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The stigma of seeking counseling and negative attitudes about counseling are primary barriers to its use. In the only known study examining the utility of attending a group counseling session to ameliorate stigma (no control group), participation was associated with reductions in self-stigma (Wade et al., 2011). Self-affirmation interventions have shown promising results in reducing stigma and promoting positive expectations about counseling, but no research has examined its effects on a counseling session. In the present, two-part study, 172 college students who had previously completed an online screening survey, including measures of stigma, participated in a single session of group counseling at a mental health clinic. Upon arrival, participants completed a self-affirmation intervention before viewing psychoeducation (n = 66; 12 groups) or only viewed psychoeducation (n = 72; 14 groups); both groups then completed a session of group counseling. After, participants completed these same measures along with measures of group relationships. The remaining participants (n = 34; 7 groups) viewed psychoeducation and completed the same stigma measures before being informed of randomization to the wait-list control condition. Our results replicate and extend findings from Wade et al. (2011): Completing a single session of group counseling reduced self-stigma and promoted positive attitudes toward counseling. Further, completing self-affirmation reduced postsession perceptions of public stigma. Self-affirmation had no impact on group relationships. Overall, findings suggest the utility of offering a "try-out" session of group counseling as a stigma-reduction intervention; preceding with a brief self-affirmation intervention provides further benefits by reducing perceptions of public stigma. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective: This study examined the relationship between public and self-stigma of seeking behavioral health services, and help-seeking attitudes and intent in a sample of active duty military personnel currently being assessed for traumatic brain injuries in a military health center. Although it has been suggested that many military personnel in need of care do not seek services due to concerns with stigma it is not fully clear what role different types of stigma play in the process., Method: Using previously collected data from a clinical sample of 97 military personnel, we conducted path analyses to test the mediation effects of self-stigma on the relationship between public stigma and attitudes toward and intentions to seek behavioral health care., Results: In contrast to a model of military stigma but in line with research with civilian samples, results from this study indicate that self-stigma fully mediates the relationship between public stigma and help-seeking attitudes and intentions., Conclusions and Implications for Practice: These results indicate that programming aimed at increasing mental health care use in the military might best focus on reducing self-stigma associated with seeking mental health services., ((c) 2015 APA, all rights reserved).)

Two established but disparate lines of research exist: studies examining the self-stigma associated with mental illness and studies examining the self-stigma associated with seeking psychological help. Whereas some researchers have implicitly treated these 2 constructs as synonymous, others have made the argument that they are theoretically and empirically distinct. To help clarify this debate, we examined in the present investigation the overlap and uniqueness of the self-stigmas associated with mental illness and with seeking psychological help. Data were collected from a sample of college undergraduates experiencing clinical levels of psychological distress (N = 217) and a second sample of community members with a self-reported history of mental illness (N = 324). Confirmatory factor analyses provide strong evidence for the factorial independence of the 2 types of self-stigma. Additionally, results of regression analyses in both samples suggest that the 2 self-stigmas uniquely predict variations in stigma-related constructs (i.e., shame, self-blame, and social inadequacy) and attitudes and intentions to seek help. Implications for researchers and clinicians interested in understanding stigma and enhancing mental health service utilization are discussed.

Stigma is considered an important barrier to seeking mental health services. Two types of stigma exist: public stigma and self-stigma. Theoretically, it has been argued that public stigma leads to the development of self-stigma. However, the empirical support for this assertion is limited to cross-sectional data. Therefore, the goal of this research was to examine the relationship between public stigma and self-stigma over time. Perceptions of public and self-stigma were measured at Time 1 (T1) and then again 3 months later at Time 2 (T2). Using structural equation modeling, we conducted a cross-lag analysis of public stigma and self-stigma among a sample of 448 college students. Consistent with assertions that public stigma leads to the development of self-stigma, we found that public stigma at T1 predicted self-stigma at T2, whereas the converse was not true. These findings suggest that if self-stigma develops from public stigma, interventions could be developed to interrupt this process at the individual level and reduce or eliminate self-stigma despite perceptions of public stigma.

Researchers have found that the stigma associated with seeking therapy--particularly self-stigma--can inhibit the use of psychological services. Yet, most of the research on self-stigma has been conducted in the United States. This is a considerable limitation, as the role of self-stigma in the help-seeking process may vary across cultural groups. However, to examine cross-cultural variations, researchers must first develop culturally valid scales. Therefore, this study examined scale validity and reliability of the widely used Self-Stigma of Seeking Help scale (SSOSH; Vogel, Wade, & Haake, 2006) across samples from 6 different countries (England, Greece, Israel, Taiwan, Turkey, and the United States). Specifically, we used a confirmatory factor analysis framework to conduct measurement invariance analysis and latent mean comparisons of the SSOSH across the 6 sampled countries. Overall, the results suggested that the SSOSH has a similar univariate structure across countries and is sufficiently invariant across countries to be used to explore cultural differences in the way that self-stigma relates to help-seeking behavior.

Objective: This research developed and tested the Military Stigma Scale (MSS), a 26-item scale, designed to measure public and self-stigma, two theorized core components of mental health stigma., Method: The sample comprised 1,038 active duty soldiers recruited from a large Army installation. Soldiers' mean age was 26.7 (standard deviation = 5.9) years, and 93.6% were male. The sample was randomly split into a scale development group (n = 520) and a confirmatory group (n = 518)., Results: Factor analysis conducted with the scale development group resulted in the adoption of two factors, named public and self-stigma, accounting for 52.1% of the variance. Confirmatory factor analysis conducted with the confirmatory group indicated good fit for the two-factor model. Both factors were components of a higher order stigma factor. The public and self-stigma scales for the exploratory and confirmatory groups demonstrated good internal consistency (α = .94 and .89; α = .95 and .87, respectively). Demographic differences in stigma were consistent with theory and previous empirical research: Soldiers who had seen a mental health provider scored lower in self-stigma than those who had not., Conclusions: The MSS comprises two internally consistent dimensions that appear to capture the constructs of public and self-stigma. The overall results indicate that public and self-stigma are dimensions of stigma that are relevant to active duty soldiers and suggest the need to assess these dimensions in future military stigma research., (© 2012 Wiley Periodicals, Inc.)

Student veterans experiencing mental health concerns could benefit from seeking counseling (Rudd, Goulding, & Bryan, 2011), though they often avoid these services. Self-affirmation interventions have been developed to increase openness to health-related behaviors (Sherman & Cohen, 2006), and may also help promote psychological help-seeking intentions. This study explored whether a self-affirmation intervention increased intentions to seek counseling in a sample of 74 student veterans who had not previously sought counseling services. Participants completed pretest (Time 1) measures of distress and help seeking (i.e., self-stigma, attitudes, and intentions to seek counseling). A week later (Time 2), participants completed one of two conditions: (1) a self-affirmation intervention before viewing a psychoeducational video and brochure or (2) only the psychoeducational video and brochure before completing the same help-seeking measures as Time 1. A week after the intervention (Time 3), participants again completed the help-seeking measures. A focused longitudinal mediation model was conducted, examining the effect of the self-affirmation experimental condition on help-seeking intentions. Compared with those in the psychoeducation-only group, student veterans who completed the self-affirmation intervention reported increased intentions to seek counseling both immediately postintervention (Time 2) and a week later (Time 3). [ABSTRACT FROM AUTHOR]

Stigma is an important barrier to seeking psychological services worldwide. Two types of stigma exist: public stigma and self-stigma. Scholars have argued that public stigma leads to self-stigma, and then self-stigma is the primary predictor of attitudes toward seeking psychological services. However, this assertion is largely limited to U.S. samples. The goal of this research was to provide a first step in understanding the relationship between public stigma, self-stigma, and attitudes toward seeking psychological services in international contexts (N = 3,276; Australia, Brazil, Canada, Hong Kong, Portugal, Romania, Taiwan, Turkey, United Arab Emirates, and United States). Using structural equation modeling, we found that self-stigma mediated the relationship between public stigma and attitudes toward seeking services among college students in each country and region. However, differences in path strengths emphasize the need to pay attention to the role of public and self-stigma on attitudes toward seeking psychological services throughout the world. [ABSTRACT FROM AUTHOR]

One of the major obstacles to seeking psychological help is the stigma associated with counseling and therapy. Self-stigma, the fear of losing self-respect or self-esteem as a result of seeking help, is an important factor in the help-seeking process. In the present study, college students meeting a clinical cutoff for psychological symptoms participated in 1 session of group counseling that either contained therapist self-disclosure or did not. In general, participants reported significantly less self-stigma following the session. Working alliance-bond and session depth significantly predicted the change in self-stigma. Furthermore, self-stigma (as well as bond, depth, psychological symptoms, and being female) predicted the intention to seek help following the session. Self-stigma and session depth also predicted interest in continuing with counseling. The therapist self-disclosure condition, however, had no effect on the change in self-stigma, intentions to seek help, or interest in continuing with group counseling. [ABSTRACT FROM AUTHOR]

Public and self-stigmas have been implicated as factors in the underutilization of individual counseling. However, group counseling is also underutilized, and yet scholars know very little about the role of different types of stigma on attitudes toward seeking group counseling. Therefore, the current study examined the relationships between public and self-stigma and attitudes toward group counseling among a sample of 491 U.S. college students. Results of structural equation modeling analyses indicated that public stigma is internalized as self-stigma and self-stigma is then negatively related to attitudes toward group counseling. Furthermore, public stigma and self-stigma explained 52% of the variance in attitudes toward seeking help. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Fear of being stigmatized is the most cited reason why individuals avoid psychotherapy. Conceptually, this fear should be strongest when individuals consider the reactions of those they interact with. Across 5 samples, the authors developed the Perceptions of Stigmatization by Others for Seeking Help (PSOSH) scale. In Sample I (N 985), the 5 items of the PSOSH were selected (α = .91). In Sample 2 (N = 842), the unidimensional factor structure of the scale was examined across a diverse sample. In Sample 3 (N 506), concurrent validity was supported through moderate associations with 3 different stigma measures (i.e., public stigma toward counseling, r = .31; public stigma toward mental illness, r = .20; and self-stigma, r = .37). In $ample 4 (N = 144), test-retest reliability across a 3-week period was calculated (.82). Finally, in Sample 5 (N = 130), reliability (a = .78) and validity were explored with a sample experiencing symptoms of psychological distress. Relationships between variables (i.e., public stigma toward counseling, r = .31, and self-stigma, r = .40) were similar to those in previous samples. [ABSTRACT FROM AUTHOR]

This study examined the mediating effects of the self-stigma associated with seeking counseling and attitudes toward seeking counseling on the link between perceived public stigma and willingness to seek counseling for psychological and interpersonal concerns. Structural equation modeling of data from 676 undergraduates indicated that the link between perceived public stigma and willingness to seek counseling was fully mediated by self-stigma and attitudes. Perceptions of public stigma contributed to the experience of self-stigma, which, in turn, influenced help-seeking attitudes and eventually help-seeking willingness. Furthermore, 57% of the variance in attitudes toward counseling and 34% of the variance in willingness to seek counseling for psychological and interpersonal concerns were accounted for in the proposed model. [ABSTRACT FROM AUTHOR]

Self-stigma is an important factor in people's decisions not to engage in therapy. To measure this construct, the authors developed the 10-item Self-Stigma of Seeking Help (SSOSH) scale. In Study 1 (n = 583), the SSOSH had a unidimensional factor structure and good reliability (.91) among participants. Study 2 (n = 470) confirmed the factor structure. Studies 2, 3 (n = 546), and 4 (n = 217) cross-validated the reliability (.86 to .90; test-retest, .72) and showed evidence of validity (construct, criterion, and predictive) across the study samples. The SSOSH uniquely predicted attitudes toward and intent to seek psychological help. Finally, in Study 5 (n = 655) the SSOSH differentiated those who sought psychological services from those who did not across a 2-month period. [ABSTRACT FROM AUTHOR]

Given the dramatic rates of mental health concerns among military veterans, more needs to be done to connect wounded warriors to the resources available to them. Through focus groups with veterans of the Operation Enduring Freedom (OEF) and/or Operation Iraqi Freedom (OIF) conflicts (N = 30) we sought to understand the current post-deployment difficulties, barriers to seeking mental health care, and possible intervention methods for reducing those barriers. Post-deployment difficulties involved troubles relating to others, psychological difficulties, and behavioral or physical problems. Help-seeking barriers included stigma and concerns about the therapy process. Participants' perspectives on ways to reduce those barriers to seeking help have implications for clinicians' approach to therapy and outreach with veterans and can inform the development of larger-scale intervention efforts that could be tested through future research. [ABSTRACT FROM AUTHOR]