Are psychotherapists' first clinical impressions fundamentally biased? An experimental approach.

Abstract

Fifty years ago, the Rosenhan experiment was one of the most impactful psychological studies across decades. One of the main claims of the experiment was that clinicians could be negatively biased in their first clinical impressions, which would negatively impact further clinical decisions. We conducted two experiments (N = 56 and 64) in which psychotherapists were asked to give their first clinical impressions in two consecutive cases after a brief presentation of the case (case description and video excerpt) and a short recall task of the information provided. The attentional focus in the recall task served as an independent variable. Therapists had to adopt either a symptom-focused or a strength-focused attentional focus to recall the cases, that is, therapists rated their first case in either the symptom-focused or the strength-focused condition and the second case in the opposite condition. In both studies, therapists in the symptom-focused conditions rated patients as slightly more distressed, less resilient, and less psychosocially integrated in comparison to the strength-focused conditions. However, even statistically significant, these effects were rather small to clinically negligible. Our preliminary results suggest that the first clinical impressions of contemporary psychotherapists are vulnerable in both experiments to be slightly, but not as dramatically, distorted as the Rosenhan experiment would suggest at the time. (PsycInfo Database Record (c) 2025 APA, all rights reserved).