Bringing Psychotherapy to People Living in Poverty

The “problem of the poor” is typically discussed as a client/patient problem. However, interviews of poor people, and those with whom they work, consistently reveal the role of the environment in maintaining the intractability of this status, as well as the role of the mental health professional who unknowingly contributes to the cycle. The barriers to mental health services for the poor are complex and interdependent; a domino effect ensues that results in ongoing stressors. Classism and the failure of our standards of care to include class competency in cultural competency training, research, and practice are profound. These omissions and the models available for evidence-based practice through continuing education and graduate training are described. Empirically supported treatments and qualitative research are reviewed, demonstrating more effective outcome expectations than were possible with traditional approaches. Settings and systems that hold promise for a path toward the future are identified.