Preferences regarding therapists’ history of personal therapy or suicidal ideation: A comparison of undergraduates and mental healthcare providers.

Abstract

A majority of mental health care providers seek personal therapy (i.e., are prosumers), and many providers experience suicidal ideation. Although mental health care providers may have more awareness of mental health than undergraduates, stigma is prevalent across both mental health care professionals and within universities. Furthermore, suicidality is a particularly stigmatized aspect of mental health. Stigma may affect a client’s willingness to work with therapists who are prosumers. Although client preferences have implications for treatment engagement, retention, and outcomes (Swift & Callahan, 2009, 2010; Swift, Callahan, & Vollmer, 2011), we are unaware of any research that considers clients’ preferences regarding a prosumer therapist. The current study used a delay discounting paradigm to compare undergraduates’ and mental health care providers’ preferences of a prosumer therapist (i.e., with or without prior treatment history or prior suicidal ideation). We hypothesized that mental health care providers would be more accepting of a prosumer therapist, compared to undergraduates. Across both samples we expected a therapist with prior personal therapy to be more preferred than a therapist who has experienced prior suicidal ideation. Results were as expected, which may indicate a greater degree of mental health stigma among undergraduates compared to the mental health profession and greater stigma toward suicide in comparison to therapy experience in general.

Preferences for a potential therapist’s suicide lived experience and use of therapy.

“…The scarce research available on this topic has indicated that both providers and clients generally have positive reactions to the use of personal therapy (Elkins et al, 2017; Orlinsky et al, 2011); however, preferences differ depending on the reason for seeking treatment and the specific type of lived experience (Elkins et al, 2017). The present study serves as a replication and extension of prior work (particularly Bulla et al, 2022) and examines potential client preferences for a therapist who has sought personal therapy, experienced suicidal ideation, or made a suicide attempt in a sample of community members.…”

“…Despite these limitations, the present study has several unique strengths including the use of a delay discounting paradigm to assess treatment preferences and the unique consideration of participants’ experiences with suicidal thoughts and behaviors. The study was designed as a replication and extension of previous work elucidating lesser preferences for providers with a history of suicidal ideation (Bulla et al, 2022). Consistently, our findings demonstrate that a nontreatment seeking community sample reported a lesser preference for providers who had a history of suicidal ideation and attempts.…”

“…Bulla et al’s (2022) delay discounting task was adapted from Swift and Callahan (2010). It involved two series of questions regarding a provider with a history of personal therapy and suicidal ideation.…”

“…Consistent with Elkins et al (2017), participants with negative attitudes toward help-seeking are expected to sacrifice more efficacy in all paradigms and, as such, have a lesser preference for a therapist who has a history of personal therapy, suicidal ideation, or suicide attempts. The literature regarding the influence of stigma on views of providers’ usage of personal therapy is mixed (e.g., Bulla et al, 2022; Elkins et al, 2017). However, given the overall impact of stigma on views of treatment (Corrigan, 2004), we hypothesize that social and self-stigma will impact preferences for all of the therapist characteristics, such that participants with greater levels of stigma will demonstrate lesser preference (i.e., more sacrificed efficacy) across the paradigms.…”

“…In fact, we are aware of only one study that considered whether views of a therapist with a history of suicidal thoughts may differ from views of a provider who has sought therapy for personal reasons. Bulla et al (2022) aimed to expand upon the previously reviewed literature by investigating preferences for therapists rather than focusing on attitudes or perceptions in general.…”