“Is making someone a meal when they collapse on your floor from starvation, therapy? Well, I'd say, yeah, it is”: Counselling Psychologists' experiences of adapting therapy with clients experiencing poverty: an Interpretative Phenomenological Analysis
Background: Roughly 14 million people (1 in 5) are estimated to live in poverty in the UK (JRF, 2017). Those in poverty are more likely to experience mental health problems compared to their wealthier counterparts (Collins et al., 2011). Researchers found that when therapy is tailored to be sensitive to poverty, focuses on economic stressors or when therapists are considerate of economic difficulties, it is more helpful. Rationale: Research exploring the perspectives of individuals providing therapy for those in poverty is limited. However, previous work has shown that how UK Psychologists conceptualise the relationship between poverty and mental health impacts the therapeutic interventions used (Sams, 2008). The perspective of US psychologists revealed that significant therapeutic adaptions are often made (Borges, 2014). In comparison, data indicates that UK psychotherapists also make adaptations, yet these are less extreme than in the US (Ballo, 2020). With poverty in the UK set to increase (Belfield et al., 2017), there is a need to provide appropriate interventions, especially as Counselling Psychologists often work in organisations/sectors providing therapy to those in poverty (DCoP, 2018; Rethink Mental Illness, 2020). CoP’s commitment to social justice and diversity leads to Counselling Psychologists being well positioned to devise effective interventions (Eleftheriadou, 2010, Cooper, 2009). However, the perspectives of UK Counselling Psychologists are almost completely absent. Therefore, this research aims to investigate how Counselling Psychologists tailor therapy to facilitate therapeutic work with those in poverty. Methodology and main findings: Interpretative phenomenological analysis (IPA) was used for the current research. Six semi-structured interviews were conducted with Counselling Psychologists working with those experiencing poverty. Three superordinate themes emerged from the analysis: Awareness of the relationship between poverty and mental health, Resources that are drawn upon, and Adapting practice in the light of economic differentials. Conclusions and implications: This study highlighted that traditional and/or manualised ways of delivering therapy to those experiencing poverty may not be helpful or appropriate for this population. The present findings highlight the importance of flexibility within therapeutic work. A significant finding to emerge was that the more extreme the experience of poverty was for the client, the more extreme the therapeutic boundary adaptation. The discussion describes these findings in relation to the wider literature and explores implications for Counselling Psychology Training, Practice and the Wider Community.
360 Social problems & services; associations, 610 Medicine & health
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