Therapeutic work with clients living in poverty

Background: Financial inequalities appear to be increasing and poverty is becoming ubiquitous. Poverty affects mental health but its impact on mental health and wellbeing is rarely highlighted within health research. Aims: The Covid-19 pandemic, the Ukrainian invasion and other international and national events have led to a cost-of-living crisis for many people. This is likely to lead to an increase in related referrals and therefore active consideration of the relevant issues relating to poverty appears vital. This paper reports a study which sought to understand how therapists experienced their work with clients who self-refer due to living in poverty. Method: Eight therapists participated in semi-structured interviews analysed using Interpretative Phenomenological Analysis (IPA). Results: Three superordinate themes were elicited: firstly ‘Resilience in the struggle to engage with therapeutic work’, secondly ‘Struggling to promote social activism’ and thirdly, ‘Navigating multiple challenges and barriers’. Each superordinate theme contains two or three sub themes. Conclusions: Issues of structural inequality (including but not limited to poverty) impact significantly on people’s lives but are often ignored or minimised in therapeutic work. It is important that therapists are aware of poverty and take this into account when working with clients.