Psychotherapy is not just for Rich White People: Outcomes for Clients from Minoritized Backgrounds and in a Community Training Clinic.

Although dose-response and similar psychotherapy outcome studies have been plentiful in recent years, most assume a one-size-fits-all approach. They often rely on homogeneous populations, which usually means wealthy, Eurocentric groups. Although financial hardship, race, ethnicity, and sexual minoritized status are associated with significantly worse mental health outcomes, these samples remain underrepresented in psychotherapy research. Previous research on the contributions of these demographic factors has produced mixed results. Understanding whether these factors impact psychotherapy outcomes will help to advance the inclusivity of psychotherapy research and provide guidance on how to better tailor treatments to meet the needs of the wider population. We examined the impact of financial hardship, race/ethnicity, and sexual minoritized status on baseline symptoms, and changes in symptoms during the course of psychotherapy using multilevel growth models. At a community-based graduate training clinic, 137 adult clients (18-81 years old, 39.4% clients of color, 21.9% LGBTQ +) completed weekly anxiety and depression symptom measures. Clients of color and clients endorsing high financial hardship reported significantly more severe anxiety symptoms at baseline than those without financial hardship. Clients with moderate or high financial hardship reported significantly greater depression symptoms at baseline. There were no other significant differences in symptom trajectories based on financial hardship, race/ethnicity, and sexual minoritized status. Consistent with the literature, those reporting financial hardship were more likely to enter psychotherapy with more severe symptoms than those without these characteristics; however, these clients benefitted from psychotherapy in a similar way.