Professional Psychology: Research and Practice Copyright 2005 by the American Psychological Association

2005, Vol. 36, No. 3, 323–329 0735-7028/05/$12.00 DOI: 10.1037/0735-7028.36.3.323

Predictors of Psychological Help Seeking in Clinical and Counseling

Psychology Graduate Students

Ronda L. Dearing James E. Maddux and June Price Tangney

University at Buffalo, State University of New York George Mason University

Psychologists are often called upon to provide supervision, mentorship, and training to graduate student
therapists-in-training. In these roles, psychologists may influence whether graduate students enter
personal therapy during their training. This study investigated variables (including perceived faculty
attitudes about students in personal therapy) that predict psychotherapy help seeking in clinical and
counseling psychology graduate students (N ⫽ 262). The findings indicated that confidentiality issues,
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This document is copyrighted by the American Psychological Association or one of its allied publishers.

general attitudes about therapy, and perceptions of the importance of personal therapy for professional
development were important predictors of graduate student help seeking. The implications for faculty,
supervisors, and mentors of therapists-in-training are discussed.

Keywords: help seeking, therapists-in-training, personal psychotherapy, self-care, graduate training

Mental health professionals are not immune from life’s every-
day difficulties. In addition, working with distressed people is
a complex and demanding task that can take its toll on the ser-
vice provider. Thus, psychotherapy can help mental health pro-
fessionals and trainees deal with distress and develop as psycho-
therapists. Because a high percentage of psychotherapists and
psychotherapists-in-training engage in personal therapy, it is im-
portant to gain a better understanding of how and why these
individuals decide to seek or not to seek personal psychotherapy.
Past research has seldom focused on trainees’ attitudes about
seeking personal therapy, and few studies have investigated the
RONDA L. DEARING received her PhD in clinical psychology from George
Mason University in 2001. She is a research scientist at the Research
Institute on Addictions, University at Buffalo, State University of New
York. Her research interests include help seeking for alcohol problems,
treatment engagement and outcome, and issues related to shame and guilt.
JAMES E. MADDUX received his PhD in clinical psychology from the
University of Alabama in 1982. He is professor and director of clinical
training in the Department of Psychology at George Mason University. He
is also the editor of the Journal of Social and Clinical Psychology. His
major area of research and clinical interest is the interface of social and
clinical/counseling psychology.
JUNE PRICE TANGNEY received her PhD in 1985 from the University of
California, Los Angeles. She is professor of psychology at George Mason
University and a fellow of the American Psychological Association. Her
research on the development and implications of moral emotions across the
life span is summarized in Tangney and Dearing (2002). She is currently
examining the implications of moral emotions and cognitions in a longi-
tudinal study of incarcerated offenders, drawing on principles of restorative
justice and criminology to learn how to better facilitate desistence and
rehabilitation.
THIS ARTICLE IS BASED ON the dissertation of Ronda L. Dearing. We thank
Patricia Wanschura, Cheryl Bartholomew, and the research participants for
their contributions to the study.
CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Ronda
L. Dearing, Research Institute on Addictions, 1021 Main Street, Buffalo,
NY 14203. E-mail: rdearing@ria.buffalo.edu
323
effects of mentoring relationships on students’ help-seeking be-
havior. Because these issues have seldom been explored, the
current study focuses on the help-seeking attitudes and behaviors
of psychotherapists-in-training.
Most of the available research on help-seeking behavior has
focused on more seasoned mental health professionals rather than
on therapists-in-training. When possible, we have included back-
ground information specific to psychotherapist trainees; however,
we have included related information regarding more experienced
therapists as a means of providing a more comprehensive review
of the relevant literature. Research specific to practicing therapists
provides the closest comparison for exploring help-seeking issues
pertaining to trainees, and many of the findings are likely to be
applicable to trainees, who will soon join the ranks of established
clinicians.
Psychotherapists report high levels of distress in a variety of
areas, including depression, drinking problems, relationship diffi-
culties (Deutsch, 1985; Thoreson, Miller, & Krauskopf, 1989), and
feelings of loneliness and isolation (Mahoney, 1997; Thoreson et
al., 1989). In addition to experiencing the pressures associated with
providing mental health services to others, psychotherapy trainees
frequently have other stressors, including juggling multiple roles
(e.g., student, wage earner, parent, spouse), often in an unfamiliar
geographic location away from one’s primary social support net-
work. The high levels of personal distress experienced by mental
health professionals and psychotherapy trainees may result in a
decreased ability to provide optimum care to clients (Guy, Stark, &
Poelstra, 1988).
Consistent with research that demonstrates the efficacy of psy-
chotherapy in the general population (“Mental Health,” 1995;
Smith & Glass, 1977), the vast majority of experienced therapists
and therapists-in-training attest to the value of psychotherapy for
helping to alleviate personal distress (Henry, Sims, & Spray, 1971;
Kaslow & Friedman, 1984; Mackey & Mackey, 1993; Williams,
Coyle, & Lyons, 1999). As an added benefit, personal therapy can
be a means of gaining insight into being an effective therapist
(Bruss & Kopala, 1993; Kaslow & Friedman, 1984). For these
 324 DEARING, MADDUX, AND TANGNEY
reasons, mental health professionals may seek psychological ser-
vices during their training or after. In fact, 57% (Norman &
Rosvall, 1994) to 75% (Holzman, Searight, & Hughes, 1996) of
mental health professionals and trainees engage in psychotherapy
at some time during their careers.
Previous research has demonstrated that favorable attitudes to-
ward psychotherapy are positively associated with voluntary help
seeking (Deane & Todd, 1996; Fischer & Cohen, 1972; Tijhuis,
Peters, & Foets, 1990). For example, Fischer and Farina (1995)
reported a correlation coefficient of .39 ( p ⬍ .01) between positive
help-seeking attitude and reported history of help-seeking behav-
ior. For the purpose of the current study, attitude about therapy
refers to a collection of beliefs about therapy and the evaluative
component of these beliefs. These beliefs include whether the
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individual sees therapy as potentially beneficial and whether the
individual views personal psychotherapy as an option for himself
or herself.
Help seeking in the general public is often studied in terms of
systemic and individual obstacles to entering treatment. Some
researchers have found that individuals who do not enter treatment
are more likely to express concerns about potential obstacles to
therapy than are individuals who do seek help (Kushner & Sher,
1989; Pipes, Schwarz, & Crouch, 1985). Drawing on previous
models of access to care and the fit between potential clients and
the health care delivery system (e.g., Aday & Andersen, 1974;
Penchansky & Thomas, 1981), Stefl and Prosperi (1985) investi-
gated the relative importance of four key “barriers” to help seek-
ing: availability (knowledge about available services), accessibility
(transportation concerns), acceptability (concerns about what oth-
ers would think), and affordability (cost-related concerns). Afford-
ability was rated as being the most likely to affect decisions to seek
mental health services, followed by availability, accessibility, and
acceptability, in that order (Stefl & Prosperi, 1985). Also, individ-
uals who were identified as needing services (as measured by
symptom/dysfunction scales) and those who used services viewed
the barriers as more of a concern than did individuals who neither
needed nor used services. Furthermore, the magnitude of perceived
barriers increased with greater level of need.
Consistent with affordability barriers to therapy seen in the
general population, 41.3% of practicing doctoral-level therapists
indicated that they were concerned about the expense associated
with personal therapy (Mahoney, 1997). Although many perceived
obstacles are similar to those seen in the lay public, some may be
unique or more pronounced for helping professionals, such as
concerns about confidentiality (Fay & Lazarus, 1984; Norman &
Rosvall, 1994). Deutsch (1985) found that psychotherapists’ most
common reason for not entering therapy was a scarcity of available
service providers with whom the therapist was not personally or
professionally acquainted. Further, some psychotherapists did not
seek help because of “fear of exposure, concerns about confiden-
tiality, [and] fear of professional censure” (Deutsch, p. 310).
Additionally, there may be unique considerations about entering
psychotherapy that are specific to student therapists-in-training.
The intensity of graduate training in clinical and counseling psy-
chology results in a socialization process whereby attitudes held by
faculty members and supervisors are likely to influence attitudes of
graduate-level therapists-in-training. One issue on which graduate
students are likely to look to mentors for guidance is the impor-
tance of personal therapy during graduate school and beyond. For
example, one study of counseling psychology graduate students
revealed that trainees would be more likely to engage in personal
therapy if they believed that it was viewed as valuable by their
professors (Farber, 1999).
Issues of confidentiality concerning program faculty may be of
particular concern to therapists-in-training. For example, Holzman
and colleagues (1996) commented that “in an academic setting,
students may fear that receiving treatment could raise questions
among faculty and peers about their emotional stability and ap-
propriateness for the profession” (p. 98; see also Wampler &
Strupp, 1976). Similarly, Beck (1976) reported that despite prom-
ises of confidentiality by university counseling center therapists,
students may still have concerns about a link between the coun-
seling center and the graduate department. There is also the po-
tential concern that being a client at a university counseling center
may hinder future training opportunities at that site.
The aim of the current study was to learn more about the
help-seeking attitudes and behaviors of psychotherapists-in-
training, as well as to investigate predictors of psychotherapy help
seeking for these individuals. Further, specific goals of the study
included gaining a better understanding of the relationship be-
tween help-seeking attitude and help-seeking behavior and explor-
ing the potential association between perceived faculty attitudes
about students in therapy and students’ help-seeking behavior. We
hypothesized that favorable attitudes toward seeking personal ther-
apy would be positively related to participation in personal psy-
chotherapy during graduate school. In addition, we predicted that
higher ratings of potential obstacles to therapy would be associated
with not having sought help during graduate school. Finally, we
predicted that students would be less likely to have participated in
therapy if they perceived that faculty viewed students’ entering
therapy as a sign of weakness.
Graduate Student Help-Seeking Study
Study materials were sent to a random sample of 959 psychol-
ogy graduate student members of the American Psychological
Association (APA). A follow-up postcard was sent to all partici-
pants one month after the initial mailing. Three hundred forty-two
participants returned the questionnaire. Selection criteria for mail-
ing labels from the APA membership was for clinically affiliated
APA graduate student members; however, on the basis of inquiries
to the investigator (n ⫽ 25) and returned questionnaires from
students in other disciplines (n ⫽ 40), there was apparently a
problem with the selection criteria of the APA mailing list. Thus
the response rate (35.7%) is difficult to interpret because it was
likely substantially affected by the problems with the mailing list.
Studies aimed toward a similar population have had somewhat
higher response rates (50%, Holzman et al., 1996; 46%, McEwan
& Duncan, 1993).
Surveys from graduate students in disciplines other than clinical
or counseling psychology were excluded (n ⫽ 40), as were surveys
from individuals who began their current episode of psychotherapy
before graduate school and who continued with the same therapist
during graduate school (n ⫽ 40), because the primary aim of this
study was to investigate help-seeking behavior that was initiated
during graduate school. After these exclusion criteria were applied,
262 student surveys remained.
 GRADUATE STUDENT HELP SEEKING
Participants completed a five-page questionnaire, which in-
cluded demographic variables (age, gender, and graduate program
information), personal experiences with therapy, attitudes toward
seeking personal therapy, potential obstacles to therapy, and per-
ceived faculty attitudes about students in therapy.
Participant Characteristics
The majority of participants were women (76.7%), which is
consistent with the gender breakdown of first-year psychology
graduate students (70%; Pate, 2001a) and students applying for
doctoral internships (72%; Pate, 2001b). Participants’ ages ranged
from 22 to 62 years, with a mean age of 33.1 (SD ⫽ 9.2). The
students represented all years of graduate training; the majority
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(77.1%) were in the second through sixth year of training. Twenty
participants (7.6%) had completed graduate training within one
year prior to having completed the survey; these students were
coded as being in Year 6 of training for all analyses. Most students
were seeking either a PhD (48.5%) or a PsyD (26.7%), and most
of the remaining students were working toward a master’s degree.
Clinical psychology students represented the largest group
(62.2%), followed by counseling psychology (28.2%) and “other”
(9.5%; primarily combined clinical/counseling or clinical/commu-
nity). Most students were enrolled in APA-accredited programs
(72.9%), and participants represented a variety of graduate pro-
gram training orientations. Specifically, students identified their
clinical orientation as psychodynamic or psychoanalytic (17.3%),
cognitive– behavioral (29.1%), eclectic (38.6%), or other (15.0%).
The majority (70.2%) of all students had been in therapy at some
time prior to or during graduate school. Forty-seven percent of
participants had engaged in therapy during graduate school. This
number may be more accurately depicted by including the 40
students who had been omitted from other analyses because they
had continued with the same therapist they had seen before grad-
uate school. When these respondents were included (N ⫽ 302),
54.3% of students were in therapy during graduate school. For
students who had participated in therapy (not including the stu-
dents who continued in therapy that had begun before graduate
school), the mean number of therapy hours during graduate school
was 61.54 (SD ⫽ 83.16); total therapy hours ranged from 1 to 456.
Individuals who were further along in their graduate program were
somewhat more likely to have sought personal therapy during
graduate school (r ⫽ .15, p ⬍ .05).
Potential Obstacles to Therapy
Students were asked to rate 11 potential concerns in terms of
how much each item was a consideration in his or her decision to
enter (or not enter) personal therapy. We created these items to
represent empirically based obstacles to psychotherapy generally
(e.g., availability, accessibility, acceptability, and affordability), as
well as concerns that have been reported in the literature as being
pertinent to therapists (confidentiality and dual relationship con-
cerns) and therapists-in-training (concerns about faculty reaction,
concerns about therapy interfering with school obligations). The
possible scores ranged from 1 (not at all important) to 5 (extremely
important). Across all participants, only three potential obstacles
had mean scores above a 3 (i.e., moderately important). Cost came
up as the highest ranking factor (M ⫽ 3.74, SD ⫽ 1.36), followed
325
by time (M ⫽ 3.28, SD ⫽ 1.35) and confidentiality (M ⫽ 3.06,
SD ⫽ 1.59). All other concerns (dual relationships, what one
would learn about oneself, not knowing what services were avail-
able, what others might think, encountering peers, faculty reaction,
therapy interfering with school, and transportation) had mean
scores below a score of 2 (i.e., a little important). Because of the
relative lack of importance placed on the other potential obstacles,
only cost, time, and confidentiality were used in subsequent
analyses.
Individual Help-Seeking Attitudes
General attitudes about seeking personal therapy were measured
with the 10-item short version of the Attitudes Toward Seeking
Professional Psychological Help (ATSPPH; Fischer & Farina,
1995; Fischer & Turner, 1970). The questionnaire measures atti-
tudes toward seeking personal therapy in terms of an overall belief
in the value of psychotherapy for help with personal problems and
receptivity to the idea of seeking therapy. A representative item is
“If I were experiencing a serious emotional crisis at this point in
my life, I would be confident that I could find relief in psycho-
therapy.” Items were rated on a 5-point scale, ranging from 1
(disagree) to 5 (agree). Student attitudes toward seeking personal
therapy were generally very favorable (M ⫽ 4.21, SD ⫽ 0.51).
Internal consistency reliability (␣) for the ATSPPH in the current
study was .75. In addition to being asked about their general
attitude toward seeking personal therapy, students were asked the
extent to which they disagreed (1) or agreed (5) with the statement,
“Personal psychotherapy is a necessary and integral part of the
training of a mental health professional.” Students tended to en-
dorse the necessity of therapy to training (M ⫽ 3.71, SD ⫽ 1.22).
Perceived Faculty Attitude Toward Students in Therapy
Students were asked their perception of how their graduate
program faculty members view therapy for graduate students,
ranging from 1 (an admission of weakness) to 5 (a growth expe-
rience). Students generally perceived faculty attitudes about stu-
dents in personal psychotherapy as being mildly positive, with the
mean score falling about midway between neutral and a growth
experience (M ⫽ 3.88, SD ⫽ 0.96). However, 31.3% of students
indicated that they perceived faculty attitudes about students in
therapy as neutral, and 6.1% rated faculty attitudes about students
in therapy as below neutral.
Relations Between Students’ Attitudes About Seeking
Personal Therapy and Students’ Help Seeking
Descriptive data and bivariate correlations for all variables un-
der investigation are presented in Table 1. As predicted, there was
a positive relationship between favorable attitude toward seeking
personal therapy (as measured by the ATSPPH) and participation
in personal therapy during graduate school. There was also a
positive relationship between students’ endorsement of therapy as
an integral part of training and participation in therapy during
graduate school. Number of therapy hours was not used as the
measure of help-seeking behavior primarily because the number of
hours in therapy was thought to be more a function of therapist
orientation and how long the student had been in graduate school
 326 DEARING, MADDUX, AND TANGNEY
Table 1
Descriptive Data and Intercorrelations for Variables Used in Regression Equation
Variable M SD
a
1. Therapy during graduate school 0.47 0.50 —
2. Year in program 3.79 1.73 .15*
3. Therapy necessary and integral to training 3.71 1.22 .44**
4. Attitude toward personal therapyb 4.21 0.51 .32**
5. Concerns about cost 3.74 1.36 .26**
6. Concerns about time 3.28 1.35 ⫺.04
7. Concerns about confidentiality 3.06 1.59 .49**
8. Perceived faculty view 3.88 0.96 .19**
Note. ATSPPH ⫽ Attitudes Toward Seeking Professional Psychological Help.
a
0 ⫽ no, 1 ⫽ yes. b As measured by the ATSPPH.
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* p ⬍ .05. ** p ⬍ .01.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
than a function of favorable orientation toward help seeking. In
fact, attitude toward seeking personal therapy (as measured by the
ATSPPH) was not significantly related to personal psychotherapy
hours during graduate school (r ⫽ .06, p ⬎ .05).
Relations Between Potential Obstacles (Cost, Time, and
Confidentiality) and Students’ Help Seeking
As shown in Table 1, students’ ratings of cost and confidenti-
ality as important factors in their decisions to enter therapy dem-
onstrated significant positive relations with help seeking. Concern
about time as a factor was not significantly related to help seeking
and was therefore not used in subsequent analyses. The relations of
cost and confidentiality to help seeking were in the direction
opposite to the hypothesized relationship; namely, students who
rated cost and confidentiality as more of a concern in relation to
their decision to enter therapy were more likely to seek help. We
speculated that perhaps individuals who enter therapy may be
forced to give more consideration to potential obstacles. For ex-
ample, confidentiality issues may become more salient once an
individual is faced with revealing intimate details of his or her life
to a therapist.
In order to test this speculation, we analyzed whether non-help-
seeking students’ perception of a need for therapy was related to
their ratings of the importance of cost and confidentiality. Students
who indicated a perceived need for therapy (but did not seek
therapy) reported greater concerns about cost (r ⫽ .39, p ⬍ .01)
and confidentiality (r ⫽ .31, p ⬍ .01) than did students who neither
needed nor entered therapy. Similarly, we found a significant
positive relationship between the degree to which non-help-
seekers had considered entering personal therapy and their con-
cerns about cost (r ⫽ .31, p ⬍ .01) and confidentiality (r ⫽ .19,
p ⬍ .05). These outcomes are consistent with Stefl and Prosperi’s
(1985) findings—namely, that individuals who needed services
and those who used services were more likely to endorse concerns
about barriers than were individuals who neither needed nor used
services (and thus who had perhaps given little consideration to
these potential obstacles).
Relations Between Perceived Faculty Attitude About
Students in Therapy and Students’ Help Seeking
As predicted, there was a significant positive correlation be-
tween perceptions of a favorable faculty view of students in
1 2 3 4 5 6 7 8
—
⫺.06 —
.02 .33** —
.04 .21** .08 —
⫺.05 .06 .02 .29** —
.03 .23** .14* .31** .08 —
⫺.12 .28** .21** .15* .01 .02 —
therapy and student help seeking during graduate school (r ⫽ .19,
p ⬍ .01). Perception of a favorable faculty attitude about students
in therapy was also related to positive student attitudes toward
personal therapy and to the belief that therapy is integral to
training. A test of mediation revealed that the relation between
faculty attitudes and student help seeking was partially mediated
by student attitudes, indicating that perceived faculty attitudes
about therapy affected student help seeking, both directly and
indirectly via their influence on student attitudes.
Additional Analyses
To determine the degree to which we could “predict” whether
students did or did not seek help during graduate school on the
basis of the variables measured, we conducted a logistic regression
that simultaneously tested year in program (as a control), students’
belief that therapy is integral to training, students’ attitude toward
seeking personal therapy (as measured by the ATSPPH), cost
concerns, confidentiality concerns, and perceived faculty attitude
about students in therapy. Results of this logistic regression anal-
ysis are presented in Table 2. An odds ratio indicates the magni-
tude of increased likelihood of an individual’s seeking help that
would correspond to a 1-unit increase in the predictor variable with
all other variables held constant. So, for example, when the vari-
ables belief in the professional benefits of therapy, attitude, cost,
confidentiality, and perceived faculty view were held constant, a
student in Year 2 of training was 1.44 times more likely to have
sought help than a student in Year 1. Similarly, if all other
variables were held constant, a 1-point increase on the 5-point
attitude scale would coincide with a 4.10 times greater likelihood
of having sought help. The independent variables predicted 57.0%
of the variance in help seeking on the basis of the Nagelkerke
estimate of R2 (Nagelkerke, 1991). Students’ belief that therapy is
integral to training, students’ attitude toward seeking personal
therapy, and confidentiality concerns were each significantly re-
lated to entering therapy during graduate school. Perceived faculty
attitude approached significance as a predictor, and cost concerns
did not add appreciably to the prediction of help seeking. Interac-
tion terms were tested for each attitude measure (i.e., attitude
toward seeking personal therapy and belief that therapy is integral
to training) with year in program; no interaction effects were
demonstrated.
 GRADUATE STUDENT HELP SEEKING
Table 2
Logistic Regression Predicting Graduate School Help Seeking
Variable B SE B
Year in program (control) 0.36
Therapy necessary to training 0.75
Attitude toward seeking personal therapya 1.41
Concerns about cost 0.16
Concerns about confidentiality 0.80
Perceived faculty view 0.36
Note. ATSPPH ⫽ Attitudes Toward Seeking Professional Psychological Help.
a
As measured by the ATSPPH. b N ⫽ 244.
† p ⫽ .07. ** p ⬍ .01.
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Limitations
The primary limitations of the study are the cross-sectional
design and the retrospective reporting of help-seeking behavior.
Our findings are consistent with those of previous research, which
has established that positive attitudes are a strong predictor of
entering therapy (e.g., Kahn & Williams, 2003). However, it is
also possible that participation in therapy results in more positive
attitudes toward therapy. Because attitude was measured subse-
quent to help seeking, it is impossible to disentangle the degree to
which positive attitudes resulted from rather than led to help
seeking. Further, it is unclear the degree to which attitude change
was a result of positive experiences in therapy rather than of
cognitive dissonance, given the considerable time and energy
necessary for participation in therapy. We believe that although
attitude change resulting from positive therapy experiences and
cognitive dissonance may account for some portion of the positive
attitudes held by help seekers, the attitudes of help seekers (com-
pared with the attitudes of those who did not seek help) are likely
to have been more positive prior to the help-seeking event. Pro-
spective research that investigates attitudes before and after ther-
apy would help one discern the degree to which attitude predicts
help seeking, compared with the degree to which attitude change
is attributable to participation in therapy.
Implications
APA ethical guidelines (APA, 2002) require that psychologists
“take appropriate measures” when personal problems threaten to
interfere with competent work performance. In addition, the term
therapist “self-care” is being used with increasing frequency, plac-
ing emphasis on prevention of distress and impairment (e.g.,
Baker, 2003; Gilroy, Carroll, & Murra, 2002). Finding healthy
ways to cope with emotional stress and distress during training can
set the stage for effective coping and self-care during the course of
an individual’s career. The findings of the current study emphasize
how students’ perceptions of faculty attitudes about students in
therapy may affect students’ own attitudes about seeking personal
therapy, which in turn may influence students’ help-seeking be-
havior. These findings and the findings of other studies (e.g., Bruss
& Kopala, 1993; Farber, 1999) suggest that students are more
likely to seek personal therapy when faculty convey more favor-
able and supportive attitudes about students in therapy. It is likely
that other mentors (e.g., clinical supervisors) have a similar influ-
327
Wald ␹2
Odds ratio statisticb
.11 1.44 11.33**
.17 2.12 18.36**
.44 4.10 10.03**
.15 1.18 1.24
.13 2.23 37.32**
.20 1.44 3.38†
ence on student attitudes and behavior. Thus, clinical faculty,
supervisors, and mentors have an important responsibility to edu-
cate trainees regarding appropriate pathways to self-care and pre-
vention of impairment. This is not meant to imply that students
should necessarily enter therapy during graduate school. However,
it is important that opportunities to enter therapy are made avail-
able to students, that information is conveyed to students about the
potential benefits of therapy, and that students are encouraged to
enter therapy if they believe that it would be beneficial.
The potential professional benefit of personal therapy emerged
as a central factor related to help-seeking behavior. Thus, although
the importance of student self-care cannot be overstated, profes-
sional benefit as a likely motivator for students entering therapy is
an important area for future study. Kaslow and Friedman (1984)
provided an interesting qualitative study of this issue from the
perspective of graduate students and the therapists who treat them.
Although training programs with certain clinical orientations (e.g.,
psychoanalytic) have traditionally emphasized therapy for their
students as an adjuvant to training, other orientations (e.g.,
cognitive– behavioral) have been less inclined to do so. Given the
potential benefits of personal therapy for professional growth
(Bruss & Kopala, 1993; Kaslow & Friedman, 1984), program
faculty, regardless of orientation, should give consideration to the
possibility of therapy as an instructional opportunity for trainees.
These findings highlight the importance of self-awareness and
self-monitoring on the part of faculty and supervisors regarding
their perceptions of help seeking. To facilitate this awareness,
psychologists should evaluate and gain a clear understanding of
their own attitudes toward therapy. For example, they should
consider their reactions to the following questions: Is therapy
likely to benefit the “average” student or only those experiencing
emotional distress? Is therapy intended primarily for individuals
with mental disorders? Is therapy a potential avenue for dealing
with the stresses and strains associated with being a mental health
professional? Are there professional benefits to be gained by
engaging in personal therapy? After gaining an understanding of
one’s own views regarding these issues, psychologists should
consider the extent to which they are willing to share their own
personal beliefs and experiences concerning personal therapy with
trainees. In particular, psychologists who are involved in training
should be careful not to convey stigmatizing attitudes about stu-
dents’ participation in personal therapy.
 328 DEARING, MADDUX, AND TANGNEY
Training program faculty should work together to establish
messages that will be conveyed by the department as a whole
regarding personal therapy. The issue of student therapy could be
an item for discussion on the agenda of a clinical or counseling
psychology department faculty meeting. Issues for discussion
might include the following: Does the program have a formal
policy regarding whether personal therapy is recommended to
students? In training programs where student therapy is recom-
mended or required, do faculty members discuss the rationale for
this recommendation with students? Are referral sources for stu-
dents readily available? Is there any formalized discussion with
trainees (i.e., in the context of course work or supervision) of the
potential benefits of personal psychotherapy? Are ethical issues
related to therapist impairment discussed as part of general training
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in ethics? Are there specific safeguards in place regarding main-
taining the confidentiality of students in therapy? Do formal pol-
icies exist regarding dealing with students who are obviously
experiencing distress?
Although students who are experiencing difficulties may partic-
ularly benefit from psychotherapy, this is a difficult group to target
because of confidentiality and boundary issues. Thus, strategies
that include all students would likely be more feasible. Because
cost was strongly endorsed by most students (regardless of help-
seeking status) as a consideration to entering therapy, training
departments might consider potential means of making cost less of
an obstacle for students who are interested in personal therapy. For
example, schools in metropolitan areas with multiple clinical and
counseling graduate programs could consider developing a coop-
erative agreement between local counseling centers whereby stu-
dents could be seen by therapists not affiliated with their own
university. This would allow for increased confidentiality and
would retain the advantage of low-cost, high-quality services for
students. Graduate programs could also recruit alumni of their
program to provide low-cost or pro bono services to students and
could provide all current students with a list of such referrals.
University counseling centers, in particular those that train stu-
dent therapists, should also consider having policies specific to
psychology graduate students who are seen as clients. For exam-
ple, one counseling center at an East Coast public university does
not allow therapists-in-training to provide therapy services to other
graduate students (regardless of department), and staff do not
discuss clients who are psychology graduate students in case
conference meetings (J. Moosman, personal communication, Sep-
tember 22, 2003). Other strategies might include keeping student
files in a location not accessible to trainees and discussing with
student therapists the importance of confidentiality, in particular
with regard to other trainees.
Graduate students also should take stock of their own attitudes
and beliefs regarding personal therapy. When making decisions
about what graduate program to attend, students may want to
consider whether therapy is a requirement of the program and to
take into account any financial considerations related to personal
therapy (e.g., whether the program has any means of offsetting the
costs of therapy). Students should consider the potential personal
and professional benefits to be gained from engaging in the pro-
cess of therapy and should be aware of the importance of self-care
to minimize the effects of stress. Students may want to initiate
discussions of the potential benefits of personal therapy in the
context of related courses or in their clinical supervision. This
would allow them to benefit from the experiences of other stu-
dents, as well as from the knowledge of faculty and supervisors.
Overall, we think that the findings of the current study empha-
size the importance of psychologists developing increased aware-
ness regarding an array of concerns related to student therapy. We
encourage clinical faculty and others who work with graduate
student trainees to understand their own beliefs about therapy and
to develop standardized solutions to address trainees’ therapy-
related issues. In addition, we recommend any strategies that will
facilitate the process of students entering personal therapy when
they are interested in doing so. All of the suggestions presented
should serve to increase the likelihood that therapists-in-training
will develop healthy and enduring self-care habits to manage the
stress inherent to being mental health care providers.
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Received October 22, 2002
Revision received July 29, 2004
Accepted November 15, 2004 䡲