The Perceptions of White Clients in a Substance Abuse Program in Which They Are in the Minority

Background: There is a large body of literature regarding the need for culturally-informed practice with non-white populations in substance abuse treatment. Virtually nothing, however, has been written regarding the needs of white clients when they represent a small minority in treatment programs. Objectives: The primary purpose of this study is to compare perceptions of treatment and completion rates between white and nonwhite clients in a substance abuse treatment program where white clients represent a small minority. Methods: In New York City in 2009/2010, at a short-term inpatient program where white clients represented 12% of the population, 611 clients completed surveys that included scales measuring satisfaction, therapeutic alliance, social cohesion, and connection to the program. White and non-white clients were compared regarding results of these scales as well as program completion rates. Furthermore, demographic/background characteristics of the white and nonwhite clients obtained from the surveys were compared. Results: White clients reported lower levels of connection to the treatment program than non-white clients at levels that were statistically significant. However, there were no statistically significant differences between them for the other scales and program completion rates. Although white clients reported greater frequency and number of substances used, they were far less likely to have had felony convictions. Conclusions: Although differences were not extreme, there was evidence that greater sensitivity to the needs of white clients in programs in which they are in the minority is needed. Furthermore, this study demonstrates racial disparities in criminal justice involvement between white and non-white substance users.