Academic journal article Child Welfare

"Just Therapy" with Families on Low Incomes

Academic journal article Child Welfare

"Just Therapy" with Families on Low Incomes

Article excerpt

This article addresses the inadequacies of counseling, therapy, and social work that occurs with low-income families. The author argues that many families who seek help arrive with problems that are usually assessed separately from their socioeconomic and cultural contexts. Careful questioning will often lead to the discovery that the onset of many family problems are located in events external to the family, such as unemployment, bad housing, and racist, sexist, or heterosexist experiences. They can be extremely depressing ongoing experiences that eventually lead parents and children into a state of stress that opens them up to physical and mental illnesses. This article argues that a wide body of research supports such a view and that counseling, therapeutic, and social work practices should address these issues much more directly. It also argues that practitioners have an important role to play in social and economic policy development out of respect for their clients' struggles.

When we speak of families and therapy, we tend to think in mental health or relationship categories. In this article, the term families refers to any primary intimate group, who either through genealogy or intentional commitment identify themselves as family. The term therapy in this context refers to the healing and problem-solving discourses that the helping professions carry out, including those of psychologists, social workers, counselors, psychiatrists, and nurses. A family in need of therapy may require help because of the unpredictable behavior of one or a number of household members, or because relationships between members have become disrupted in some way. If, instead of referring simply to families, we refer to poor families, we are triggered into issues of context.

Addressing the Context

What is good therapy when families are poor? How does a therapist address relationships when parents who struggle to feed their families are not able to access decent housing? Do current clinical and therapeutic courses adequately prepare students to address the therapeutic issues of poor families? The words families and therapy tend to elicit a reasonably predictable set of expectations, but if one uses the adjective poor to describe a set of particular families, those expectations become challenged.

Consider for example, how a group of therapists are likely to answer the question, "What is absolutely basic to a family or family life?" They would probably answer along the following lines: There must be at least a minimal commitment to relationship among members. There must be some evidence of emotional warmth among members. There must be some cooperative patterns of behavior that order at least some of their life together, and one would hope that there would be some evidence of what is referred to in the non-social science world as love.

Consider now how a group of community workers may answer the same question concerning what is absolutely basic to a family or family life. They would probably answer along the following lines: Families require adequate and safe housing. They require sufficient income to live out of poverty. They need to be able to access affordable health care, and they need to be able to live free from fear and harassment.

Both views, of course, are correct in as far as they go, but their emphases are quite different. One is focused primarily on family dynamics, whereas the other is focused primarily on social and economic context. The same divergence of views would probably occur if therapists and community workers were asked a further question: "What causes the problems of poorer families who visit therapists for help?"

Many therapists, when referring to particular stresses poor families face, would probably still make a list characterized by the following sorts of problems: inadequacies in communication, the loss of emotional warmth, tensions in relationships, an inability to make decisions, and difficulties resolving conflict. …

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