Adolescence, emotional and behavioral problems, and counseling: Where's the stigma

Using a vignette methodology, this study examined adolescent attitudes toward common emotional and behavioral problems and school-based counseling within a rural community. Participants included 442 high school students from rural Florida. Peers described as exhibiting behaviors associated with depression, family conflict, and conduct disorder were consistently rated less favorably than peers without any problems, with particularly strong effects for conduct disorder. Stigma (i.e., negative attitudes) attached to emotional and behavioral problems appeared stronger than the stigma attached to counseling. Although peers without apparent psychological problems were rated less favorably if they attended counseling, they were still rated significantly more favorably than peers with problems, regardless of their counseling status. Gender, rurality, perceived similarity, prior counseling experience, and ethnicity moderated some of the effects related to emotional and behavioral problems and counseling status. For example, adolescents characterizing themselves as living in the country rated peers who attended counseling less favorably than those living in town, which suggests that adolescents living in the country may be less tolerant or understanding of peers who attend counseling. Males and females also had significantly stronger and opposite reactions to their same-sex peers with depression. Females viewed their same-sex peers with depression in counseling most positively, and males viewed their same-sex peers with depression less positively compared to those with family conflict but not conduct disorder.; This study indicated that the manifestations of emotional and behavioral problems seem to impact attitudes more than counseling, per se. Consequently, the message that counseling can help ameliorate emotional and behavioral problems that might already be negatively impacting social relationships, and seems to have little additional negative effects with respect to adolescent attitudes, can help allay adolescent and parental concerns about their children attending counseling with a psychologist. Education about the nature and prevalence of common emotional and behavioral problems as well as the effectiveness of counseling in addressing these problems should be an integral part of any school-based mental health program in order to foster more open discussion of mental health issues, and perhaps lead to less stigmatization and more support among the peer group.