School Counseling Empirical Article

Featured Research

Spotlighting Stigma and Barriers: Examining Secondary Students’ Attitudes Toward School Counseling Services

Richard W. Auger 1 , Nicholas R. Abel

2 , and Brandie M. Oliver

2

Abstract Student attitudes toward accessing school counseling services were the focus of a survey of 3,584 middle school and high school students. Respondents identified barriers to seeking help from school counselors, including stigma, a desire to manage problems themselves, a lack of a positive relationship with their school counselor, and a concern that the counselor would not keep disclosures confidential. This study also examined the impact of gender, age, and race/ethnicity on students’ willingness to seek help from their school counselor. We present implications for practice and future research.

Keywords adolescents, confidentiality, help seeking, school counseling, stigma, willingness

Considerable research has supported the value of counseling

services for children and adolescents in schools (Fox & Butler,

2007; Reback, 2010; Whiston, Tai, Rahardja, & Eder, 2011).

For example, analysis of a large national sample of elementary-

aged students found that states with greater availability of

school counselors, due to policies supporting elementary

school counseling, showed higher third-grade test scores in

math and reading and lower levels of internalizing and exter-

nalizing problem behaviors among students (Reback, 2010).

Furthermore, a meta-analysis of the effectiveness of 153 school

counseling interventions found a small to moderate effect size

of d ¼ .30, indicating that students who received school coun- selor interventions have measurably higher outcomes across

cognitive, behavioral, and affective domains than students who

do not receive those interventions (Whiston et al., 2011).

School counseling services have also proven effective for a

range of more specific issues and goals, from supporting immi-

grant students’ career development (Watkinson & Hersi, 2014)

to reducing the achievement gap by increasing the academic

achievement of African American high school students (Bruce,

Getch, & Ziomek-Daigle, 2009). The broad finding is clear:

Counseling in schools is an effective way to address a range of

student issues (Reback, 2010; Whiston et al., 2011).

Despite the proven effectiveness of counseling for middle

school and high school students, many adolescents have shown

a consistent reluctance to seek and accept therapeutic help

(e.g., Chandra & Minkovitz, 2006; Del Mauro & Williams,

2013; Gulliver, Griffiths, & Christensen, 2010). In fact,

researchers have found that the willingness of youth with

mental health issues to seek and accept counseling help drama-

tically decreases as they move through adolescence (Cuffe

et al., 2001). Research inside and outside the United States

reveals that more than half of all high school students may

be reluctant to seek professional help for their problems (Heath,

Baxter, Toste, & McLouth, 2010; Rughani, Deane, & Wilson,

2011). Reasons for this reluctance include the stigma surround-

ing mental health treatment, a fear that confidentiality will not

be upheld, concern about being judged, a lack of faith regarding

the effectiveness of counseling, and the belief that seeking

counseling is a sign of weakness (Del Mauro & Williams,

2013; Fox & Butler, 2007; Gulliver et al., 2010; Rughani

et al., 2011; Timlin-Scalera, Ponterotto, Blumberg, & Jackson,

2003). Adolescent boys—specifically African American

boys—seem particularly reluctant to seek counseling services

for social/emotional issues (Chandra & Minkovitz, 2006; Eliot,

Cornell, Gregory, & Fan, 2010).

The findings above suggest that many adolescents are reluc-

tant to seek help from counselors, even though counseling is a

demonstrably effective service. Although a moderate body of

research addresses general help seeking among adolescents

1 Minnesota State University, Mankato, MN, USA 2

Butler University, Indianapolis, IN, USA

Corresponding Author:

Richard W. Auger, PhD, Minnesota State University, 107 Armstrong Hall,

Mankato, MN 56001, USA.

Email: [email protected]

Professional School Counseling Volume 22(1): 1-12

ª 2019 American School Counselor Association

Article reuse guidelines: sagepub.com/journals-permissions

DOI: 10.1177/2156759X18811275 journals.sagepub.com/home/pcx

(Chandra & Minkovitz, 2006; Eliot et al., 2010), minimal

research has been conducted on middle school and high school

students’ attitudes toward services provided by school counse-

lors, and much more information is needed to better understand

this phenomenon. An important step in delivering effective

counseling services in middle schools and high schools is to

better understand the reasons students may be reluctant to see

their counselor. The purpose of this article is to explore stu-

dents’ attitudes about school counseling services and examine

barriers that may prevent them from seeking those services. To

that end, we conducted a large, multistate study in which we

surveyed middle school and high school students on their atti-

tudes toward school counselors and school counseling services.

Many adolescents are reluctant to seek help from

counselors, even though counseling is a

demonstrably effective service.

Attitudes Toward Seeking Counseling Help Among Adolescents

A large body of research indicates that seeking professional help

for social–emotional problems is difficult for adolescents (Chan

& Quinn, 2012; Corry & Leavey, 2017; Del Mauro & Williams,

2013; Fox & Butler, 2007; Raviv, Raviv, Vago-Gefen, & Fink,

2009). Survey research has consistently indicated that fewer than

half of adolescents report being willing to seek help from a

health-care professional for a variety of emotional troubles

(Boldero & Fallon, 1995; Chandra & Minkovitz, 2006; Rughani

et al., 2011). In a seminal study of 1,013 adolescents in Australia,

Boldero and Fallon (1995) found that respondents were much

more likely to seek help from friends (40%) or parents (36%), as opposed to a professional helper such as a doctor or counselor

(12.7%). A more recent study of Australian adolescents found that only 17% of males and 29% of females were willing to seek help from a health-care professional for emotional issues (Rugh-

ani et al., 2011). Chandra and Minkovitz (2006) found a similar

pattern of results when surveying 274 eighth graders in the

United States, with respondents being more than 5 times more

likely to turn to friends when experiencing an emotional prob-

lem, as opposed to turning to a counselor. More recently, Corry

and Leavey (2017) found through focus group research that

adolescents reported a persistent lack of trust that served as a

barrier to seeking help from medical professionals. Perhaps most

concerning is the finding that adolescents who have the highest

level of suicidal ideation, and thus are in the greatest need of

professional support, are least likely to report an interest in seek-

ing help from either professional or informal sources of support

(Goodwin, Mocarski, Marusic, & Beautrais, 2013; Wilson,

Deane, & Ciarrochi, 2005).

Barriers to Seeking Professional Help

Researchers have identified several barriers that interfere with

adolescents’ willingness to seek professional help for social/

emotional problems (Boldero & Fallon, 1995; Chan & Quinn,

2012; Chandra & Minkovitz, 2006; Del Mauro & Williams,

2013; Fox & Butler, 2007; Gulliver et al., 2010; Wilson &

Deane, 2012). A consistent finding across studies is that ado-

lescents often prefer to manage problems on their own, rather

than turn to professional helpers (Boldero & Fallon, 1995;

Chan & Quinn, 2012; Chandra & Minkovitz, 2006). Although

part of the reason adolescents may avoid seeking help from

counselors is that they are engaging in the normal and healthy

process of developing a sense of personal autonomy and desire

to manage problems on their own (Wilson & Deane, 2012), this

tendency toward self-reliance can also be a contributing factor

in inhibiting adolescents from seeking needed professional

counseling help. A second barrier to seeking counseling help

is adolescents’ sense that the counselor is a virtual stranger

with whom they do not feel comfortable sharing problems

(Fox & Butler, 2007). Another barrier identified in the liter-

ature is the stigma adolescents frequently associate with talk-

ing to a counselor (Chandra & Minkovitz, 2006; Fox &

Butler, 2007; Gulliver et al., 2010). Chandra and Minkovitz

(2006) found that 59% of eighth graders were too embarrassed to see a counselor because of what other students might say if

they found out. Similarly, Fox and Butler (2007) identified

that fear of being seen by other students entering the counse-

lor’s office is a barrier.

Stigma may serve as a barrier for many adolescents, but even

those adolescents who do not appear to stigmatize help from

counselors may still avoid seeking professional help. Focus

group research with U.S. adolescents found that even if adoles-

cents find value in counseling and would not judge peers who

were in counseling, they would resist seeking professional coun-

seling help for themselves (Del Mauro & Williams, 2013), a

finding more pronounced for boys (Raviv et al., 2009). Adoles-

cents tend to overestimate their ability to manage emotional

problems, presuming they are better able to handle their own

problems than may actually be the case (Raviv et al., 2009).

Another critical barrier that interferes with adolescents’

willingness to seek help from professional counselors is a lack

of trust in the counselor. Multiple studies have found that start-

lingly high percentages of adolescents do not trust counselors

and do not believe counselors will keep their conversations

confidential (Chan & Quinn, 2012; Chandra & Minkovitz,

2006; Del Mauro & Williams, 2013; Fox & Butler, 2007;

Timlin-Scalera et al., 2003). For example, when Chandra and

Minkovitz (2006) surveyed a group of eighth graders to iden-

tify barriers to seeking counseling help, 42.7% of the respon- dents indicated that they did not trust counselors. Research has

indicated that adolescents who report higher levels of trust

regarding counseling are more likely to seek counseling help

(Biolcati, Palareti, & Mameli, 2018). A final barrier that may

impact adolescents’ desire to seek help from counselors is a

fear of being judged; some studies indicate that adolescents

may resist seeking counseling help because they are worried

what the counselor will think about them and their problems

(Del Mauro & Williams, 2013; Yap, Reavley, & Jorm, 2013).

2 Professional School Counseling

Age, Gender, and Racial/Ethnic Differences in Help- Seeking Behavior

Within the context of the broad finding that adolescents often

are reluctant to seek help from counselors, research has also

revealed differences in help-seeking patterns based on age,

gender, and race/ethnicity (Cuffe et al., 2001; Heath et al.,

2010). Age appears to be closely related to use of mental health

services. One longitudinal study found a striking decrease in

use of mental health services from early adolescence to early

adulthood, with usage rates across the three data collection

points falling from 24% to just 3% (Cuffe et al., 2001). Other survey research has found that middle school students are more

likely than high school students to seek help from school-based

programs for nonsuicidal self-injury (Heath et al., 2010).

Researchers have also identified gender differences in help

seeking with findings consistently indicating that adolescent

boys tend to be more reluctant than adolescent girls to seek

counseling help both in school (Eliot et al., 2010) and out of

school (Boldero & Fallon, 1995; Chandra & Minkovitz, 2006;

Cheung, Dewa, Cairney, Veldhuizen, & Schaffer, 2009).

Among adolescents who experience suicidal ideation or

attempts, boys are again substantially less likely than girls to

access mental health services (Cheung et al., 2009). Although

the broad finding is that adolescent boys are less likely than

adolescent girls to seek counseling help, the research reveals

more subtle gender differences. One study of more than a thou-

sand adolescents in Scotland found that boys were more likely

to view going to counseling as a sign of weakness, while girls

were more likely to question the value of counseling (Chan &

Quinn, 2012). Moreover, although girls are more likely to seek

counseling, they are more prone to worry about being judged

by the counselor (Yap et al., 2013).

In several studies, researchers have examined the relation-

ship between race/ethnicity and adolescent help seeking

(Bryan, Moore-Thomas, Day-Vines, Holcomb-McCoy, &

Mitchell, 2009; Eliot et al., 2010; Ho, Yeh, McCabe, & Hough,

2007). Their results consistently revealed that race/ethnicity

matters when examining patterns of help seeking, but showed

that these relationships are complex and sometimes contradic-

tory (Bryan et al., 2009; Eliot et al., 2010). As a case in point, a

survey of more than 7,000 ninth-grade students found that

African American students were significantly less likely to

seek help for bullying and threats of violence as compared to

other racial groups (Eliot et al., 2010). Conversely, examina-

tion of a large national sample of eighth-grade students in the

United States showed that African American students were

substantially more likely to see their school counselor as com-

pared to White students, although it was not clear how many of

those students sought out their school counselor voluntarily

(Bryan et al., 2009). Other research revealed lower mental

health usage rates among Latino and Asian/Pacific Islander

adolescents as compared to White and African American youth

(Ho et al., 2007). Research has identified several factors that

may help explain racial differences in help-seeking behavior,

including cultural mistrust of majority helpers (Duncan &

Johnson, 2007) and strong parental affiliation with an alterna-

tive culture (Ho et al., 2007). In sum, the existing research

suggests that race is an important influence on students’ will-

ingness to seek counseling services, although the precise man-

ner in which race is related to help seeking is complex and not

yet fully understood.

To further examine the issues above in the specific context

of school counseling services, we surveyed a large group of

middle and high school students to assess their attitudes toward

counseling and school counselors. Our ultimate goals were

(a) identifying factors that feed the reluctance of middle and

high school students to seek help from their school counselors

and (b) developing recommendations to address these factors,

thereby enhancing student willingness to access school coun-

seling services. As a first step toward these larger goals, we

designed the current study to seek preliminary answers to the

following research questions:

(1) What attitudes or beliefs do middle school and high

school students hold that either increase or decrease

the likelihood they will seek help from their school

counselor?

(2) What is the impact of gender, age, and race/ethnicity

on students’ willingness to seek help from their school

counselor?

Method

Procedures

Upon receiving approval for the study from the institutional

review boards at our respective universities, we invited and

received commitments from school counselors at 11 secondary

schools (N ¼ 11) in two Midwestern states to serve as site coordinators for the study. Coordinators were not invited at

random but contacted based on their existing relationships with

one or more of the authors, either as a graduate program alum-

nus or an internship site supervisor. In exchange for a US$100

stipend, coordinators were asked to distribute informed consent

documents, invite students to participate, and ensure that a link

to the online survey instrument was distributed to willing par-

ticipants in a manner convenient for students and staff.

Although each coordinator used a slightly different method for

survey administration, they most commonly asked teachers to

share the link with participants during a study hall, homeroom,

or other noninstructional time. Site coordinators were given

freedom to invite groups of students to participate according

to school data needs and convenience. Ultimately, nine schools

elected to invite all students to participate and two schools

chose to invite selected grade levels. Site coordinators worked

with their building and district administrators to determine pro-

cedures for parental consent, with all schools ultimately choos-

ing to use a passive consent process. Site coordinators reported

that no parent/guardian chose to opt their student out of the

project and no student was unwilling to participate. This was

Auger et al. 3

confirmed by the researchers who discovered that all students

who accessed the survey answered “yes” to the informed assent

statement, signaling their willingness to participate.

Instrument

Unable to locate an instrument to measure all the variables in

question, we created our own tool later named the Barriers,

Experiences, and Attitudes Toward School Counseling

(BEATS) survey. Design of the instrument began with a thor-

ough review of literature related to adolescent help seeking,

specifically in school and professional counseling settings.

As noted above, previous research on the topic has uncovered

numerous reasons why some adolescents tend to avoid seeking

help and, when they do, which persons in their life they are

most likely to approach. Ultimately, the 51-item BEATS

instrument consisted of five sections, each grounded in the

literature and designed to gather data related to the research

questions: (a) basic demographics (e.g., grade, ethnicity); (b)

experiences with the school counselor (e.g., number of meet-

ings this year, reasons for meetings); (c) willingness to see the

school counselor for various academic, college/career, and

social/emotional issues (e.g., “Change your schedule,”

“Explore college options,” and “You’ve been feeling very sad

lately”) provided on a Likert-type Scale with responses from 1

(very unlikely) to 5 (very likely); (d) perceived barriers to see-

ing the school counselor for each issue above (e.g., “The coun-

selor might tell someone what I said,” “I don’t know my

counselor well enough to talk about this,” and “I like to handle

stuff like this on my own”) provided on a Likert-type Scale

with responses from 1 (definitely WOULD NOT stop me) to 5

(definitely WOULD stop me); and (e) open-response items

(e.g., “What could the school counselors in your school do to

be more helpful to students?”).

Prior to the study, we pilot tested the BEATS on seven

willing adolescents between the ages of 12 and 18. Following

completion of the survey, we asked these participants to pro-

vide feedback on length, clarity, reading level, and content. We

revised the instrument based on this feedback, and the survey

was deemed acceptable for use in the study.

Participants

The study was carried out at 11 secondary schools (N ¼ 11) in two Midwestern states. General characteristics of the schools

were as follows: two large, public high schools with Grades

10–12 (suburban); two medium-sized, Catholic high schools

with Grades 9–12 (one suburban and one medium-sized city);

three small, public high schools with Grades 9–12 (rural); one

small, public secondary school with Grades 6–12 (rural); one

large, public middle school with Grades 6–8 (medium-sized

city); one small, public middle school with Grades 6–8 (rural);

and one small, public middle school with Grades 7–8 (rural).

Table 1 provides additional characteristics of the participating

school sites, including student demographics.

A total of 3,584 students in Grades 6–12 took the survey,

with participants in Grades 6–8 (n ¼ 1,287) categorized as middle school (MS) students and those in Grades 9–12

(n ¼ 2,287) considered high school (HS) students. Ten parti- cipants did not indicate a grade level. Participants self-

identified their gender in an open-response format and were

categorized as male (n ¼ 1,731, 48.3%), female (1,773, 49.5%), gender nonconforming (31, 0.9%), no response (21, 0.6%), or other response (28, 0.8%). Students similarly self-identified their ethnicity and were categorized as White

(n ¼ 2,756, 76.9%), African American (191, 5.3%), Latina/ Latino (158, 4.4%), multiracial (135, 3.8%), Asian/Pacific Islander (121, 3.4%), American Indian (17, <1%), no response (90, 2.5%), or other response (116, 3.2%).

Results

Basic Descriptive Statistics

We analyzed quantitative data using the PSPP free statistical

software package (GNU Project, 2016). Basic descriptive anal-

yses revealed that the vast majority of students indicated

Table 1. Participating School Characteristics.

General Information Approximate Student Population (Ethnicity Counts Expressed in %)

Grade Levels Setting/Type

School Counselors Total White

African American Latina/o

Asian/ Pacific Islander

American Indian Multiracial

School A 7–12 Rural/public 1 444 96.6 0.2 1.4 0.9 0.9 0.9 School B 6–8 Rural/public 1 298 78.2 2.0 17.8 0.6 0.3 1.3 School C 9–12 Suburban/private 4 732 91.8 0.8 3.1 1.1 0.1 3.0 School D 9–12 Rural/public 2 857 87.9 4.0 2.1 2.4 0.2 3.4 School E 9–12 Urban/public 9 2,388 25.9 51.5 14.7 1.1 0.1 6.7 School F 9–12 Rural/public 1 251 78.8 0.8 19.5 .4 0 0 School G 9–12 Rural/public 1.3 509 83.1 0.4 13.6 0.2 0.4 1.0 School H 6–8 Medium outstate city/public 2 888 84.0 8.0 3.4 2.1 0.3 2.0 School I 10–12 Suburban/public 6 1,598 60.6 18.9 9.1 .1 0.4 4.2 School J 7–8 Rural/public .7 253 81.8 0 14.2 0 0.4 2.8 School K 9–12 Medium outstate/private 1 137 91.2 1.5 2.2 0 0 2.9

4 Professional School Counseling

knowing their school counselor’s name (90.4%) and office location (88.3%), although a lower percentage reported know- ing how to schedule a meeting with their school counselor

(73%). Students reported meeting with their school counselor (defined in the survey as an individual or group counseling

session) approximately 2–3 times in the past year (M ¼ 3.36, median ¼ 2), although more than 20% of participants reported zero meetings with their school counselor during that time.

Academics (46%) were the most common reason for these meetings, followed by college/career planning (29%), and social/emotional issues (18%). When asked to rate their will- ingness to seek help from their school counselor for specific

issues across the academic, college/career, and social/emo-

tional domains on a Likert-type Scale from 1 (very unlikely)

to 5 (very likely), students reported being most willing to seek

help for academic or college/career reasons, with the most

likely scenarios being: “Changes to your schedule” (M ¼ 3.47, SD ¼ 1.50), “Exploring college options” (M ¼ 3.42, SD ¼ 1.35), and “Deciding which classes to take” (M ¼ 3.33, SD ¼ 1.36). Students indicated they were least likely to seek help for social/emotional reasons, with the lowest-rated

scenarios being, “You’ve been feeling very sad lately” (M ¼ 1.98, SD ¼ 1.20), “Ongoing problem with your parents or friend” (M ¼ 2.11, SD ¼ 1.19), and “Anxiety or stress” (M ¼ 2.31, SD ¼ 1.31). Differences were detected by demo- graphic variables on a number of items; we discuss this below.

Students reported meeting with their school

counselor approximately 2–3 times in the past year,

although more than 20% of participants reported zero meetings with their school counselor during

that time.

Barriers to Seeking Help From the School Counselor

To answer the first research question related to barriers to

seeking help, students were asked to respond to a list of eight

reasons an adolescent might choose not to seek help from their

school counselor. As explained above, a small body of litera-

ture exists on general attitudes toward help seeking among

adolescents, and the eight reasons selected for inclusion in this

study were drawn from common findings across previous stud-

ies. In the present study, we asked participants to rate the

degree to which each of these eight reasons would stop them

from seeing their school counselor for various academic, col-

lege/career, and social/emotional issues, using a Likert-type

Scale from 1 (definitely WOULD NOT stop me) to 5 (definitely

WOULD stop me). Table 2 shows the results for this section of

the survey. Regardless of the type of presenting concern, stu-

dents consistently rated the following reasons as the greatest

barriers to seeking help from the school counselor: (a) “I would

talk to a parent, friend, or teacher about this instead”; (b) “I like

to handle this stuff on my own”; (c) “I don’t know my counse-

lor well enough to talk about this”; and (d) “The counselor

might tell someone what I said.”

Differences by Developmental Level, Ethnicity, and Gender

To answer the second research question, we utilized w2 and one-way analysis of variance followed by post hoc tests

(Bonferroni method) to detect differences by developmental

level, ethnicity, or gender.

Differences by developmental level. We noted many differences between middle school and high school students, starting with

the percentage of middle school students (47.7%) and high school students (17.3%) who reported no meetings with their school counselor in the previous year. The reasons for meetings

that did occur also differed, with middle school students being

much more likely than high school students to report meeting

with the school counselor for a social/emotional reason (26.7% vs. 12.5%), while the opposite was true for academics (12.8% vs. 64.6%) and college/career planning (2.5% vs. 44.3%). As illustrated in Table 3, these findings paralleled student

responses on items related to their willingness to seek help

from the school counselor, with middle school students being

more willing than high school students to seek help for all

scenarios related to social/emotional issues, but significantly

less likely for all scenarios related to academics and college/

career planning (all differences significant at p � .001). For

Table 2. To What Degree Would the following Reasons Stop You From Seeing Your School Counselor for Help With Each Type of Issue?

Academic College/Career Social/Emotional

M SD M SD M SD

I would talk to a parent, friend, or teacher about this instead 3.01 1.37 2.65 1.34 3.17 1.43 I like to handle this stuff on my own 2.89 1.36 2.53 1.33 3.15 1.42 I don’t know my counselor well enough to talk about this 2.59 1.30 2.21 1.22 2.93 1.43 The counselor might tell someone what I said 2.57 1.38 2.11 1.25 2.89 1.46 I didn’t know the counselor did stuff like this 2.25 1.14 2.05 1.10 2.47 1.35 I don’t know how to make an appointment with my counselor 2.12 1.25 2.09 1.21 2.31 1.30 It’s weak to get help for something like this 2.02 1.14 1.94 1.10 2.47 1.31 It’s embarrassing or not cool to get help from the counselor for this 1.89 1.00 1.77 1.03 2.43 1.34

Note. 1 ¼ very unlikely; 2 ¼ unlikely; 3 ¼ undecided; 4 ¼ likely; 5 ¼ very likely.

Auger et al. 5

example, the two issues for which middle school students

reported being most likely to seek help from the school coun-

selor were, “a friend told you they were thinking of harming

themselves” and “bullying,” while these scenarios rated only

seventh and eighth most likely for high school students.

Very few developmental differences were found regarding

perceived barriers to seeking help. Regardless of the domain of

the scenario, both middle school and high school students

endorsed two reasons far more frequently than others when

asked what would stop them from seeking help from the school

counselor: (a) “I would talk to a parent, friend, or teacher about

this instead” and (b) “I like to handle this stuff on my own.”

Those barriers were followed in likelihood by “I don’t know

my counselor well enough to talk about this” and “The coun-

selor might tell someone what I said,” with the order of these

two reasons differing slightly by developmental level and

domain of the presenting issue.

Differences by ethnicity. We also noted several differences by ethnicity, beginning with the finding that many students of

color did not know their school counselor’s name. Specifically,

White students were statistically more likely to report knowing

their counselor’s name (92.7%) than were multiracial (83.7%, p � .05) and African American (79.1%, p � .001) students. Despite this finding, no significant differences were detected

by ethnicity with regard to the number of reported meetings

with a school counselor over the past year.

w2 analyses detected statistically significant differences (p � .01) by ethnicity with regard to reasons given by students for

meeting with their school counselor over the past year. African

American (15.7%) and Asian/Pacific Islander (10.7%) students were less likely than all other groups to report meeting with a

school counselor in the past year for social/emotional reasons.

This trend was also observed in student ratings on items related

to their willingness to seek help from a school counselor for

specific scenarios involving social/emotional issues. For exam-

ple, when asked to rate how likely they were to seek out the

counselor for help with “ongoing problem with parents or

friend” on a scale from 1 to 5, African American (M ¼ 1.82) and Asian/Pacific Islander (M ¼ 1.71) students reported being significantly less likely (p � .05) than White (M ¼ 2.11) or Latina/Latino students (M ¼ 2.24).

Conversely, African American students were most likely of

all groups to report meeting with a school counselor for aca-

demic reasons (62.3%), and this was similarly reflected in their willingness to seek help from the school counselor for issues

such as “change your schedule” (M ¼ 3.66) and “learn about better ways to study” (M ¼ 2.69). Finally, although African American students typically reported being more willing than

White students to seek help for college/career planning, a

smaller percentage of African American students (26.2%) reported actually meeting with their counselor for this reason

as compared to White students (31.6%).

Differences by gender. We found very few statistically signifi- cant differences by gender in this sample, as male, female, and

nonconforming students reported both similar levels of willing-

ness to see the school counselor and similar perceived barriers

to doing so. We did note differences in the number of contacts

with a school counselor in the past year, with nonconforming

students reporting significantly more (M ¼ 8.68, p � .05) than male (M ¼ 3.4) and female (M ¼ 3.27) students. The reported reasons for these meetings also differed, with female (22.3%) and nonconforming (45.2%) students reporting more meetings than males (12.1%) for social/emotional issues. Given the lit- erature on help seeking and gender, we found the relatively

sparse differences detected in this sample somewhat surprising.

Open-Ended Questions

Research trends are shifting to include qualitative data within

quantitative studies as a way to reveal themes and common

threads in a specific area being studied (Erwin, Brotherson,

& Summers, 2011) and to provide a broader and more holistic

understanding of the phenomenon (Wright, 2014). The primary

purpose of qualitative questioning within a survey is to gain

insight into the participants’ worldviews and capture their

unique and authentic experiences and interpretations of these

experiences (Marshall & Rossman, 1999; Rubin & Bellamy,

2012; Saris & Gallhofer, 2014).

To that end, the BEATS survey included the following four

open-ended questions:

1. What would be the biggest reason that would make you

willing to see your school counselor if you had a problem?

2. What would be the biggest reason you would NOT

choose to see your school counselor when you had a

problem?

Table 3. How Likely Is It That You Would Go to Your School Counselor for the Following Issues?

Issue

Middle School

High School

M SD M SD

Change your schedule* 2.20 1.27 4.19 1.1 Exploring college options* 2.51 1.31 3.92 1.07 Deciding which classes to take* 2.42 1.28 3.83 1.13 Figuring out what jobs/careers you might like* 2.40 1.29 3.26 1.27 Learning how to pay for college* 2.29 1.23 3.17 1.24 Problem with a teacher* 2.59 1.38 3.05 1.35 A friend told you they were thinking of

harming themselves* 3.36 1.59 2.93 1.45

Bullying* 3.19 1.53 2.60 1.38 Learning new or better ways to study* 2.28 1.23 2.44 1.23 Anxiety or stress* 2.56 1.41 2.17 1.24 Ongoing problem with your parents or

friend* 2.50 1.31 1.89 1.07

You’ve been feeling very sad lately* 2.39 1.35 1.75 1.05

Note. 1 ¼ very unlikely; 2 ¼ unlikely; 3 ¼ undecided; 4 ¼ likely; 5 ¼ very likely. *Significant at p � .001.

6 Professional School Counseling

3. What could the school counselors in your school do to

be more helpful to students?

4. If you feel hesitant to see your school counselor, is there

anything she or he can do to make you more willing to

go? If yes, what would that be?

To explore the meaning and synthesize the open

responses, two members of the research team conducted a

thorough review of the data set by reading and rereading the

text. Independently, the researchers carried out a descriptive

content analysis of the data and determined main themes from

the four open-ended questions. Next, the two authors came

together and worked collaboratively to arrive at a consensus

on the main themes and patterns that emerged from the data

analyzed. This review of responses revealed a variety of clear

themes and patterns.

For Question 1, two main themes emerged, each illustrating

a condition under which the students would be willing to see

the school counselor: (a) for help with task-oriented items and

(b) when their perceived safety is at risk or there is a feeling of

crisis. With regard to the first theme, seeing the school coun-

selor for schedule changes or college-related questions was

commonly described. One student shared, “I would only see

my counselor if it was about college prep, SAT/ACT testing, or

about my schedule.” These task-oriented meetings represent

low-risk opportunities for quick interactions with the school

counselor that do not require a prior relationship or put the

student at risk of being judged. The second theme focused on

safety concerns (bullying, suicide, abuse, etc.). Students

reported a reluctant willingness to seek help in these cases,

although seeing the counselor was clearly viewed as a last

resort. For example, a student wrote that they would seek help,

“If I had a serious problem like suicide, family problems,

abuse, or severe bullying,” and another shared, “[If] one of

my friends was having a serious mental health issue.” A num-

ber of comments portrayed seeing the school counselor as a last

resort: “It would be that I cannot find any other way to solve it

and no one else that knows better” and “If I could not get help

anywhere else.” These responses suggest many students see

school counselors as responsive services providers to be called

upon only for simple tasks or during crises when nobody else

can help.

The following five themes emerged across responses to

Question 2, which asked students to identify the main reason

they would not choose to see the school counselor: (a) concern

about confidentiality, (b) lack of rapport/connectedness, (c)

stigma associated with school counseling, (d) counselor com-

petence, and (e) prefer others/self as support. The most preva-

lent among these concerns was confidentiality. Many students

were clearly worried about their privacy and did not believe

conversations with their school counselor would be kept con-

fidential. One student expressed the concern in this way: “The

biggest reason I would not choose to see my school counselor

would be if they told everyone what you two talked about in

private.” Another student shared a specific example of a breach

of confidentiality: “Because of them telling about my family

issues. They have done that before where they say things are

confidential and then tell what I said.”

The most prevalent among these concerns was

confidentiality. Many students were clearly worried

about their privacy and did not believe

conversations with their school counselor would be

kept confidential.

A second barrier mentioned by many respondents was a lack

of rapport or connection with the school counselor that resulted

in students being less willing to seek out their school counselor

for support. This was reflected in comments such as “I don’t

take my problems to people I don’t know” and “The biggest

reason I would choose not to see the counselor would be that I

do not know her very well and don’t feel comfortable talking

about my problems.”

The third area that students discussed was the stigma sur-

rounding school counseling. For example, one student stated,

“My friends would think that I am weird if I go see the

counselor.” Others made similar comments, such as “I am

afraid someone might find out and make fun of me and tell

everyone and they would make fun of me” and “The biggest

reason . . . would be that I would be embarrassed if my friends saw me going to the office. I wouldn’t want other people start-

ing to talk about me and wondering what problems I have.”

These feelings seem directly connected to a negative percep-

tion of entering the school counseling office and speak to how

the student body perceives the services offered as well as how

“problems” are viewed in the school.

The final two themes were counselor competence and the

preference to rely on others or self for support. Student

responses indicated a general sense that the problem would get

worse if they saw the school counselor or a feeling that the

school counselor is not helpful or competent. One student sim-

ply stated, “They don’t know anything,” which, while harsh,

accurately represented a number of student responses. In a

similar vein, another student wrote, “Our school counselor

never does anything about the situation until someone gets

hurt,” and another said, “It might make the problem worse.”

One student simply shared, “She isn’t very helpful.” These

statements could indicate a lack of understanding of the level

of training and scope of work of a school counselor, as well as a

sense that students were not satisfied with how a previous issue

was addressed. This might contribute to the finding that many

students want to handle problems on their own or with friends

and family, rather than with a school counselor. This was

summed up by responses such as “I like handling it myself or

talking to my closest friends and family” and “Friends are

easier to talk to and more accessible.”

Four themes emerged from responses to the final two open-

ended questions, providing insight into how school counselors

might be more helpful to students. These themes (a) provide

more individual meetings, (b) increase accessibility, (c) explain

Auger et al. 7

the roles/responsibilities of a school counselor, and (d) normal-

ize help seeking. Students repeatedly stated a desire for school

counselors to be more visible in the school, more involved in

students’ lives, and to intentionally reach out to students. For

example, one student noted that, “She [school counselor] could

meet us in class and show us how to plan a meeting and talk to

us one-on-one about our personal life.” Other students sug-

gested that counselors could “Socialize with the students more

so they can get to know them better” or “Have more scheduled

meetings for students who don’t go and make appointments

themselves” in order to build rapport and increase accessibility.

Students repeatedly stated a desire for school

counselors to be more visible in the school, more

involved in students’ lives, and to intentionally

reach out to students.

Interestingly, these sentiments seem to contradict the

responses given to the previous questions when students

reported a general distrust and lack of desire to seek help from

school counselors. But when asked explicitly about how school

counselors could be more helpful, many students stated that

counselors should actively reach out to students and get to

know them outside the counseling office. Students encouraged

counselors to “just talk to us more” and “interact with more

kids” as simple yet effective examples of how to foster open-

ness in the student–counselor relationship.

In addition to a better relationship, students reported need-

ing to learn the basics about school counseling, including the

name of their counselor, how to schedule an appointment, the

services offered by the school counselor, and the roles and

responsibilities of a school counselor (including confidential-

ity). The following are a few examples of participant responses

related to this need: “Assure me that I don’t need to be afraid to

talk with them or other people,” “Make it more well known

how to get in contact with them,” “Make it easier to set up

appointments,” and “Email me or talk to me to see if I have

problems.” In summary, the suggestions offered by students

reflect a genuine interest in connecting with their school coun-

selor in a meaningful, intentional way.

Finally, we emphasize that many students used the open-

ended response items to state that their school counselor was

doing a good job and should not change a thing (e.g., “Keep

being awesome”; “I think they’re fantastic as it is”). Although

the spirit of constructive criticism inherent in academic research

tends to pull researchers’ attention toward issues that are proble-

matic, we want to acknowledge the impressive efforts of the

school counselors represented in our study and those across the

country, most of whom are doing the best they can, given their

training, caseloads, and constraints of their work settings.

Discussion

The results of this study highlight many notable patterns in

secondary students’ attitudes toward seeking help from a

school counselor. One important finding supported by both

quantitative and open-ended responses was related to the rea-

sons students choose not to see their school counselor. First and

foremost, secondary students clearly prefer to solve all but the

most serious problems on their own or with the help of a friend

or family member before turning to a school counselor.

Although the exact reasons for this are unclear, two contribut-

ing factors could be concerns about confidentiality and a lack

of rapport/relationship with the school counselor, both of which

students consistently expressed in quantitative and qualitative

responses. All of these barriers have been identified in previous

studies on help seeking among children and adolescents (Del

Mauro & Williams, 2013; Fox & Butler, 2007; Rughani et al,

2011; Timlin-Scalera et al., 2003), and they also seem relevant

in the context of school counseling services.

This study uncovered many differences by ethnicity and

developmental level regarding the reasons students will see their

school counselor. High school students were much more likely

than middle school students to have met with their school coun-

selor in the previous year, although the reasons for these meet-

ings differed greatly, with most high schoolers reporting

academics or college/career planning as the reason for seeing

their counselor, while middle schoolers were more likely to

report social/emotional reasons. Although this may be expected

given the nature of student development and concerns at various

ages, a counselor working within a comprehensive school coun-

seling program would aim to provide students with needed ser-

vices across all domains and at the very least work to ensure that

students feel equally comfortable seeking help from the counse-

lor for a variety of issues. That said, in this particular sample,

middle school students indicated a far greater willingness to seek

help for social/emotional reasons (e.g., “bullying”) than issues in

the other domains, while high school students expressed the

most willingness to seek help related to academics (e.g., “change

my schedule”). Similar differences were noted by ethnicity, with

African American and Asian American students expressing less

willingness than White students to seek help for social/emotional

concerns. Very few differences were detected by gender in this

sample, with male, female, and nonconforming students report-

ing similar degrees of willingness to seek help from the school

counselor and similar barriers to doing so.

The results of this study point to the importance of school

counselors acknowledging and addressing student concerns and

demographic differences through outreach, relationship build-

ing, and education on the role of the school counselor. Confi-

dentiality weighs especially heavily on the minds of adolescents

and is not a simple issue to address, given the complexities of

balancing student trust and relationship with the counselor’s duty

to disclose certain information when required by law or guided

by professional ethics and decision-making (Stone, 2017).

Limitations

Like all research findings, the results of this study should be

interpreted with caution. First, the study participants were not

8 Professional School Counseling

chosen at random, but out of convenience given their standing

as students at a school where the research team had an existing

relationship with the school counselor. This makes the results

dependent on the work of just a few school counselors, all of

whom were previously known to the researchers. Furthermore,

the settings and demographics of these schools do not perfectly

represent the states in which they are located (let alone the

United States as a whole) and, therefore, are not widely gen-

eralizable. Third, given the nature of survey research, the

degree to which participants’ responses accurately represented

their feelings and experiences, rather than a pattern of social

desirability, is also unclear. This is especially true in light of the

findings regarding student concerns about confidentiality.

Another limitation is the BEATS instrument, for which mea-

surements of reliability and validity were not available since it

was developed specifically by the researchers for use in this

study and tested on only a small pilot sample of adolescents

prior to deployment. Fifth, given the length and quantity of

open-ended responses provided by participants, we were not

able to analyze these data in a thorough, systematic manner,

which may raise concerns about validity. Although the results

may be interesting to some and useful in supporting quantita-

tive findings, they should not be used to draw major conclusions.

Finally, we did not measure the overall effectiveness of each

school counseling program, including the degree to which coun-

seling departments were using a comprehensive school counsel-

ing approach such as the American School Counselor

Association (ASCA) National Model (2012). Research has

shown that comprehensive school counseling programs provide

many benefits (Carey & Harrington, 2010a, 2010b), and the

variables examined in this study might have been impacted by

the degree of structure within each school’s counseling program.

Implications for Practice

As noted above, we observed many differences by ethnicity and

developmental level. Noting these differences, reflecting on pos-

sible reasons for them, and developing strategies to address them

are critical for school counselors. For example, middle school

students in the sample were far more likely and willing to see a

school counselor for social/emotional reasons than were high

school students. Counselors at both levels might consider

whether this is the case at their school, and if so, why that might

be. Are high school counselors doing enough intentional out-

reach, education, and prevention on social/emotional develop-

ment and wellness? Conversely, are middle school counselors

doing enough work related to academic planning and college/

career readiness? School counselors are in a position to be

change agents who work to address equity gaps and increase the

multicultural competency of the faculty and staff. Effective com-

prehensive school counseling programs cannot survive without

great efforts on the part of the school counselor to win the

investment of the entire school community. School counselors

can no longer work in silos or wait for students to approach them

for help. Instead, counselors must take the lead in reaching out

and educating students, teachers, administrators, families, and

the general public on the value and scope of school counseling

programs and on the importance of working collaboratively.

School counselors would also be wise to address the barriers

to seeking school counseling services noted by the students in

this study, especially since these findings were consistent with

previous research on adolescent help-seeking behaviors. Con-

cern about confidentiality, the tendency to rely on self or family

and friends for help, and a lack of trust and rapport with the

school counselor are issues that cannot be ignored if school

counselors hope to establish an environment in which students

feel comfortable seeking help for a variety of issues. Educating

students and staff on the role of the school counselor and build-

ing an advisory council (ASCA, 2012) might be first steps

toward addressing these concerns. By widely educating stake-

holders and convening a team that understands issues such as

confidentiality, program goals, and appropriate tasks and use of

time, school counselors help ensure they have the trust and time

needed for direct services to build rapport with students and

establish a safe, secure environment in which all students feel

comfortable seeking out school counseling services.

Concern about confidentiality, the tendency to rely

on self or family and friends for help, and a lack of

trust and rapport with the school counselor are

issues that cannot be ignored.

To ensure school counselors have the opportunity to imple-

ment evidence-based programming and develop more compre-

hensive school counseling programs, they must work closely

with their building-level administrators to identify a shared

vision for school counseling services and clear roles and

responsibilities for the school counselor (ASCA, 2012; Mallory

& Jackson, 2007). In an effort to build support for a more

comprehensive program, school counselors may be helped by

sharing research with principals demonstrating that students

who feel their school counselor cares about them are more

likely to feel connected to school in general, which in turn is

associated with a host of positive academic and nonacademic

outcomes (Lapan, Wells, Petersen, & McCann, 2014).

The ASCA National Model (2012) provides a framework for

school counselors to develop and deliver outcome-based ser-

vices to address the academic, social/emotional, and college/

career readiness needs of all students through a comprehensive

program organized around four components: foundation, man-

agement, delivery, and accountability. All the while, school

counselors are called to display the key skills, attitudes, and

dispositions needed to be effective, including the four specific

themes of the ASCA National Model (2012): leadership, advo-

cacy, collaboration, and systemic change. Although schools

must examine solutions to the barriers identified in these

research findings in the context of their specific settings and

student populations, as a starting point, we offer suggestions

that align with the ASCA National Model (2012). As with any

intervention, counselors should target each action toward a

Auger et al. 9

specific goal and measure the effectiveness of the response in

impacting student outcomes.

� Implement looping (i.e., having school counselor move through the grade levels with the same set of students) to

maximize the development of close student–counselor

relationships (Delivery, Collaboration, Advocacy).

� Hold regularly scheduled individual or small group meetings with students to build trust and rapport (Deliv-

ery, Collaboration, Leadership, Advocacy).

� Use technology to regularly communicate with students and make it easy to schedule meetings (Delivery, Col-

laboration, Leadership).

� In schools with multiple counselors, allow students to see any counselor without an appointment for simple

requests. Use technology to communicate the content

of these meetings to the assigned counselor (Delivery,

Collaboration, Leadership, Systemic Change).

� Educate students and staff about school counseling. Pos- sible topics include the training and expertise of school

counselors, services provided, a typical meeting with the

counselor, how to schedule appointments, and confiden-

tiality. Reach out to students as early as possible, includ-

ing at transition meetings, visits to other buildings in a

district, and back-to-school events. Be proactive—do

not wait for students to find you (Delivery, Collabora-

tion, Leadership, Advocacy, Systemic Change).

� Seek regular feedback from students, staff, and parents regarding the effectiveness of the school counseling pro-

gram, including barriers to seeking help. School coun-

selors might use our study results as a starting point for

surveying students on reasons they do or do not seek out

their counselor. Keep an open mind and operate from a

growth mindset when analyzing feedback. Remember

that counselors are in schools to serve students, so we

need to listen to their voices (Management, Account-

ability, Systemic Change, Leadership, Advocacy).

� Keep the school website updated with information about the school counseling program and protocols such as

scheduling appointments so it is easily accessible to

students and stakeholders (Foundation, Management,

Leadership, Advocacy, Collaboration).

� Consider using volunteers for work that does not require access to confidential student information in order to

free up time to meet face-to-face with students and build

trust and rapport (Delivery, Collaboration, Leadership).

Suggestions for Future Research

Further research is needed in the area of student attitudes

toward seeking help from the school counselor. For example,

researchers might consider replicating this study in different

geographic locales and/or with demographic samples more rep-

resentative of the national population. Qualitative researchers

might build on the findings from the open-ended questions

using smaller samples and more rigorous methodology.

Researchers also might gather data from other stakeholders

such as school counselors, teachers, parents, and administrators

to allow for comparison with student attitudes. Future studies

might use experimental methods to determine the effectiveness

of specific interventions targeted at student concerns raised in

this study (e.g., confidentiality, trust). Especially helpful

research would address such interventions embedded within a

comprehensive school counseling program, such as one based

on the ASCA National Model (2012) and studied longitudinally

with an eye toward measurable student outcomes. Reviewing

school counseling intervention research, particularly evidence-

based programs that could be modified to address the needs of

the school, might also be advantageous. For example, the All

Hands on Deck program provides an excellent template show-

casing a school counselor-led initiative focusing on academic

pressure, social support, and relational trust (Salina et al.,

2013). Finally, interested researchers might include other vari-

ables such as student-to-school-counselor ratio, degree and

fidelity of implementation of a comprehensive school counsel-

ing program, and type of student–counselor interaction to mea-

sure any differences in student outcomes and attitudes.

Conclusion

School counselors provide essential support and services to

students, but the results of this study indicate that a variety of

beliefs, attitudes, and barriers impede the ability and willing-

ness of students to seek help from their counselor. Finding

ways to minimize these barriers is critical, so that students can

receive the support and guidance they need. Some positive

steps in this direction are easy, such as ensuring students

know how to access school counseling services. Addressing

other barriers, such as student concern about confidentiality,

is much more complex. School counselors need to find ways

to educate students and other stakeholders about the services

they can provide and reach out to students who may be reluc-

tant to seek help on their own. Further research clearly is

needed in this area.

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Author Biographies

Richard W. Auger, PhD, is a professor of counselor education

at Minnesota State University in Mankato, MN. Email: richard.

[email protected]

Nicholas R. Abel, EdD, is an assistant professor of counsel-

ing in the College of Education at Butler University in

Indianapolis, IN.

Brandie M. Oliver, EdD, is an associate professor, also in the

College of Education at Butler University.

12 Professional School Counseling