International Students’ Intentions to Seek Group Therapy and Self-Stigma: Effects of Informational and Therapist Rapport Interventions

Abstract

Literature supports that group therapy could be an advantageous treatment for international students because of its emphasis on relationships and concerns of loneliness, which are common in this population. However, group therapy tends to be underutilized among international students. First, the present study investigated how personal and vicarious (hearing about experience of a friend or a family member) experience with therapy, mental health concerns, and self-stigma predict willingness to seek group therapy (also referred to as group willingness) in international students. Second, effectiveness of two interventions (I-1 – providing group therapy information and I-2 – building rapport with international students) for reduction of self-stigma and improvement of group willingness was studied in comparison to the control condition (CC – providing an overview of counseling center services). Participants were 306 international undergraduate and graduate students in the U.S. They were randomly assigned to watch one of three videos (I-1, I-2, or CC) and completed a survey online that included the Self-Stigma of Seeking Help questionnaire and the Intentions to Seek Counseling Inventory adapted for group therapy. Students reported their mental health concerns and personal and vicarious experience with therapy. Having positive personal or vicarious experience did not predict group willingness. Higher mental health concerns were associated with higher group willingness, and lower self-stigma predicted higher group willingness for students who endorsed moderate or low levels of distress. I-1 lowered self-stigma compared to the CC for students with higher distress. It also lowered self-stigma and increased group willingness compared to the CC among students who had positive vicarious experience with therapy. I-2 did not affect self-stigma or group willingness compared to the CC. Results suggest that international students’ ability to recognize their distress may play an important part in their consideration to seek group therapy. Findings also indicate that providing information about group therapy could be an effective intervention for lowering self-stigma and increasing group willingness for some international students. Specifically, students who experience high distress or have heard positive feedback about counseling from a close person may be more receptive to the intervention and feel more positively about seeking group therapy as a result.