Socioeconomic dynamics in an American psychoanalytic psychotherapy training clinic: an exploratory qualitative analysis of doctoral education and practice

Abstract

It is understudied how a patient’s or psychotherapist’s socioeconomic status (SES) might influence psychotherapeutic treatments. This project addressed this gap in research by investigating how doctoral therapists-in-training understood the impact of SES in their psychotherapeutic work. Reflexive thematic analysis with a phenomenological approach was used to analyze conversations with doctoral student therapists at a university clinic. Specific themes emerged concerning therapist self-worth, addressing patient SES, self-disclosing about one’s SES, and working through SES fantasies. It was found that therapists-in-training routinely avoided conversations with patients related to SES. These findings suggest that doctoral training is not adequately preparing psychoanalytic psychotherapists to work with patients in lower SES positions. Limitations of the study and suggestions for future research are explored.