The current study examined the effects of classist beliefs on trainee attitudes toward their client based on perceived social-class status. This study sought to determine whether classist attitudes contribute to meaningful differences in clinical decision making. A sample of mental health trainees (n = 147) attending graduate-level programs in the U.S. were recruited and randomly assigned to one of two clinical vignette conditions. Both vignette conditions included identical data regarding a hypothetical client’s presenting concerns (e.g., sleep disturbance, worry, rumination, loneliness), but differed on indicators of client socioeconomic status (SES). Results showed statistically significant between-group differences on ratings of clinical judgement based on random assignment to vignette condition. Participants who were randomized to the low SES vignette rated their client more severely on scales of psychological, social, occupational well-being, life functioning, and rated themselves as feeling less competent to successfully treat the client. Conversely, participants who were randomized to the high SES vignette provided superior ratings on the outcome variables and expressed a greater sense of competence to treat the client. Implications, limitations, and future directions for research are discussed.
","abstract_html":"<p>The current study examined the effects of classist beliefs on trainee attitudes toward their client based on perceived social-class status. This study sought to determine whether classist attitudes contribute to meaningful differences in clinical decision making. A sample of mental health trainees (n = 147) attending graduate-level programs in the U.S. were recruited and randomly assigned to one of two clinical vignette conditions. Both vignette conditions included identical data regarding a hypothetical client’s presenting concerns (e.g., sleep disturbance, worry, rumination, loneliness), but differed on indicators of client socioeconomic status (SES). Results showed statistically significant between-group differences on ratings of clinical judgement based on random assignment to vignette condition. Participants who were randomized to the low SES vignette rated their client more severely on scales of psychological, social, occupational well-being, life functioning, and rated themselves as feeling less competent to successfully treat the client. Conversely, participants who were randomized to the high SES vignette provided superior ratings on the outcome variables and expressed a greater sense of competence to treat the client. Implications, limitations, and future directions for research are discussed.</p>","abstract_has_math":false,"creators":["Coleman, Jeremy J."],"institution":null,"degree_name":"Ph.D.","degree_level":"Dissertation","degree_discipline":null,"degree_department":null,"school":null,"contributors":["Patton Garriott","Jesse Owen","Kathy Green","Jayson Richardson"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2021,"date_issued":"2021-01-01T08:00:00Z","date_published":"2021-01-01T08:00:00Z","updated_at":"2026-07-24T02:03:19Z","subjects":["Classism","Clinical decision making","Income inequality","Psychotherapy","Social class","Trainees","Clinical Psychology","Counseling","Counseling Psychology","Inequality and Stratification","Psychology","Social Justice"],"languages":["en"],"rights":["Copyright is held by the author. User is responsible for all copyright compliance.
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"],"dc:subject":["Classism","Clinical decision making","Income inequality","Psychotherapy","Social class","Trainees","Clinical Psychology","Counseling","Counseling Psychology","Inequality and Stratification","Psychology","Social Justice"],"dc:title":["Trainee Attitudes Toward Social Class as Predictors of Clinical Decision Making: Exploring the Effects of Classism in Psychotherapy"],"thesis:degree_level":["Dissertation"],"thesis:degree_name":["Ph.D."]},"updated_at":"2026-07-24T02:03:19Z"}