Psychotherapy For The Poor
A striking failure in modern-day psychotherapy is the absence of adequate treatment approaches and academic/professional trainings that are apparently useful to lower- and working-class patients. I believe a big part of the cause lies in that contemporary mental health prototype and the middle-class prototype have become operationally equivalent.
The other week, I was again the featured expert of GMA 7's newest TV mental health weekly program entitled "Out of Control." The TV crew brought me to a squatter community to shoot a brief therapy segment with a 60-year-old woman suffering from onychophagia (chronic nail biting). This was one of those times when I needed to adjust from my "middle classness" to fit a "lower-class" ethic.
Necessary therapeutic adjustments are important in "psychotherapy for the poor." For example, my language as a "middle class" therapist may have considerable personally disorganizing effect upon the "lower-class" patient. If careless, the "message" I'd set forth could be most unrealistic or prejudicial to the "lower-class" patient when conducted in a manner consistent with "middle-class" culture. I felt happy about the successful result of my recent "psychotherapy for the poor" episode at GMA 7 because it showed the appropriateness and adaptiveness that context-sensitive therapy can apply for the realities found in a lower-class environment.