Social class and the therapeutic relationship: The perspective of therapists as clients. A qualitative study using a questionnaire survey

Abstract

AbstractBackgroundThis research aimed to explore clients’ perceptions of the impact of social class and whether, if so how, perceived social class disparities impact upon the therapeutic relationship.MethodA total of 45 completed questionnaires, via an online survey, were returned, comprising 30 middle‐class and 15 working‐class qualified and practising therapists from their role as client. A quasi‐phenomenological approach was taken and thematic analysis used to interrogate the data.FindingsFour primary themes were identified as follows: (1) Perceptions of own social class; (2) Social class as a facilitative aspect of therapy; (3) Negative impact of social class on therapy; and (4) Clients perceptions of their therapeutic relationship. The findings show that where there was social class disparity, it was the explicit recognition and acknowledgement of disparity that were shown to have a positive impact on the client; improving equality, increasing rapport and enabling greater psychological growth.Implications for practiceTherapists’ lack of awareness of social class was shown to lead to inadvertent oppressive and/or classist behaviour. For a client to take full benefit from therapy, therapists must recognise the importance of social class and classism and their impact upon the therapeutic relationship, and be prepared to attend to these dynamics when appropriate.ConclusionsThough many respondents thought social class was an irrelevant factor within their therapeutic relationship, this study illustrates that social class was a silent but powerful force affecting clients’ feelings of equality and the effectiveness of therapy.