Effects of sex and gender in ten types of psychotherapy

Psychother Res. 2017 Jan;27(1):74-88. doi: 10.1080/10503307.2015.1072285. Epub 2015 Aug 20.


Objective: This paper addresses the results of two samples of a large naturalistic (effectiveness study) outpatient process-outcome study in Switzerland (Practice-Oriented Outpatient Psychotherapy Study). Ten different types of psychotherapy were investigated by looking at the role of the sex or gender of therapists and patients with regard to treatment outcome by including several nonspecific therapeutic factors.

Method: Ten different types of psychotherapy, 237 patients, and 68 therapists were included in the study. A subsample of 116 cases was analyzed with regard to therapists' technical interventions.

Results: Sex and gender issues of both therapists and patients did not play a crucial role in any type of psychotherapy investigated. Gender issues appeared to play an indirect role. Female therapists intervene more empathically, whereas male therapists tend to use more confrontational techniques.

Conclusions: Since the results show that therapists differ substantially with regard to their intervention techniques due to their sex, they should become more conscious of their interventions by considering patients' severity of psychological problems and patients' level of psychological functioning so as to not over or underchallenge them.

Keywords: gender in psychotherapy; sex of patient; sex of therapist; therapeutic alliance; treatment adherence.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Mental Disorders / therapy*
  • Outcome and Process Assessment, Health Care / methods*
  • Professional-Patient Relations*
  • Psychotherapy / methods*
  • Severity of Illness Index
  • Sex Factors