Help-Seeking Attitudes Among Israeli Adolescents - Statistical Data Included

Adolescence, Summer, 2001 by Orya Tishby, Miriam Turel, Omer Gumpel, Uri Pinus, Shlomit Ben Lavy, Miriam Winokour, Semi Sznajderman

ABSTRACT

This study investigated the willingness of Israeli adolescents to seek help for emotional and health problems, and their preference for various helping agents. Nearly fifteen hundred students in grades 7-12 participated in a comprehensive survey of attitudes, health status, and concerns, and the data were analyzed. Gender and age were identified as factors associated with help-seeking attitudes. Females reported a higher level of distress and greater willingness to seek help than did males. Younger adolescents tended to state that they would turn to parents for help, whereas older adolescents increasingly preferred peers. In general, the adolescents preferred to seek help from family and peers for emotional and social problems, rather than turning to professionals. Adolescents in grades 9-10 reported the highest level of distress and were least willing to seek help for interpersonal problems and depressed mood. Overall, level of distress was not directly related to willingness to seek help. In subgroups of de pressed and suicidal adolescents, an inverse relationship was found between willingness to seek help and levels of depression and suicidal ideation. Recommendations for health care services and counseling programs are discussed.

During the past decade, mental health professionals have increased their interest in studying the physical and emotional well-being of adolescents. Contrary to traditional belief, that adolescence is a period of "storm and stress" (Blos, 1962; Freud, 1958), current research shows that most adolescents do not experience severe turmoil. Nevertheless, the transition from childhood to adulthood entails dramatic developmental changes which impact both adolescents' health and their well-being (Offer et al., 1991).

Recent studies have focused on the needs of the nonclinical adolescent population, in an attempt to define the "normative" stresses in this age group. Larson and Lampman-Petraitis (1989) found an increase in negative affect during adolescence, and suggested that this may be caused by the numerous life changes experienced at this age. Larson and Ham (1993) concluded that adolescence is associated with an increased sensitivity to environmental stressors such as conflict, resulting in higher levels of distress.

There may be cross-cultural differences in adolecents' well-being. Harel et al. (1997) found that Israeli adolescents had higher levels of stress and depressed mood compared with adolescents in 23 countries in Europe and North America. In addition, a higher percentage of the Israeli sample reported physical symptoms.

Several studies have investigated adolescents' willingness to seek help and their actual use of health services for various problems. Although the literature on help seeking is sparse, some consistent findings have emerged. Most studies show that adolescents rarely seek professional help (Millstein & Litt, 1994; Offer et al., 1991; SeiffgeKrenke, 1989; Whitaker et al., 1990), instead preferring informal helping agents such as family or friends (Dunbow et al., 1990; Feldman et al., 1986; Offer et al., 1991). When they do turn to professionals for help, adolescents prefer medical personnel to mental health practitioners, for both physical and emotional problems.

Factors that have been found to be related to help seeking include a high motivation for psychotherapy, a belief in its efficacy (SeiffgeKrenke, 1989), and guaranteed confidentiality (Riggs & Cheng, 1988). Saunders et al. (1994) found that gender was the only demographic variable differentiating students who did and did not perceive themselves as needing help. Females were more likely than males to identify a need for help. Obtaining help was associated with informal help-seeking behavior, socioeconomic status (SES), parental marital status, and having a checkup within the previous year.

Contrary to expectation, help seeking does not seem to be directly related to levels of subjective distress (Keellam et al., 1981). In fact, depressed/suicidal adolescents may be those least likely to obtain help (Saunders et al., 1994). Erlich (1992) claimed that there is no direct relationship between the severity of adolescents' psychopathology or the degree of pain that they experience and their willingness to seek help. Rather, adolescents' developmental phase and their available ego strength determine their willingness to seek help.

Nadler (1991) has presented a model of help seeking that can be used to understand adolescents' behavior. In this model, the process of help seeking is described as an interaction between the characteristics of the person seeking help (self-image, achievement motivation, shyness, self-awareness, and locus of control) and the type of help sought and the identity of the helper. The act of seeking help is an instrumental, target-oriented behavior, like other coping behaviors. However, it entails psychological "costs," such as feeling dependent, inferior, and that one's self-esteem is threatened. The final decision as to whether or not to seek help is a function of all these factors (Nadler, 1991). In adolescence--when conflicts regarding dependence and self-esteem are central--the costs of help seeking may be too high.