Date of Award

Spring 4-12-2024

Document Type


Degree Name

PHD - Doctor of Philosophy


Counseling & Psychology

First Advisor

Dr. Rakhshanda Saleem

Second Advisor

Dr. Pewei Li

Third Advisor

Dr. Sandra Butler


This dissertation explored the experiences and perceptions of white therapists’ social class by white clients facing poverty in rural Maine. Employing an intersectional methodology rooted in Critical White Theory, Critical Theory, and the Critical Theory of Care in Nursing, the study utilized semi-structured interviews, thematic coding, and discourse analysis. The findings revealed that regional cultural values, specifically intergenerational ideals of independence, privacy, and self-sufficiency, significantly impacted clients’ encounters with stigma and social exclusion. Notably, participants perceived that Mainecare’s, Maine’s Medicaid program, reimbursement rates influenced therapist accessibility and questioned if it was associated with a lower social class.

This study made a distinctive contribution by uncovering rural Maine’s nuanced perspectives shaped by regional cultural values. Theoretical frameworks from critical white theory and discourse analysis informed the examination of Mainecare’s influence on care perceptions. The intersection of racial homogeneity and poverty emerged as vital considerations for therapists. Recognizing the impact of Mainecare bureaucracy on care perceptions and acknowledging the significance of intergenerational values, therapists should be attuned to their own social class positionality. In conclusion, this research emphasized the necessity for mental health practitioners to navigate the unique socio-cultural landscape of rural areas, fostering a deeper understanding of clients’ experiences and promoting more effective and culturally sensitive therapeutic practices.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.



Number of Pages