart from symptoms of hostility and somatization, the type of symptom distress suffered appeared less important than the number of symptoms and their severity. In this little studied but increasingly prevalent population of clients, it is possible to predict the formation of a promising therapeutic relationship by means of a relatively straightforward model of symptoms and adjustment.