Change in symptomatic burden and life satisfaction during short‐term psychotherapy: Focusing on the role of family income

Abstract

Objective The article examines the role of family income on the relationship between change in symptomatic burden and change in life satisfaction during six sessions of naturalistically delivered individual psychotherapy. Method Five hundred and thirty‐two clients receiving psychotherapy were assessed at baseline and on a session‐to‐session basis with the OQ‐30.2 and with a life satisfaction questionnaire. Data were analysed using a bivariate latent class model with structured residuals that included cross‐lagged and autoregressive components between residual scores at each time point. Adjusted family income and a binary low versus high‐income group variable were added as exogenous baseline covariates at different stages of the analyses. Results Regardless of income level, clients show improvement in psychological distress and life satisfaction as a function of time during treatment. Initial levels and improvement in life satisfaction are related to initial levels and improvement in psychological distress, and lower family income is related to slower decreases in psychological distress. When the whole sample is analysed, psychological distress and life satisfaction show reciprocal prospective relationships at the within‐person level. When models are estimated by income group, casual relationships at the within‐person level vary as a function of income. Conclusion Family income level appears to play a significant role in the relationship between symptom improvement and life satisfaction during psychotherapy.

Monitorización de Resultados en Psicoterapia: Estado Actual y Perspectivas Futuras en Iberoamérica

“…Encontraron que el malestar al inicio del proceso psicoterapéutico no se relacionó con el abandono. Behn et al (2018) abordaron, por su parte, el rol de los ingresos familiares en la relación entre el cambio sintomátológico y el cambio en la satisfacción con la vida durante seis sesiones de psicoterapia. Encontraron que los consultantes mostraron mejoras en el malestar psicológico y la satisfacción con la vida en función del tiempo del tratamiento, y que los consultantes con ingresos más bajos mostraron una disminución más lenta del malestar.…”

‘Rarely discussed but always present’: Exploring therapists’ accounts of the relationship between social class, mental health and therapy

“…Balmforth, 2009;Trott & Reeves, 2018), shows how class status impacts the experience of therapy (Moloney, 2013). Historically, people living in poverty have been less likely to be offered and to access therapy (Ballinger, 2017) and when they do access it they are less likely to recover from problems like depression and anxiety (Behn et al, 2018;Delgadillo et al, 2016). For low income or working-class clients, class differences can produce feelings of discomfort, shame and powerlessness, and a power imbalance that they perceive to permeate the therapeutic experience (Balmforth, 2009;Moloney, 2013).…”

Worlds apart: Social inequalities and psychological care

“…Even when they are able to access and start counselling, low‐income clients tend to have higher distress levels at the start and end of treatment compared with high‐income clients (Berzins, Babins‐Wagner & Hyland, ). This does not mean that low‐income clients cannot benefit from therapy; in fact, recent evidence demonstrates that clients tend to show improvements in psychological distress and life satisfaction during therapy regardless of income level (Behn, Errázuriz, Cottin & Fischer, ). However, symptomatic improvements appear to predict subsequent improvements in life satisfaction in high‐income clients, whereas for low‐income clients symptomatic improvements tend to be slower and preceded by gains in life satisfaction (Behn et al., ).…”