Academic journal article Journal of Mental Health Counseling

Enhancing Attitudes and Reducing Fears about Mental Health Counseling: An Analogue Study

Academic journal article Journal of Mental Health Counseling

Enhancing Attitudes and Reducing Fears about Mental Health Counseling: An Analogue Study

Article excerpt

This study examined the effects on 330 college students of addressing and validating negative client attitudes and fears associated with seeking counseling at a university counseling center, and client willingness to engage in counseling past the first session. Results suggest that addressing fears and negative beliefs about counseling during an intake interview influenced male students who had not previously sought counseling. Their image concerns were reduced and their tolerance for stigma associated with seeking counseling increased. Suggestions about how to address negative attitudes and fears about counseling are provided.


There is a discrepancy between the number of individuals who have a diagnosable psychological disorder and the number who utilize mental health counseling (MHC) services. Regier et al. (1993) found, for instance, that in the United States less than one-third of individuals with a mental disorder seek MHC services. Furthermore, using data from the 2001-2002 U.S. National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), Blanco et al. (2008) found that in a one-year period only 18% of 18-24-year-old college students with a psychological disorder sought treatment. Because reasons for the discrepancy between those who might benefit from mental health services and those who seek it can be numerous (e.g., effect of time, natural process of healing, and relief provided by a social network), scholars have sought to identify barriers to seeking treatment (e.g., Vogel, Wester, & Larson, 2007). The search for barriers is grounded in the notion that the decision to seek MHC is influenced by two opposing forces (Kushner & Sher, 1991; Vogel et al., 2007): approach factors (e.g., positive counseling attitudes, experience of distress) and avoidance factors (e.g., fear of and negative attitudes to treatment).


Kushner & Sher (1989) described treatment fear as a state of apprehension resulting from negative expectations about seeking and using mental health services. Treatment fear has been linked to attitudes toward seeking psychological help (Cepeda-Benito & Short, 1998; Deane& Chamberlain, 1994); intentions to seek help (Vogel, Wester, Wei, & Boysen 2005); and actual help-seeking (Kushner & Sher, 1989). Kushner and Sher (1989), for instance, found that individuals who had never sought psychological treatment reported being more fearful than actual clients about seeking counseling services. Similarly, Deane and Chamberlain (1994) found that treatment fears were predictive of the likelihood that college students would use psychological services in that greater fear was associated with a decrease in intention to seek help. Moreover, Vogel and Wester (2003) reported that a fear of having to express emotions in therapy decreased help-seeking intentions. Thus, fear appears to affect the help-seeking decision-making process, especially for those who have never previously used mental health services (Hammer & Vogel, 2010). It seemed important, therefore, to target such fears when constructing an intervention designed to increase help-seeking attitudes and intentions.

Another barrier associated with seeking counseling is dread of stigma. Corrigan (2004) divided stigma into two categories: public stigma and self-stigma. Public stigma refers to the negative social labels attached to persons who seek mental health services. Self-stigma is the internalization of the negative stereotyped messages that are given persons who seek such services. Stigmatization can lead to stereotyping, prejudice, and discrimination toward those who seek counseling. Corrigan (2004) suggested that to avoid the stigma of having a psychological disorder, a person might decide not to seek treatment that could be beneficial: not seeking help becomes a way to protect against the fear of being stigmatized. …

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