TPC Journal-Vol 10- Issue 2-FULL ISSUE

220 Daniel Gutierrez, Allison Crowe, Patrick R. Mullen, Laura Pignato, Shuhui Fan Stigma, Help Seeking, and Substance Use Researchers used path analysis to examine self-stigma, help seeking, and alcohol and other drug (AOD) use in a community sample of individuals ( N = 406) recruited through the crowdsourcing platform MTurk. Self- stigma of help seeking contributed to AOD use and was mediated by help-seeking attitudes. We discuss the implications for advocacy and stigma reduction in substance use treatment. Counselors and counselor educators can implement and advocate for interventions and training that increase positive attitudes toward seeking help, such as providing appropriate training with supervisees and counselors-in-training, providing clients and the community with mental health literacy, and engaging in more advocacy. Moreover, they can challenge thoughts of seeking help as weakness, normalize seeking psychological help, and discuss the benefits of counseling and therapy to address the development and effects of self-stigma of help seeking for individuals with substance use issues. Keywords: alcohol and drug use, self-stigma, help seeking, help-seeking attitudes, stigma reduction In 2015, approximately 20.1 million people over the age of 12 suffered from an alcohol or substance use disorder (SUD) in the United States (Bose et al., 2016). However, only 3.8 million people (1 in 5) who needed treatment received any substance use counseling (Bose et al., 2016). Barriers to receiving substance use treatment include the location of the program, legal fears, peer pressure, family impact, concerns about loss of respect, and stigma (Masson et al., 2013; Stringer & Baker, 2018; Winstanley et al., 2016). Of these concerns, stigma is arguably the most complex and the least understood. In response, substance use prevention and mental health care researchers have begun to turn their attention to stigma and how it influences counseling treatment and recovery (Livingston et al., 2012; Mullen & Crowe, 2017; Stringer & Baker, 2018). Researchers have found that individuals with SUDs experience higher levels of stigma than individuals with any other health concern (Livingston et al., 2012). However, more research on the intersection of stigma, help seeking, and alcohol and other drug (AOD) use is still warranted. Thus, this article delves further into these concepts and describes a study that examined the relationships between these variables. Stigma and Substance Use Individuals with substance use concerns report high levels of public stigma in the form of negative labeling, discrimination, and prejudice by others (Crapanzano et al., 2019; Goffman, 1963). Prejudice against people with substance use problems is common and widespread on individual, interpersonal, and institutional levels (Barry et al., 2014). There remains a substantial public belief that those using illicit substances simply need to take responsibility for their choices (Barry et al., 2014). As a result, individuals with SUDs report experiencing judgment, mockery, inappropriate comments, overprotection, and hostility from the public (Mora-Ríos et al., 2017). Even health professionals hold negative perceptions toward patients using substances, believing them to be dangerous, violent, manipulative, irresponsible, aggressive, rude, and lazy (Ford, 2011). Daniel Gutierrez, PhD, NCC, LPC, CSAC, is an assistant professor at the College of William & Mary. Allison Crowe, PhD, NCC, LPCS, is an associate professor at East Carolina University. Patrick R. Mullen, PhD, NCC, is an assistant professor at the College of William & Mary. Laura Pignato is a doctoral student at the College of William & Mary. Shuhui Fan, NCC, is a doctoral student at the College of William & Mary. Correspondence may be addressed to William & Mary, Daniel Gutierrez, School of Education, P.O. Box 8795, Williamsburg, VA 23187-8795, dgutierrez@wm.edu. The Professional Counselor™ Volume 10, Issue 2, Pages 220–234 http://tpcjournal.nbcc.org © 2020 NBCC, Inc. and Affiliates doi:10.15241/dg.10.2.220