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Shaping Attitudes Towards Psychological Services Lisa M University of Northern Colorado Scholarship & Creative Works @ Digital UNC Dissertations Student Research 5-1-2012 Shaping Attitudes Towards Psychological Services Lisa M. Bobby Follow this and additional works at: http://digscholarship.unco.edu/dissertations Recommended Citation Bobby, Lisa M., "Shaping Attitudes Towards Psychological Services" (2012). Dissertations. Paper 78. This Text is brought to you for free and open access by the Student Research at Scholarship & Creative Works @ Digital UNC. It has been accepted for inclusion in Dissertations by an authorized administrator of Scholarship & Creative Works @ Digital UNC. For more information, please contact [email protected]. UNIVERSITY OF NORTHERN COLORADO Greeley, Colorado The Graduate School SHAPING ATTITUDES TOWARDS PSYCHOLOGICAL SERVICES A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Lisa Marie Bobby College of Education and Behavioral Sciences Department of Counseling Psychology May 2012 This Dissertation by: Lisa Marie Bobby Entitled: Shaping Attitudes Towards Psychological Services Has been approved as meeting the requirement for the Degree of Doctor of Philosophy in College of Education and Behavioral Sciences, Department of Counseling Psychology Accepted by the Doctoral Committee ________________________________________________________________________ Brian D. Johnson, Ph. D., Chair ________________________________________________________________________ Basilia Softas-Nall, Ph. D., Committee Member ________________________________________________________________________ Jennifer Murdock, Ph. D., Committee Member ________________________________________________________________________ Nathan Kling, Ph. D., Faculty Representative Date of Dissertation Defense ________________________________________________________________________ Accepted by the Graduate School ________________________________________________________________________ Linda Black, Ed. D., LPC Acting Dean of the Graduate School & International Admissions © 2012 LISA MARIE BOBBY ALL RIGHTS RESERVED iii ABSTRACT Bobby, Lisa Marie. Shaping Attitudes Towards Psychological Help Seeking. Published Doctor of Philosophy dissertation. University of Northern Colorado, 2012. Despite a high need for effective mental health treatment, psychological services are often underutilized. Prior research has revealed factors associated with help-seeking behaviors or avoidance of psychological services. However, little is currently known about how to communicate effectively about psychological services in a manner that may increase rates of utilization. This dissertation documents original research that compared the impact of message framing on factors known to be associated with help seeking; particularly attitude, self-stigma, and intention. One-hundred and fifty-one freshmen at a Midwestern University were exposed to either a positive, negative or neutrally framed message about psychological services on campus. They were then assessed in a variety of domains including: Attitudes towards psychological services; perceptions of self-stigma; and intention to seek help. Information about demographic variables was also collected, including previous experience in mental health treatment, current levels of psychological distress, gender, race, and age. MANOVA procedures comparing the effect of the messages in the population as a whole, and between participants with and without current subjective psychological distress showed that there was not a significant relationship between message framing on attitude, stigma or intention. However, message framing was shown to have significant impact on attitude, stigma and intention (particularly around perceptions of self-stigma) when explored in the context of moderating variables iv including gender, past experience with mental health treatment, and race. It was shown that men experience greater self-stigma around help seeking after being exposed to a negatively framed message. People with past experience in therapy reported higher positive attitudes towards therapy and greater intentions to seek help after being exposed to a positively framed message. People with past experience in therapy reported lower levels of self-stigma after being exposed to a positive message about mental health treatment. Additionally, this study found some evidence to suggest that participants identifying as Hispanic may hold poorer attitudes, greater perceptions of self-stigma and lower intentions to seek help after being exposed to either a positively or negatively framed message about psychological service, as compared to a neutral control message. The clinical implications of these findings are addressed, and suggestions for future research are provided. v ACKNOWLEDGEMENTS This dissertation would not exist without the ocean of support I received from the people in my life. I am so grateful to you. I feel that this accomplishment is yours much as it is mine. We are a team. Your love supported me, and any success I have as a result will always be the purpose of enriching our life together and finding ways to show you my appreciation. Thank you especially to my husband Mat, who has been a constant source of help and support throughout the process of this degree. Your loyal kindness, generosity and sacrifice afforded me the opportunity to focus on school, and be stressed / heartbroken / obsessed / annoyed (annoying) and generally self-absorbed most of the time. Thank you for listening to me, loving me, and putting up with me all these years. Marrying you was the best thing I ever did. I sincerely hope that all the work we both put in to achieve this degree will make our lives together happy and prosperous. Thank you to my mother who came to the rescue when our son was born in year three of this program, allowing me to do my internship and finish this dissertation with a peaceful heart knowing that my baby was safe and happy in her care. I will never be able to repay this debt to you, but have every intention of helping my own children the same way should I ever be so lucky to be a grandmother. Your love will pay forward and touch the children of our children’s children with unconditional warmth. It is eternal. Thank you so much to my wonderful cohort: Sarah, Danielle, Amy and Angie. Our friendship was the best part of this experience, and I am so thankful for your vi encouragement, advice, feedback and patience. Thank you to the rest of my wonderful friends and family who supported and encouraged me throughout the ups and downs of this process over the years. Thank you to my committee. Dr. Johnson, I sincerely appreciate the many hours you spent in reading, editing, and critiquing this dissertation. Your feedback and direction helped me make this a dissertation I feel proud of. Drs. Kling, Murdock and Softas-Nall, I am so grateful for your warmth, time, guidance, and practical help in the researching and data collection process. You were all a pleasure to work with. Lia, I especially appreciate how readily you signed up for my committee after I lost part of my committee mid-way through this project. Thank you Dr. Henderson for generously allowing me to survey your University 101 students. Thank you too, to Dr. Jay Shaffer in the statistics department who so generously read my methods section and consulted with me on data analysis after I lost my statistics advisor. I took your advice! vii TABLE OF CONTENTS CHAPTER PAGE I. INTRODUCTION …………………………………………………………. 1 Theoretical Basis Psychological Help Seeking Theory of Planned Behavior Message Framing Need for This Study Purpose of the Study Research Questions Assumptions Limitations Definition of Terms II. REVIEW OF THE LITERATURE................................................................... 18 Consequences of Untreated Mental Illness On Individuals On Children and Families On Society Prevalence of Mental Illness Globally United States Rates of Utilization of Psychological Services Globally United States US College Students Help Seeking External Barriers Demographic Characteristics Individual Variables The Theory of Planned Behavior In Research In Psychological Help Seeking Measurement of Help Seeking Variables Message Framing viii III. METHOD…………....................................................................................... 116 Participants Instrumentation Data Collection Procedure Data Analysis Research Questions, Hypotheses and Statistical Analysis Procedure IV. RESULTS..................................................................................................... 135 Procedure Descriptive Statistics Help Seeking Variables Hypotheses and Statistical Analysis Supplemental Analysis V. DISCUSSION................................. ………………………………………… 163 Conclusions Findings of Original Hypotheses Analysis of Help Seeking Factors Analysis of Help Seeking Factors and Message Framing Discussion Message Framing Past Experience and Message Framing Gender and Message Framing Race and Message Framing Clinical Implications Limitations of the Study Future Research REFERENCES ……………………………………………………..………….…. 186 APPENDIX A. JOURNAL MANUSCRIPT………………………………………………........ 227 B. DEMOGRAPHIC QUESTIONNAIRE……………..………....…………........ 276 C. PAST EXPERIENCE WITH PSYCHOLOGICAL SERVICES………....……. 278 D. DEPRESSION, ANXIETY AND STRESS SURVEY (DASS-21)……………. 280 E. INVENTORY OF ATTITUDES TOWARD SEEKING PSYCHOLOGICAL SERVICES (IASMHS………………………….……………………………......... 283 ix F. SELF STIGMA FOR SEEKING HELP
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