According to a study by the U.S. Census Bureau, there were 46.7 million Americans living in poverty in 2014, or a poverty rate of 14.8 percent. The picture was even bleaker for many ethnic and racial minorities. The same study found that 26.2 percent of African Americans (10.8 million people) and 23.6 percent of Hispanic Americans (13.1 million people) lived in poverty. Children were also particularly vulnerable. The study reported that 21.1 percent of Americans under the age of 18 lived in poverty.

What qualifies as living in poverty? The answer is not simple. A number of factors are involved in calculating income, and the Census Bureau has created 48 possible poverty thresholds. Broadly, however, any single individual younger than 65 with an income of less than $12,316 or any single individual 65 or older with an income of less than $11,354 is considered to be living in poverty. The poverty threshold for two people under the age of 65 living together is $15,934, and the threshold for two people over the age of 65 living together is $14,326. For a family of three — one child and two adults — the threshold is $19,055. For a family of three with one adult and two children, the threshold is $18 higher at $19,073.

The thresholds are derived using the Orshansky Poverty Thresholds, a formula originally developed in the 1960s by Mollie Orshansky, an economist working for the Social Security Administration. The formula compares pretax cash income against a level set at three times the cost of a minimum food diet in 1963 in today’s prices (updated annually for inflation using the Consumer Price Index).

However, these numbers can’t truly capture the reality of daily life for those living under the strain of poverty, say counselors who regularly work with client populations that are economically disadvantaged. Imagine taking multiple buses and dedicating up to two hours of travel time to get someplace that someone who owns a car can reach in 20 minutes. Imagine having to choose between buying groceries or paying the electric bill. Imagine managing a chronic illness while living on the streets.

Counselors are trained in diversity and multiculturalism, but does this awareness of discrimination and alternative worldviews necessarily include those living poverty? Not often enough, asserts Pam Semmler, a licensed professional counselor (LPC) and private practitioner in Denver. “I’ve been to a lot of diversity trainings, and none of them covered socioeconomic barriers,” she says.

The average counselor doesn’t have adequate training or even a good frame of reference when it comes to clients living in poverty, says Semmler, who spent more than nine years counseling clients at the Colorado AIDS Project. The project is part of the Colorado Health Network, a statewide organization that provides health services, case management, substance abuse counseling, housing assistance, transportation, nutrition services and financial assistance to people with HIV and those at risk. Semmler has also provided training to staff at the Colorado Coalition for the Homeless on diversity issues specifically related to working with those in poverty.

Of course, people living in poverty are not one monolithic culture, Semmler stresses. However, they do share something deeply significant: a lack of money and limited access to the resources that money typically makes available.

“Poverty is actually a lack of multiple resources,” Semmler says. Financial resources are the most obvious, but those living in poverty also often lack health, housing, social, family, emotional and sometimes even spiritual resources, she continues.

To help clients living in poverty, counselors first need to understand the barriers that these individuals face in their everyday lives, say Semmler and other experts.

A different world

“We tend not to talk about a ‘culture of poverty’ as in years past,” says Louisa Foss-Kelly, a professor in the Counseling and School Psychology Department at Southern Connecticut State University whose research interests include counseling people who are economically disadvantaged. “However, people living in poverty often share perspectives and engage in similar survival-related activities. They do whatever it takes to meet their needs or those of the family’s.”

“For example,” she continues, “a client may sell belongings on the street to make some quick cash, barter services with neighbors and find other creative ways to pay bills that might not be understood by people in the middle or upper class.”

Because counselors often come from middle-class backgrounds, the practice of counseling often reflects those experiences and values, but practitioners should take care not to judge clients through this lens, says Foss-Kelly, an American Counseling Association member and LPC who has worked in community counseling settings with clients living in poverty.

“Unfortunately, many counselors have never been challenged to explore their own biases about poverty,” she says. “They may not understand the impact of their own socioeconomic history on the process of counseling.”

Counselors simply aren’t trained in the realities of living in poverty as part of their counseling education, says Victoria Kress, an ACA member and past president of the Ohio Counseling Association whose research interests include working with client populations that are economically disadvantaged. “For example, I was trained as a counselor in the early 1990s, and my training was based on middle-class values and assumptions,” she says. “It was assumed that my future clients would come in for counseling of their own volition; they would have food in their bellies; they’d be safe; they’d be verbal and forthcoming; they’d have transportation; they’d be invested in growing and living up to their optimal potential. As I began to see clients, it became increasingly clear that none of these assumptions was accurate.”

“People living in poverty engage in a constant financial battle,” Foss-Kelly adds. “They may have to work two or three jobs, find food banks and navigate the maze of social services organizations. They may struggle with children in emotional distress because of frequent moves or other family disruptions. These clients may arrive to counseling tired, hungry or late. A judgmental counselor might say that [these clients aren’t] serious about changing or that they’re too disorganized or lazy to take care of themselves.”

Chelsey Zoldan, an LPC, currently works as a counselor at the Medication Assisted Treatment Department at Meridian HealthCare in Youngstown, Ohio. But she has also counseled those in the rural Appalachian section of the state and says that time issues — mainly clients not having enough of it and being late to appointments — were among the most common obstacles.

Many clients living in poverty have unreliable transportation or no transportation at all, Zoldan points out. In some states, public agencies may provide transportation to community clinics and other services for those living at or below the poverty line, but there is no guarantee that transportation will be timely, she continues. Some clients rely on rides from friends and family, but the person doing the driving sets the schedule, which may not fit with the client’s needs. In other instances, friends and family members may not be reliable when it comes to promises to drive or offer other assistance, she says. Public transportation may not be readily available or may require multiple transfers on a sporadic schedule.

Zoldan, an ACA member, points out that it may take clients relying on area bus service two hours to get somewhere that it would take her 20 minutes to drive to in her car. She adds that the bus schedule is inscrutable to her and her colleagues, but that clients who are struggling to get by financially routinely navigate the inconsistent routes and take multiple buses to get where they need to go. Unfortunately, as a result, they are often late or even miss appointments altogether. “Some counselors might interpret this as meaning that they [the clients] don’t care or aren’t committed to the process,” Zoldan says, acknowledging that she had to shift her own perspective regarding timeliness when she first started working with clients who were economically disadvantaged.

Some health care and other service providers may not be willing to accommodate these scheduling challenges, and that is a problem, Zoldan says, because these clients still need to be seen. And if a provider turns them away after they are late in arriving, they may not come back at all, she points out.

Clients who are economically disadvantaged may also have limited work flexibility or lack child care, adds Kress, who is the community counseling clinic director, clinical mental health counseling program coordinator and addiction counseling program coordinator at Youngstown State University in Ohio. Counselors need to be sensitive to the logistical problems that these clients face, she says.

When possible, Kress says, practitioners should consider providing in-home counseling and flexible or drop-in scheduling. In addition, clinics or practices that have the resources might consider offering day care and transportation assistance, which could involve providing the actual transportation or giving out public transportation vouchers, Kress says.

Meeting basic needs

As Kress began her counseling career, she realized that many of her clients living near the poverty line were struggling simply to survive. This reality often required her to be more “active” in these clients’ lives than her training had prepared her for.

“One of my first clients — a teenage mother — came [to counseling] in crisis because her electricity had been turned off,” Kress remembers. “In that situation, what she needed from me was to help her figure out how to get it turned back on. Having never had my electricity turned off, I had no idea where to begin. And my counseling textbooks didn’t talk about how to get one’s electricity turned back on. I had to put aside my expectations, be flexible and roll with helping her problem-solve her electricity situation.”

Before counselors can begin to effectively address traditional counseling concerns, they must make sure that their clients’ basic survival needs — including food, shelter and clothing — are being met, say the professionals interviewed for this article.

In doing so, counselors working with clients in poverty may find themselves playing many different roles, says Zoldan, who is also a doctoral student in the counseling program at the University of Akron. “You might have to be care coordinator, do case management, perform vocational counseling,” she says. “You might also … help with county health funds, student loans, transportation.” Counselors might also serve as de facto mental health educators for their clients, their clients’ families and even the community at large, particularly in rural settings, Zoldan adds.

Some might think that many of these services are the purview of social workers, not counselors. But Kress has a message for those who protest this expanded vision of meeting the needs of clients.

“I’d say this: How can a person work on higher order counseling goals if they are worried about where their next meal is coming from or how they will get their electricity turned back on?” Kress says. “Effective counselors are flexible and meet their clients where they are at.”

Foss-Kelly agrees. “Counselors treat the whole person in context,” she emphasizes. “So we have to acknowledge and respond to the crises our clients face when they leave the counseling room, even if those crises are financial in nature. Counselors are well-trained to provide referrals and work alongside social workers. In addition, we have to integrate the client’s basic needs into case conceptualization, treatment and treatment planning.”

Kress adds that she believes it is “old-school thinking” to state that counselors shouldn’t also help clients with their basic needs. In fact, she says, in the area of community mental health, the days of clients being assigned to a case manager who was a social worker and then to a separate counselor are long gone. “Now what we see is clients being assigned one mental health professional who provides counseling and case management. The system has had to adapt to the needs of consumers.”

Although counselors in community clinics or facilities affiliated with local social services might more commonly work with individuals living in poverty, Kress and others interviewed for this article say that most practitioners will encounter clients who are economically disadvantaged at some point.

Zoldan urges counselors to be deliberate about ensuring that these clients feel empowered in their own treatment. Taking an authoritative approach as the counselor and neglecting or diminishing the client’s input is potentially detrimental, she points out. The counselor might very well be unaware of the individual’s basic needs that are going unmet, she says, and the client may not trust the practitioner at first because he or she is viewed as an outsider. “The goal is to collaborate with your client on everything,” Zoldan says. “People in poverty are used to feeling oppressed in different ways.”

“Many people who live in poverty perceive that existing institutions do not serve their interests and needs, and counselors need to recognize that they are part of the system, whether they like it or not,” Kress adds. “Counselors must be flexible and sensitive to clients’ needs.”

Because counselors are part of the system, they should work it to their clients’ advantage, say Zoldan and Kress. It can be important for counselors to align with agencies, clinics or charities that offer assistance with food, housing, health care and other needs, Zoldan points out. She urges counselors to build relationships with these organizations and to also make contacts with officials in local service agencies such as job and family services so that clients’ needs can be better met.

Seeking solutions

In addition to the challenges related to basic survival, those living in poverty face many other barriers, Kress says. Common issues among this population include substance abuse, chronic mental or physical illnesses, teenage pregnancy and unsafe living environments that might involve intimate partner violence, she explains.

“In my experience, clients need to have counselors acknowledge and validate their experiences,” she says. “Many times, clients may not even connect the dots that these experiences are having a significant impact on their lives. In many ways, these experiences have been such a part of the landscape of their lives that they don’t recognize the impacts they have on them.”

Semmler agrees, saying that many of her clients have never had anyone explain to them how poverty has affected the entire trajectory of their lives.

Those in poverty are often blamed for their circumstances and stereotyped as lazy or incapable of saving money, Zoldan says. The reality is that many of these individuals are working two or even three jobs just to scrape by and aren’t saving money because they don’t have any to spare, she says.

“Each day may start with managing different crises — trying to find food or a place to sleep or meeting other basic needs of the family,” Foss-Kelly observes. “This survival focus inevitably impacts both the content and process of any counseling session. A person-centered approach is a critical foundation for counseling, but it may move at a pace that’s too slow for addressing crises of survival.”

Adds Kress, “When working with these populations, counselors need to be active, involved and focused on concrete and present solutions.”

Several of the counselors we spoke to emphasized the need to help these clients recognize and build on the strengths they have already developed to survive under the strain of poverty. As with any client, counselors should take into account the worldview and individual context of a person living in poverty, says Zoldan, who likes to use strength-based counseling, particularly for those coming from generations of poverty.

Contrary to the stereotype of lazy people just looking for a handout, living in poverty actually requires a significant amount of self-sufficiency, Zoldan points out. These clients typically must navigate public transportation and assistance systems and may juggle multiple jobs with child care and other family responsibilities, all of which requires a great deal of planning, she notes. Zoldan recalls a former client who had a backup plan for any major eventuality, including what to do if she couldn’t pay her rent, couldn’t afford food, lost her primary means of transportation and so on.

Kress notes that those affected by poverty may also acquire skills and strengths — including the ability to accept and handle difficult situations and live in the moment as needed — that aren’t readily apparent to most casual observers. “Identification and expansion of client and client-system strengths help to provide hope and support clients’ well-being,” she says.

In general, people who live in poverty also strongly value relationships, Zoldan says. This can oftentimes be very positive. For example, friends and family members can provide the person both emotional and practical support in the form of child care, meal sharing, housing and so on.

However, in some cases, it can also erect another barrier, Zoldan says. “Relationships are valued above all else,” she observes, meaning that counselors need to be aware that getting these clients to set boundaries or remove themselves from unhealthy living situations can be a complicated proposition.

Simply telling a client to cut off a relationship is not culturally appropriate, Zoldan says, so counselors may need to encourage other alternatives. For instance, if a client is struggling with substance abuse and her mother and sister are still using in their homes, a counselor might suggest that, rather than cutting off all contact, the client and her relatives talk only by phone or meet in public instead of in the relatives’ homes.

Ending or limiting these relationships with family and friends represents a significant loss of connection for clients. So Zoldan and her colleagues encourage these clients to get involved in 12-step programs in which they can get support and build a family of sorts within the recovery group. Zoldan’s agency also encourages group therapy, which can offer another source of connection and support for clients living in poverty.

Semmler is an attachment-focused therapist, so she always circles back to relationships. “When people attach in order to survive, the relationships are not always the most healthy,” she observes. Becoming psychologically healthy may require clients to break some of those ties, so Semmler, during her time with the AIDS project, would encourage clients to make healthy attachments to service providers and other participants in the program.

Helping the youngest living in poverty

Children living in poverty face many challenges that make it difficult for them to get an education, says Christi Jones, an ACA member who is an elementary school counselor in rural Alabama. The board of education for her school district is trying to remove one significant barrier by matching students who are in need of psychological assistance with mental health counselors. Part of Jones’ job is to help facilitate this process.

“At my school, mental health services are provided one day a week,” Jones says. “As a school counselor with approximately 600 students, collaboration with our local mental health agency assists in meeting student needs. At the beginning of each school year, I introduce the mental health counselor to teachers and staff members and assist in developing a schedule. When coming from the outside to work in a school, it is essential to have an understanding of the school culture.”

“I work with the mental health counselor to build relationships with key staff members who can assist in success in the school setting,” she continues. “The mental health counselor in turn ensures I understand what is required for students to qualify to receive services in the school setting. I can then share information about the program with both teachers and parents.”

Jones explains that students in the rural area where she works often need help beyond what she can give them as a school counselor. Transportation is an issue for many of the children’s families, so having an in-house mental health counselor at the school eliminates that barrier and also provides a source of long-term support for children and their families.

Jones sometimes continues to collaborate with the mental health counselor to address a student’s difficulties. In addition, because the mental health counselor is at the school only one day per week, Jones sometimes sees students who need additional support.

Another equally important part of her role as a school counselor is to advocate for students’ overall well-being, which sometimes means helping to meet basic needs such as food and clothing, Jones asserts. “My mentor counselor told me during my first year as a school counselor that basic needs must be met before you can work on issues,” she says. “I provide counseling to my students, but I also believe that social justice is an important part of my role as a school counselor. I work to connect my students and their families to resources.”

It is hard for children to focus on learning if they are hungry or worried about where the next meal is coming from, Jones says, so she worked with church and community leaders to create a weekend backpack program. “Local churches come each Friday and provide backpacks of food from our local food bank for students to take home,” she explains. During the winter and spring school breaks, families are also given enough food to last until school starts again.

Jones also maintains a clothing closet stocked with various seasonal clothes for students in need. She doesn’t wait for these students to approach her before offering assistance.

“If you take the time to get to know your students, it is not hard to find out who is in need,” Jones says. “If they see you on a regular basis and you talk to them, they will share their struggles and successes with you. Also, I see things just by observing students in the halls or in their classrooms. Students will sometimes come to school in flip-flops in cold weather, or you can tell their shoes or clothes are too small. Teachers also provide information about student needs.”

“As the school counselor, I have had the opportunity to help many of the families in my community,” Jones says. “Where I work, it is small enough that you get to watch your students grow up. You know all the families, and you care about your students long after they leave your building. Beyond data, I measure success in graduation invitations and students coming back to tell me they are going to college. [They are] often the first in their family to do so. There are many challenges to working with students living in a rural, high-poverty area, but there are opportunities to make a difference that make it the most rewarding profession.”

Embracing counseling’s core values

The counselors interviewed for this story emphasize that clients living in poverty want help and want to be heard. “The most important advice I can give [to counselors]: Be authentic and be understanding,” Zoldan says.

To build a therapeutic relationship with clients dealing with impoverishment — or any client, for that matter — practitioners must fall back on the core values of counseling, says Almeta McCannon, an ACA member who co-led a roundtable session at the 2016 ACA Conference & Expo in Montréal on counseling people affected by poverty. “I would advise clinicians to go back to the cornerstones of our profession: empathy, compassion, unconditional positive regard,” she says. “These are what allow us to relate to people who have experienced things we could never imagine and still be able to help them through a difficult time or situation. Assuming is the enemy here. I would encourage [counselors to ask] questions about the things that they do not understand and to really listen to the responses to those questions.”

Foss-Kelly believes counselors also need to take the next step and advocate for those living in poverty. “Counselors can play a key role in advocating for the marginalized, including those in poverty,” she says. “Of course, this advocacy begins with individual clients and communities, but it should also include spreading awareness in professional circles and among power brokers. People living in poverty come to counseling in a vulnerable state. We as counselors must fight to help other counselors understand their unique needs.”

 

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To contact the people interviewed for this article, email:

• Louisa Foss-Kelly at fossl1@southernct.edu
• Christi Jones at cjones@tallapoosak12.org
• Victoria Kress at victoriaekress@gmail.com
• Almeta McCannon at almetamccannon@gmail.com
• Pam Semmler at pamsemmler@yahoo.com
• Chelsey Zoldan at cazoldan@gmail.com

 

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Additional resources

To learn more about the topics addressed in this article, see the following resources offered by the American Counseling Association.

Books (counseling.org/bookstore)

• ACA Advocacy Competencies: A Social Justice Framework for Counselors edited by Manivong J. Ratts, Rebecca L. Toporek & Judith A. Lewis
• Counseling for Multiculturalism and Social Justice: Integration, Theory and Application, fourth edition, by Manivong J. Ratts & Paul B. Pedersen
• Multicultural Issues in Counseling: New Approaches to Diversity, fourth edition, by Courtland C. Lee

Webinars (counseling.org/continuing-education/webinars)

• “Why Does Culture Matter? Isn’t Counseling Just Counseling Regardless?” with Courtland C. Lee

Podcasts (counseling.org/continuing-education/podcasts)

• “Hunger, Hope and Healing” with Sarahjoy Marsh
• “Multiculturalism and Diversity. What Is the Difference? Is Not Counseling … Counseling? Why Does It Matter?” With Courtland C. Lee

VISTAS Online articles (counseling.org/knowledge-center/vistas)

• “Counselor Training and Poverty-Related Competencies: Implications and Recommendations for Counselor Training Programs” by Courtney East, Dixie Powers, Tristen Hyatt, Steven Wright & Viola May
• “Preparing Counseling Students to Use Community Resources for a Diverse Client Population: Factors for Counselor Educators to Consider” by Sarah Kit-Yee Lam
• “Professional Counseling in Rural Settings: Raising Awareness Through Discussion and Self-Study With Implications for Training and Support” by Dorothy Breen & Deborah L. Drew

In addition, counselors who would like to get involved in issues of diversity and social justice may be interested in joining Counselors for Social Justice, a division of ACA. Founded in 2000, CSJ’s mission is to work to promote social justice in society through confronting oppressive systems of power and privilege that affect professional counselors and their clients and to assist in the positive change in society through the professional development of counselors. Visit CSJ’s website at counseling-csj.org.

 

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Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editor: ct@counseling.org