This chapter discusses ways in which economics affects our psycho-social well-being: theories of the self and models, of psychotherapy, including CAT, rarely if ever take account of economic conditions and how they affect mental health. This is a stark omission given that deteriorating levels of mental health in the population are strongly associated with the prevalence of neoliberal economic policies that have led to widening inequalities in the distribution of wealth and power in society. It will consider how the development and practice of CAT has interacted with economic conditions and the extent to which the values of CAT have been compromised by economic realities.

The chapter will then discuss how psychotherapy informed by the ethics of the Russian philosopher, Mikhail Bakhtin, could potentially offer a space in which we could, alongside our clients, find the freedom to think for ourselves and recover some of the original values of CAT. There is a growing awareness of and anger about the effects of government policies on mental health among psychotherapists and psychologists, but what happens in the therapy room is unlikely to lead to significant political change without political action outside it. The very least we can do is not perpetuate the insidious values of neoliberalism in our work and instead provide a space where people can question the roles society has assigned to them and the values associated with those roles.