193 Individuals living in poverty have higher rates of mental health disorders compared to those not living in poverty. Measures are available to assess adults’ levels of psychological distress; however, there is limited support for instruments to be used with a diverse population. The purpose of our study was to examine the factor structure of Outcome Questionnaire-45.2 scores with an economically vulnerable sample of adults (N = 615), contributing to the evidence of validity of the measure’s scores in diverse mental health settings. Implications for professional counselors are considered, including clinical usage of the brief Outcome Questionnaire-16 and key critical items. Keywords: poverty, psychological distress, factor structure, Outcome Questionnaire-45.2, validity In the United States, it is estimated that 34 million adults live in poverty (i.e., income less than $12,880 per year), and poverty is a significant factor contributing to poor mental and physical health outcomes (Hodgkinson et al., 2017). Poverty, or economic vulnerability, refers to the extent to which individuals have difficulty living with their current level of income, increasing the risk for adverse social and economic consequences (Semega et al., 2021). Economically vulnerable adults often experience greater social inequality, lower educational attainment, less economic mobility (Stanford Center on Poverty and Inequality, 2015), and difficulty securing full-time employment (Dakin & Wampler, 2008), which leads to increased distress (Lam et al., 2019). Lower income levels are also associated with several mental health conditions (e.g., anxiety, depression, suicide attempts; Santiago et al., 2011). Further, Lam and colleagues (2019) found strong negative associations between income, socioeconomic status, and psychological distress. To effectively support their clients, counselors must understand the unique context and financial stressors related to living in poverty. Incorporating poverty-sensitive measures into assessment and evaluation practices is essential to providing culturally responsive care that considers the systemic and environmental barriers of poverty (Clark et al., 2020). Implementing culturally responsive assessments ensures that counselors use outcome measures that are attuned to poverty-related experiences (Clark et al., 2020). Such measures can help counselors identify and prioritize treatment planning approaches and acknowledge the reality that economic disadvantages create for clients (Foss-Kelly et al., 2017). However, the availability of poverty-sensitive assessments is limited. Measuring Psychological Distress in Adults Living in Poverty Because of the risk of mental health issues related to economic vulnerability, assessments with evidence of validity and reliability that measure psychological distress relative to income are warranted. Professional counselors can individualize their therapeutic approach to meet the needs of this population with the assistance of accurate assessments of related mental health conditions. Naher The Professional Counselor™ Volume 13, Issue 3, Pages 193–205 http://tpcjournal.nbcc.org © 2023 NBCC, Inc. and Affiliates doi: 10.15241/ddt.13.3.193 Dalena Dillman Taylor, Saundra M. Tabet, Megan A. Whitbeck, Ryan G. Carlson, Sejal Barden, Nicole Silverio The Factor Structure of the Outcome Questionnaire-45.2 With Economically Vulnerable Adults Dalena Dillman Taylor, PhD, LMHC, RPT-S, is an associate professor at the University of North Texas. Saundra M. Tabet, PhD, NCC, CCMHC, ACS, LMHC, is an assistant professor and CMHC Program Director at the University of San Diego. Megan A. Whitbeck, PhD, NCC, is an assistant professor at The University of Scranton. Ryan G. Carlson, PhD, is a professor at the University of South Carolina. Sejal Barden, PhD, is a professor at the University of Central Florida. Nicole Silverio is an assistant professor at the University of South Carolina. Correspondence may be addressed to Dalena Dillman Taylor, 1300 W. Highland St., Denton, TX 76201, Dalena.dillmantaylor@unt.edu.
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