American Psychological AssociationPsychology2019intermediate

Psychological Practice for People with Low-Income and Economic Marginalization

Published by American Psychological Association

9Recommendations

Summary

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This APA guideline provides recommendations for psychologists to deliver culturally competent care to individuals experiencing low-income and economic marginalization (LIEM). It covers four main domains: training and education, health disparities, treatment considerations, and the intersection of LIEM with career concerns and unemployment. The document emphasizes the need for practitioners to address social class biases, understand systemic barriers to healthcare access, and utilize flexible, evidence-based treatments tailored to this population.

psychologylow-incomeeconomic marginalizationAPApsychological practicesocial class biashealth disparitiesculturally competent care

Key Takeaways

1
Psychologists must recognize and address personal and systemic biases related to social class.
2
Economic marginalization significantly contributes to health disparities.
3
Therapists should adapt treatments to address barriers to access for LIEM individuals (e.g., transportation, scheduling, telepsychology).
4
Social class and poverty critically impact career development, academic success, and employment stability.
5
Advocacy and interprofessional collaboration are crucial components of culturally competent care for LIEM populations.

Key Recommendations

Domain 1: Training and Education

Guideline 1
Psychologists strive to gain awareness of how their biases related to social class may impact the training and education they provide.
Training and Education
Guideline 2
Psychologists are encouraged to increase their knowledge and understanding of social class issues, including poverty and wealth, through continuing education, training, supervision, and consultation.
Training and Education

Domain 2: LIEM and Health Disparities

Guideline 3
Psychologists strive to understand the contribution of economic and social marginalization to the substantial health disparities in our society.
Knowledge and Awareness
Guideline 4
Psychologists strive to promote equity in the access to, and the quality of, healthcare available for people from LIEM backgrounds.
Advocacy and Practice

Domain 3: Treatment Considerations

Guideline 5
Psychologists acknowledge the presence of social class as a variable that is present in mental health treatment settings. Psychologists are encouraged to seek to a) understand how social class influences psychotherapists’ ability to effectively engage clients in treatment, and b) attend to ways that social class differences manifest and impact the experience of mental health treatment for clients.
Clinical Practice
Guideline 6
Psychologists aim to understand the barriers that prevent persons with low SES from better accessing mental health care and make efforts to alleviate these barriers when providing psychological interventions and/or creating mental health care delivery systems.
Clinical Practice and Systemic Delivery
Guideline 7
Psychologists strive to understand the common clinical presentations that may be more likely to occur among persons who are from LIEM situations and how best to address these in treatment settings.
Clinical Intervention

Domain 4: Intersection of LIEM with Career Concerns and Unemployment

Guideline 8
Psychologists seek to understand the impact of social class on academic success, career aspirations, and career development throughout the lifespan.
Career Counseling
Guideline 9
Psychologists seek to understand the interaction among economic insecurity, unemployment, and underemployment and attempt to contribute to re-employment processes for individuals.
Career Counseling and Intervention

Scope & Objectives

Clinical Topic

Psychological Practice with Low-Income and Economically Marginalized Populations

Objectives

To assist psychologists in the provision of culturally competent care for those whose economic position has negatively impacted or constrained their health and well-being.

Target Patient Population

Adults, children, and families who have previously experienced, or are currently experiencing, economic marginalization

Target Providers

PsychologistsPsychology traineesCounselorsSocial workersPhysiciansNursesPublic health officials

Patient Criteria & Setting

Therapeutic Area

Mental Health

Guideline Scope

Training and EducationHealth DisparitiesTreatment ConsiderationsCareer Concerns and Unemployment

Care Settings

Clinical careEducational settingsResearch settingsCommunity health centersPrimary careIntegrated healthcare

Special Populations

Racial and ethnic minoritiesRefugeesImmigrantsOlder adultsVeteransPersons with disabilitiesIndividuals with mental illnessLGBTQI individualsSingle mothersYouthFoster children

Authors & Contributors

Cindy L. JuntunenAstrea GreigJameson HirschAmy H. PetermanKipp PietrantonioDenise RossMindi Thompson

Guideline Features

Multidisciplinary

Learning Context

Difficulty

intermediate

Learning Paths

Social Class BiasHealth DisparitiesPoverty and Mental HealthCulturally Competent CareCareer CounselingLIEM Populations