Setting the stage: The effect of affirming personal values before psychotherapy intake screenings on perceptions of self-stigma and self-disclosure.

Abstract

As an individual takes concrete steps toward psychotherapy (e.g., attending an intake) and the salience of becoming a help seeker increases, he or she may experience heightened levels of self-stigma and view self-disclosing personal information to a counselor as a risk. There is evidence that eliciting self-affirmation, a psychological process that temporarily bolsters self-worth, can diminish these risks. However, self-affirmation has yet to be tested with individuals who are about to complete an intake assessment, and it is unclear whether it could also impact their expectations about disclosing to a counselor. Thus, the present research utilized a randomized experimental between-subjects design to test the effectiveness of a self-affirmation intervention in reducing self-stigma and improving subsequent expectations of self-disclosing to a counselor in a sample of students about to attend an intake session (N = 124). Results indicated that, compared with a control group, those in the self-affirmation group reported lower self-stigma. Moreover, self-affirmation resulted in a negative indirect effect, through self-stigma, on anticipated risk of disclosure and a positive indirect effect on anticipated benefit of disclosure. Findings suggest that including brief self-affirmation interventions (i.e., in the waiting room) could be one way to reduce self-stigma and increase positive expectations regarding initial intake appointments, which could facilitate a more positive intake experience.

Using Item Response Theory to Develop Revised (SSOSH-7) and Ultra-Brief (SSOSH-3) Self-Stigma of Seeking Help Scales

“…Brief measures of self-stigma would also ease the assessment of self-stigma in applied clinical settings such as University Counseling Centers. Self-stigma inhibits comfort self-disclosing to a counselor (Seidman, Lannin, et al, 2019), deters treatment adherence, and contributes to early therapy dropout (Wade et al, 2011). Understanding a client's self-stigma could thus help practitioners identify and address this barrier in therapy.…”

The effects of group counseling and self-affirmation on stigma and group relationship development: A replication and extension.

“…For example, completing a self-affirmation intervention is associated with reductions in self-stigma (Lannin et al, 2013) and increases in positive beliefs and intentions to seek counseling (Lannin et al, 2017; Seidman et al, 2018). Furthermore, completing self-affirmation immediately before attending a counseling intake session is associated with reductions in self-stigma, and through the indirect effect on reductions in self-stigma, self-affirmed participants reported more favorable expectations about self-disclosure in the upcoming session (Seidman et al, 2019). However, despite growing evidence that self-affirmation offers potential clients a less threatening experience of seeking counseling—and thus, possibly a more favorable experience of counseling itself—there is no known research examining its effects after attending counseling, which precludes an understanding of its impact on an actual session experience and help-seeking constructs important for continued use of counseling.…”

Self-Reliance, Social Norms, and Self-Stigma as Barriers to Psychosocial Help Seeking Among Rural Cancer Survivors with Cancer-Related Distress

“…The copyright holder for this preprint this version posted July 16, 2021. ; https://doi.org/10.1101/2021.07.13.21260150 doi: medRxiv preprint 13 values) to increasing self-worth prior to confronting information that could decrease these positive self-perceptions. Self-affirmation interventions, have started to receive some support in increasing use of psychosocial services (Lannin et al, 2013;Seidman et al, 2018Seidman et al, , 2019, but needs to be further evaluated with rural cancer survivors, as this approach, if tailored to this population, may be able to directly reduce stigma and self-reliance as barriers to access.…”

“…One possible strength-based approach, that might be particularly salient to address this, is based in self-affirmation theory (Sherman & Cohen, 2006;Sherman & Hartson, 2011;Steele, 1988). Self-affirmation theory notes that we are inherently motivated to keep a positive sense of self-worth, and when we experience information that could decrease positive self-perceptions (i.e., reduce the belief that we are self-reliant and self-sufficient), we are driven to protect these positive views of the self, leading to avoidance of treatment for mental health issues (Lannin et al, 2013;Seidman et al, 2019). Fortunately, self-affirmation theory also asserts that we can reduce this drive to protect our self-worth, and thus increase likelihood of seeking therapy, by using self-affirmations (i.e., reflecting on a positive and self-relevant personal characteristic or values) to increasing self-worth prior to confronting information that could decrease these positive self-perceptions.…”

“…Fortunately, self-affirmation theory also asserts that we can reduce this drive to protect our self-worth, and thus increase likelihood of seeking therapy, by using self-affirmations (i.e., reflecting on a positive and self-relevant personal characteristic or values) to increasing self-worth prior to confronting information that could decrease these positive self-perceptions. Self-affirmation interventions, have started to receive some support in increasing use of psychosocial services (Lannin et al, 2013;Seidman et al, 2018Seidman et al, , 2019, but needs to be further evaluated with rural cancer survivors, as this approach, if tailored to this population, may be able to directly reduce stigma and self-reliance as barriers to access.…”