TPC Journal V8, Issue 4- FULL ISSUE

299 Michael T. Kalkbrenner, Edward S. Neukrug Identifying Barriers to Attendance in Counseling Among Adults in the United States: Confirming the Factor Structure of the Revised Fit, Stigma, & Value Scale The primary aim of this study was to cross-validate the Revised Fit, Stigma, & Value (FSV) Scale, a questionnaire for measuring barriers to counseling, using a stratified random sample of adults in the United States. Researchers also investigated the percentage of adults living in the United States that had previously attended counseling and examined demographic differences in participants’ sensitivity to barriers to counseling. The results of a confirmatory factor analysis supported the factorial validity of the three-dimensional FSV model. Results also revealed that close to one-third of adults in the United States have attended counseling, with women attending counseling at higher rates (35%) than men (28%). Implications for practice, including how professional counselors, counseling agencies, and counseling professional organizations can use the FSV Scale to appraise and reduce barriers to counseling among prospective clients are discussed. Keywords : barriers to counseling, FSV Scale, confirmatory factor analysis, attendance in counseling, factorial validity According to the World Health Organization (WHO), mental health disorders are widespread, with over 300 million people struggling with depressive disorders, 260 million living with anxiety disorders, and hundreds of millions having any of a number of other mental health disorders (WHO, 2017, 2018). The symptoms of anxiety and depressive disorders can be dire and include hopelessness, sadness, sleep disturbances, motivational impairment, relationship difficulties, and suicide in the most severe cases (American Psychiatric Association, 2013). Worldwide, one in four individuals will be impacted by a mental health disorder in their lifetime, which leads to over a trillion dollars in lost job productivity each year (WHO, 2018). In the United States, approximately one in five adults has a diagnosable mental illness each year, and about 20% of children and teens will develop a mental disorder that is disabling (Centers for Disease Control, 2018). Substantial increases in mental health distress among the U.S. and global populations have impacted the clinical practice of counseling practitioners who work in a wide range of settings, including schools, social service agencies, and colleges (National Institute of Mental Health, 2017; Twenge, Joiner, Rogers, & Martin, 2017). Identifying the percentage of adults in the United States who attend counseling, as well as the reasons why many do not, can help counselors develop strategies that can make counseling more inviting and, ultimately, relieve struggles that people face. Although perceived stigma and not having health insurance have been associated with reticence to seek counseling (Han, Hedden, Lipari, Copello, & Kroutil, 2014; Norcross, 2010; University of Phoenix, 2013), the literature on barriers to counseling among people in the United States is sparse. Appraising barriers to counseling using a psychometrically sound instrument is the first step toward counteracting such barriers and making counseling more inviting for prospective clients. Evaluating barriers to counseling, with special attention to cultural Michael T. Kalkbrenner, NCC, is an assistant professor at New Mexico State University. Edward S. Neukrug, NCC, is a professor at Old Dominion University. Correspondence can be addressed to Michael Kalkbrenner, 1224 Stewart St., Las Cruces, NM 88003, mkalk001@nmsu.edu. The Professional Counselor Volume 8, Issue 4, Pages 299–313 http://tpcjournal.nbcc.org © 2018 NBCC, Inc. and Affiliates doi:10.15241/mtk.8.4.299