Age, Gender and Health Bias in Counselors: An Empirical Analysis.

A substantial body of research shows that psychologists, social workers and psychiatrists exhibit age and gender bias that affects the way they diagnose and treat older clients. Other findings show bias against people who are in poor health. Relatively little research has examined how vulnerable professional counselors are to these biases. The current study compared the responses of professional clinical counselors with psychologists and clinical social workers. Using the Age Bias Questionnaire the research found that mental health professionals judged older clients significantly less competent and less likely to improve than younger clients. They also judged female clients as less competent than male clients regardless of age. This pattern was consistent across all three professions. Length of time in practice had an inverse relationship to judgment of competency. No evidence of health bias was found. Implications of these findings for access to counseling services for older Americans are discussed. Persons over the age of 65 underutilize mental health services. Between 10% and 40% of older adults suffer from some type of mental disorder (Molinari, 1996), yet this age group accounts for only 4% to 5% of the clients in community mental health agencies (Lagana, 1995; Lasoski, 1986). They also represent only 9% of all clients seen in private mental health offices (Gottlieb, 1994). Molinari calls this population the most underserved age group in the United States. A number of barriers to treatment exist for older adults (Nordhus, Nielson, & Kvale, 1998), but two merit special attention. The first is the belief systems of elders (Raue & Meyers, 1997). Their beliefs often include negative feelings about aging, acceptance of the society's stereotypes about them, and negative expectations about the capacity of counseling to be useful to them (Lagana, 1995; Lasoski, 1986). Attitudes of mental health professionals towards older adults form the second major barrier to treatment (Knight, 1996; Raue & Meyers, 1997). Researchers have found that mental health professionals are reluctant to work with older persons and perceive them of less interest than other adults (Gatz & Pearson, 1988; Kastenbaum, 1963; Myers, 1998). They also tend to view older individuals as having poorer prognoses than younger individuals (Busse, 1994; Ford & Sbordone, 1980: Ray, Raciti, & Ford, 1985), though the research is not unanimous on this point (Wadsworth, 1996). Myers (1998) concluded that counselors tend to view older individuals as being more set in their ways, less able to change, and less likely to benefit from mental health services in spite of the absence of any empirical evidence to support that conclusion. In fact, recent evidence suggests that elders are more open to changing their beliefs than those at mid-life (Visser & Krosnick, 1998). Treating older adults for psychosocial stress and mental illnesses has been found beneficial not only to those concerns (Nordhus et al., 1998), but also in alleviating physical discomfort related to medical problems (Klausner & Alexopoulos, 1999). In spite of this substantial body of evidence that counseling is effective for older adults, Myers (1998) reported that counselors-in-training have little interest in specializing in issues faced by older clients. In addition, Woolfe and Biggs (1997) concluded that counselors have little insight into the concerns of this age group. Similarly, Gatz, Karel, and Wolkenstein (1991) found that only a small percentage of psychologists currently working with older clients have specialized training in this area. Negative biases towards older adults have also been shown to influence the diagnostic process. Mental health professionals tend to attribute problems of older adults to situational factors over personality problems, even when evidence of personality dysfunction is present (James & Haley, 1995; McConatha & Ebener, 1992; Morrow & Deidan, 1992; Ray et al. …