Effects of client and therapist ethnicity and ethnic matching: a study of outpatient mental health treatment in indigenous and majority populations in Norway
Pages 456-460 in S. Chatwood, P. Orr and Tiina Ikaheimo, eds. Proceedings of the 14th International Congress on Circumpolar Health, Yellowknife, Canada, July 11-16, 2009. Securing the IPY Legacy: from Research to Action. International Journal of Circumpolar Health 2010; 69 (Suppl 7).
Sami National Centre for Mental Health, Lakselv, Norway
Department of Clinical Psychiatry, Institute of Clinical Medicine, University of Tromso, Tromso, Norway
Norwegian Institute of Public Health and Department of Psychology, University of Oslo, Oslo, Norway
Source
Pages 456-460 in S. Chatwood, P. Orr and Tiina Ikaheimo, eds. Proceedings of the 14th International Congress on Circumpolar Health, Yellowknife, Canada, July 11-16, 2009. Securing the IPY Legacy: from Research to Action. International Journal of Circumpolar Health 2010; 69 (Suppl 7).
Objectives: We explored the effects of ethnicity on mental health treatment in the Indigenous Sami and non-Sami Norwegian population of northern Norway. We examined the variations in client or therapist ethnicity or client-therapist ethnic matching on the delivery of treatment and in treatment outcome or improvement.
Method: Client (n=335) and therapist (n=33) demographics and ethnicity were recorded prior to intake. Self-reported psychosocial distress was recorded at intake, termination and at a 20-month follow-up. Therapists reported their clinical assessments at intake and discharge. The association between the ethnic variables, treatment delivery and clinical status were examined with regression analyses and analyses of variance. We used linear growth curves to explore ethnic variation in change in improvement over time.
Results: The results showed that the delivery of treatment and improvement did not differ significantly by client ethnicity. Therapist ethnicity was associated with the amount and type of service provided. Ethnic matching was associated with greater symptomatic improvement in treatments of moderate duration.
Conclusions: This study was conducted in the small multi-ethnic communities in northern Norway with a moderate sample size. The use of a categorical ethnic classification, global measures for description of clinical status and global categorization of the interventions may have served to veil the complexity of the interaction between ethnicity and treatment. Yet, within these limitations, the finding s indicate that ethnic matching positively impacted outcome and the ethnic background of the therapists seemed to influence their choice of treatment.