Date of Award
Doctor of Psychology (PsyD)
Graduate Department of Clinical Psychology
Kathleen Gathercoal, PhD
Nancy Thurston, PhD
Sarah Hopkins, PhD
Discussing pro bono therapy has not been a popular topic in psychology literature. What has been written from a theoretical perspective is generally opposed to the idea of free therapy. The few empirical studies regarding pro bono therapy suggest that the relationship between pro bono therapy and negative therapeutic outcome is not clear. In fact, it can be argued that the main negative dynamics in free therapy reside within the therapist, not the client. Thus, the purpose of this study was to understand the impact of a pro bono therapy request on therapists' diagnosis. Members of AP A Division 12 (Practicing Psychologists) (n=89) responded to a mailed survey, which asked them to respond to a cases presentation by choosing the best diagnosis from a list of ten possible choices. Half of the participants (n = 47) responded to a case in which the client had requested pro bono therapy and the others (n = 42) responded to the same case without any mention of pro bono therapy. Participants also provided information about their age, gender, religious affiliation (if any), number of years they have been practicing, primary population served, and income (within a range). An independent samples t-test was calculated with case study type (pro bono or neutral) as the independent variable and diagnosis as the dependent variable. No significant differences were found between these groups; however, qualitative analysis of spontaneously offered alternative diagnoses suggests that respondents who received a case with a request for pro bono therapy were more likely to offer an Axis II diagnosis than those who received the same case without the pro bono request. Given these qualitative differences, it seems possible that the methodology chosen to research this question was not sensitive enough. Suggestions for further study are offered.
Bergen, Darin L., "Fee Guilt: Examining Clinician Bias Against Pro Bono Patients" (2007). Doctor of Psychology (PsyD). 508.