The Role of Attachment and Stigma in the Relationship Between Stress and Attitudes Toward Counseling in South Korea

Using structural equation modeling, the authors investigated the mediators between stress and attitudes toward seeking professional help among 298 undergraduate students in South Korea. Results indicated that attachment styles (avoidance and anxiety) and stigma (public and self‐stigma) mediated the relationship between stress and attitudes toward seeking help. Furthermore, public and self‐stigma had different paths depending on attachment styles related to help seeking. Regarding previous counseling experience, differences in the relationships between stress, attachment styles, stigma, and attitudes toward seeking help were evident.     

Stigma,Attitudes, and Help‐Seeking Intentions for Psychological Problems in Relation to Regional Suicide Rates

In this ecological study, we investigated whether help‐seeking related to stigma, intentions, and attitudes toward suicide are associated with the suicide rates of 20 regions within the Netherlands and Belgium. Significant associations were found between regional suicide rates and the intention to seek informal help (β = ?1.47, p = .001), self‐stigma (β = 1.33, p = .038), and shame (β = .71, p = .030). The association between self‐stigma and suicide rate was mediated by intentions to seek informal help. These results suggest that to promote suicide prevention at the level of the regional population, stigma, shame, and intentions to seek help should be targeted in the public domain.     

Self‐Stigma,Mental Health Literacy,and Attitudes Toward Seeking Psychological Help

This study examined self‐stigma of seeking psychological help and mental health literacy as predictors of college students’ (N = 1,535) help‐seeking attitudes, with additional attention to psychological and demographic correlates. Results indicated that mental health literacy predicted help‐seeking attitudes above and beyond self‐stigma. Asian American race/ethnicity, male gender, current psychological distress, and help‐seeking history were also significant predictors. Implications for addressing mental health literacy and self‐stigma while attending to demographic and psychological variations in help seeking are discussed.     

Attitudes Toward Seeking Professional Help for an Eating Disorder: The Role of Stigma and Anticipated Outcomes

This study examined the relationship between self‐stigma, anticipated risks and benefits associated with seeking counseling, and attitudes toward seeking counseling among college students with disordered eating attitudes and behaviors. The results of hierarchical regression analyses demonstrated that self‐stigma and the anticipated risks and benefits significantly predicted attitudes toward counseling for people with disordered eating. In addition, self‐stigma had a stronger relationship with men's attitudes toward counseling than with women's, and anticipated benefits had a stronger relationship with women's attitudes toward counseling than with men's.     

Relationships Between Treatment Attitudes,Psychological Symptoms,Emotional Competence,and Help‐Seeking Intentions

The authors examined whether emotional competence (i.e., awareness, coping strategies) predicted help‐seeking intentions above and beyond previously identified factors (i.e., attitudes and perceived stigma toward professional help, psychological symptom severity) in an undergraduate sample (N = 531). Emotional awareness predicted help‐seeking intentions for personal/emotional problems and suicidal thoughts. Emotional coping strategies predicted help‐seeking intentions for suicidal thoughts and moderated the relationship between symptom severity and help‐seeking intentions for suicidal thoughts. Efforts to increase help‐seeking should address students' emotional competence.     

Stigma in help-seeking: the case of adolescents

Stigma associated with seeking help has been found to be a key help-seeking barrier, however its role is less clear for: (a) adolescents, (b) groups outside the United States and (c) different types of therapy. This study addresses these omissions by examining the relationships between perceptions of public stigma of mental illness and the self-stigma of seeking help, and how they are related to help-seeking attitudes and intentions for both individual and group therapy among adolescents in Israel (N?=?238). Path analysis confirmed that self-stigma of seeking help was negatively related to attitudes towards psychological help which was then positively related to intentions to seek help, across both individual and group therapy. Consistent with the only other study conducted in Israel, but contrasting research from other parts of the world, the relationship between perceptions of public stigma of mental illness and self-stigma of seeking help was not present for either individual or group therapy. However, perceptions of public stigma of mental illness were a direct negative predictor of help-seeking attitudes for group therapy. Overall, participants reported more negative perceptions of group therapy than individual therapy. These results have implications for future interventions to increase help-seeking behaviours for adolescents.     

Self‐Stigma of Mental Illness and Help Seeking Among School Counselors

The authors reported the findings from a correlational investigation examining the relationship between school counselors' (N = 333) self‐stigma of mental illness, help‐seeking behaviors, burnout, stress, and life satisfaction. The authors used a path analysis to test a hypothesized causal framework that self‐stigma of mental illness contributed to help‐seeking behaviors, which contributed to stress and burnout. The findings showed that the data fit the hypothesized model. The authors discuss the implications of the findings.     

Increasing help-seeking for eating pathology among collegiate athletes: An examination of a novel,customized intervention

Athletes experience elevated risk for eating pathology (EP), but evidence lower levels of help seeking for EP than the general population. Indeed, athletes experience general (e.g., stigma) and athlete-specific (e.g., “push past physical and mental pain” attitude) barriers to help-seeking. Although general mental health help-seeking interventions have improved help seeking outcomes in athlete samples, no study has developed an intervention to increase EP help-seeking among athletes. The current study examined the effects of a 75-min mental health literacy and stigma reduction intervention among 107 collegiate athletes (54.2% female) randomly assigned to an intervention or control group. All athletes completed measures of help-seeking stigma, attitudes, intentions, and behavior at baseline, post-intervention, and six-week follow-up.At post-intervention, the intervention group demonstrated significant improvements in attitudes and intentions towards seeking help for EP and general mental health, relative to the control group. No significant differences in stigma were found between the groups. At six-week follow-up, the intervention group demonstrated higher rates of help-seeking and/or referring a friend for help than the control group. However, sustained improvements in help-seeking attitudes and intentions were not present in the intervention group compared to the control group, apart from EP help-seeking attitudes. Findings support the effectiveness of a customized intervention to improve EP help-seeking variables among athletes.     

Relationships Among Personality,Expectations About Counseling,and Help‐Seeking Attitudes

This study investigated the relationships among personality variables, counseling expectations, and help‐seeking attitudes. Participants (N = 411) completed the Revised NEO (Neuroticism, Extraversion, Openness to New Experiences) Personality Inventory (Costa & McCrae, 1992), the Expectations About Counseling Questionnaire‐Brief Form (Tinsley, 1982), and the Attitudes Toward Seeking Professional Psychological Help scale (Fischer & Turner, 1970). Results indicate that personality factors are related to help‐seeking attitudes and these relationships are moderated by expectations about counseling.     

Self‐Stigma,Mental Health Literacy,and Health Outcomes in Integrated Care

The authors describe research on the self‐stigma of mental illness and help seeking, mental health literacy, and health outcomes in an integrated care medical center. Results revealed that self‐stigma of mental illness and self‐stigma of seeking help had an inverse relationship with mental health literacy. No statistically significant relationships were found between health outcomes, either type of self‐stigma, and mental health literacy. The authors discuss these and other findings and offer research and counseling implications.     

Seeking help from a female friend: Girls' competencies,friendship features,and intentions

Adolescent girls frequently manage problems by seeking help from friends. We examined girls' intentions of seeking help from a female friend and whether these intentions were related to their competencies (emotional competence, self‐disclosure) directly and/or indirectly via specific friendship features (companionship, closeness). Participants included 222 Canadian girls (Grades 9–12) who completed an anonymous survey at school. Results showed that girls had high intentions of seeking help from a female friend and that higher self‐disclosure competence was linked directly to higher intentions. Both competencies were linked indirectly to higher intentions mediated by friendship features. These findings indicate that competencies make help seeking by girls from girls likely in multiple ways and suggest how coping programs can address help seeking in girl–girl friendships.     

Attitudes toward seeking professional psychological help among Chinese students at a UK university

Aim: In this study we aimed to investigate whether Chinese international and British home students at a university in the United Kingdom differed in their attitudes towards seeking psychological help. Method: The total sample comprised 323 participants. Participants completed measures to assess their attitudes toward seeking professional psychological help (recognition of need for psychological help, stigma tolerance, interpersonal openness, confidence in mental health practitioners). Results: Chinese students reported significantly less interpersonal openness than that reported by British students. Contrary to prediction, however, no significant group differences were found on any of the other mental health attitudes (i.e. recognition of need for psychological help, confidence in mental health practitioners or stigma tolerance). Within‐group contrasts also showed that Chinese students reported lower scores on interpersonal openness than on stigma tolerance and confidence in mental health practitioners. In contrast, British participants reported less confidence in mental health practitioners and recognition of the need for psychological help than reported for stigma tolerance and interpersonal openness. Conclusion: The findings highlight the need for a greater understanding of students' cultural inclinations toward mental health issues and cultural attitudes that may hinder and/or facilitate students' access and engagement with psychological services in higher education institutions.     

Self‐criticism and self‐reassurance as mediators between mental health attitudes and symptoms: Attitudes toward mental health problems in Japanese workers

Japanese workers suffer high rates of mental health symptoms, recognised recently by the Japanese government, which has enacted workplace well‐being initiatives. One reason for poor mental health concerns negative attitudes about mental health problems such as shame, which may be mediated by self‐reassurance and self‐criticism. This study aimed to evaluate shame‐based attitudes toward mental health problems and explore the relationship between mental health attitudes, self‐criticism, self‐reassurance, and mental health symptoms. Japanese workers (n = 131) completed three measures: attitudes toward mental health problems, mental health symptoms, and self‐criticism/reassurance. A high proportion of workers reported negative attitudes about mental health problems. There were strong relationships between mental health attitudes, mental health symptoms, self‐criticism, and self‐reassurance. Path analyses revealed that the total and indirect effects (through self‐criticism and self‐reassurance) of mental health attitudes on mental health were larger than the direct effect alone. Hated‐self and family reflected shame were identified as predictors for mental health symptoms. The findings suggest the importance of self‐criticism and self‐reassurance in mental health and mental health attitudes. Implications for help‐seeking behaviours also are discussed. Interventions aimed at reducing self‐criticism and enhancing self‐reassurance are recommended to improve mental health attitudes and increase help‐seeking in Japanese workers.     

The impact of stigma on behavioral health care utilization among active duty service members

This study assessed the relationship between the stigma of seeking psychological help and use of outpatient behavioral health services over a 2-year period among active duty military service members initially referred for neuropsychological evaluation secondary to their histories of mild traumatic brain injury. Although research has examined how stigma predicts proxies for help-seeking (i.e., attitudes towards/intentions to use services), very little research has looked at actual behavior, and studies that do have largely focused on previous use. In this study, we examined the relationship between participants’ stigma and subsequent behavioral health use. Our results indicated that whereas greater self-stigma (i.e., negative self-judgments for seeking psychological help) was associated with attending fewer behavioral health care sessions, public stigma (i.e., perceptions of public attitudes towards people who seek psychological help) was not associated with service use. These findings support the need for addressing the self-stigma associated with seeking behavioral health care.     

Predictors of help‐seeking behavior: Distinction between help‐seeking intentions and help‐seeking behavior

The overall goals of this research were to: (a) examine whether help‐seeking intentions, subjective needs, depressive symptoms, and social support can predict actual help‐seeking behavior; and (b) clarify the moderating effects of social support on help‐seeking behavior using a longitudinal design. University students (N = 370) completed questionnaires that measured social support, subjective needs, depressive symptoms, and help‐seeking intentions during Time1, and questionnaires that measured actual help‐seeking behavior during Time2. Only subjective needs showed a positive effect on both help‐seeking intentions and actual help‐seeking behavior. Although depressive symptoms had a negative effect on help‐seeking intentions, they had a positive effect on actual help‐seeking behavior. Moreover, social support had a positive effect on help‐seeking intentions, and moderated the influence of subjective needs on actual help‐seeking behavior. Simple slope analysis indicated that subjective needs did not facilitate help‐seeking behavior among those with low levels of social support.     

Help‐Seeking and Counseling Within a Traditional Male Gender Role: An Examination From a Multicultural Perspective

A traditional male gender role reflects an affirmation of masculine identity associated with such qualities as success and self‐reliance. This gender role is examined from a diversity perspective in counseling, because it may affect many men's help‐seeking attitudes and behaviors. Suggestions from the literature are reviewed from the standpoint of the Multicultural Counseling Competencies (P. Arredondo et al., 1996). The counseling profession would benefit from greater sensitivity in aiding men endorsing this role.     

Colonial Mentality and Mental Health Help‐Seeking of Filipino Americans

Filipino Americans present with very low rates of mental health help‐seeking. Because of the colonial history between the Philippines and the United States, the authors examined how colonial mentality and internalized oppression, along with ethnic identity, acculturation, and social support, were related to mental health help‐seeking attitudes of Filipino Americans (N = 410). Furthermore, the authors investigated how colonial mentality affects the ethnic identity of Filipino Americans. Major findings included that colonial mentality was negatively related to ethnic identity development and social support, and higher levels of colonial mentality significantly predicted negative mental health help‐seeking attitudes above and beyond ethnic identity, acculturation, social support, and demographic variables. Implications for the counseling profession are considered.     

An Adaptation and Extension of the Attitudes Toward Seeking Professional Psychological Help Scale1

Despite its utility, several conceptual and methodological concerns are raised regarding Fischer and Turner's (1970) Attitudes Toward Seeking Professional Psychological Help Scale (ATSPPHS). These concerns were addressed in an adaptation and extension of the ATSPPHS using 208 adult volunteers. The new Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS) consists of 24 items and 3 internally consistent factors: psychological openness, help‐seeking propensity, and indifference to stigma. We replicated this 3‐factor model with 293 university undergraduates, and established test‐retest reliability with 23 student volunteers. Validity was demonstrated by the ability of the IASMHS to distinguish between those who had and had not used mental health services in the past, and those who would and would not use these services in the future. It also discriminated between participants’ intentions to use professional and nonprofessional help. Finally, expected gender differences in help‐seeking attitudes were demonstrated.     

Counseling Expectations Among Students in an Opportunity Program: Dispositional and Cultural Influences

College students (N = 102) from African American and Latino backgrounds who participated in an opportunity program completed H. E. A. Tinsley's (1982) Expectations About Counseling‐Brief Form (EAC‐B) and measures of self‐esteem, attributional style, problem‐solving appraisal, acculturation, and cultural congruity. Lower self‐esteem and a more depressive attributional style were linked to lower counseling expectations. All 3 dispositional variables were more strongly related to counseling expectations among students reporting higher levels of immersion in their ethnic group of origin. Implications for help‐seeking and the counseling relationship are discussed.     

Help seeking for alcohol problems in a college population

Despite the availability of effective treatments for problem drinkers, only a minority seek professional assistance. The authors investigated the influences on help seeking for alcohol-related difficulties in two separate studies. In Study 1, 59 men and 74 women completed questionnaires regarding their alcohol use, related problems, readiness to change, and help-seeking interest. The authors also developed a measure of stigma related to alcohol help seeking. Problem recognition, anxiety symptoms, and stigma predicted a global rating of help-seeking. Students (22 men and 60 women) participated in Study 2, which incorporated a multi-item measure of help-seeking intentions as well as attitude and personality measures. Positive attitudes, less perceived stigma, and greater self-efficacy increased help seeking. The findings highlight the importance of both approach and avoidance factors that affect help-seeking decisions, and the authors suggest directions for further research.