Cognitive Behavioral Therapy is designed by white, upper middle class, non-disabled  people.  The further you are from this demographic the worse you will fare.

The changes one is expected to make in order to better themselves are more likely to be met with roadblocks when one is far from privilege.  Most changes one makes to their life involve a social dynamic.  A person without privilege generally faces a harsher social environment so change is stunted.  There is also the issue of a success percentage.  There is a threshold (different for each person) that when dipped below the changes one tries do more emotional harm than good.  Naturally those without privilege will have a lower success percentage.

Those without privilege generally can call the therapist’s self-worth bluff.  They know worth is not innate, it comes from privilege.  It’s asinine to hold someone of non-privilege culpable for their poor self-image.  Their self-image is theirs, not yours, and it comes from life experiences.

Non-Privilege is a singularity.  A white therapist generally isn’t going to reach a black teenager who has seen his brother get twice the sentence a white person did for the same stupid crime.

They generally don’t have access to positive influences.  There’s this idea that people can find edifying friends.  For those without privilege this is more often untrue.  Addiction-oriented people are all they have to choose from.

They often cannot afford therapy.  This means that therapy might only be sought after issues have gotten so bad that it is of less help than if the issues had been dealt with earlier.