Between a rock and a hard place : a qualitative investigation of the experience of accessing counselling

Abstract

Clients’ experiences in attempting to access counselling help have rarely been studied. As such, a full and clear understanding of clients’ experiences with accessing services, as well as identification of the barriers encountered by clients and clients’ ideas about what would make accessing more comfortable, have eluded researchers. Typically, the research focus has been quantitative investigations of the no-show phenomenon, whereby clients fail to arrive at pre-booked counselling appointments. Such studies have left 24% of the variance in the unexplained "other" category. More recently, researchers have begun to question whether or not mental health stigma impacts counselling attendance. The present study sought to describe the experience of individuals who self identified as having booked a counselling appointment within the previous 8-months and then had failed to attend. A basic interpretive qualitative research design (Merriam, 2002) was employed for the purpose of describing and understanding this phenomenon, with special emphasis given to identifying possible barriers to accessing counselling. Interviews with four middle class Caucasian adults aged 27-33; two of whom had accessed counselling previously and two of whom had not, were conducted. Transcripts were analyzed in terms of a shared meaning and descriptive categories (Kearney, 2001). Findings revealed that stigma, self-stigma, several fears, and some counselling practices functioned as barriers. However, participants also expressed positive emotions associated with reaching out and accessing counselling help and a desire for information about what to expect in counselling, whether they had accessed previously or not. The beginnings of a pattern associated with accessing counselling are discussed and implications for counselling practice and future research are described.