Theses Doctoral

Poor and Working-Class Clients' Social Class-Related Experiences in Therapy

Appio, Lauren Marie

This investigation explored how poor and working-class people experience, understand, and negotiate class issues and class differences with their therapists. Data were collected through semi-structured interviews with 22 self-identified poor and working-class people with experience as clients in individual counseling. Interviews were transcribed and analyzed using constructivist grounded theory methodology (Charmaz, 2006). A core narrative emerged that depicted a dynamic, interactional process of seeking mutual understanding to navigate class issues in therapy. Participants played an active role in this process by making decisions to share or withhold information or their reactions to therapy experiences. Participants' sociocultural awareness provided the context for their observations of class cues and perceptions of therapists' social class, which in turn influenced their reactions and behaviors towards their therapist. Seeking mutual understanding emerged as a process that allowed poor and working-class clients to build connections with therapists of shared and different social class backgrounds. Participants shared positive, meaningful interactions with therapists who demonstrated genuineness and attended to class issues in the therapeutic encounter. When working with therapists who engaged in these mutuality-enhancing actions, participants felt deeply understood and connected to their therapists, which contributed to growthful therapeutic outcomes. Participants also described feeling misunderstood and disconnected from therapists who appeared inauthentic and neglected to attend to class issues. These participants reported feeling "stuck" and unhelped through counseling. The findings of this study suggest that social class issues are salient for poor and working-class clients in their interactions with therapists. Further, therapists can promote positive therapeutic outcomes in work with class-oppressed clients by a) fostering authenticity and mutuality within the working alliance and b) openly addressing clients' material concerns and thoughtfully exploring class differences and other class issues present in the therapeutic relationship. Additional implications for training and practice are provided and include the need for counselors to incorporate social justice advocacy into their work. Suggestions for future research include further exploration of the ways social class and classism operate within the psychotherapeutic process, emphasizing the need for researchers to attend to intersections of identity and position poor and working-class people's voices and perspectives at the center of their inquiry.


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More About This Work

Academic Units
Counseling Psychology
Thesis Advisors
Smith, Laura
Ph.D., Columbia University
Published Here
September 19, 2013