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Attitudes towards seeking professional counseling: The role of outcome expectations and emotional openness in English-speaking Caribbean college students in the United States and the Caribbean

Dissertation
Author: Wendy-Lou Leslie Greenidge
Abstract:
Purpose . The college environment is documented as a universally stressful period where students face many challenges (Baysden, 2002; Pandit, 2003). In addition to these potential stressors, international students face other unique challenges such as loss of support network, feelings of isolation, economic hardship, coping with oftentimes competing cultures, and anxiety which emanates from unfamiliarity (Kim & Omizo, 2003; Rounds & Kline, 2005). Unsuccessful resolution of these challenges can negatively impact the acculturation process, their mental health, and their academic programs (Roysircar, 2002). Despite these many challenges, research consistently shows that international students are less likely than their US counterparts to seek professional counseling (Bayer, 2002). Further, those who do seek counseling services are also more likely to terminate services prematurely (Anderson & Myer, 1985). Although there is an abundance of research on the attitudes towards seeking professional counseling of Asian and other international student populations (Kim & Omizo, 2003; Lau & Takeuchi, 2001; Leong & Lau, 2001; Liao, Rounds & Kline, 2005; Pandit, 2003), there is a dearth of knowledge on Caribbean college students. This dissertation sought to determine which factors influence the attitudes towards seeking professional counseling of English-speaking Caribbean college students in the U.S., as well as those attending colleges in the Caribbean. Method . Two research questions and five null hypotheses were used to examine what influences the attitudes towards seeking professional counseling of 500 Caribbean college students. The variables of interest were stigma tolerance, level of social support, level of acculturation, outcome expectations and level of emotional openness. Stigma Tolerance was measured using the Stigma Scale for Receiving Psychological Help (SSRPH), Outcome Expectations were measured using the Disclosure Expectations Scale, Emotional Openness was measured using the Distress Disclosure Index and Social Support using the Multidimensional Scale of Perceived Social Support. Attitudes towards seeking professional counseling were measured using the Attitudes towards seeking Psychological Help instrument by Fischer and Turner (1970) and acculturation was measured using responses from the demographic questionnaire. Several analyses were conducted including a stepwise regression analysis, multiple regression analysis, a MANOVA, ANOVA and a linear regression analysis. Major findings . The results of this study indicated that stigma tolerance and anticipated risks of seeking counseling both have a significant inverse relationship with the attitudes towards seeking professional counseling of English-speaking Caribbean college students. Results also indicated that anticipated utility of seeking professional counseling has a significant relationship with the attitudes towards seeking professional counseling. The level of emotional openness as well as the level of social support also have a direct relationship with the attitudes towards seeking professional counseling of English-speaking Caribbean college students. Students who reside and attend college in the Caribbean reported higher mean scores for anticipated risk, anticipated utility and attitudes towards seeking professional counseling than their counterparts who reside and attend college in the U.S. Results also indicated that length of stay in the U.S. was not a statistically significant predictor of one's attitudes towards seeking professional counseling.

TABLE OF CONTENTS LIST OF FIGURES .....................................................................................................................xiii LIST OF TABLES .......................................................................................................................xiv LIST OF ACRONYMS ................................................................................................................xv CHAPTER ONE INTRODUCTION ............................................................................................1 Purpose of Study .........................................................................................................................3 Social Significance of the Study .................................................................................................4 Statement of the Problem ............................................................................................................5 Conceptual Framework ...............................................................................................................9 Rationale ...................................................................................................................................12 Research Questions and Hypotheses ........................................................................................14 Research Question One and Hypotheses ..............................................................................14 Research Question Two and Hypotheses ..............................................................................15 Definition of Terms ...................................................................................................................15 Limitations ................................................................................................................................16 CHAPTER TWO LITERATURE REVIEW ...............................................................................18 Theoretical Framework .............................................................................................................19 The English-Speaking Caribbean .............................................................................................22 Caribbean College Students and Challenges They Face ...........................................................24 Attitudes towards Seeking Professional Counseling ................................................................25 Factors which Influence One’s Attitude towards Seeking Professional Counseling ................27 Emotional Openness .............................................................................................................28 Stigma ...................................................................................................................................32 Social Support .......................................................................................................................34 Outcome Expectations ..............................................................................................................37 Anticipated Risks & Anticipated Utility ...............................................................................38 Fear of Embarrassment .........................................................................................................39 Other Sources of Treatment Fearfulness ...................................................................................40 Acculturation .............................................................................................................................40 Attitudes towards Seeking Professional Counseling among African Americans .....................43 Attitudes towards Seeking Counseling in International Students .............................................47 Help-Seeking Attitudes and Behaviors of Caribbeans ..............................................................54 Summary of the Literature ........................................................................................................59 CHAPTER THREE METHODOLOGY .....................................................................................61 Research Questions and Hypotheses ........................................................................................61 Research Question One and Hypotheses ..............................................................................61 Research Question Two and Hypotheses ..............................................................................62 Population .................................................................................................................................63 Participants ................................................................................................................................63 Procedures .................................................................................................................................66 Instrumentation .........................................................................................................................68 Demographic Questionnaire .................................................................................................68 Attitude towards Seeking Professional Psychological Help (ATSPPH) ..............................68 Stigma Scale for Receiving Psychological Help (SSRPH) ...................................................71 x

Disclosure Expectations Scale (DES) ...................................................................................71 Distress Disclosure Index (DDI) ...........................................................................................72 Multidimensional Scale of Perceived Social Support (MSPSS) ...........................................73 Variables ...................................................................................................................................73 Independent Variables ..........................................................................................................74 Dependent Variable ..............................................................................................................74 Research Design ........................................................................................................................75 Research Question One and Hypotheses ..............................................................................75 Research Question Two and Hypotheses ..............................................................................76 Conclusion ................................................................................................................................77 CHAPTER FOUR RESULTS .....................................................................................................78 Research Questions and Hypotheses ........................................................................................78 Preliminary Analysis .................................................................................................................80 Results of Data Analysis ...........................................................................................................81 Testing for Hypothesis One ......................................................................................................82 Results of the Study ..............................................................................................................83 Testing for Hypothesis Two ......................................................................................................85 Results of the Study ..............................................................................................................85 Testing for Hypothesis Three ....................................................................................................86 Results of the Study ..............................................................................................................87 Testing for Hypothesis Four .....................................................................................................90 Results of the Study ..............................................................................................................91 Testing for Hypothesis Five ......................................................................................................92 Results of the Study ..............................................................................................................93 Conclusion ................................................................................................................................94 CHAPTER FIVE DISCUSSION .................................................................................................96 Research Questions & Hypotheses ...........................................................................................97 Discussion Summary of Results for the Hypotheses ................................................................99 Summary of Findings ..............................................................................................................109 Implications for Clinical Practice ...........................................................................................109 College Campuses ...............................................................................................................109 Professional Development ..................................................................................................112 Programming and Outreach ................................................................................................114 Other Clinical Issues ...............................................................................................................118 The Greenidge Model for Conceptualizing West Indian Clients ............................................122 Implications for Professional School Counselors ...............................................................125 Implications for Counselor Educators ....................................................................................127 Theoretical Implications .........................................................................................................129 Study Limitations ....................................................................................................................131 Implications for Future Research ............................................................................................132 Conclusion ..............................................................................................................................133 APPENDIX A: INSTITUTIONAL REVIEW BOARD APPROVAL .......................................137 APPENDIX C: INFORMED CONSENT ...................................................................................142 APPENDIX D: INSTRUMENTS ...............................................................................................145 APPENDIX E: BIOGRAPHICAL SKETCH .............................................................................154 xi

REFERENCES ...........................................................................................................................164

xii

LIST OF FIGURES Figure 1: Wong's Postulated Component Model ..........................................................................11 Figure 2: The Greenidge Model for Conceptualizing West Indian Students ..............................125

xiii

LIST OF TABLES Table 1: Frequencies of Key Demographic Variables ..................................................................65 Table 2: Pearson Correlation Coefficients among Variables of Interest ......................................81 Table 3: Means and Standard Deviations among Variables of Interest ........................................82 Table 4: The Overall Relationship between Outcome Expectations and Attitudes ......................83 Table 5: Relationship among Variables for Outcome Expectations .............................................84 Table 6: Overall Model for Emotional Openness and Attitudes ...................................................86 Table 7: Correlation between Emotional Openness and Attitudes ...............................................86 Table 8: Relationship between Residence and Dependent Variables ...........................................88 Table 9: Tests of Between-Subjects of Dependent and Independent Variables ...........................88 Table 10: Descriptive Statistics of Mean Scores of Dependent Variables by Residence .............90 Table 11: Levene's Tests of Equality ............................................................................................91 Table 12: Descriptive Statistics of Attitudes towards Seeking Professional Counseling .............92 Table 13: Relationship between Length of Stay in the U.S. and Attitudes ..................................94

xiv

LIST OF ACRONYMS ATSPCH Attitudes towards Seeking Professional Counseling Help

EO Emotional Openness

GM-CWC The Greenidge Model for Conceptualizing West Indian Students

OE Outcome Expectations

UWI The University of the West Indies xv

CHAPTER ONE INTRODUCTION The need for counseling services among college students is well documented in the counseling literature (Baysden, 2002; Davis, 1995; Pandit, 2003). For many students, this period represents the first major transition and adjustment in familiar support and resources (Baysden, 2002). Coupled with novel decisions and challenges, this period also epitomizes a time of identity exploration (Marcia, 1980), transition into more adult roles and responsibilities (Levinson, 1978) and more concrete career choice and development (Super, 1957). International students are not immune to these challenges. Research reveals that many experience even greater challenges as they must simultaneously learn to cope with and adjust to differing and often competing cultures, feelings of isolation, economic hardship, anxiety which emanates from unfamiliarity, and a loss of family support and social networks (Baker & Siryk, 1986; Bradley, Parr, Lan, Bingi & Gould, 1995). Adaptation to these changes usually occurs within a relatively short time and the stress involved in this process is often further aggravated by the usual demands of college life (Baysden, 2002). Although these may impact students differently, unsuccessful resolution of these challenges slows down the acculturation process, which may subsequently negatively impact one’s academic achievement and academic self- concept (Lafromboise, Coleman & Gerton, 1993; Marsh, 1990; Roysircar, 2002). Though international students may be in great need of professional counseling to help deal with these stressors, research contends that they are less likely to seek professional counseling and more apt to visit the medical health center to treat the associated somatic symptoms (Baysden, 2002). Even when they do seek counseling, the primary reasons are educational and vocational in nature (Leong & Sedlacek, 1985) and they remain more likely to 1

secede than their U.S. counterparts (Anderson & Myer, 1985). Many suggest that this incongruence between need and use may be largely due to the incompatibility between the nature of Western psychotherapy and minority cultures (Atkinson, Morten & Sue, 1988; Sheu & Sedlacek, 2002; Sue & Sue, 1999). The counseling needs of international populations in the U.S. have been widely researched and remind us that there are differences in the attitudes and utilization patterns of mental health services among ethnic groups (Sue, Zane & Young, 1994). However, to date much of the literature centers on the Asian population (Kim & Omizo, 2003; Lau & Takeuchi, 2001; Leong & Lau, 2001; Liao, Rounds & Kline, 2005; Pandit, 2003), and a few on South African populations ( Peltzer, Nzewi & Mohan, 2004; Van Shorr & Whittaker, 1988 ). The U.S. Census Bureau (2001) estimates that about 8.4 million Caribbeans currently reside in the U.S (USCIS, 2003). Although migration to the United States for academic pursuits is not a new phenomenon, many of these students, like other international students, face challenges, which if not effectively resolved, may result in psychological problems, academic failures or eventual withdrawal from their programs of study (Gopaul-McNicol, 1993). Some of the common problems endured by West Indians who have migrated away from home include depression, socio-cultural issues, financial hardship, culture shock, familial problems, cultural gaps and acculturation stressors, major academic and social adjustment issues, long-distance relationships and racial and ethnic discrimination (Carr, Koyama & Thiagarajan, 2003; Mitchell, 2005). Researchers also postulate that Caribbeans find it more difficult than other groups to assimilate into the American culture (Pessar, 1995; Stepick, 1998). Despite these findings, there exists only minuscule emphasis on the mental health needs, attitudes and behaviors of 2

Caribbeans. The research which does exist mainly focuses on schizophrenic and other mentally ill patients primarily in the United Kingdom (Keating & Robertson, 2004), substance abuse (Day, Devieux, Reid et al., 2004), depression (Ali & Toner, 2001; Edge & Rogers, 2005) and other risk behaviors (Ohene, Ireland & Blum, 2005). Unfortunately, there is an overwhelming gap in the existing literature on identifying those factors which influence the attitude towards seeking professional counseling of Caribbean populations. This chapter presents a synopsis of the challenges which international students and in particular, Caribbean college students experience as they pursue academic studies away from their countries of citizenship. More specifically the factors which influence one’s attitude towards seeking professional counseling will be briefly discussed. The purpose of this study, social significance, and statement of the problem will also be outlined. Finally, research questions, definition of terms, and limitations will be proffered. Purpose of Study The purpose of this study is to reveal core factors which influence the attitude of English- speaking Caribbean college students towards seeking professional counseling. This study will provide results which will help eliminate the gap in the research about Caribbean college students and their behaviors and attitudes toward seeking professional counseling. To date, no grand theory exists to help with the understanding of the attitudes of Caribbean college students toward professional counseling. This study, therefore, also seeks to motivate researchers to assist in developing a grand theory and conceptual framework by which to understand the counseling needs of Caribbean college students. This study examines the following variables that research shows influences one’s attitude towards seeking professional counseling: the role of (1) emotional openness, (2) stigma 3

tolerance, (3) anticipated risk and anticipated utility of seeking professional counseling and (4) perceived social support of Caribbean college students. This study also has four main objectives: (1) to build on existing literature by determining what influences the counseling seeking attitudes of Caribbean college students, (2) to determine how core cultural variables impact this attitude, (3) to determine whether acculturation would mediate the relationship between emotional openness and attitudes towards seeking professional counseling and (4) to help inform counseling services and programs both on and off college campuses in the Caribbean and the U.S. Empirical and anecdotal research shows that although Caribbean islanders are viewed as being similar in cultural and behavioral traits by outsiders, there are inter-island differences and subcultures among these people (Murphy & Mahalingham, 2006; Thrasher & Anderson, 1988). Despite this, researchers suggest that “within the context of migration, West Indians view themselves as sharing some broad similarities and are not generally opposed to endorsing a monolithic West Indian identity” (Murphy & Mahalingham, 2006, p. 120). There are enough commonalities in their cultures and experiences to address them as a whole (Foner, 2001). For the purpose of this study, the term West Indian and Caribbean will be used interchangeably and will be used to refer to the English-Speaking Caribbean. Caribbean college students also specifically refers to Black English-speaking Caribbean College students. Social Significance of the Study Although there is a profusion of research on the attitudes towards seeking counseling (Baysden, 2002; Fischer & Turner, 1970; Liao, Rounds, & Kline, 2005; Pandit, 2003; Van Shorr & Whittaker, 1988), Caribbeans, and more specifically, Caribbean college students remain neglected as a population of concern. Educators, counselors, and other professionals admit to 4

knowing very little about the Caribbean culture and even less about the historical, social, and culture peculiarities of the people and how these influence their mental health and counseling attitudes and behaviors (Thomas, 1992). Because of this dearth of knowledge, many often regard black Caribbeans and African Americans similarly and assume homogenous cultures and backgrounds (McKenzie, 1986; Waters, 2001). A review of the literature, on search engines such as PsychINFO, Academic Search Premier, PsychARTICLES and ERIC, reveals that while there exist approximately 25,934 articles about mental health counseling, less than twenty focus on Caribbeans. Further, there are approximately 21,163 journal articles which address attitudes towards seeking professional counseling and still, only about 14 of these focus on the Caribbean culture. Of those studies which have examined utilization of mental health services of Caribbeans (Venza, 2002), none have focused on the role of outcome expectations and emotional openness or even the differences between those who still reside in the Caribbean and those who have migrated to the U.S or other countries. Such information is imperative to help inform counseling programs both on and off college campuses in an effort to attract and increase retention of this population. Counselors are charged with the responsibility of becoming multiculturally competent in three areas: their attitudes, knowledge and behaviors (Arredondo & Arciniega, 2001; Sue & Arredondo, 1992; Thomas, 1992). In order to assist with the cultivation and sustenance of these competencies as they relate to Caribbeans, providing more extensive and current empirical research on the counseling needs, attitudes and behaviors of this population is pivotal. Statement of the Problem The Office of Immigration Statistics (2006) also reports that in 2003, 617,556 F-1 5

(Student) Visas were issued and admitted to the U.S, 613,221 in 2004 and 621,178 in 2005. Similarly, in 2003, 321, 660 J-1 (Exchange Visitors – students and scholars) Visas were issued and admitted to the U.S., 321,975 in 2004 and 342,742 in 2005. Florida has remained the host of the highest percentage of these immigrants for the past three years, with California and New York ranking second and third consecutively. The growing numbers of these international populations suggest a need to address the mental health needs of these migrants. In 2005, more than 22,000 Caribbean students migrated to the U.S to pursue academic studies (Office of Immigration Statistics, 2006), and this population continues to rise. Although there is a wealth of research on Latino and Asian populations, there is still a dearth of knowledge on the mental health needs and outcomes of Afro-Caribbean and West Indian populations (Murphy & Mahalingham, 2006; Thomas & Lindenthal, 1990). Additionally, a paucity of empirical research on the attitudes towards seeking professional counseling in the English-Speaking Caribbean islands exists. The West Indies is comprised of the Greater Antilles (Cuba, Jamaica, Haiti, Dominican Republic & Puerto Rico), Lesser Antilles (Leeward Islands, Windward Islands, Trinidad & Tobago & Barbados) and the Bahamas. Although the terms West Indies and the Caribbean are used interchangeably, the West Indies is the archipelago of islands between North and South America and the Caribbean represents the region where these islands are housed. “West Indians share a common history of British Colonialism, Creole culture and linguistic background” (Chierici, 2004, p57). Although West Indians and African Americans are phonotypically similar in that they were both forced away from their lands, racism and the dehumanizing which goes along with it are not evident in the West Indies. In the West Indian culture, where mental health still bears a negative stigma and emotional openness is discouraged, West Indian students are 6

more prone to greater emotional distress and are less adept at expressing their feelings than North Americans (Gopaul-McNicol, 1993). Research shows that the prevalence of HIV infection in the Caribbean, in 2002, was second only to sub-Saharan Africa (Day, Devieux, & Reid, 2004; UNAIDS/WHO, 2002). Substance use and abuse are increasing at an alarming rate (Day, Devieux & Reid, 2004) and psychological problems such as depression and anxiety (Ali & Toner, 2001; Halcon et al., 2003; Marwaha & Livingston, 2002) are also prevalent. Other factors such as increasing conduct and behavioral problems, particularly in schools (Dudley-Grant, 2001; Halcon et al., 2003) incest, sexual and physical abuse (Halcon et al., 2003), and the accompanying mental health symptoms are also very rampant on many of these islands but are often left untreated due to avoidance factors which are culturally based (Schreiber, Stern & Wilson, 2000) and ineffective counseling programs (Campbell, Cornish & Mclean, 2004; Watters, 1996). Longitudinal studies show that college is a universally stressful period which potentially leads to an increase in psychological distress (Baysden, 2002; Fisher & Hood, 1987). Other researchers contend that failure or difficulty adapting to these stressors can escalate into a period of crises (Kenny, 1990). Despite this, international students and college students from ethnic backgrounds underutilize mental health services and this contributes to an increase in substance abuse, suicide ideology, academic problems, somatic symptoms, decreased self-esteem, and interpersonal and familial problems (Lopez, Campbell, & Watkins, 1988; McClanahan & Holmbeck, 1992; Pinkey, 1992). Previous studies identified several factors that are deemed to be associated with one’s reluctance to seek professional counseling (Komiya, Good & Sherrod, 2000). Some of these factors are self-concealment or the tendency to conceal negative information about one’s self 7

(Kelly & Achter, 1995); reluctance to self-disclose (Hinson & Swanson, 1993), low interpersonal dependency (Bornstein, Krukonis, Manning, Mastrosimone & Rossner, 1993), religiosity, perceived social support and low stigma tolerance (Komiya, Good, & Sherrod, 2000; Stefl & Prosperi, 1985;). Other factors include low socio-economic status (Tessler & Schwarts, 1972); ethnic minority status (Narikiyo & Kameoka, 1992) and low educational level (Leaf et al., 1987). Fisher & Turner (1970) proposed that one’s attitude towards seeking professional psychological help directly influences his or her counseling-seeking behaviors. This raises significant concern for Caribbean college students as research shows that individuals who are more willing to seek professional counseling enjoy better adjustment and fewer emotional and behavioral problems (Fallon & Bowles, 2001; Watson, 2005). Fear of emotions is documented as a major predictor of one’s reluctance to seek professional counseling (Komiya, Good, & Sherrod, 2000; Vogel & Wester, 2003). Greenson (1987) contends that resistance in psychological treatment stems from the individual’s fear of experiencing painful emotions. These clients may not only become discomposed by external expression of emotions but likewise with the internal experiencing of strong emotions (Komiya, Good & Sherrod, 2000). Researchers affirm that this concept especially applies to cultures, such as the Asian culture, where emotional control is valued and expression of emotions is viewed as a negative personality trait (Kim, 1995; Narikiyo & Kameoka, 1992). Research suggests that anticipated utility, which is the belief that seeking help will reduce feelings of distress, (Vogel, Wester, Wei, & Boysen, 2005) influences one’s attitude towards seeking professional psychological help. Thus, attitudes predict an individual’s outcome expectations (Ajzen & Fishbein, 1980). For instance, if an individual believes that seeking help will result in more adaptive anger management, then he or she will have a more positive attitude 8

towards seeking help. Conversely, if an individual anticipates risk associated with seeking help, this may negatively influence him/her to do so (Schreiber, Stern & Wilson, 2000). For many individuals from cultures which devalue emotional openness, their perceived or anticipated risks of seeking professional counseling may appear worse than the actual problem itself (Fisher, Goff, Nadler, & Chinsky, 1988). These findings affirm that an individual’s belief in the efficacy of counseling is paramount to his/her decision to seek help or not (Strong & Clairborn, 1982). Although many West Indians are accepting of psychological difficulties, others remain more judgmental, even regarding these as character or moral flaws (Leong & Zachar, 1999). This stigma in receiving professional counseling serves as a major treatment deterrent (Komiya, Good, & Sherrod, 2000; Stefl & Prosperi, 1985). Additionally, West Indians generally maintain negative perceptions of those who have received mental health services and those psychosocial barriers (social stigma) often deflect individuals from professional counseling services (Dean & Chamberlain, 1994). Conceptual Framework This study was guided by and sought to expand the postulated component model put forward by Wong (1991). To date, it appears that Wong’s (1991) model of help-seeking behavior represents the only attempt at providing a conceptual framework from which to understand the counseling-seeking behaviors of international students. This model examines the relationship between acculturation, opinions about mental health and attitudes towards seeking psychological help and the use of psychological services by international students. Figure 1 demonstrates the components of Wong’s model which are (1) an individual’s attitude towards professional psychological help, (2) an individual’s need for professional psychological help and (3) perceived or actual barriers to utilizing psychological help. The 9

Full document contains 212 pages
Abstract: Purpose . The college environment is documented as a universally stressful period where students face many challenges (Baysden, 2002; Pandit, 2003). In addition to these potential stressors, international students face other unique challenges such as loss of support network, feelings of isolation, economic hardship, coping with oftentimes competing cultures, and anxiety which emanates from unfamiliarity (Kim & Omizo, 2003; Rounds & Kline, 2005). Unsuccessful resolution of these challenges can negatively impact the acculturation process, their mental health, and their academic programs (Roysircar, 2002). Despite these many challenges, research consistently shows that international students are less likely than their US counterparts to seek professional counseling (Bayer, 2002). Further, those who do seek counseling services are also more likely to terminate services prematurely (Anderson & Myer, 1985). Although there is an abundance of research on the attitudes towards seeking professional counseling of Asian and other international student populations (Kim & Omizo, 2003; Lau & Takeuchi, 2001; Leong & Lau, 2001; Liao, Rounds & Kline, 2005; Pandit, 2003), there is a dearth of knowledge on Caribbean college students. This dissertation sought to determine which factors influence the attitudes towards seeking professional counseling of English-speaking Caribbean college students in the U.S., as well as those attending colleges in the Caribbean. Method . Two research questions and five null hypotheses were used to examine what influences the attitudes towards seeking professional counseling of 500 Caribbean college students. The variables of interest were stigma tolerance, level of social support, level of acculturation, outcome expectations and level of emotional openness. Stigma Tolerance was measured using the Stigma Scale for Receiving Psychological Help (SSRPH), Outcome Expectations were measured using the Disclosure Expectations Scale, Emotional Openness was measured using the Distress Disclosure Index and Social Support using the Multidimensional Scale of Perceived Social Support. Attitudes towards seeking professional counseling were measured using the Attitudes towards seeking Psychological Help instrument by Fischer and Turner (1970) and acculturation was measured using responses from the demographic questionnaire. Several analyses were conducted including a stepwise regression analysis, multiple regression analysis, a MANOVA, ANOVA and a linear regression analysis. Major findings . The results of this study indicated that stigma tolerance and anticipated risks of seeking counseling both have a significant inverse relationship with the attitudes towards seeking professional counseling of English-speaking Caribbean college students. Results also indicated that anticipated utility of seeking professional counseling has a significant relationship with the attitudes towards seeking professional counseling. The level of emotional openness as well as the level of social support also have a direct relationship with the attitudes towards seeking professional counseling of English-speaking Caribbean college students. Students who reside and attend college in the Caribbean reported higher mean scores for anticipated risk, anticipated utility and attitudes towards seeking professional counseling than their counterparts who reside and attend college in the U.S. Results also indicated that length of stay in the U.S. was not a statistically significant predictor of one's attitudes towards seeking professional counseling.