Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.


Counseling and Human Development

Degree Program

Counseling and Personnel Services, PhD

Committee Chair

Hooper, Lisa

Committee Co-Chair (if applicable)

Choi, Namok

Committee Member

Choi, Namok

Committee Member

Foster, Eugene

Committee Member

Woo, Hongryun

Author's Keywords

mental illness; stigma; multicultural counseling self-efficacy; counseling trainees


Research has shown that the stigma of mental illness is a pervasive social issue, in the United States and globally (Arboleda-Florez, 2008), one that has been considered by the surgeon general to be one of the single greatest barriers to addressing mental health care in the United States (U.S. Department of Health and Human Services, 1999). Furthermore, research has indicated that mental health care providers hold stigmatizing views toward people with mental illnesses at rates equal to or higher than the general public (Nordt, Rössler, & Lauber, 2006). This experience of being stigmatized because of a mental illness diagnosis by the individuals who treat those illnesses has been found to be heightened for those individuals who identify as members of racial or ethnic minorities (Knifton, 2012). Mental illness stigma is included in a category of therapist effects or relational factors suspected of contributing to variance in counseling outcomes (Okiishi, Lambert, Nielsen, & Ogles, 2003). Other therapist effects include factors such as multicultural counseling self-efficacy and empathy. Although the study of a relationship among mental illness stigma and multicultural counseling self-efficacy has not been studied jointly, the tenets of Relational Cultural Theory (RCT; Miller, 1976) offer a framework that supports the study of such therapist relational factors and their possible interactional relation with client outcomes. The purpose of the study was to investigate the extent to which mental illness stigma and multicultural counseling self-efficacy are related, as well as the moderating effects of empathy and the multicultural training environment on this relationship among a sample of graduate counseling trainees. Differences in mental illness stigma scores and multicultural counseling self-efficacy scores based on select demographic factors and program affiliation were also examined. Results indicated that a statistically significant relationship did not exist among mental illness stigma and multicultural counseling self-efficacy. The four factors of empathy, however, as described by Davis (1980) were found to be related individually and separately to the primary constructs. This may indicate that, although the stigma of mental illness cannot be expected to be affected by a counseling trainee’s level of multicultural counseling self-efficacy, other relational factors, such as empathy, may serve to influence both.