Date of Award


Document Type


Degree Name


Organizational Unit

Morgridge College of Education, Counseling Psychology

First Advisor

Trisha Raque

Second Advisor

Jesse Owen

Third Advisor

Nicole Taylor

Fourth Advisor

Abbie Beacham

Fifth Advisor

Apryl Alexander


Behavioral health, Counselor self-efficacy, Gender microaggression, Integrated primary care, Multicultural orientation, Women trainees


Gender microaggressions are a form of sexist discrimination that have detrimental effects on women’s psychological well-being. Unfortunately, these sexist occurrences are commonplace in the United States and can be experienced in a variety of ways. As such, there is a need to understand behavioral health providers’ experiences with patient-delivered gender microaggressions. In doing so, we may be able to better support women behavioral health trainees’ during their clinical development by potentially understanding the ways in which women trainees are affected by sexist patient encounters. Therefore, the present study sought to apply the Social Cognitive Model of Counselor Training and the Multicultural Orientation framework to understand the ways in which women trainees are affected by gender microaggression in the context of their clinical work in integrated primary care settings. It was hypothesized that negative affective reactions may cause decreases in trainees’ perceptions of their counseling abilities as well as their evaluation of the impact of the behavioral health interactions wherein gender microaggression occur. It was also hypothesized that women’s level of stigma consciousnesses and their cultural comfort would serve as protective factors to the effects of gender microaggressions on women trainees’ counseling self-efficacy and their overall evaluations of the behavioral health interaction wherein gender microaggressions occur. Results revealed that participants who experienced gender microaggressions endorsed lower counselor-efficacy beliefs, less session smoothness, and higher arousal states (e.g., anxious, excited, fast). Results also revealed that arousal partially mediated the effects of gender microaggressions on women trainee’s evaluations of session smoothness. Implications such as supporting and empowering women trainees in how they choose to respond to gender microaggression, creating dedicated supervision time and mentorship programs to facilitate women trainees’ clinical development, and specific supervisory approaches to navigating gender microaggression are discussed. Future directions are also highlighted, including understanding the experiences of trainees’ who hold more than one marginalized identity when they encounter patient-delivered discrimination, protective factors that draw on the internal resources and strengths of women trainees, and the complex nuances of integrated primary care training.

Publication Statement

Copyright is held by the author. User is responsible for all copyright compliance.

Rights Holder

Julia Ratchford Kauffmann


Received from ProQuest

File Format




File Size

150 pgs


Counseling psychology, Women's studies, Clinical psychology