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Matching Client and Therapist Ethnicity Language and Gender a Review of Research

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Customer-therapist dyads and therapy outcome: Does sex activity matching matters? A cross-sectional report

BMC Psychology book 10, Article number:52 (2022) Cite this article

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Abstract

Matching clients and therapist based on demographic variables might enhance therapeutic outcomes. Notwithstanding, research in this field is nonetheless inconclusive and non much is known about same-gender client therapist dyads in the context of cognitive behavioral (CBT) and psychodynamic methods. For this purpose, we studied the therapy outcomes of North = 1.212 participants that had received therapy (3 months–6 years) in Germany. The results showed a trend for same-gender client therapist dyads in terms of symptom reduction and quality of life specific to psychodynamic approaches. The latter applied specifically to female customer-therapist dyads. On the other hand, this trend was non fully axiomatic for CBT-based therapies. In decision, despite the robust sample and observed trends, it is not clear whether matching same gender dyads is advantageous with regards to symptom reduction and quality of life. Regardless, these results are preliminary and further studies are needed in order to notice out whether same gender client-therapist dyads enhance therapy outcomes or not.

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Introduction

Identifying whether aforementioned gender client-therapist dyads heighten therapy outcomes or not, is highly relevant for clinical practice. In this way, the brunt of illness for patients and wellness care organization can be reduced. Past evidence related to customer therapist gender matching lacked statistical power or analyzed a single type of disorder. Hence, we examined several diagnosis in a robust sample, which distinguishes our research from past studies. Furthermore, previous evidence did non consider gender-matching in the context of specific psychotherapy methods. Therefore, our results were examined based on two established psychotherapy methods that are covered by the German health insurance, which is key when it comes to health-associated policies or individual preferences. In addition, nosotros illustrate a moving-picture show of the psychotherapeutic landscape in Federal republic of germany from the perspective of the patients, by providing detailed information on the issues and diagnosis of patients, including their symptom development.

Matching clients and therapist based on demographic variables is common clinical practise [1], as one possible arroyo in trying to optimize the fit between both parties (e.g., therapeutic relationship) also as psychotherapy outcomes [2, iii]. As suggested past past evidence, a strong therapeutic relationship predicts positive treatment outcomes [4], including positive effects in symptom reduction and full general ratings of success (amongst others); [iv,5,6]. Thus, information technology is plausible to assume that, in average, a skilful fit between client and therapist could be reflected in a strong bond / therapeutic relationship, as suggested by other researchers [7,viii,ix]. A proficient fit betwixt clients and therapist could also refer to equally having a similar understanding about managing emotions and attitudes [10,11,12]. Bowlby [13] reported that the psychotherapeutic relationship is comparable to the concept of attachment. Like in a parental or main caregiver human relationship, the psychotherapist offers emotional support, comfort and a "secure base of operations". In general, a positive therapeutic relationship is related to positive effects [4, half-dozen, 14, 15].

Ethnicity, historic period or personality variables take been too used every bit matching indicators. All the same, analyzing gender equally a matching indicator is widely recommended and is one of the most examined variables in counseling inquiry [iii, 16,17,18,19,xx]. Some researchers fifty-fifty discussed, that gender matched client-therapist dyads are essential for therapist to optimally adapt to the client'due south needs [16, 17]. Gender dyads or matching refers to client-therapist constellations of the same gender, e.m., female clients are assigned to female therapist, while male clients will be matched to male person therapist.

Theories suggest that individuals better identify and empathize with others if they believe to exist like to themselves [21, 22]. Accordingly, individuals develop certain gender-based behaviors or interactional styles and the convergence or divergence of these influences the quality of the human relationship and communication with others [23,24,25]. In this context, gender plays an important role, since information technology does not only refer to physical attributes, just to cultural aspects that touch on personality, attitudes, and behaviors [ii, 24]. The latter affects the individuals' world view in a way, that gendered schemas and social roles are internalized. As a result, social roles and gender expectations are reflected in specific behavioral interactional styles associated to gender [23, 25]. As an example, in western cultures men are typically socialized with traits attributed to authority and agency, such as striving for ability and independence. On the other hand, women are more than acquainted with communal traits or pro-social behaviors, such as solidarity and connectedness [26,27,28]. Correspondingly, both theories imply that aforementioned-gender client-therapist dyads have a greater convergence in terms of internalized gendered perspectives. For instance, men might instantly suppose that the male therapist will "get it" and consciously or unconsciously assume already an alliance [18]. Therefore, it is more likely that same-gender dyads share similar points of view and a comparable conceptualization of therapeutic related variables (due east.g., working brotherhood, well-being). These are thought to business relationship for a greater patient-therapist bail, translating into ameliorate therapeutic outcomes [iii, 28].

In the case of psychotherapy, positive outcomes refer to successful treatment, measured by a favorable treatment response, i.e., reduction of disorder specific symptoms, comeback in the quality of life, lower drop-out rates and even a better working alliance [29, thirty]. Many authors accept posited that addressing client preferences may boost therapy outcomes. In this regard, inquiry on client-therapist dyads has been reporting preferences towards same gender therapist [31,32,33,34,35]. However, in terms of outcomes empirical evidence shows inconsistent results. On the ane hand, studies revealed an comeback in psychiatric symptoms of gender-matched customer-therapist dyads [36, 37] reduced drop out [36, 38], better working brotherhood [3, xix], and greater satisfaction with the therapeutic human relationship [20, 33, 36]. Importantly, a previous study demonstrated that matched clients had significantly less utilization of intensive care services, saving costs effectually $one thousand (annually) per matched client [39]. On the other manus, authors have stated that gender matching is non a priority for clients neither an advisable predictor of the therapy processes and outcomes [1, 40,41,42], especially since the reported effect sizes are pocket-sized [3, 37, 43] and in some cases unknown [nineteen, 36]. A farther caption of these mixed findings may be related to limitations in methodological procedures, small sample sizes and heterogeneity concerning blazon of therapy.

Until now, symptom reduction has not been well documented in the context of same gender dyads and a specific types of therapy. For example, Staczan and colleagues [20] pointed out this gap and analyzed several treatment outcomes including symptom reduction in same gender pairings. Their written report showed highly significantly results in most of the studied variables in matched than in mismatched gender dyads. Nevertheless, no pregnant differences were shown amongst psychotherapy methods in terms of symptom reduction.

Regardless, the mentioned study did not examine cerebral-behavioral, behavioral, or psychoanalysis-based methods and if, some calculations included very modest sample sizes (eastward.thousand., Psychodynamic n = 4)—making findings susceptible to random fluctuations. Therefore, information technology is nevertheless not clear whether gender matching is relevant or not, depending on the type of therapy patients received.

The optimization of therapeutic outcomes may persistently reduce psychological symptoms and at the aforementioned time improve the quality of life of the patients [39, 44]. Identifying whether aforementioned gender client-therapist dyads enhance therapy outcomes or not has several advantages related to enhanced therapy outcomes (east.g., better quality of life, reduction of long-term financial burden for the health care system). Since cognitive-behavioral and psychoanalysis-based (i.due east., depth psychotherapeutic and psychodynamic therapy approaches) methods are covered by the High german public health insurance, price-effective measures that improve psychological interventions is a public/social concern.

Effective symptom reduction based on client therapist dyads is a very feasible procedure that can be easily implemented, if it turns out to exist a useful process that is evidenced based. Taking the described aspects into consideration the purpose of the nowadays study is to determine the relationship between aforementioned-gender client-therapist dyads and symptom reduction based on unlike types of therapies (Cognitive Behavioral Therapy, Psychodynamic approaches: e.g., Psychoanalysis and Depth psychotherapy). Based on previous findings, nosotros expect more positive outcomes in aforementioned gender customer-therapist dyads, compared to mismatched dyads. For this purpose, we assessed the post-obit outcome variables: Symptom reduction and quality of life in 2 different therapy approaches, 1. CBT and 2. Psychodynamic based methods.

Methods

Participants

The information of the study at hand were commissioned by the University of Leipzig and approved by their ethic committee (Approval number: WREBAM16102006DGPS). The data drove was carried out by the enquiry institute USUMA GmbH, Berlin. In general, north = 873 (72%) females and northward = 339 (28%) males with different mental wellness conditions participated in the study—a detailed clarification of the sample and psychiatric disorders is displayed in Tables i and 2. The length of therapy that participants received according to the therapy method is presented in Table 3.

Table 1 Demographic variables

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Table 2 Conflicts and diagnosis of the patients a) and Improvement on the specified diagnosis

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Tabular array three Therapy length received by the participants in each therapy method

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Process

The information was collected in Federal republic of germany in the context of a cross-sectional study design. First, in a general and nationwide telephone surveys of the population, citizens in individual households who had received psychotherapy within the final 6 years or had been treated for at to the lowest degree 3 months were identified and asked if they were willing to provide information well-nigh their treatment. After informed consent, these participants were asked most their outpatient psychotherapy by trained interviewers in a standardized phone interview. All households were selected via the High german market place research institutes (ADM) by a telephone sampling "eASYSAMPLe" (Bik-Aschpurwis and Behrend GmbH 2009) that also identifies phone numbers that are non recorded in the phone book which (Gabler-Heder method) [45]. In this mode, a random selection of the households contacted could be ensured. Within the household, the target participant was also randomly determined using the "Sweden cardinal" [46].

The inclusion criteria consisted in screening target participants of at to the lowest degree 18 years one-time, who were treated within the past six years or had been treated for at least iii months. From these, North = iv.306 participants were targeted. A full of Northward = 1.913 (44.42%) people agreed to participate in the written report. Of those who were willing to participate, only Due north = one.212 (28.fourteen%) interviews were carried out (response rate 74%). Reasons for exclusion of those who agreed were: The current therapy time was likewise short (< 3 months), the therapy was too long agone (> 6 years), the target person refused the interview (north = 71; 5.85%), the connexion was interrupted or the person was non available (northward = 73; vi.02%). In n = 170 (fourteen.02%) cases, the interviewer found out that the target person had received physiotherapy rather than psychotherapy.

Measures

The current study was based on questions that reflect the outpatient psychotherapeutic care in Deutschland from the patient's point of view, as previously reported [47]. The standardized telephone interview independent questions from "Consumer Reports" which were based on the method of Seligman's "Consumer Reports Study" [48]; German version, [49] and which was supplemented by further questions apropos the evaluation of psychotherapy. Such consisted in information almost several aspects including patients' diagnosis (e.g., anxiety disorders, depression, eating disorders), illness duration and assessment of the treatment too every bit type of psychotherapy method (east.k., CBT, psychoanalysis, depth psychotherapy). For this purpose, the participants were asked: "What symptoms/complaints prompted you to seek therapeutic help?" The responses of the participants were rated past trained interviewers based on four predefined ICD diagnosis (i.e., anxiety disorders, low, addictive behavior, eating disorders) and other somatic symptoms or complaints (east.g., coping with somatic affliction, sexual problems, work related conflicts). These diagnosis and symptoms were called, considering they are the most prevalent in Germany and most of the patients seeking psychotherapy are affected past these conditions as stated past the federal offices of statistics [l] and the lodge of psychiatry and psychotherapy [51].

The general state of listen of the participants was assessed at the showtime of therapy, which was reported on a 5-point scale from "i: very bad" to "5: very skilful". To gauge the degree of symptom reduction in the corresponding ICD diagnoses of those who completed treatment, the participants were asked: "Did the therapy helped to alleviate the symptoms / problems you sought aid for?" The answers were categorized as followed: ane = "I am doing a lot better", 2 = "I am doing slightly better", 3 = "… no modify", iv = "… I am doing worse", 5 = "…not certain/don't know". For the cess of the duration of the handling, the participants were asked to study how many sessions they had completed from the beginning until the cease of treatment. A therapy session last 50 min in Germany.

For the purpose of the present study, nosotros assessed the quality-of-life domain. Patients rated their perception in a self-written report calibration from 1 to 5 (i = "I am doing a lot ameliorate", 2 = "I am doing slightly improve", 3 = "… no alter", iv = "… worse", v = "not sure/don't know").

Statistical analysis

All statistical analyses were performed with the Statistical Package for the Social Sciences (SPSS version 24.0) and R [52]. For the present written report, we calculated a 2 (therapists' sex activity) × 2 (patients' sexual practice) between ANOVA with an blastoff-level of = 0.025 (Bonferroni adjustment), which takes into business relationship multiple testing. Subsequently, mail service-hoc-tests (i.eastward., estimated marginal means and bonferroni adjusted pairwise comparisons) were computed to specify differences throughout the comparisons of dyads of the dependent variables. As an effect size we reported partial η 2 with a 90% confidence interval. We tested the assumptions for the ANOVA (e.g., normality of residual distribution, homogeneity of variances) showing a normal distribution (F\(\le \hspace{0.17em}\)one.62, p ≥ 0.183). Regardless, the Shapiro Wilk was p < 0.001 besides as skewness and kurtosis demonstrated a low-cal divergence (i.e., for kurtosis the largest deviation was iii.44 and for skewness 0.75). Nevertheless, the ANOVA remains robust fifty-fifty if the normal distribution is non given, as demonstrated past Schmider and colleagues [53].

Results

Therapy setting

The majority of the psychotherapist were female person (57%), with a degree in Psychology (71%). Xl seven per centum of the respondents mentioned behavioral therapy, 41% therapy based on depth psychology and 5% psychoanalytic therapy equally a handling method, which was implemented as individual psychotherapy in 91% of the cases. Four per centum of the participants reported receiving a different psychotherapy method other than the higher up mentioned and three,6% were not sure nigh the method received. These latter mentioned groups were not included in the analyses, since the psychotherapy method was not clear. The 698 subjects who had completed therapy had an average of 48 sessions (SD ± 68.half-dozen) and a median of 30. There were no significant differences in terms of the boilerplate treatment length across therapy methods (F(3, 479) = 2.43; p = 0.064) – see Table 3. Forty three pct of all respondents had received outpatient psychotherapy in the by. Fifty five percent of all participants took medication for their mental health status.

Outcomes

Tables 4 and 5 show the results of the 2 × ii ANOVA and post-hoc tests (Figs. one, 2, 3, four) regarding client-therapist dyads by therapy arroyo and examined variables (i.east., symptom reduction and QoL). Neither the gender of the client nor of the therapist indicated a significant effect for symptom reduction / QoL in the two therapy-approaches (F\(\le \hspace{0.17em}\)3.28, p ≥ 0.070, η 2\(\le \hspace{0.17em}\)0.042).

Table 4 Mail-hoc tests and Interaction effects of gender-customer therapist matching in terms of QoL and Symptom reduction in CBT

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Table v Post-hoc tests and Interaction effects of gender-customer therapist matching in terms of QoL and Symptom reduction in CBT

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Fig. ane
figure 1

Post-hoc tests in QoL in psychodynamic-methods

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Fig. ii
figure 2

Postal service-hoc tests in symptom reduction in psychodynamic-methods

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Fig. 3
figure 3

Postal service-hoc tests in QoL in CBT-methods

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Fig. iv
figure 4

Post-hoc tests in symptom reduction in CBT-methods

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Further, none of the interaction furnishings demonstrated a significant result (run into Tables iv, five; Figs. 1, 2, 3, 4). The results of the post-hocs test revealed the post-obit outcomes. For CBT-methods female therapist matched with female person clients reached a significantly amend outcome in QoL compared to male therapist matched with male or female person clients. Concerning psychodynamic approaches, female person therapist matched with female clients reached a significantly better outcome in QoL compared to male person therapist matched with male or female clients. Male clients matched with male therapist showed a significant comeback compared to female clients matched with male person therapists. With regards to symptom reduction, female person therapist matched with female clients obtained significantly superior results than female therapist matched with male person clients (run across Tables iv, 5). Overall, the postal service-hoc tests indicated a positive outcome towards a same gender client-therapist matching especially for the female gender (vs. male client-therapist dyads) in QoL and symptom reduction within psychodynamic approaches vs. CBT-methods. For the latter, merely the dyad female person client and female person therapist in QoL was significant (see Tables 4, 5).

Diagnosis of the patients and symptom reduction descriptives are illustrated in Table 2. To make up one's mind the former, the participants were asked to report their complaints and symptoms that were crucial for seeking outpatient psychotherapeutic help. The majority of the respondents reported depressive (85%) and anxiety related symptoms (63.3%), while a minority sought outpatient psychotherapy due to addictive behaviors (thirteen.5%). Eighty iv percentage of the participants rated their initial condition at the beginning of therapy as "very bad" or "bad" (M = 1.72, SD ± 0.80).

Table 2 also depicts the accented and relative frequencies of the diagnosis and complaints reported as reasons for seeking handling besides as the distribution of the answers to the five categories to the question: "Did the therapy helped to alleviate the symptoms / problems you sought help for?" As demonstrated, virtually of the patients answered this question by "feeling much ameliorate" at the time they were asked to rate their perception of symptom alleviation after psychotherapy treatment. Improvement rates over 50% were observed in the post-obit variables: Suicidality (58.eight%), anorexia nervosa (56.2%) and bulimia nervosa (51.1%), panic attacks (50.6%). On the other mitt, the "deterioration rates" were consistently below five%, with the exception of "Issues in the workplace" = six.2%.

Of those participants who completed treatment (n = 698, mean therapy duration 15.75 months ± SD 15.77, 48 sessions, SD ± 68.six), they experienced an improvement in their complaints and problems after an boilerplate of approx. 50–56 treatment hours. Respondents who assessed their condition as "unchanged" completed an average of 35 therapy hours.

Discussion

The purpose of the study at hand was to decide the human relationship between same-gender client-therapist dyads and therapy outcomes (due east.yard., symptom reduction and QoL) based on different types of therapies (i.e., CBT-Methods and psychodynamic approaches). Birthday, the main findings did not support the epitome of improved treatment outcomes in same gender customer-therapy dyads. Nonetheless, based on our analyses one could speak of a trend in favor of same gender client-therapist (female-female) in terms of symptom reduction and quality of life in the context of psychodynamic approaches, compared to CBT-based psychotherapy. This latter consequence is in line with previous research showing no effect of same gender customer-therapist dyads [1, 40, 54, 55], fifty-fifty if not specific to CBT-based approaches. In add-on, the former finding was not consistent with the literature showing a positive upshot of same gender client therapist dyads on treatment outcome describing a better identification with similar others. Such understanding implies that same-gender customer-therapist dyads are more than likely to have a greater convergence in terms of internalized worldviews [18, 24, 25], consequently reflecting in enhanced therapy outcomes [3, 26, 28]. A possible explanation for the deviation between this and our results could be peradventure due to a lack of statistical ability. Our study only revealed a trend in favor of female customer matched with a female therapist rather than a significant issue. Thus, this corresponds with the results revealed in the nowadays report only at a descriptive level.

Notwithstanding, if considering the trends in the current study the better identification with similar others mostly applied to psychodynamic approaches. For the CBT-based psychotherapy QoL was enhanced in the female client-therapist dyad, while no other significant outcome was revealed in symptom reduction. Concerning psychodynamic approaches, merely a trend towards an interaction issue (gender-matching) was observed.

Of greater relevance, are the significant mail-hoc examination revealing a female effect: i.due east., generally female therapist matched to either female or male reached significantly better outcomes in QoL in both therapy approaches, compared to male therapist matched to males or females. Further, symptom reduction was also significantly greater in female person customer-therapist dyads (vs. male person-male dyads) if treatment was based on psychodynamic approaches. In other words, it is suggested that there is a tendency of female person and male clients to benefit more from treatment provided by female therapist (vs. male therapist), as reported in the past [3, 37, 43, 56, 57]. A possible explanation could exist that female person therapists are more responsive and empathic towards their clients. In improver, clients of both genders also tend to reply in a more positive mode to a female therapist at the kickoff of the treatment, which might influence the remaining treatment grade, as supported past previous bear witness [56,57,58].

The results in psychodynamic compared to CBT can be explained by the type of therapy methodology. Psychodynamic therapies (e.one thousand., depth psychotherapy/psychoanalysis) put more emphasis in interpersonal aspects (e.g., attitudes towards females or males), hence suggesting a greater relevance of gender [27, 28, 59], while CBT-based approaches tend to focus on modifying disorder specific behaviors. In depth psychotherapy, transference and countertransference are central aspects, whereby both, the gender of the client and the therapist may influence the therapeutic relationship [60]. For example, Tolle and Stratkötter [61] revealed that in same-gender therapy dyads transferences of both genders were reported, while in gender-mismatched dyads, the gender of the transference figure corresponded with the biological gender of the person. Nonetheless, the psychodynamic assumption of different transference patterns along gender boundaries is controversially discussed in depth psychology literature [62]. A basic supposition is that the gender of the therapist triggers (by) images in clients, which affect the interpretation of their "reality" by which transferences are build. The therapists react to this with countertransference or empathic responses, which are likewise influenced by gender part stereotypes [59].

An additional explanation of this female effect could be that in therapies using transference interpretations (equally in the case of depth psychotherapy and psychoanalysis), women experience the human relationship towards their therapist as an "affectively expressive" brotherhood. With male patients, female therapist might adjust the working relationship to the needs of their male clients and may grant or foster greater autonomy [63]. Additionally, it is conceivable that CBT-approaches and male person-male customer-therapist dyads may also fulfil the need for more than altitude and autonomy in male clients [63].

In spite of these findings, the therapeutic process is complex and might not be dependent on gender just. Importantly, our results are based on an observational rather than on an experimental sample and only pointed out a tendency with small to medium effect sizes. In improver, the outcomes of the present study must be interpreted with circumspection, since the results are based on the subjective perception of patients without considering the point of view of the therapist. Another limitation refers to the blazon of information collection. The results of the present study are based on a retrospective view and on a standardized interview rather than on validated instruments, making findings less comparable and perhaps less reliable. With regards to the latter business organization, fifty-fifty if retrospective studies are a valid method to collect information, such harbor advantages and disadvantages, as every other method. For example, it is known that cognitive processes (eastward.grand., memory) are not isolated from the electric current country of mind. Specifically, emotions and motivations might influence our perception and the judgments we make near the present and the by. Thus, in some cases, retrospective reports may not accurately represent specific recollections of information and rely on estimates and inferences [64, 65]. This reconstruction process could be a source of memory mistake, that might lead to a biased event, e.g., under or over-reporting of symptoms. Over-reporting tends to be greater for long term period events, when compared to brusque term periods [66]. Thus, it is possible that our participants might have overrated their symptoms, the longer ago the therapy was. Further, longer retrieve intervals could be associated with lower reliability of call back, and thus with a higher measurement error [65]. Fifty-fifty so, the recall intervals are distributed randomly across the different group variables. Hence, it is not expected to have adverse effects on the tests or the analyses. If anything, less reliable measurement / higher measurement error would rather pb to less statistical power and thus we would erroneously reject our hypothesis. Still, taking these aspects into consideration, further studies are needed to see how these results replicate.

Moreover, nosotros observed a gender disproportion, specially since more female than males participated in the study. In this respect, there is also a gender imbalance with regards to the therapists, since more females compared to males participated. Thus, information technology could be more probable to have a college female person matching in client-therapist dyads. This situation however reflects the current occupational distribution of psychotherapist in Germany. Information technology is estimated that around lxx% of the therapist are female, with a rising tendency [67]. A farther limiting aspect concerns the smaller sample sizes in the variable symptom reduction (vs. to QoL) for both therapy methods; which compromises its representativeness. Farther studies would benefit from larger samples in this domain. Perhaps time to come studies could target a greater responder rate by collecting data face-to-face. Possibly, an disability to create and maintain rapport vial telephone could accept affected the compliance to participate, considering not seeing the facial expression or body language of the interviewer might have negatively affected the response rate. Finally, our results excluded participants, who were in therapy for less than iii months. Hence, sudden gains or worsening of symptoms in this menstruation of fourth dimension is unknown.

In sum, a remarkable strength of the nowadays study is the large sample and the diverseness of disorders that patients reported, compared to past studies. Moreover, nosotros examined nearly widespread psychotherapy methods covered by the health insurance in Germany, which is relevant for public health related policies, economy and for individual choices, when seeking therapy. In addition, related studies could do good from including the perspective of the therapist in the analyses.

In conclusion, a recommendation to match same gender dyads in the context of psychotherapy is non quite clear based on our results. Therefore, more studies looking at the human relationship betwixt treatment consequence (due east.one thousand., symptom reduction in initial diagnosis) and the quality of the working alliance in the context of client-therapist gender matching with validated scales (e.grand., Symptom Bank check-List-90, Patient Wellness Questionnaire, Eating Disorders Inventory, Working-Alliance, Client Zipper to Therapist Scale) are needed to shed light on the revealed trend of the present study. This could allow a clarification whether or not same gender matching is relevant, especially in the context of depth psychotherapy approaches in terms symptom reduction and quality of life. If so, the results could be useful for health care policies and for clients in terms of decision-making when seeking psychotherapy.

Availability of information and materials

The datasets used and/or analyzed during the current study are available from the corresponding writer on reasonable request.

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Acknowledgements

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Funding

Open Access funding enabled and organized by Projekt Deal. Open Admission Funding past the Publication Fund of the TU Dresden.

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Author notes

  1. Katja Petrowski and Elmar Brähler are shared senior authorship

Affiliations

  1. Department of Medical Psychology and Medical Sociology, University Medical Centre of the Johannes-Gutenberg University Mainz, Mainz, Deutschland

    Ileana Schmalbach & Katja Petrowski

  2. Abteilung Für Innere Medizin 3, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Duesbergweg 6 (Campus), Dresden, Federal republic of germany

    Katja Petrowski

  3. Section of Psychotherapy and Psychosomatic Medicine, Academy Infirmary Leipzig, Leipzig, Germany

    Cornelia Albani

  4. Integrated Research and Treatment Centre (IFB) Adiposity Diseases, Universitätsmedizin Leipzig, Philipp-Rosenthal-Str. 27 (Red Business firm / House G), 04103, Leipzig, Germany

    Elmar Brähler

  5. Dispensary and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medicine Heart Mainz, Mainz, Deutschland

    Elmar Brähler

Contributions

KP: Conceptualization. IS: Methodology, writing of the main paper. KP and EB: Software and Validation, CA: Investigation and data management. All authors read and canonical the last manuscript.

Corresponding author

Correspondence to Katja Petrowski.

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Schmalbach, I., Albani, C., Petrowski, One thousand. et al. Customer-therapist dyads and therapy outcome: Does sex matching matters? A cross-sectional study. BMC Psychol 10, 52 (2022). https://doi.org/10.1186/s40359-022-00761-four

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