West African Journal of Open & Flexible Learning
Volume 7, Number 1, July 2018
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Influence of Clients’ Counselling Expectations on Psychological Help Seeking Behaviour among Students in National Open University of Nigeria

Influence Des Attentes des Clients Au Conseil Pédagogique Sur La Recherche D’aide Psychologique Parmi Les Étudiants De L’université Nationale Ouverte Du Nigéria

Fidel O Okopi (PhD) 1 and Clifford Amini (PhD) 2
  1. National Open University of Nigeria Email: okopifidel@yahoo.co.uk
  2. Regional Training and Research Institute for Distance and Open Learning (RETRIDOL), National Open University of Nigeria

Abstract

The researchers investigated the influence of counselling expectations of students on their behaviours toward seeking psychological help in NOUN in Nigeria. The descriptive survey research design was used for this study. Four research questions and four hypotheses were formulated. Stratified randomisation was used to select six hundred (600) students from Lagos study, Port Harcourt Centre, Enugu Centre, Makurdi Centre and Maiduguri Centres of the National University of Nigeria. The brief form of abbreviated version of Counselling Expectations survey questionnaire containing 52 items was used. The questionnaire which is designed to measure expected counsellor’s expertise, students’ personal commitment and counsellor’s facilitative ability in building therapeutic relationship was validated, piloted tested and used for the research. Counsellor’s expertise was the most influential factor in students’ counselling expectations. When the hypotheses were tested at P<.05, Alpha level significant using IBM SPSS statistics 20, Paired Samples Test, differences were noted between students’ personal commitment factor and counsellor’s expertise; students’ personal commitment factor and counsellor’s facilitative ability in building therapeutic relationship factor, counsellor’s expertise and counsellor’s facilitative ability in building therapeutic relationship factor. Though, Counsellor’s expertise factor was the most influential expectancy in students’ seeking psychological help in NOUN, other two expectations were considered to be germane and relevance to their expectations. In conclusion therefore the counsellor’s expertise, attitude and attribute in counselling play a pivotal role in the students’ counselling expectations in seeking psychological helping behaviour.

Keywords: Counselling expectation; psychological help seeking behaviour and psychological disorder.

Résumé

Les chercheurs ont étudié l'influence des attentes des étudiants en matière de conseil sur leurs comportements en vue de chercher une aide psychologique à NOUN au Nigéria. L’enquête descriptive a été utilisée méthode pour faire cette étude. Quatre questions de recherche et quatre hypothèses ont été formulées. La randomisation stratifiée a été utilisée pour sélectionner les six cent (600) étudiants de l'étude au nivau des centres de Lagos, de Port Harcourt, de Enugu, de Makurdi et des centres Maiduguri de l'Université nationale du Nigéria. Le sommaire de la version abrégée du questionnaire de l'enquête sur les attentes en matière de conseil contenant 52 éléments a été utilisée. Le questionnaire conçu pour mesurer l’expertise attendue du conseiller, l’engagement personnel des étudiants et la capacité du conseiller à établir des relations thérapeutiques a été validé, testé, et utilisé pour la recherche. L’expertise du conseiller a été le facteur le plus influent dans les attentes des étudiants en matière de conseil. Lorsque les hypothèses ont été testées à p <0,05, niveau alpha significatif, à l’aide des statistiques IBM SPSS 20, le test des échantillons appariés, des différences ont été constatées entre le facteur d’engagement personnel des étudiants et l’expertise du conseiller; le facteur d'engagement personnel des étudiants et le facteur de la capacité facilitatrice du conseiller à établir des relations thérapeutiques, l’expertise du conseiller et la capacité facilitatrice des conseillers à établir un facteur relationnel thérapeutique. étaient considérés comme pertinents et conformes à leurs attentes. En conclusion, l’expertise, l’attitude et les attributs du conseiller jouent un rôle central dans les attentes des étudiants en matière de conseil dans la recherche d’un comportement d’aide psychologique.

Mots clés : Attente de counseil pédagogique; aide psychologique à la recherche d'un comportement et d'un trouble psychologique.

Introduction

The researchers investigated the influence of counselling expectations of students on their behaviours toward seeking psychological help in NOUN in Nigeria. Expectation as widely described by many theorists to mean:

“Subjectively held probability statements that represent the person’s estimate of the likelihood that an event will occur (e.g., the counsellor will understand my problem) or a condition will exist (e.g., the therapist will seem trustworthy) Counsellors’ and clients’ expectations are important determinants of their behaviour in counselling” (IResearchNet, Retrieved, 2019)

IResearchNet (2019) further advocate that, those clients’ expectations influence their decision to enter into and remain in therapy and moderate the effectiveness of therapy. IResearchNet notes that, clients approach therapy with expectancies regarding the nature of therapy and their own roles and that of counsellors. Patterson, Uhlin and Anderson (2008) explain that, expectations about counselling refer to client’s beliefs about the outcome of therapy, the therapist characteristics, and the amount of emotional disclosure required in a counselling session. Fischer, Jome, & Atkinson, (1998) as cited by Kim, Ng and Ahn (2005) advocated that, client’s counselling expectations such as having or not having hope and faith about positive counselling outcome could be influenced by clients’ personal commitment to undergo counselling process, counsellor’s facilitative ability in building therapeutic relationship and counsellor’s expertise.

Fischer, Jome, & Atkinson, (1998) as cited by Kim, Ng and Ahn (2005) acknowledge four common factors that can facilitate psychological seeking help or avoidance behaviours. These factors are a) client expectations for counselling success, (b) a shared worldview, (c) the therapeutic relationship, and (d) interventions that exist across counselling methods. Brown, (2011) and Ponton (2011) observe that, clients’ expectation for counselling success may lead to positive perceptions about counselling and motivate them to engage in the interventions more fully and persistently in resolving their problems This research focuses on the main elements in clients’ expectations of counselling which include: the expected of role a client in counselling process, counsellor’s attitudes that enhance the therapeutic relationship, and counsellor’s expertise.

However, it is important to explain influence of counselling expectations on psychological helping behaviour of NOUN students. Counselling as explained by Brown, (2011) and Blagen and Yang (2008) is geared towards helping individual overcome life’s challenges, regain a sense of control (feel empowered), regain happiness in life, and experience a more flexible, wider range of emotional maturity. APA (2019) reveals that, counselling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. In other words, counselling is aimed at changing the client’s behaviour or thought patterns; motivating the client to learn new ways of coping with thoughts, feelings and behaviours.

Nevertheless, Butcher, Mineka and Hooley (2007) as cited by Brogarrd (2015), define psychological dysfunction as cessation of purposeful functioning of cognition, emotions or behaviour. They further revealed that, one way to think about whether or not behaviour is abnormal is when something normal is done to the extreme. From the above definition of psychological disorders, the study would now examine the role of counselling psychologists in the treatment of the disorder. APA (2019) describes counselling psychologists as therapists whose main responsibility to help people with physical, emotional and mental health issues improve their sense of well‐being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms). For the client to approach a counsellor for psychological help, the client must have hope and faith in the counsellor’s expertise in counselling psychology who is to help her/him to overcome the problems, has the ability to enhance therapeutic relationship, and confident his or her own ability to commit his/herself to the success of the counselling process.

There are various factors that could either inhibit or facilitate clients’ psychological help seeking behaviour. Latalova, Kamaradova and Prasko (2014) propose that, factors could facilitate or inhibit clients’ psychological help seeking behaviour are social stigma, unwillingness to share problems with an unfamiliar person, believing that, private problems should be kept in the family, believing that one can solve his/her problems and not knowing enough about the psychological help process. They further opine that, other inhibiting or facilitating factors include, availability or unavailability of psychological services, the believing in the benefits of psychological services, trusting the mental health professional, and receiving help free of cost/

This research therefore adopted Patterson, Uhlin and Anderson (2008) and MacDonald (2016) perspective of counselling expectations which they identified as client’s belief about the outcome of counselling, the counsellors’ characteristics and counselee personal commitment to self-disclosure as required in the counselling sessions and counsellor’s expertise in counselling psychology.

MacDonald (2016), succinctly point out that, for a client to overcome an adversity and achieve successful counselling outcomes, the client must have culmination of the following four attributes: strong desire, belief, courage, and patience to push the counselling process through. When a client has the strong desire to make, changes and the motivation to do so, trust in the counsellor or the therapist expertise, courage to push through life in spite of adversity and forming new habits, new methods of doing things, and changing thinking patterns or behaviours, patience and dedication to the treatment process are needed attributes of the client

The Counsellors Expertise

As cited by Brown (2011) H. E. A. Tinsley, Brown, de St. Aubin, and Lucek (1984) wrote about therapist’s expertise: In general… “The counsellor is expected to be warmly interested in each client, highly trained and expert, and confident in his or her ability to help the client” They advocated that, the counsellor is expected to be thoroughly prepared for each interview, at ease with the client and the client’s problem and trustworthy (i.e., maintain confidentiality). (p. 149). The counsellor is expected to have learned and able to effectively practise the skills of empathy which are an essential ingredient in the healing process. Empathy by Rogers and as cited by Weeding and Corsini (2013) means the therapist's ability to accurately understand what the client is experiencing (thinking, feeling, sensing, perceiving) from the client's own frame of reference and the therapist's ability to communicate that understanding back to the client both verbally and nonverbally. Rogers cited by Weeding and Corsini (2013) opine that, empathic responses involve accurately surmising more than the client has said which based on counsellor’s past experiences with the client, theoretical knowledge, and practice wisdom

Meanwhile Corsini, & Weeding, (2011) reveal that, counsellor’s ability in facilitating therapeutic relationship client is a vital condition for successful counselling. The client’s expectation of a counsellor is that of a person whom the client can build together a partnership based on acceptance, empathy and trust They further explained that, Rogers identified these counsellor’s attributes as having unconditional positive regard for the client, shows genuineness, and be empathetic throughout the counselling sessions. All clients expect to find a safe, private conducive environment where education occurs, learning takes place, feelings are discussed, and thoughts are examined in relation to feelings while the counsellor listens without judgment and without an air of superiority to their problems. They further explained that, counselling environment is expected to be safe the development of the relationship are expectations of counselling and all has a direct association with a successful outcome.

Relevance of Students Seeking Psychological Help in ODL

Seeking psychological help is very important to the college students whose experience stressful and sometime frustrating period coupled with many challenges (Baysden, 2002; Rice & Van Arsdale, 2010) According to Ercan, (2010) & Flansburg, (2012), the problems experienced by university students include; education, family, personality, sexual, generational conflict, future expectations, finances, unemployment, drug abuse, depression and also psychological problems. Ryan, Shochet, & Stalliman, (2010) reveal that, research suggested that, university students are high-risk population for mental health illness problems. Wittenburg, K.J & Norcross J (2001) point out that, being at university may present threats to the student’s emotional well-being social support, and outcome expectations.

More so, in NOUN where teacher and learners are separated, though united by the use of technical media (usually print) students and staff are also saddled with extra psycho-social burdens such as: who to go to when confronted with issues; clarifications of their real needs; reconciling conflicting demands of home and work, coming to terms with isolation and concomitant problems resulting from previous experiences (NOUN, 2006). Moreover, students are confronted with other challenges which include: developing individual strategy for studying under a distance education system; overcoming study and learning difficulties; problem of interacting at a distance and interpersonal relationship problems. Furthermore, other encumbrances experienced by NOUN students involve choosing courses, study skills, balancing time with the demands of study, work and personal life. Under these conditions mentioned above, the ODL students are likely to develop concomitant psychological problems.

Meanwhile under this relatively new educational system in Nigeria, the NOUN is expected to provide robust and effective individualized, personalised, and democratised learning system and support services to every learner at a distance, in addition to meeting their psychological help needs. In NOUN many study centres the expected support services provided seems to be inadequate in (NOUN, 2006). The counselling psychologists who are expected to provide psychological help are not adequate in the entire NOUN centres and in some centres are not available at all making it extremely difficult to meet the counselling expectation of the students. Though, the responsibility of seeking psychological help lies with the individual student, the Open University has the responsibility of providing robust guidance and counselling services.

As of June 2016, the University employed and deployed seventy–six student counsellors to its seventy-seven study centres with the student’s population of over three hundred thousand for the purpose of providing guidance and counselling services. Among other services, the counsellors are expected to provide include socio-psychological counselling, services induction/orientation for students; learning and study skills assistance, information, advising, career, monitoring academic progress and referral services (NOUN, 2006). As stated in NOUN (2006), the counsellors also have the responsibility of keeping in constant touch with every distance learner and providing any early warning signals regarding difficulty with studies in order to provide prompt remedial actions.

Why are people reluctant to seek psychological help?

Despite the effort of NOUN in providing support services, preliminary investigation has revealed that seeking psychological help is the least patronised support service by most staff and students. Mitchell, Greenwood, & Guglielmi, (2007) opine that, support services sought by staff and student are mostly educational and vocational in nature even when they need to seek counselling or psychological help more than other services, The underutilization of socio-psychological help is often related to stigma (Jorm et al., 2007; Gulliver et al., 2010); reluctance to disclose a diagnosis (Hinson and Swanson, 1993) and anticipated costs (Vogel and Wester, 2003). Picco, Abdin, Chong, Pang et.al (2016); Gulliver et al., (2010); Chong et al., (2012b); Wilson and Deane, (2012). Thompson et al., (2004); Sareen et al.,( 2007) explain that attitudinal barriers such as choosing to handle the problem on one's own and thinking the problem will go away factors militate against psychological help-seeking attitudes have been found to vary by gender. Citing Kelly & Achter, 1995; Mackenzie, Gekoski, & Knox, 2006; Morgan, Ness, & Robinson, 2003; Yoo, Goh, & Yoon, 2005; Ægisdóttir & Gerstein, 2009), Picco et.al (2016) opine that, women typically express more positive attitudes toward psychological help-seeking than men. From the above aforementioned discussion, counsellor’s pivotal roles (in terms of expertise and building therapeutic relationship) in students’ expectations of successful counselling outcomes were considered to be the most influential factors in this research.

Objectives of the Study

The main objective of this research is to determine the most influential counselling expectancy among these three expectancies: counsellor’s expertise, students’ personal commitment and counsellor’s ability to forge therapeutic relationship on students’ desires seek psychological help. One other research objectives were to address the question of whether or not expected counsellor’s expertise, students’ personal commitment and counsellor’s ability to forge therapeutic relationship have significant influences on NOUN students’ desires to seek psychological help.

Statement of Research Problem

In NOUN counsellors are well trained professionally and are expert in counselling psychology. Also they have ability to help students and staff in overcoming their psychological problems. But paradoxically counsellors in NOUN are grossly inadequate in number compare to students’ enrolment population of 476,047 and active population of 103,383 students with 78 study centres scattered all over the country population (2018 edition of NOUN at a glance a publication from the VC’s office). Counsellors in NOUN perform more of administrative duties rather than counselling. Facilities and equipment for counselling are grossly inadequate and in some study centres, completely non-available These factors mentioned above, are most likely to negatively influence the students counselling expectations in NOUN. Despite the effort of the University in providing robust support services, preliminary investigations revealed that, most staff and students rarely sought counselling or psychological help but mostly sought guidance services such information, and advice on educational and vocational issues. This behaviour could be attributed to not only having hope and faith in the expectations of counselling outcomes but also having inadequate knowledge of benefits derivable from successful counselling and negative counselling expectations. The research therefore investigated the influence of expected students’ personal commitment to the counselling process, counsellor’s attitudes that enhance the therapeutic relationship, and expected counsellor’s expertise and empathy on the students’ psychological help-seeking behaviour in NOUN.

Research Design

A descriptive Ex post facto research design was used for this research

The main research question:

Do NOUN students’ counselling expectations influence their psychological help seeking behaviour?

Sub-research Questions

  1. Do NOUN students’ personal commitments expectations to counselling process significantly influence their psychological help seeking behaviour?
  2. Does expectation of counsellor’ expertise significantly influence students’ psychological help seeking behaviour?
  3. Do expected counsellor’s attitudes towards building therapeutic relationship for counselling significantly influence students’ psychological help seeking behaviour?

Null Hypotheses

Ho 1 There was no significant relationship between expected counsellor’s expertise and students’ personal commitments in seeking psychological help among students in NOUN.

Ho 2 There was no significant relationship between expected counsellor’s expertise and expected counsellor’s attitudes towards building facilitative therapeutic relationship in seeking psychological help among students in NOUN.

Ho3 There was no significant difference between students’ personal commitments expectations and expected counsellor’s aattitudes towards building facilitative therapeutic relationship in seeking psychological help among students in NOUN

Research Population and Sample

The research population consisted of all the 350, 000 students of the National Open University of Nigeria. Six hundred (600) students were selected from six study centres from the six geopolitical zones of Nigeria as samples for the study. One hundred (100) students were selected randomly from each centre: Lagos study, Port Harcourt Centre, Enugu Centre, Makurdi Centre and Maiduguri Centre

Research Instrument

The instrument for the study was the Expectations about Counselling- Brief Form (EAB-B). The scale was first developed in 1980 as a 153-item questionnaire to measure students’ expectations of counselling. Tinsley, Brown and Ray (1988) later developed a brief version of the questionnaire, the EAB-B as a shorter alternative to the original Expectations about counselling. The survey contains 52 items which measures expected counsellor’s expertise (9 items) students’ personal commitments (22items) and counsellor’s attitudes in building facilitative therapeutic relationship (21 items) towards Seeking Professional Psychological Help Scale- Abbreviated version, and the Expectations about Counselling- Brief Form. These versions which were adapted for this study have reliability index of 0.88. This instrument measures expectations in three areas (a) Personal Commitment, (b) counsellor’s attitude towards building facilitative therapeutic relationship and (c) Counsellor Expertise, created by Hatchett and Han (2006) cited by. Nyavanga and Barasa (2016),

  1. Client’s Personal Commitment factor (Client expected roles and responsibility in counselling): This factor is made up of twenty-two (22) items subdivided into seven (7) subscales
  2. The Counsellors attitudes towards facilitative therapeutic relationship factor made up of twenty-one (21) items consisting seven (7) sub-scales).
  3. The Counsellor’s Expertise factor (attributes of a counsellor) made up of 9 items consisting seven (7) sub-scales

According to Hatchett, and Han, (2006); Aegisdottir, Gersteni, and Gridley (2000] as cited by Nyavanga and Barasa (2016), although some studies have used the four-factor model of the EAC-BF, some research has suggested that a three-factor model might provide a better description of the factor structure of the EAC-BF. This study used the three main factors scale

Eight hundred copies of the questionnaires were sent to the student counsellors of selected study centres between the months of October and December 2018 through mails. At the study centres the copies of the questionnaires were administered by research assistants who were the student counsellors. Six hundred and twenty copies were returned and six hundred were properly and correctly filled.

Data Analysis

Data obtained from respondents were analysed using mean standard deviation and regression analysis. The results are presented in the tables below:

DESCRIPTIVE VARIABLES= PERSONAL COMMITMENT, FACILITATIVE CONDITIONS AND COUNSELORS’ EXPERTISE/STATISTICS=MEAN AND STD DEV .

Descriptive

Numbers of sample = 600 students

  1. Personal Commitment factor made up of twenty-two (22) items
  2. The Counsellor’s attitude towards building facilitative therapeutic relationship factor made up of twenty-one (21) items
  3. The Counsellor’s Expertise factor made up of 9 items
Table 1

Descriptive statistics
Counselling Expectations N Minimum Maximum Mean Std. Deviation percentage
per 22 1201.00 2686.00 1888.9545 540.90220 44.98%
fac 21 1335.00 2888.00 1981.8571 517.12168 47.19%
cou 9 2212.00 2841.00 2522.7778 254.27042 60.07%
Valid N (listwise) 9          

Research Question

Table 1: The descriptive statistic result above shows that, mean score of students in personal commitments was 1888.95 which translated 44.98% of the total scores in that area whiles the mean score of students in Counsellor’s attitude towards building facilitative therapeutic relationship factor was 1981.86 which translated to 47.19% in the area. The students mean score in counsellor’s expertise was 2522.778 which translated to 60.07%. Counsellor’s expertise factor is the most significant influenced factor in students’ counselling expectations. This is so because the counsellor’s expertise plays a pivotal role in the clients’ counselling expectations and process

Table 2

Paired Samples Test
Counselling Expectations Paired Differences      
Mean Std. Deviation t df Sig. (2-tailed)
Pair 1 per - cou -620.22222 691.97612 230.65871 -2.6898 .028
Pair 2 fac - cou -539.22222 639.75499 213.25166 -2.5298 .035
Pair 3 per - fac -129.28571 89.07926 19.43869 -6.65120 .000

The Alpha level of significance was set at @ .05 (P< .05)

Comparison of the three variables

Pair 1: Per/cou = P < value level of significance was .028

Pair 2: Fac/cou == = P < value level of significance was .035

Pair 2: per/fac == = P < value level of significance was .000

Key: “Per” means Client personal commitments variable

“Cou” means counsellor’s expertise

“fac” means facilitative therapeutic relationship

P-value is less than 0.05, all the above null hypotheses are rejected

Research Findings

  1. Finding above on tables 2: (a): shows that, the obtained p-value of .028 is less than 0.05, thereby rejecting the null hypothesis, indicating a significant difference between expected counsellor’s expertise and students’ personal commitments to the counselling process, in seeking psychological help among students in NOUN.
  2. Finding above on table 2: (b) shows that the obtained p-value of .035 is less than 0.05, thereby rejecting the null hypothesis indicating a significant difference between expected counsellor’s expertise factor and counsellor attitude toward building facilitative therapeutic relationship factor in seeking psychological help among students in NOUN
  3. Finding above on table 2 (c): shows that, the obtained p-value of .000 is less than 0.05, thereby rejecting the null hypothesis indicating a significant difference between expected counsellor’s attitude towards building therapeutic relationship factor and students’ personal commitments factor in seeking psychological help among students in NOUN.

Conclusion

In conclusion therefore, the finding of this research indicated that, NOUN students considered counsellor’s expertise as the most influential expectancy in their anticipation for seeking psychological help. For NOUN students to consider seeking psychological help, they expected that the counsellor must be well-trained competent professionals counselling psychologists who would be able to build therapeutic relationship and ability to provide the needed help. Other influential factors include; NOUN students’ personal commitments such as their hope, faith and belief in anticipated positive counselling outcomes which served in motivating them towards seeking psychological In building more confidence in students the need to seek psychological help, NOUN needs to employ more professionally qualified and competent counselling psychologists in all its study centres across the country. NOUN also as matter of urgency, should provide conducive counselling offices properly equipped with necessary facilities that will motivate both students and staff to seek psychological help

References

American Psychological Association (APA) (2019) 750 First St NE Washington DC.

American Psychiatric Association Diagnostic Manuel (2019) the DSM-J.

Ægisdóttir, S., O’Heron, M. P., Hartong, J. M., Haynes, S.A., & Linville, M. K. (2011). Enhancing attitudes and reducing fears about mental health counselling: An analogue study. Journal of Mental Health Counselling 33 (4), 327-346.http://dx.doi.org/10.17744/mehc.33.4.a5673mh711w3g441.

Baysden, M. (2002). International and United States citizen student adaptation to college, opinions about mental illness, and attitudes toward seeking professional help. Dissertation Abstracts International Section A: Humanities and Social Sciences,64(2-A).

Blagen, M. T., & Yang, J. R. (2008, March). Courage and hope as factors for client change: Important cultural implications and spiritual considerations. Based on a program presented at the ACA Annual Conference & Exhibition, Honolulu, HI. Retrieved June 27, 2008, from http://counselingoutfitters.com/vistas/vistas08/Blagen.htm.

Broggard, B (May 2015) What is a psychological Disorder Psychology. One in four adults in the US is diagnosable with a psychological disorder. Post May 12, 2015 Psychology Today.

Brown, T. D. (2011). The relationships among counselling expectations, attitudes toward seeking psychological help, psychological distress, and intention to seek counselling (Doctor Dissertation, Ball State University.

Butcher, J. N., Mineka, S., & Hooley, J. M. (2007). Abnormal psychology (13th ed.). Boston, MA, Allyn & Bacon/Pearson Education.

Chong S. A., Abdin E., Vaingankar J. A., Kwok K. W., Subramaniam M. (2012b). Where do people with mental disorders in Singapore go to for help? Ann. Acad. Med. Singapore 41, 154–160.

Corsin R.J. & Wedding D (2014) Current Psychotherapies Brooks/Cole.

Ercan, L. E. (2010). An analysis of the relationship between attitudes towards seeking psychological help and problem solving among university students. Procedia-Social and Behavioral Sciences 2 (2), 1814-1819. http://dx.doi.org/10.1016/j.sbspro.2010.03.990.

Flansburg, T. (2012). Factors Involved in College Students’ Use of Counselling Services Master of Social Work Clinical Research Papers. Paper 23. Retrieved from http://sophia.stkate.edu/msw_papers/23.

Fischer E. H., Turner J. L. (1970). Orientations to seeking professional help: development and research utility of an attitudes scale. J. Couns. Clin. Psychol. 35, 79–90. 10.1037/h0029636.

Gulliver A1, Griffiths KM, Christensen H ( 2010 ) Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review, BMC Psychiatry. 2010 Dec 30;10:113. doi: 10.1186/1471-244X-10-113.

Hinson J. A., Swanson J. L. (1993). Willingness to seek help as a function of self-disclosure and problem severity. J. Couns. Dev. 71, 465–470. 10.1002/j.1556-6676.1993.tb02666.x [Cross Ref.

Jorm A. F., Wright A., Morgan A. J. (2007). Where to seek help for a mental disorder? National survey of the beliefs of Australian youth and their parents. Med. J. Aust. 187, 556–560.

Jorm, A. F., & Griffiths, K. M. (2006). Population promotion of informal self-help strategies for early intervention against depression and anxiety. Psychological Medicine, 36, 3–6.

Kelly, C. M., Jorm, A. F., & Wright, A. (2007). Improving mental health literacy as a strategy to facilitate early intervention for mental disorders. Medical Journal of Australia, 187(7), S26-S31.

Kim, B, S.K; Ng G F; Ahn A J (2005) Effects of Client Expectation for Counseling Success, Client-Counselor Worldview Match, and Client Adherence to Asian and European American Cultural Values on Counseling Process with Asian Americans. January 2005 Journal of Counseling Psychology 52(1) DOI: 10.1037/0022-0167.52.1.67.

Latalova, k Kamaradova & Peasko (Jul 2014) Perspectives on perceived stigma and self-sigma in adult male patients with depression. Neuropsychiatric Dis.Treat.10.1399405 doi 10. 2147/NDT.S54081. eCollection 2014.

Macdonald, CA (2016). How to achieve success with counselling. Health Psychology of San Diego Org Retrieved 18th March 2018.

Mackenzie, C.S Gekoski & Knox (December 2006) Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes Aging and Mental Health 10(6):574-82 DOI: 10.1080/13607860600641200.

Mitchell S, l; Greenwood G.K.& Guglielmi M.C (2011) Utilization of Counselling Services: Comparing International and U.S. College Students. First published: 23 December 2011https://doi.org/10.1002/j.2161-1882.2007.tb00012.x.

Morgan, T; Ness D.; Robinson, M. (2003) Students' Help-Seeking Behaviours by Gender, Racial Background, and Student Status. Canadian Journal of Counselling, v37 n2 p151-166 2003.

National Open University of Nigeria 2006) Getting to know your university Lagos Victoria Island.

Nyavanga E.J & Barasa M (2016), Attitudes towards Professional Psychological Help Seeking Among Young Adults in Kenya: Case Study of Public Teacher Training College. Psychology and Behavioral Sciences Volume 5, Issue 3, June 2016, Pages: 69-76.

Patterson, C.L Uhlin B & Anderson T (Oct, 2008) Clients' pretreatment counseling expectations as predictors of the working alliance Journal of Counselling Psychology 55 (4) 528-34 Doi: 10.1037/a0013289.

Picco. L, Abdin E, Chong S.A, Pang S, Shafie S Chua, B.Y, Vaingankar, J A, Ong, L.P, Tay, J & Subramaniam, M (2016) Attitudes Toward Seeking Professional Psychological Help: Factor Structure and Socio-Demographic Predictors Front Psychol. 2016; 7: 547. Published online 2016 Apr 25. doi: 10.3389/fpsyg.2016.00547.

Ponton L. (2018) Characteristic of effective counselling. Oct. 2018 Psych Central.

Rice, K., & Van Arsdale, A. (2010). Perfectionism, perceived stress, drinking to cope and alcohol-related problems among college students. Journal of Counseling Psychology, 57(4), 439-450.

Rickwood, Frank P Deane & Coralie J Wilson November 2007 When and how do young people seek professional help for mental health problems? The Medical journal of Australia 187(7 Suppl):S35-9.

Ryan, M.L Shochet I,M & Stalliman H (August, 2010) Universal online interventions might engage psychologically distressed university students who are unlikely to seek formal help. Advances in Mental Health 9(1):73-83 DOI: 10.5172/jamh.9.1.73.

Sareen J., Jagdeo A., Cox B. J., Clara I., ten Have M., Belik S., et al.. (2007). Perceived barriers to mental health service utilization in the United States, Ontario, and The Netherlands. Psychiatr. Serv. 58, 357–364. 10.1176/ps.2007.58.3.357.

Schreiber T, Stern P, N; Wilson, C (February 2000) Being Strong: How Black West‐Indian Canadian Women Manage Depression and Its Stigma. Journal of Nursing Scholarship 32(1):39-45 DOI:10.1111/j.1547-5069.2000.00039.x.

Stalliman H.M (2011) Psychological distress in university students: A comparison with general population data Austrian Psychologist First published: 29 March 2011 https://doi.org/10.1080/00050067.2010.48210.

Shochet, I. M., Holland, D., & Whitefield, K. (1997). Resourceful Adolescent Program: Group Leader’s Manual. Brisbane: Queensland University of Technology.

Thompson A., Hunt C., Issakidis C. (2004). Why wait? Reasons for delay and prompts to seek help for mental health problems in an Australian clinical sample. Social Psychiatry Psychiatr. Epidemiol. 39, 810–817. 10.1007/s00127-004-0816-7.

Vogel D. L., Wester S. R., Wei M., Boysen G. A. (2005). The role of outcome expectations and attitudes on decisions to seek professional help. J. Couns. Psychol. 52, 459–470. 10.1037/0022-0167.52.4.459.

Wedding D & Corsini R.J (March, 2013) Current Psychotherapies. Cengage Advantage Books. Brooks Code 20th edition.

Wilson C. J., Deane F. P. (2012). Brief Report: need for autonomy and other perceived barriers relating to adolescents' intentions to seek professional mental health care. Journal of. Adolescence. 35, 233–237. 10.1016/j.adolescence.2010.06.011.

Wilson, C. J., Deane, F. P., Ciarrochi, J., & Rickwood, D. (2005). Measuring help-seeking intentions: properties of the General Help-Seeking Questionnaire. Canadian Journal of Counselling, 39(1), 15–28.

Wittenburg, K.J & Norcross J (2001) Practitioner, perfection, relationship in aubiquity, tolerance and work satisfaction. Journal of Clinical Psychology37, 1543-1550.

Yoo S.K, Goh, M and Yoon E (2005) Psychological and Cultural Influences on Koreans' Help-Seeking Attitudes. Journal of Mental Health Counselling: July 2005, Vol. 27, No. 3, pp. 266-281. https://doi.org/10.17744/mehc.27.3.9kh5v6rec36egxlv.