Effectiveness of a Feminist Empowerment Model

Chandler, Worell, Johnson, Blount, and Lusk (1999) studied effectiveness of feminist therapy practices, using the TWS to differentiate feminist from nonfeminist therapists and assessing progress in therapy via a well-validated measure, the Personal Progress Scale (PPS), which assesses increases in empowerment on cognitive, affective, and interpersonal aspects of the psychosocial axis of empowerment. They found that with both very brief (four or less sessions) or slightly longer (seven or more sessions), clients in feminist therapy improved significantly more on empowerment variables that those getting nonfeminist interventions. They found that these changes persisted at longer-term follow-up and were also consistent with clients’ self-perceptions when those were assessed qualitatively.

Consequently, the very small amount of quantitative literature on feminist therapy suggests that the therapist’s application of the core constructs of empowerment and egalitarian relationship can enhance the outcomes of therapy when contrasted with therapies as usual.

FEMINIST THERAPY AS AN EMPIRICALLY SUPPORTED RELATIONSHIP PARADIGM

The bulk of support for feminist practice comes from the literature on common factors contributing to good outcome in psychotherapy, and situates feminist therapy in the context of that scholarship on empirically supported therapy relationships. As Mary Ballou (1990) noted in her foundational discussion of epistemics and methodologies in feminist therapy, this is a theory that privileges a multiplicity of forms of evidence and knowledge claims, making the broadest definition of evidence basis available to feminist therapists. Feminist practice integrates information not only from randomized controlled clinical trials but also from qualitative studies, clinical case examples, and single-participant designs and, importantly, from what clients who experience feminist therapy tell their therapists about what works. Feminist therapy’s focus on empowerment and the quality of the therapist-client relationship generates therapy alliance variables that are consistently identified in psychotherapy process research as contributory to good outcomes of treatment (Norcross & Lambert, 2005).

Feminist therapy is also an intentionally culturally competent model, with its emphasis on making central issues of oppression, identity, and power and its reliance on a culturally informed knowledge base. Since a growing body of research indicates that the presence of cultural competence in psychotherapists improves their effectiveness with almost all of their clients (Coleman, 1998; Constantine, 2002), it is reasonable to extrapolate these findings to feminist practice. Similarly, as noted in Norcross (2002), other variables that derive directly from the egalitarian methodology of feminist practice, such as tailoring treatment to the client, collaborating on goals of therapy, and creating a strong working alliance, have been definitively and empirically linked to positive outcomes in therapy.

In feminist therapy the client is actively engaged as a co-equally valued participant in the process whose voice, perceptions, and desires are privileged; as a result, effectiveness is also likely to be enhanced. Common factors research indicates that when clients experience ownership of the psychotherapeutic process, they become an active component of improved outcomes for treatment (Bohart, 2005). Feminist practice amplifies and centers on this empirically supported common factor of effective psychotherapy process, making it core. Messer (2005) notes that clients’ expressions of satisfaction or its absence are also important components of the evidence supporting a model of psychotherapy, and feminist therapy relies on this data stream, making authorities out of clients.

WHERE AND WITH WHOM DOES FEMINIST THERAPY WORK? OR NOT?