ABSTRACT
Psychotherapy research, much like most other research, traditionally has paid insufficient attention to highly salient variables such as ethnicity and social class. Treatments that are developed and tested with one population may or may not be effective with another. In the 21st century, the authors are seeing increasing attention to the question of how well results can be generalized to those from different ethnicities and social classes. The prevalence of stories such as Louise's is confirmed by clinical research, which has established that traditional psychotherapy has a less-than-impressive track record with people in poor communities. Fortunately, research is finally beginning to offer a picture of what works best for clients whose problems are entangled with dangerous neighborhoods, social isolation, and lack of economic opportunities. The most successful treatments for disadvantaged clients typically address multiple levels within the system, combining ingredients from family and individual therapies with ideas drawn from prevention programs, family preservation, and social work.
