Through Their Eyes: Perceptions of Psychotherapy and the Mental Health Field Held by Members of the Working Poor

Document Type


Degree Name

Doctor of Psychology (PsyD)

Year of Completion


First Advisor

Eva Feindler


As a result of the economic changes over the last decade, the middle class is quickly disappearing as the classes below it grow. In particular, a group often forgotten in psychological research, the working poor, continues to expand. Currently available research on utilization of mental health services and client retention places heavy emphasis on samples consisting of urban, unemployed persons of color, when in fact the majority of those living in poverty are White, living in rural or suburban areas, and are employed at least part of the year. Little is known about perceptions of mental health services or alternatives to treatment seeking amongst the working poor. Additionally, research on economically disadvantaged groups often fails to consider the subjective experiences of study participants. This qualitative study does just that, using a narrative, semi-structured interview format. Small group interviews with members (N = 17) of the working poor were conducted with a focus on their perceptions of psychotherapy and the mental health field. How these perceptions affect the likelihood of participants seeking services and remaining in treatment, as well as alternative coping strategies utilized in lieu of mental health services were interpreted through the lens of three theories: Bronfenbrenner's (2005) Process-Person-Context-Time model, Maslow's (1943) theory of human motivation, and Lazarus's (1991) Cognitive-Motivational-Relational theory of emotion. Recommendations for mental health practitioners and educators, as well as suggestions for future research were generated from the findings.