Academic journal article Journal of Humanistic Counseling

Counseling People Living in Poverty: The CARE Model

Academic journal article Journal of Humanistic Counseling

Counseling People Living in Poverty: The CARE Model

Article excerpt

Counselors frequently counsel clients who live in poverty. The authors describe the new CARE model that addresses the influence of multiple systems on poor clients' experiences. A social justice, humanistic intervention, the CARE model emphasizes cultivating a positive counseling relationship with poor clients, empathizing with their unique realities, and working to remove barriers to future success and well-being by building on their strengths.


A large proportion of the clients served by community mental health centers are individuals classified as working poor and those living in poverty (Gilens, 1999). Indeed, people living in poverty tend to be among the most marginalized and stigmatized people in the United States (Gilens, 1999). Despite the need this population has for counseling services, the values, expectations, and requirements for participating in counseling may be at odds with the needs of many poor people. This is often the case because most traditional counseling models are more consistent with middle-class values than with values exhibited by poor people in U.S. society (Gonzalez, 2005; Javier & Herron, 2002). People struggling to have their personal and psychological needs met may find that the services provided by community mental health centers in general and professional counselors in particular do not meet these unique needs, nor do they honor the myriad strengths that are commonly manifested by many poor persons in society.

In this article, we introduce a model that is useful in conceptualizing effective counseling strategies for people living in poverty. The model is titled the CARE model, which highlights the need to cultivate relationships, acknowledge realities, remove barriers, and expand the strengths of poor clients. A unique aspect of this model is that it addresses the impact that multiple systems have on poor clients' lived experiences. This model emerges from a humanistic perspective that encourages the growth and the development of clients as outlined by the American Counseling Association's (ACA) Code of Ethics (ACA, 2005; Preamble and Section A, Introduction).

Because the CARE model is developmental in its focus, it is grounded in the belief that people (a) are dynamic rather than static and (b) have an innate propensity to healthy growth and purposeful living (Sperry, 2002). Developmental perspectives are inherently humanistic in that they offer hope that a client's problems are not permanent and that positive change is always possible. Central to the humanistic and developmental perspective is the belief that people have the capacity to move forward, to change, to become empowered, and to ultimately attain wellness (Fitzsimons & Fuller, 2002).

The ACA Code of Ethics (2005) mandates that counselors provide culturally and contextually sensitive and competent services when working with clients. Multicultural competence includes the recognition that it is important to understand and address broader societal influences when counseling clients in marginalized and devalued groups (Sue, Arredondo, & McDavis, 1992).

Multiculturally competent counselors are also aware that persons with less power in society commonly experience a greater level of stress from multiple sources. These heightened stressors greatly increase poor people's biological predisposition and psychological vulnerability to various health problems as compared with individuals in more privileged and empowered groups (Belle & Doucet, 2003). Culturally sensitive, developmental, humanistic, and social-justice-minded counselors do not separate clients' difficulties from their sociocultural group experiences. Instead, these practitioners search for culturally competent and responsive ways to foster the health, well-being, and empowerment of persons living in poverty.


The Diathesis-Stress Model predicts that life stressors may interact with genetic or physiological variables to cause various mental health problems (Barlow & Durand, 2005). …

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