Class Identity, Social Hierarchy, and Psychotherapy explores the often-ignored influence of class identity on psychological care. Written by two psychologists with working-class roots, this book explores the development of American psychology both within and in support of a capitalist social structure. Through surveys, interviews, and personal experiences, it is revealed how the middle-class norms and neoliberal values in which the practice of psychotherapy is rooted often alienate many of the working-class people it seeks to help. Through the voices of both working- and middle-class clients and clinicians, authors demonstrate how hidden rules about emotional expression, vulnerability, and competence often shape therapy spaces. They explore how those living between socioeconomic worlds experience both marginalization and pressure to conform within clinical spaces not built for them. A model of critical narrative humility is introduced, which encourages therapists to interrogate their own class position, training, and biases, and re-consider how these factors might impact their ability to authentically hear the complex and nuanced accounts of their clients. Urging a shift from individual practice to systems-level thinking, the book offers a radical reimagining of therapeutic practice grounded in critical self-reflection. This book will appeal to advanced students, trainees, and early-career professionals and practitioners interested in decolonizing practice and moving to consider class as an integral aspect of intersectional identity.