Patients might tend to assess the efficacy of a psychotherapist more by the office décor than by the innate skills of the physician, an Ohio State University study seems to show.
After only viewing photos of offices, study participants gave higher marks to psychotherapists whose offices were neat and orderly, decorated with soft touches like pillows and throw rugs, and which featured personal touches like diplomas and framed photos.
Interestingly the therapists in the top-rated offices were more likely to be seen as men, whereas those in the bottom-rated offices were more often identified as women in the open-ended comments, pointing to the prevalence of gender stereotypes.
"People seem to agree on what the office of a good therapist would look like and, especially, what it wouldn't look like," said Jack Nasar, co-author of the study and professor of city and regional planning at Ohio State University.
"Whether it is through cultural learning or something else, people think they can judge therapists just based on their office environment."
Nasar conducted the study with Ann Sloan Devlin, professor of psychology at Connecticut College. Their study appears online in the Journal of Counseling Psychology and will appear in a future print edition.
The research involved several experiments in which people viewed 30 digital color photographs of actual psychotherapist offices in Manhattan. All were taken by photographer Saul Robbins as part of an artistic project, and he gave permission to the researchers to use the photographs in the study.
The photos showed a view of the therapist's chair and surrounding office from the perspective of where the client would sit.
Altogether, 242 college students participated in the studies - about 60 percent of whom had seen a therapist themselves. The researchers found no difference in results between those who had seen a therapist and those who hadn't, men and women, people of different ages, or residents of a small Northeastern town and residents of a large Midwestern city, suggesting the results are generalizable, Nasar said.
Before the study began, 12 graduate students rated each of the 30 offices on a wide range of characteristics, such as neatness, spaciousness and amount of personalization.
In the first study, students were asked to imagine visiting a therapist for an emotional problem. As they looked at each photo, they were asked to rate each office for the quality of care expected and how comfortable they would feel in it. They rated these qualities on a seven point scale from very poor to very good.
Participants said they would be more comfortable and expect better care in offices that had been rated as more orderly and that had more personal touches, such as a pillow, diplomas hanging on the wall or photos. They also thought more highly of therapists whose offices had a "softer" feel - those that had cushioned chairs, carpeting, table lamps, plants and throw rugs.
In a second study, participants thought orderly, personalized and softer offices had therapists who were bolder and more qualified. Offices rated as softer were viewed as having friendlier therapists.
A third study asked participants to view the photos and simply write the first thought or feeling that came to mind regarding a patient's likely experience in the office, the therapist who occupied the office, and the office itself. And in a final study, the researchers asked the participants to choose which offices they would want to go to if they had to see a therapist, and which ones they would most want to avoid.
"The top-rated offices also pointed to the importance of softness and order," Nasar said. "For the top five offices, participants most frequently described the office as comfortable, nice, clean, warm and inviting."
In contrast, the bottom five offices were described as cluttered, cramped, messy, uncomfortable and unprofessional.
Nasar said there was more agreement about which offices were the worst than about which were the best.
"People have less agreement about what makes an office good, but the negative aspects really stood out to them in a consistent way," he said.
Therapists who worked in the top five rated offices were also seen more favorably - more organized, professional, friendly, experienced — than those in the bottom five offices.
That is where the gender stereotyping creeps in.
But Nasar said the hunch of where one could get better therapists might turn out to be true. Research shows that judgments about people from the places they occupy are often accurate.
Even if the judgments are not accurate, therapists should take the look of their offices seriously.
"These results suggest that someone visiting a therapist in a low-rated office for the first time may not want to come back.
"It may seem obvious that people will judge someone by the office they keep, but we found that these offices vary a great deal. There are therapists out there who don't know or who don't care that they are sending out bad signals to their clients."
Nasar said therapists should take these findings to heart.
"I would tell therapists to keep their offices soft and friendly looking. Put up your diplomas and personalize the office. Arrange everything in a neat and orderly way and keep it that way."