Abstract Background This article presents a qualitative study, conducted in Chile and Colombia, on mental health care access and experiences with psychotherapy from the perspectives of economically disadvantaged clients. Current epidemiological data show it is important to conduct psychological interventions to address depression in poor populations, given the high prevalence of this disorder in these groups. However, despite efforts made in both countries at the health care policy level, the impact of the available psychological care has been weaker than expected. Aims Based on this observation, this study sought to collect more information for understanding this problem by incorporating patients’ views. Materials & Methods To shed light on this issue, 24 participants from Chile and Colombia were interviewed with respect to their opinions on access to psychotherapeutic care and their experience with it. Semi‐structured interviews conducted were analysed using Grounded Theory procedures. Results The facilitating and impeding factors that low‐income people have regarding access to psychotherapy, in an institutional context, and specific challenges involving changes in their understanding of their problems and their own role in recovery are presented. These changes involve distancing themselves from their original culturally‐shaped understanding of psychological disorders. Discussion The influence of psychotherapy as a force capable of shaping culturally determined meanings in clients from economically disadvantaged areas is problematised. Conclusion The results of this research may encourage clinicians to see the client's uniqueness within a certain social order and a social network as different from that of the therapist.