Working with low-income families: Lessons learned from basic and applied research on coping with poverty-related stress

Poverty and low socioeconomic status create tremendous amounts of physical and psychosocial stress that compromise health and well-being. This paper explores how the stressors created, exacerbated, and maintained by living in poverty lead to compromised mental health, and at the same time present significant challenges to participating in and benefitting from traditional psychotherapy. This paper summarizes the strong research evidence supporting the causal role of poverty-related stress in contributing to mental (and physical) health problems, discusses the physiology that underlies this process and how it affects clients' ability to make use of psychotherapy, and presents recommendations for incorporating a multi-faceted approach to coping in clinical work with low-income clients and families. Addressing the pernicious effects of economic stress with a multi-step approach to effective coping can serve to prepare low-income clients to better engage in and get the most out of psychotherapy.