Psychological help-seeking attitudes and intentions of lesbian, gay, and bisexual individuals: The role of sexual minority identity and perceived counselor sexual prejudice.

Abstract

In the current study, the psychological help-seeking attitudes and intentions of 140 lesbian, gay, and bisexual (LGB) individuals were examined in relation to their LGB identity and perceived sexual prejudice of mental health counselors. Relying on the theory of planned behavior (Ajzen, 1991), the looking glass self (Cooley, 1902(Cooley, /1964, and the threat-to-self-esteem model (Nadler & Fisher, 1986), we hypothesized that perceived counselor sexual prejudice mediated the relationship between an individual'sLGB identity and their intentions to seek psychological services using path analysis. Contrary to expectations, perceived counselor sexual prejudice did not mediate the relation between LGB identity and intentions to seek psychological services. Results indicated LGB Identity Affirmation, but not Negative LGB Identity, was related to perceived counselor sexual prejudice such that the more affirming LGB individuals are of their sexual identity the less they perceive counselors to display sexual prejudice. The model illustrated that attitudes toward mental health counseling mediated the relationship between perceived counselor sexual prejudice and intentions to seek psychological services. Furthermore, a negative relationship was found between LGB identity and intentions to seek psychological services, such that the more negative an individual views their LGB identity, the higher their intentions to seek psychological services. Finally, a positive relationship emerged between prior counseling experience and help-seeking attitudes and intentions. Implications of these findings are discussed in terms of training, practice, and research.

“Sincerely Held Principles” or Prejudice? The Tennessee Counseling Discrimination Law

“…For our study, the scores for Stigma Tolerance and Expertness were combined to reflect a composite measure of attitudes toward seeking psychological help and Intent remained a standalone subscale (cf. Spengler & Ægisdóttir, 2015). We changed the wording of the original scale from seeking help from a “psychologist” to a “counselor” to be more generalizable to the field of mental health counseling.…”

“…Kite and Deaux (1986) established initial construct validity through significant correlations with a scale measuring attitudes toward traditional gender roles (Smith, Ferree, & Miller, 1975). Following Spengler and Ægisdóttir (2015), we reworded items to reflect how participants believed a counselor would answer them. For example, the item “I won’t associate with known homosexuals if I can help it” was reworded to “A counselor won’t associate with individuals known to be lesbian or gay if they can help it.” Kite and Deaux reported strong internal consistency (Cronbach’s alpha = .93); Spengler and Ægisdóttir reported similar reliability in their modified version (Cronbach’s alpha = .90), and we observed a Cronbach’s alpha of .97.…”

“…For example, research suggests there is a higher prevalence of negative mental health outcomes in states that recently enacted policies to restrict LGBT+ individual’s rights (Hatzenbuehler, Keyes, & Hasin, 2009; Rostosky, Riggle, Horne, & Miller, 2009). Although LGBT+ people use mental health services at disproportionately higher rates than straight and cisgender people (Cochran, Sullivan, & Mays, 2003), there are still questions about how LGBT+ people negotiate help-seeking, especially when laws and other structural dynamics may directly or indirectly impede their abilities or willingness to seek care as well as their expectations that care will be competent as well as nondiscriminatory (Meyer, Teylan, & Schwartz, 2015; Spengler & Ægisdóttir, 2015).…”

The English and German versions of the Lesbian, Gay, and Bisexual Identity Scale: Establishing measurement invariance across nationality and gender groups.

“…Since its publication, numerous findings have supported the validity of the LGBIS subscales. Among the most important are arguably the findings that pointed to critically important links between LGBIS subscales and health-related variables, such as mental health (Mereish & Poteat, 2015; Morandini et al, 2015; Puckett et al, 2015), gay men and lesbian women’s intentions to seek a psychotherapist’s help (Spengler & Ægisdóttir, 2015), physical health risk behavior (Harper et al, 2015), or physical health (Denton et al, 2014). For instance, Denton et al (2014) deployed the three LGBIS subscales Internalized Homonegativity, Acceptance Concerns, and Concealment Motivation and found that Internalized Homonegativity and Acceptance Concerns were weakly to moderately associated with LGB participants’ self-reported physical symptoms such as sleep problems or headaches ( r = .15 and r = .22, respectively; p s < .01).…”

Attitudes Toward Medical Care and Sexual Orientation Identity in Lesbian, Gay, and Bisexual Individuals

“…Within the behavioral health domain, factors of sexual orientation identity significantly relate to psychological help-seeking attitudes in LGB individuals (Spengler & Ægisdóttir, 2015). Identity affirmation, which includes positive attitudes regarding one's sexual orientation as well perceiving support from the community, positively relates to increased help-seeking attitudes.…”