Study Finds Racial and Class Discrimination in Psychotherapy

A new study suggests that psychotherapists are human beings in a society, subject to the same influences as other people in that society.

"Psychotherapists are not immune to the stereotypes that influence the decisions of other professionals," Heather Kugelmass, the author of the study, said. "Moreover, because therapists in solo private practice have high levels of professional autonomy, they have a lot of latitude to make decisions that are consistent with their biases." 

"Among those who were called back, however, Kugelmass found a disturbing trend. Once reached, white patients who sounded like they were middle-class were offered an appointment 30% of the time, while middle-class black women were offered an appointment 21% of the time and middle-class black men received such an invitation only 13% of the time. The offer for psychotherapy appointments also seemed to depend on gender and class divisions."

“For those [potential clients] who do persist in their search for care, every instance of blocked access means additional time and effort spent placing numerous phone calls to identify a psychotherapist willing to respond and accommodate their schedules. This is time and effort that those suffering from mental [health issues]—especially those of low socioeconomic status—do not have to spare.”

Just the stigma of being on benefits leads to homelessness.

Zineb's children stayed with her on a police waiting room floor

A mother and her three young children claim they were forced to spend the night on a police station floor after being being made homeless.

"It's hard to think of a worse time in the last 50 years to be on benefits and living in London. Soaring rents, a massive shortage of social housing and the effects of the benefit cap have left thousands of people struggling to find a place to live. Add to that the stigma which is now attached to claiming welfare and you have a situation which makes it almost impossible for the capital's poorest residents to find a home.

"These difficulties were highlighted by a recently leaked email from the estate agents Foxtons. It showed one of the company's employees trying to discourage a landlord from renting to people on housing benefit. Foxtons were quick to confirm that this isn't company policy and said they were disappointed to learn about the incident. But the attitude of the employee who sent the email will come as no surprise to anyone who receives benefits and has tried to rent a property in recent years."

Natalie Bloomer 

Managing the need to polarise.

Either you're for regulation or you're against it. Either you're for the law or you're against it. Either you despise white working class culture or you're a racist.

Counsellors and psychotherapists live in a world of nuance, listening very carefully to what people believe they're saying and actually say and attempting to discern what might actually be going on for them. But when it comes to diversity we still remain, as a profession, pretty blunt in our approach. We tend to be reactive rather than proactive - watching our professional orgs beginning to scrabble with excuses and pompous, unrealistic announcements

We . . . will continue to engage with the Joint Work and Health Unit to critically examine their ongoing work, to ensure that the full range of potential co-location options trialled are in the best interests of clients, and that the evaluations will be thorough and robust enough to pick up on all of our areas of concern.

is a good example of our need for status and our inability to acknowledge that there are huge holes in our experience and knowledge. The organisations involved in this Statement seem to have forgotten that this government dismissed their demand for regulation: they don't take us terribly seriously.

So, read Paul Mason's piece on why working class white children, particularly boys, are failing so miserably.

It was not always the case that ethnic-minority children did better than white English ones, but the reason why some of them do now is pretty obvious: their problem – racism – is defined; their language skills tend to be well-developed; their culture is one of aspiration; they have social and religious institutions that promote cohesion.

By contrast, the problem of poor white kids cannot be properly defined: not in the language of freemarket capitalism, at least. It has nothing to do with being “overtaken” – still less with any reverse discrimination against them.

It is simply that a specific part of their culture has been destroyed. A culture based on work, rising wages, strict unspoken rules against disorder, obligatory collaboration and mutual aid. It all had to go, and the means of destroying it was the long-term unemployment millions of people had to suffer in the 1980s.

At a time when we have come to believe that the individual is solely responsible for their own fate a little nuance, a little thought, a little emersion in the experience of the Other and a little reading of history will go a long way.

We Live In Interesting Times

Tomorrows protest march is against cuts in disability benefits. Just as the protest against the scrapping of the Education Maintenance Allowance (a payment to the children of very poor households) was attended by thousands fewer demonstrators than protests against increases in costs to university students so there are likely to be very few people attending tomorrow. People in receipt of Disability Living Allowance and other benefits aimed at people who are too ill to work have been subjected to dreadful propaganda.


Godwin’s Law normally holds good but in this case I think there’s something to be learned from comparing the rhetoric about the cost of caring for disabled people today and how it echoes that of Nazi Germany.

Helpfully, this article also references the lies of omission around ‘Fraud and Error.’

These are turbulent times, all of us are caught up in it one way or another, it’s impossible to ignore. I wonder if psychotherapy has anything to offer to the understanding of this cycle of radicalism?


Post script Indeed, 20 people turned up in Trafalgar Square. Read a disabled activists perception of the issues.

Context Is Everything

A man is hanging out of the windows of the block across the road, he’s quietly telling a couple of children which door to go to and what to say. One the children, polite, neat and apparently confused, goes up to a door, looks back over his shoulder towards the man and says: “Is this the one?” I don’t hear any answer but the child raises his voice and says: ‘Excuse me. Excuse me. Do you live here?’ to the person going into the block. She doesn’t answer and the children wander off, back towards the other block where the man says: ‘See that car? Yes, that blue one, that’s it. Spit on it. Spit on it.’ The children, confused enough now to feel fear, walk away.

The man continues in his low, not unfriendly tone. ‘I want to fuck you. I want to fuck you. Oh, is that how it is now? Don’t you love me any more? I want to fuck you.’ My neighbours’ adult daughter comes into our block and we say hello. “Do you know that man?” I ask. She doesn’t, but he somehow knows her name and she’s more bemused than aggrieved. She goes inside, I carry on gardening, the man continues his monotone commentary. The children have long gone.

My daughter and I are walking home and we hear a cacophony of bird noises then see a blackbird fly out of a bush. There’s a nest in there with a second brood of fledglings and I take my daughter over to see it, high up above our heads in the municipal bushes. We listen to the young birds then hear an outraged: “Do you mind?” We can’t work out where it’s coming from, and again “Do you mind? I’m trying to go to the toilet.” And there, 4 feet from us squatting behind the large communal bins is a woman with her skirt pulled up around her hips. I am so shocked that I can’t find the urge or the words to reply and just leave, with no sense of threat but with the feeling that I’ve moved into a Kafkaesque world where squatting, shitting women are outraged that I’ve interrupted their public ablutions.

Across the road there’s a camper van, one of the cheaper ones and very old. The locks aren’t any good and a group of 10 year olds has broken into it. They throw everything out of it onto the street, bedding, pots and pans, a television, reams of paper, tea towels, everything. Then they cross the street and begin ripping a young pear tree apart, bending it under their combined weight, screaming loudly and intensely until the tree suddenly snaps and they land heavily. One boy is hurt and they begin to kick him. He has to get up or be beaten, staggers to his feet, laughs, throws a punch which misses and the lot of them move off down the street, leaving the road covered in the strangely unsettling contents of someone’s holiday life and the young tree. A number of us called the police who never arrive.

A family just up the road allowed their two elder children to smoke dope when they were 12 and 14 years old. The parents often went away leaving the three children alone, the youngest being 10, and they would have parties in which alcohol and illegal drugs contributed to the house being trashed, time after time. The 15 year old daughter started a relationship with a 30 year old whom her parents welcomed into the home and he tattooed her at 16 with her parents consent. On a school exchange the elder son made constant Nazi references at the two young German people staying with them which the rest of the family found amusing, and at 15 the youngest daughter put up pictures of herself on Facebook snorting coke.

Dee had what used to be called ‘emotional incontinence'. She felt she must share the most intimate aspects of her life with anyone who’d listen. Her partner who was over a decade older than her and demonstrably didn’t love her; her multiple, dramatic affairs; her children both of whom were taken from family home at the age of 8 to spend the rest of their childhood in special schools; the fact that her younger child has a close resemblance to one of her lovers; her eating disorders and self-harm. She had one job working as a nursery assistant and the rest of her life was spent supported by the State. Dee was killed in a high-speed, late-night, alcohol-fueled crash.

Context is everything. Dee is, of course, Princess Diana who is still treated with the veneration afforded to a saint. The family with dope smoking children live in a detatched home in huge grounds which means that neighbours don’t need to call the police to their rowdy parties and the underage sex and drug abuse is ignored. All of these people and families are worthy of our care and concern, but the woman who, with great dignity, squatted down in the hedge, the man in the council flat, the ‘feral children’ are much more likely to be dealt opprobrium, low-quality interventions and incarceration.
Why is that?

Them And Us

Counsellors function as part of society: as individual practitioners we hold differing political, social and personal opinions, if we didn’t there would be one psychological model and no professional debate. As members of society we are not immune from the concerns, interests and zeitgeist of that society and of course we bring all of that into the counselling room with us which is why counselling trainings are expected to address issues such as racism, sexism, homophobia, and disability awareness. Amidst the many anti-discriminatory trainings, class and income come very low down in training establishment priorities.

And yet counselling as a profession depends on people on low or no incomes. All of the agencies that student counsellors attend to gain experience and hours are attended by low or no income people because of the simple fact that they can’t afford to pay very nearly an entire weeks income for 50 minutes. In effect, low and no income clients service an industry that has demonstrated no real interest in them.

One of the reasons for this lack of interest is that low income people don’t train as counsellors.   All training establishments will all have some kind of equal opportunity statement along the lines of

It is our policy to contribute to equality and social justice by ensuring that all members of staff and applicants for employment shall receive equality of opportunity irrespective of sex, gender (including gender reassignment), sexual orientation, sexuality, race, colour, creed, religion, political beliefs, ethnic or national origin, age, marital status, disability.  [This university] is striving to break down barriers, extend opportunities and improve access to the resources of society.  It aims to reach out to all sections of the community as employees, students, clients, partners and suppliers.

People on low or no incomes are excluded from this statement. If an individual has the qualifications, aptitude and life experience perfectly suited for counselling training but cannot pay for the training she will not be accepted onto the course soley and absolutely on the basis of her income. People of colour, disabled, gay and elderly people do train as counsellors, have brought their experience to the training and challenged negative attitudes: there is no such challenge from poor people.

The experience of being in counselling has been researched over many years. We have some concept of client outcome, drop out and compliance based on statistical evidence and there is some – though very little – academic writing on the experience of the client herself. We all know from our own experience that when faced with people who have power over us we have to behave in a particular way. Incredibly, power dynamics in counselling are very seldom discussed in any detail in training or in academic literature though some counsellors will have some idea that this will be at work in all of our relationships. The experience of low income clients in counselling has been totally unresearched. Yet the low income client must contend with grotesquely unbalanced power dynamics in their everyday lives, simply to live indoors or to feed their children or buy sanitary towels. Behaviours and attitudes will form around this dynamic and these, consciously or unconsciously, will be brought to the counselling relationship.

The poor have always been discriminated against, in every period of history and almost every society. We hate Them. They are not Us. They function as something We can form our own identities around, defining what We are not. Despite being most often cited as a reason to be concerned about the poor, behaviour is certainly less important to society than economic status.