Objective Versus Subjective Indicators of SES Another possible reason for the limited pursuit of SES research is the difficulty in operationalizing SES.As a construct, SES is multifaceted, impeding the use of discrete variables (Liu et al., 2004).To respond to this shortcoming, we investigated potential links between SES and counseling outcome.SES and Mental Health SES as a Variable of Study In the last 20 years, two content analyses have reviewed cultural variables and SES within counseling (Liu, Soleck, Hopps, Dunston, & Pickett, 2004; Pope-Davis, Ligiero, Liang, & Codrington, 2001). (2004) reviewed three journals from 1981–2000 and concluded that SES was mainly studied post hoc, and used primarily to account for unexplained variance.For example, in one study at a university counseling center, 163 case files were randomly selected to evaluate the association between the Hollingshead SES rating scale and therapy outcome (Hillerbrand, 1988).According to the results, counselors rated clients with lower SES levels as having greater dysfunction, greater goal disagreement about treatment and less successful counseling outcomes.Taken together, both content analyses pointed to an overall lack of attention to SES in mental health counseling literature.There is agreement regarding the multicultural and social justice relevance of economic empowerment and SES in the field of counseling (Ratts, Toporek, & Lewis, 2010); however, available SES counseling literature is predominantly conceptual and not empirical.
Implications for SES research and counseling are discussed.
This challenge is best expressed in the old adage “Which came first, the chicken or the egg?
” In other words, do lower SES levels lead to higher rates of mental health disorders or do higher rates of mental health disorders lead to lower SES levels?
In addition, Smith, Chambers, and Bratini (2009) opined that, while research on the pathogenic impact of poverty on emotional well-being is robust and logical, the development of practitioner-based interventions has been limited.
The counseling profession has not been a leader in empirically studying this complex variable, which further limits the profession’s contributions to research-based interventions.