Psychologists release guidelines to tackle economic marginalization

A summary of the APA Council of Representatives, published in american psychologistprovides guidelines for psychologists working with people from low-income and economically marginalized (LIEM) groups in the areas of education and training, health disparities, treatment considerations, professional concerns and unemployment.

Additionally, two cross-cutting recommendations are offered: (1) the intersection of economic status and other identities impacts psychological health; (2) prejudice and stigma exacerbate negative experiences. This long-awaited report provides essential information for behavioral health professionals and researchers on how to work with LIEM groups.

“The purpose of establishing the term LIEM is to draw attention to the contextual significance of economic marginalization, not to serve as an identifier or absolute measure of socioeconomic status,” the group writes. APA work on LIEM issues.

Socioeconomic status affects a wide range of health issues, such as dealing with pain, providing therapeutic treatment, suicide, and mental health issues more generally.

The first area aims to ensure that psychologists receive appropriate training and education, especially since the majority of psychologists are remote from socio-economic status issues and do not come from low-income backgrounds. To fill this field, psychologists must strive to understand how personal biases related to social class can impact the training and education they provide. Psychologists should also increase their knowledge and understanding of social class issues through continuing education, training, supervision, and consultation.

The second area focuses on recognizing the links between adverse health outcomes and socioeconomic status. Psychologists are called upon to understand the contribution of economic and social marginalization to significant health disparities in our society. In addition, psychologists must strive to promote equity in access to quality health care offered to people from MEIs.

The third area incorporates previous evidence that financial hardship impacts the delivery and effectiveness of psychological treatment into best practice guidelines. In this area, psychologists should recognize the presence of social class as an influential aspect of mental health treatment parameters.

Psychologists should also aim to understand the barriers that prevent people of low socioeconomic status from having better access to mental health care and work to mitigate these barriers in providing psychological treatment. Additionally, psychologists would benefit from understanding common clinical presentations that may be more likely to occur in people with MIEM and learning how to best address these issues in treatment settings.

The fourth area deals with the intersection of LIEM identity with work concerns and unemployment, with the understanding that work is a pathway to power and economic well-being through increased resources. Psychologists can be aware of intersectional issues by developing an understanding of the impact of social class on academic achievement, career aspirations, and lifelong career development.

Psychologists can also navigate this intersection by seeking to understand the interplay between economic insecurity, unemployment, and underemployment and by trying to contribute to individuals’ re-employment processes. The working group writes:

“Throughout this document, the task force has provided recommendations for qualified practice with LIEM populations. Regardless of these recommendations, if growing economic inequality and meritocracy remain the unchallenged status quo in the Western world, these guidelines will remain ambitious. We believe that psychologists must view systemic economic injustice as a direct contradiction to mental well-being and not simply as a proximal aspect of people’s lives. When psychologists view economic marginalization with the same importance as other psychosocial factors, these guidelines will move from aspirational to enacted.


Juntunen, CL, Pietrantonio, KR, Hirsch, JK, Greig, A., Thompson, MN, Ross, DE, and Peterman, AH (2022). Guidelines for the psychological practice of low-income and economically marginalized people: summary. american psychologist, 77(2), 291–303. (Link)

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