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How do Social Class and Classism impact therapy

Updated: Aug 1, 2023


As mental health professionals, therapists play a pivotal role in guiding individuals toward improved mental well-being and emotional growth. To achieve this, therapists must possess a deep level of self-awareness and empathy, allowing them to connect with their clients on a deep level. However, one aspect that is often overlooked in the therapeutic process is the influence of social class and the impact of classism. In this blog post, we will explore why understanding social class and classism is crucial for therapists, emphasizing the importance of self-awareness and its role in fostering better mental health outcomes.

Self-Awareness and Therapeutic Practice

Self-awareness is the foundation upon which effective therapeutic practice is built. A therapist who is well-aware of their own beliefs, biases, and privileges is better equipped to establish an authentic and empathetic connection with their clients. Notably, classism can manifest in transference and counter-transference, presenting equal opportunity from both directions to become a clinical issue (Ryan, 2006). By acknowledging how social class and classism impact therapy, therapists' own class background, and how it affects their worldview, therapists can minimize potential power imbalances in the therapeutic relationship.

Mental Health Professionals as Impartial Guides

Social class impacts our health, well-being, quality of life, relationships, career outcomes, education, membership in social, health care, and treatment outcomes (Smith, et al., 2011; Kraus, et al, 2010; Rubin, 2012; Smith, 2013;Thompson, et al., 2012; Thompson, Goldberg, 2018; Allan, Garriott, Keene, 2016) Therapists are meant to be impartial guides, offering support and understanding to their clients without judgment. However, without a conscious understanding of how social class and classism impact therapy, they may unknowingly perpetuate stereotypes or inadvertently undermine the experiences of clients from different socioeconomic backgrounds. Such unintended actions can hinder the therapeutic process and diminish the trust between the therapist and the client.

Understanding Social Class as a Source of Identity

Social class is a fundamental aspect of an individual's identity, shaping their values, beliefs, and attitudes. A therapist who recognizes the significance of social class can better grasp the multifaceted nature of their clients' experiences. In fact, Social Economic status contributes to 40% of your health outcome (County Health Rankings and Roadmaps, 2016, 2020). Positive and negative impacts exist all across the economic spectrum. By acknowledging and validating the impact of social class on an individual's life, therapists create a safe and inclusive space where clients feel understood and heard, fostering a more productive therapeutic journey.

Identifying Classism and Its Implications

Classism, a form of discrimination based on social class, can manifest in subtle and overt ways. Classism is difficult to detect but can be roughly divided into overt and covert classism.

Overt Classism is understood as “direct prejudice against people perceived to be of a different social class”, and covert classism is “inattention or not noticing differences between groups” (Liu, 2011, p199). Classism can be objective, as measured by education, occupation, and income, it can also be subjective, as a person self-assess their own social ranking and social class placement. This is why exploring social class perception in therapy can be important and helpful, because therapists may not be able to fully or correctly identify the client’s complex social class self-identity. For therapists to provide effective support, they must recognize how classism can affect their clients' self-esteem, mental health, and overall well-being. Clients experiencing classism may grapple with feelings of inadequacy, shame, or resentment. By detecting these issues, therapists can address them directly and work towards dismantling these harmful biases.

Classism intersects with Racism

Classism and Racism intersect particularly in the United States and Western countries including the UK due to the slave trade and White-ownership class. The people of color in the United States over-represent people living in poverty. Continuing studying and examination of these intersectionalities, including the race and wealth divide, are essential for all counselors, therapists, and mental health professionals (Ryan, 2006; Smith, 2008).

Promoting Empathy and Cultural Competence

Understanding how social class and classism impact therapy enhances a therapist's cultural competence, allowing them to navigate the complexities of their client's lives more effectively. Empathy plays a crucial role in building a strong therapeutic alliance, and the ability to grasp the nuances of social class allows therapists to empathize better with their clients' struggles. A culturally competent therapist can help clients explore the impact of their social class on their mental health without making assumptions or perpetuating stereotypes.

Challenging the Status Quo

Therapists who grasp how social class and classism impact therapy are better positioned to challenge systemic inequalities and advocate for social change. As mental health professionals, they can use their platform to raise awareness about the impact of social class on mental health and work towards reducing disparities in access to mental health services. By addressing classism in both individual and systemic contexts, therapists contribute to a more just and inclusive society.

Tailoring Therapy to Individual Needs

A one-size-fits-all approach to therapy rarely yields the best results. Clients from diverse social classes may require different therapeutic strategies based on their unique experiences and challenges. While social class matching in a therapeutic relationship is not essential, social class awareness is critical in helping the therapist attune to the client’s needs and make appropriate responses. A therapist who understands social class can tailor their approach to accommodate these variations, ensuring that the therapy is both relevant and effective in addressing their clients' needs.


Understanding social class and classism is a vital component of therapeutic practice. By cultivating self-awareness, mental health professionals can create a supportive and empathetic environment, allowing them to effectively address the challenges faced by clients from different social classes. By recognizing the impact of social class on mental health, therapists can promote cultural competence, challenge discrimination, and provide more personalized and inclusive care. In embracing these principles, therapists can contribute to the betterment of their clients' lives and work towards building a more equitable and compassionate society.

Multicultural Continuing Education CE

Spring Advisory is now offering a Continuing Education (CE) credit course on how social class and classism impact therapy. This comprehensive course is designed to enhance therapists' cultural competency and provide them with valuable insights into the intricate dynamics of social class and classism. By delving into these topics, therapists will gain a deeper understanding of how to identify, categorize, and understand social class behaviors and how they influence therapeutic relationships and client experiences. Additionally, the course addresses numerous questions surrounding social class and classism, empowering therapists with the knowledge and tools to provide more equitable and inclusive care. As a bonus, this CE course fulfills multicultural CE credit requirements, allowing therapists to further expand their professional skillset and contribute to fostering a more diverse and empathetic mental health landscape. Enroll now to enrich your practice and make a positive impact on your clients' lives.


Allan, B. A., Garriott, P. O., & Keene, C. N. (2016). Outcomes of social class and classism in first- and continuing-generation college students. Journal of counseling psychology, 63(4), 487–496.

County Health Rankings & Roadmaps. (2020). 2020 County Health Rankings Key Findings Report. Retrieved from

Liu, William. (2011). Social class and classism in the helping professions: Research, theory, and practice. 10.4135/9781452230504.

Kraus, M. W., Côté, S., & Keltner, D. (2010). Social class, contextualism, and empathic accuracy. Psychological science, 21(11), 1716–1723.

Kraus, M. W., Torrez, B., Park, J. W., & Ghayebi, F. (2019). Evidence for the reproduction of social class in brief speech. Proceedings of the National Academy of Sciences of the United States of America, 116(46), 22998–23003.

Ryan, Joanna. (2006). 'Class is in you': An exploration of some social class issues in psychotherapeutic work. British Journal of Psychotherapy. 23. 49 - 62. 10.1111/j.1752-0118.2006.00008.x.

Smith L. (2013). So close and yet so far away: social class, social exclusion, and mental health practice. The American journal of orthopsychiatry, 83(1), 11–16.

Smith, L., Mao, S., Perkins, S., & Ampuero, M. (2011). The relationship of clients' social class to early therapeutic impressions. Counselling Psychology Quarterly, 24(1), 15–27.

Rubin, M. (2012). Social class differences in social integration among students in higher education: A meta-analysis and recommendations for future research. Journal of Diversity in Higher Education, 5(1), 22–38.

Thompson, M. N., Cole, O. D., & Nitzarim, R. S. (2012). Recognizing social class in the psychotherapy relationship: A grounded theory exploration of low- income clients. Journal of Counseling Psychology, 59(2), 208–221.

Thompson, M. N., Goldberg, S. B., & Nielsen, S. L. (2018). Patient financial distress and treatment outcomes in naturalistic psychotherapy. Journal of Counseling Psychology, 65(4), 523–530.

Keywords: culturally sensitive therapy

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