Realizing our commitment to diversity through outreach and research Counseling and Psychological Services Indiana University Bloomington
Outline • The history of the diversity outreach program • What we have developed and learned • Practice and research synthesis: • Diversity research project
The Indiana University Counseling and Psychological Services (CaPS) Diversity Outreach Program • In August 2008 CAPS launched the Diversity Outreach Team, with the goal of assessing and addressing the needs of under-represented students. • Relies on a multidimensional approach to address barriers to minority student service utilization, including: • Proactive outreach and service in collaboration with the campus community • Practice-oriented research, including needs assessment • Systemic interventions
Why the diversity outreach program was initiated • CaPS staff noticed underrepresentation of minority students amongst clientele • What statistics showed:
Barriers to Seeking Counseling Help • Minoritycollege students tend to avoid formal mental health treatment, such as university counseling centers. • In general, only 1 in 3 African Americans who need mental health care receive it, and furthermore are more likely to stop treatment early Why might this be? (American Psychiatric Association; 2010)
Cultural Attitudes • Stigma or shame • Negative attitudes towards mental disorders as a sign of: • Weakness • Being “crazy’ • Double disempowerment • Cultural values emphasizing family and social relationships over mental health counseling • Religious and family values/beliefs • e.g. preferring to go to family or minister with problems • Resilience: as social and religious support serves as a buffer against mental disorders within communities of color • (Constatine, Wilton, Caldwell, 2003)
Barriers to Seeking Mental Health Treatment in communities of color • Access to Care: insurance, transportation, cost, culturally competent care • Cost of therapy is often seen as a barrier (For IU students, services are available at CaPS at low cost) • Distrust of formal healthcare systems • Myths about Counseling • Fear of experiencing institutionalized racism as part of the counseling process • Distrust towards mental health professionals who tend to be predominantly white • (Constatine, Wilton, Caldwell, 2003)
Common College Student Stressors • “traditional problems” • death of a parent • dating violence • Breaking up with boyfriend/girlfriend • Academic difficulties • Family issues/conflict/ responsibilities • (Fukuyama, 2001)
Unique Stressors and Attitudes • Racism and Cultural Adaptation • Acculturative stress • racial/ethnic identity struggles, including within-group identity struggles • Racism and microaggressions • classism isolation • First generation ethnic minority students • Pressure from family, financial stress, identity struggle • (Fukuyama, 2001)
A Response to these Issues:The Development of The CaPS Diversity Outreach Team
development of the program • Year 1 (2008-2009) • One practicum student, Peiwei Li • One staff psychologist supervisor, Paul Toth • Established foundation of the program, began networking • Year 2 (2009-2010) • Two practicum students and one pre-doctoral intern; Alison Schwing, Ian Arthur, & Julia Arany • Predoctoral Internship Diversity Rotation established • Further expanded programming • Year 3 (2010-2011) • Two practicum students and one pre-doctoral intern: Amanda Voils-Levenda, Whitney Stewart & Alison Schwing • Formalized relationships, focus on outreach Dr. Paul Toth Julia Arany Alison Schwing Ian Arthur Whitney Stewart
Video Project • Multicultural focus groups • For use on IU CAPS website, multicultural offices and various outreach settings • Address: • Psychological wellness • Ways counseling can be helpful • Counseling and ethnic minority students • Myths surrounding mental health and counseling • CaPS for Everyone VIDEO
What have we learned? • Attitude • Team approach • Multi-level collaborations • Maintenance and continuity of efforts; formalization of relationships • Proactive stance towards outreach • Documentation, archiving • Iterative process, some things work better than others • Assessment • Practice-research dialectics
Campus wide survey • Ethnic minority students’ attitudes towards mental health counseling and their psychological needs • Exploratory and descriptive in nature • research questions: • What are the attitudes among ethnic minority students at IU towards mental health counseling? • What are ethnic minority students’ perceptions of CAPS? • What are the prominent stressors and psychological needs of ethnic minority students at IU? • Research purpose: • To better facilitate the development and implementation of effective programming to bridge the gap in service delivery.
Survey design • Sampling • Convenient sample • Limited generalizability • Online survey • 16 demographic Qs • 31 Likert or Likert-type Qs • 6 open-ended Qs
Measurements • Attitudes Toward Seeking Professional Psychological Help: Short Form (ATSPPH-SF) • 10 items • 0-4 Likert scale • Modified by Fischer & Farina (1995) from Fischer and Turner’s (1970) original 29-item measure. • Reported Cronbach alpha = 0.84; • Reported one month test-retest reliability = 0.80
Measurements • College Stress Inventory (CSI) • 21 items • 0-4 Likert-type scale • Applied to Hispanic college students (Solberg et al., 1993) • Three factors: Academic stress, social stress, and financial stress • Reliability on internal consistency: • 0.72 (academic stress subscale) • 0.83 (social stress subscale)
Variables • Independent variables/predictors • Seeking services at CAPS • Gender • Race/Ethnicity • Class standing • International student • Dependent variables • Attitude: Average score of ATSPPH-SF items • College stress (academic, social and financial): Average score of CSI items
Open-ended questions 1. What comes into your mind when you think about “counseling” or “mental health counseling”? 2. What are some of your major resources that help you when you feel stressed or overwhelmed? 3. Have you heard about IU CAPS? If so, what is your impression about it? If yes, provide your answer here:_________________ 4. How likely do you think you may seek services at CAPS when you experience emotional distress? Please explain your answer. 5. If you have been to CAPS, how would you describe your experiences there? 6. What suggestions do you have for CAPS to make their services more available to racial/ethnic minority students like you and your friends?
Results: Descriptives • 380 surveys collected 336 fully completed • “Prefer not to answer” responses coded as system missing data • Completion rate 88.4% • Attitude measure: 362 cases • College Stress Inventory: 336 cases
Participant demographics • Age • Gender • International student • Race and ethnicity • Class standing • Received services at IU CAPS
Age • Range: 17-47 years old • Mean: 25.8 years old • Std.Dev: 5.8 years old • -1SD ~ + 1SD : 20-32 years old
Gender (202) (144)
International student (106) (240)
Race and ethnicity (173) (74) (38) (28) (20) (13)
Class standing (227) (119)
Received services at IU CaPS (277) (69)
Analysis • Quantitative data • Descriptives • Reliability of measurements • Analysis of variance • Two-way ANOVA • Exploratory factor analysis • Quantitative data • Content analysis • Coding and themes
Results: Measurement reliability • Attitudes measure (ATSPPH-SF) • Internal consistency: Cronbach alpha = 0.79 • College stress measure (CSI) • Internal consistency: Cronbach alpha = 0.92
Results: Attitude measureAttitude by Race/Ethnicity Diff not sig.
Results: interactions Two-way ANOVA: Race/Ethnicity by Gender Gender: P=.033 Gender*Race: not sig
Attitude: Service by Ethnicity/Race Interaction CaPS service: P=.004 Service*Race: not sig
Attitude: Class standing by Ethnicity/Race Interaction Class: P=.007 Class*Race: P=.053
Attitude: Int’ student by gender interaction * Interaction was not sig.
Attitude: Int’ student by CaPS service interaction * Interaction was not sig.
Attitude: Int’ student by Class standing interaction Int’* Class interaction: P=.039
Academic stress by Race/Ethnicity * Difference not sig.
Social stress * Difference not sig.
Financial stress * Difference sig., p< 0.001
Academic stress: Gender by CaPS service Both gender and CaPS service sig.
Academic stress: Int’l & class standing Class standing: P=.038
Financial stress • Difference between int’ and non-int’ significant. • p= 0.001 • Difference between graduate and undergraduate significant. • P=0.045