Clinical Experiences With Clients Who Are Low-Income: Mental Health Practitioners' Perspectives.

The experiences of nine licensed mental health practitioners regarding their work with clients from low-income backgrounds were examined utilizing grounded theory methodology. Themes that emerged from the semi-structured interviews highlighted a rich narrative that portrayed the work as both deeply satisfying and inherently complex. Participants described the personal nature of this work, including countertransference elicited because of their own personal economic contexts and emotional reactions experienced within and outside the therapy room. Their stories acknowledged systematic challenges that act as barriers to treatment. Some participants noted that this has contributed to feelings of disillusionment toward the field as well as fears about the future of the mental health care. Based on these findings, we discuss implications for training, future research, and clinical practice.

Influence of social class perceptions on attributions among mental health practitioners.

OBJECTIVE: A vignette-based study assessed the influence of social class attributions toward a hypothetical client's difficulty. METHOD: 188 licensed mental health professionals who were recruited through professional listservs completed an online survey after reviewing one of two versions of a vignette describing a hypothetical client that varied based on social class cues. RESULTS: As expected, this sample of licensed mental health practitioners detected social class differences based on the descriptors of the hypothetical client across the two vignettes. These perceived social class differences, however, did not impact participants' attributions toward the client for causing or solving her problems, level of Global Assessment of Functioning score ascribed to the client, or willingness to work with the client. CONCLUSIONS: There was no evidence that participants differentially ascribed attributions based on social class. Implications and directions for future research are provided.

Recognizing social class in the psychotherapy relationship: a grounded theory exploration of low-income clients.

The process of psychotherapy among 16 low-income clients was explored using grounded theory (Charmaz, 2006; Glaser & Strauss, 1967) in order to understand and identify their unique experiences and needs. Semistructured interviews were conducted with 12 women and 4 men who had attended at least 6 sessions of psychotherapy within 6 months of the interview. Our grounded theory that evolved depicted a tapestry of the dynamic process by which low-income clients experience social class within psychotherapy. Specific therapist behaviors that contribute to more and less positive experiences emerged from the data and pointed to the importance of acknowledging social class within the therapy room. The significance of therapists enhancing the 50-min hour via advocacy and meaningful moments within and outside of the therapy room was highlighted among all participants. Implications for practice with low-income clients and directions for future research are provided.

The group's absence norm and commitment to the group as predictors of group member absence in the next session: an actor-partner analysis.

The group's absence norm, a construct from the applied psychology literature, was used to examine session absences in personal growth groups. Rather than examining the absence norm statically, we modeled it dynamically as a time-varying covariate (Tasca et al., 2010). We also examined moderation by modeling the interaction of the absence norm and the group member's commitment to the group in predicting the group member's absence in the next group session. Session absences in 1,722 group sessions for 66 group members in 9 interpersonal growth groups were modeled using Kenny, Mannetti, Pierro, Livi, and Kashy's (2002) adaptation of the Actor-Partner Interdependence model. Specifically, a 3-level model (sessions within group members within groups) examined the relationship of the group's absence norm (average previous absences of the other group members), commitment to the group (previous absences of the group member), and the interaction of the group's absence norm and commitment to the group on absence in the next session. As we hypothesized, (a) a greater number of previous individual absences (low commitment) increased the probability of a member being absent the next session, (b) the higher the group's absences norm, the greater the probability that an individual group member would be absent the next session, and (c) individual group members who were more committed to the group were more influenced by the group's absences norm than were group members less committed to the group. Implications for research and practice are discussed.