The impact of self-efficacy, stigma, subjective distress, and practical factors affecting clients' intent to "no-show"

Abstract

<p>Therapy is an effective means for helping those who struggle with a mental health concern (APA, 2013; Wampold, 2001); however, 20-50% of individuals who seek counseling do not attend the first counseling session (Swift & Callahan, 2010). Previous research has inconsistently identified many variables that contribute to a client's likelihood to no-show for a scheduled counseling appointment. I sought to clarify these inconsistencies and to fill additional gaps in the literature by examining the effect that self-efficacy, public- and self-stigma, and previously studied no-show variables (e.g., demographic variables, therapist variables, distress) have on participants' intent to attend or fail to attend a hypothetical scheduled counseling appointment. Participants were 290 (192 females; 79% European American) undergraduates at a large university. I randomly assigned participants to read and perspective-take either a `low distress' or a `high distress' narrative about a student experiencing depression symptoms. Participants then answered items 1) assessing their intent to attend a first counseling appointment, 2) rating the extent to which 14 variables would influence their intent to attend, 3) rating their sense of confidence with engaging in common therapy tasks, 4) rating the level of public- and self- stigma they perceived for seeking help, and 5) assessing demography and history with counseling. Results indicated that self-efficacy for counseling tasks mediated the relation between self-stigma and intent to attend, and that these two variables accounted for more variance in intent to attend than did other variables. Level of subjective distress, demographic variables, and other variables previously associated with no-show behavior were not found to be statistically significantly related to participants' intent to attend a scheduled counseling appointment. I also discuss limitations, directions for future research, and clinical implications of my findings.</p>