Therapy Congruent With Class-Linked Expectations

A SATISFACTORY plan for helping members of the lower socioeconomic class when they become mentally ill has not yet been formulated. Although a large number of psychiatric patients are members of the lower classes our primary treatment modality of psychoanalytically oriented psychotherapy is presumed to be suitable principally for those of the middle and upper classes. Perhaps because of this presumption the lower-class patient is frequently rejected for treatment. Certainly, until recently, little attention has been directed towards designing an appropriate treatment method for him. Our patients at the Psychiatric Clinic of the Los Angeles County General Hospital are predominantly from the lower socioeconomic classes and therefore, we have found it imperative to direct our attention to this major problem.

We decided to study this problem first by learning what the clinic patients' expectations were about treatment, and then secondly by observing the