This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (30)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Myths and Facts

Arlene Frank, MS; Sherman Eisenthal, PhD; Aaron Lazare, MD

Arch Gen Psychiatry. 1978;35(1):61-69.

Abstract
• Traditionally, lower-class individuals who have sought psychiatric help have been hampered in their efforts by classrelated inequities in the delivery of psychiatric services. A common explanation for this phenomenon has been that the treatment conceptions of lower-class individuals are "inappropriate." This report presents theoretical and research evidence challenging this notion. A review of the literature from 1954 through 1974 yielded no good evidence that lower-class patients need, expect, or want treatments incongruent with those of upper-middle-class therapists. An experimental study of the requests for help made by 278 walk-in clinic patients confirmed this observation. Patient requests, as measured by an 84-item, self-rated questionnaire, were largely independent of social class. It was concluded that social class differences in treatment disposition and outcome cannot be attributed to social class differences in patients' treatment conceptions. The possibility that methodological and sociological factors can account for the discrepancies between the findings of this study and past studies is discussed. Strategies for minimizing treatment biases against lower-class patients and for maximizing treatment effectiveness with higher-class patients are also suggested.

Author Affiliations
From the Department of Psychiatry, Massachusetts General Hospital, and the Departments of Psychology (Dr Eisenthal) and Psychiatry (Dr Lazare), Harvard Medical School, Boston.

Footnotes
Accepted for publication May 6, 1977.

Reprint requests to Massachusetts General Hospital, 16 Blossom St, Boston, MA 02114 (Dr Eisenthal).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Predictors of Batterer Program Attendance
DALY et al.
J Interpers Violence 2001;16:971-991.
ABSTRACT  

Equity and Changing Patient Characteristics--1950 to 1975
Mollica and Redlich
Arch Gen Psychiatry 1980;37:1257-1263.
ABSTRACT  

Sociologic Influences on Decision-Making by Clinicians
EISENBERG
ANN INTERN MED 1979;90:957-964.
ABSTRACT