Online Exclusives

Collaborating with clients to remove barriers to treatment

Heather Rudow October 2, 2013

(Photo: Wikimedia Commons)

(Photo: Wikimedia Commons)

Recent research from the University of Phoenix has revealed that even if the stigma surrounding mental health counseling is on the decline, there are still barriers in the way of people receiving that treatment.

But Leslie Baker, an American Counseling Association member who worked on the study, said that a proactive relationship between counselors and clients can decrease some of those barriers.

The survey was conducted online in March 2013 and polled more than 2,100 adults across the U.S. about whether they had ever sought mental health counseling and, if so, whether anything hindered them from receiving treatment.

The survey found that while 32 percent of Americans have sought professional counseling, 38 percent of those individuals said they experienced barriers that made it either difficult or impossible for them to receive these services. And, of those who experienced barriers, 57 percent reported that the barriers kept them from receiving the services they needed.

Participants reported being prevented by the following factors:

  • Financial barriers (58 percent)
  • Lack of health insurance coverage (36 percent)
  • Unsure whether counseling would be effective (32 percent)
  • Unsure where to seek counseling (28 percent)
  • Couldn’t find a counselor with whom they felt comfortable (21 percent)
  • Reluctance to face their problems (19 percent)
  • Social stigma (15 percent)

While social stigma remains an issue for those seeking counseling, financial and insurance woes appear to be greater barriers to receiving care.

The study’s findings “signal a potential change over time in communities regarding the acceptance of counseling as a viable option for seeking assistance,” said Baker, a licensed marriage and family therapist and lead faculty member for the University of Phoenix’s College of Social Sciences. “However, keep in mind that social stigma may rate differently depending on the culture group studied.”

Baker says she believes it is up to counselors and local organizations to find ways around financial and insurance constraints.

“Creating opportunities for counseling to be more accessible to everyone who desires counseling is important,” Baker says. “Many counselors in private practice do some work at [a reduced] fee. Nonprofit agencies and county programs offer services to assist with financial barriers.” It remains to be seen, Baker adds, what kind of impact the Affordable Care Act will have on the affordability of mental health care.

Some counties offer mental health clearinghouses that connect people in the community to counseling services, including informing them of the costs involved and how to qualify, Baker says. “Another avenue in some rural areas is the use of tele-therapy to reach people in areas where counselors are not as accessible yet, [so as to] provide lower-fee counseling and [increase] accessibility.”

However, Baker stresses the importance of potential clients assessing what type of practitioner he or she needs to see and making sure to find a counselor who will be a good fit.

Once a client connects with a counselor, building rapport should be at the top of the counselor’s to-do list, Baker says. “Research has indicated that therapeutic rapport is a crucial aspect of the relationship that develops between a therapist and client. This may include a counselor providing understanding [and being] easy to talk to, empathic, warm, caring, honest and sincere.”

Baker recommends potential clients ask counselors the following questions:

  • What is your scope of practice?
  • How long have you been practicing?
  • What type of training have you completed in this treatment area?
  • What is your general approach to treating this concern?
  • How long does treatment usually last?
  • How will you measure progress toward treatment goals?

In addition, Baker suggests proactive approaches that counselors can take to ease some of the barriers found in the study:

  • Engage in discussions and create plans of action regarding ways to minimize barriers and create ways to address those barriers on an institutional level.
  • Educate clients regarding all types of services available in the community and where to go to receive those services.
  • Provide referrals tailored to the client’s needs.
  • Engage in evidence-based research and publish the findings.
  • Provide articles, blogs, video-blogs, workshops and other information for consumers to understand the efficacy of counseling approaches, tools and techniques. “In an effort to achieve this,” Baker adds, “I have added a section on [my] website that outlines all the modalities that are offered at the counseling center so clients can review them and link to websites with more details.”

Baker believes clients and counselors can overcome many of the barriers keeping people from receiving treatment once both sides understand the scope of these problems.

“Education is key to change for both the client and the counselor,” she says. “Counseling assessment is critical. This study provides the beginning assessment toward understanding where to focus our treatment plan.”

Heather Rudow is a staff writer for Counseling Today. Contact her at hrudow@counseling.org.

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