See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/224856493

Measuring help-seeking intentions: Properties of the General Help-Seeking

Questionnaire

Article · January 2005

CITATIONS READS

643 29,558

4 authors:

Coralie J Wilson Frank P Deane

University of Wollongong University of Wollongong
75 PUBLICATIONS 5,886 CITATIONS 453 PUBLICATIONS 16,126 CITATIONS

SEE PROFILE SEE PROFILE

Joseph Ciarrochi Debra Rickwood

Australian Catholic University University of Canberra
299 PUBLICATIONS 17,850 CITATIONS 238 PUBLICATIONS 10,941 CITATIONS

SEE PROFILE SEE PROFILE

All content following this page was uploaded by Coralie J Wilson on 05 June 2014.

The user has requested enhancement of the downloaded file.

Canadian Journal of Counselling / Revue canadienne de counseling / 2005, Vol. 39:1 15

Measuring Help-Seeking Intentions:

Properties of the General Help-Seeking Questionnaire
Coralie J. Wilson
Frank P. Deane
Joseph Ciarrochi
Illawarra Institute for Mental Health & Department of Psychology,
University of Wollongong
Debra Rickwood
Centre for Applied Psychology, University of Canberra


Understanding help-seeking intentions and behaviour is fundamental to the identifica-
tion of factors that can be modified to increase engagement in counselling. Despite con-
siderable research on these variables, integrating prior research has been impeded by a lack
of consistent and psychometrically sound help-seeking measures. The General Help-
Seeking Questionnaire (GHSQ) was developed to assess intentions to seek help from
different sources and for different problems. Using a sample of 218 high school students,
the GHSQ was found to have satisfactory reliability and validity, and appears to be a flex-
ible measure of help-seeking intentions that can be applied to a range of contexts.

Il est important de comprendre les intentions de demande d’aide et leur comportement
si on veut reconnaître les facteurs à modifier afin d’augmenter l’engagement dans la rela-
tion thérapeutique. Des recherches considérables ont été menées sur ces variables, mais
elles n’ont pu être intégrées faute de mesures psychométriques homogènes et fiables pour
les analyser. Le questionnaire général de demande d’aide (QGDA) a été mis au point pour
évaluer les intentions de demande d’aide provenant de diverses sources et relatives à divers
problèmes. Utilisant un échantillon de 218 étudiants d’écoles secondaires, le QGDA s’est
avéré d’une fiabilité et d’une validité satisfaisantes, et semble constituer une mesure flexible
des intentions de demandes d’aide pouvant s’appliquer à une variété de contextes.

Young people generally prefer the informal help of friends and family before the
formal help of medical or psychological professionals when psychologically dis-
tressed (Boldero & Fallon, 1995; Offer, Howard, Schonert, & Ostrov, 1991).
Many young people indicate a preference for seeking help from “no one” for
personal-emotional and suicidal problems (Deane, Wilson, & Ciarrochi, 2001).
Although some consistent help-seeking patterns appear in studies of young people,
there are also variations between studies. Due to different measurement strategies,
it is difficult to know whether these differences are substantive or due to method-
ological variation. For example, reported rates for friends as the most preferred help
source for personal-emotional problems vary by up to 67.2% (e.g., 21.1%, Boldero
& Fallon; 88.3%, Offer et al.). Similarly, a 40% variation can be found in
16 Coralie J. Wilson, Frank P. Deane, Joseph Ciarrochi, and Debra Rickwood

preference rates for parents (e.g., 19%, Boldero & Fallon; 59%, Schonert-Reichl
& Muller, 1995), and a 22% variation can be found in preference rates for formal
help from medical or mental health professionals (e.g., 7%, Benson, 1990; 29%,
Naginey & Swisher, 1990). By proposing core components of a help-seeking mea-
sure, the capacity to compare across studies will be enhanced. The General Help-
Seeking Questionnaire (GHSQ) was developed to meet this need. The current
study describes the development and psychometric properties of the GHSQ, along
with the help-seeking intentions of a sample of high school students.
A variety of measures have been used to assess help-seeking, in particular, those
that measure attitudes (e.g., Cash, Kehr, & Salzbach, 1978) and intentions (e.g.,
Deane & Todd, 1996). Of these measures, the attitude-behaviour literature and
specifically the Theory of Planned Behavior (TPB; Ajzen, 1991, 2002), suggest
that help-seeking intentions may be more closely related to actual behaviour than
other constructs. Kim and Hunter (1993) reported that the correlation between
intentions and behaviour was generally higher than the correlation between
attitudes and behaviour.
Although the intention-behaviour relationship is well established for a wide
range of behaviours (Armitage & Conner, 2001), only recently have studies been
conducted to assess the intention-behaviour relationship within the context of
seeking counselling. While a number of studies have established the relationship
between prior help-seeking behaviour and intentions, we could not locate any
published articles that have assessed intentions then subsequent help-seeking inten-
tions and/or behaviour. The construct validity of a measure of intentions would be
supported if the measure was able to predict actual help-seeking behaviour. Using
the GHSQ, the current study examines the relationship between high school stu-
dents’ self-reported intentions and their subsequent help-seeking behaviours over
a three-week period, along with the consistency of their intentions across this time.

   - 

A large number of help-seeking studies have measured intentions as a
dependent variable. However, limitations in these measures include unclear
construct definition and highly idiosyncratic items that relate to study-specific
goals. There is also a paucity of data reporting psychometric properties for
individual measures.
Threats to construct validity include unclear construct definition. For example,
Cohen’s (1999) Willingness to Seek Help Questionnaire is reported as comprising
25 items that are statements about seeking help for particular problems. There
are several potential limitations with Cohen’s measure. Some items appear to
assess respondents’ attitudes and beliefs about help-seeking, rather than their
specific help-seeking intentions (e.g., “If I were afraid of heights, I would try to
conceal this from my friends,” “If both my legs were to be broken in an accident,
I would prefer to stay at home for a few months rather than be pushed around in
a wheelchair,” pp. 80–81). Moreover, several items appear related to social support
Measuring Help-Seeking Intentions 17

(e.g., “I believe that a time of mourning for a loved one would be a time when I
would need other people”). Because individuals seek help from different sources
for different problems (Boldero & Fallon, 1995; Offer et al., 1991), a
comprehensive measure of help-seeking would examine intentions for different
problem-types, something that is limited in Cohen’s measure. Another concern
is that “willingness” and intentions may be related, but are not the same constructs.
Part of the definition of intentions involves aspects of a plan or decision to perform
a behaviour, whereas willingness suggests openness but not necessarily a plan.
Intentions are operationalized as “a person’s motivation in the sense of her or his
conscious plan or decision to exert effort to perform the behavior” (Conner &
Norman, 1996, p. 12). Several other measures of help-seeking also focus on
willingness rather than intentions (e.g., Lopez, Melendez, Sauer, Berger, &
Wyssmann, 1998). Many measures that aim to tap intentions typically have
respondents rate the “likelihood” rather than “willingness” that they will conduct
a particular behaviour (e.g., Ajzen, 2002).
Using a matrix structure, a number of studies have asked respondents to
indicate intentions to seek help for study-specific problems from a list of potential
formal and informal help sources. Many studies ask respondents to indicate simply
“yes” or “no” but mix willingness and intentions in the item stem (e.g., Naginey
& Swisher, 1990; Windle, Miller-Tutzauer & Barnes, 1991). Although
dichotomous yes-no items are relatively simple, they do not allow respondents
to indicate degrees of intentionality and do not provide information about
differences between participants’ help source preferences.
Several studies have addressed the preference issue by extending the matrix-style
survey to rank response options. For example, Tinsley, de St. Aubin, and Brown
(1982) measured the professional psychological help-seeking intentions of 136
college students using 16 personal-emotional or vocational problem items (e.g.,
“difficulties relating to the opposite sex” and “thinking about suicide”). These items
were preceded by the stem: “Who would you talk to if…”, and followed by a list
of eight potential help sources (“self ” included). Respondents ranked their prefer-
ence for each help source (e.g., close friend, professional counsellor, clergyman).
However, ranking is a relatively difficult task for many respondents.
Several studies have used a single response item (one help source for one
problem-type) with concomitant problems with reliability. For example, Deane
and Chamberlain (1994) used a single item (“If you have a personal problem,
how likely is it that you would seek help from a professional psychologist or
counsellor?”) rated on a 9-point Likert scale (1 = “extremely unlikely,” 9 =
“extremely likely”). In later studies, Deane and colleagues used the same single
response item but for two problem-types (personal-emotional problems and
suicidal thoughts) (Deane, Skogstad, & Williams, 1999; Deane & Todd, 1996).
Other researchers have used multiple items to measure intentions for different
problem-types but again, for only one help source (Cepeda-Benito & Short, 1998;
Kelly & Achter, 1995). For example, the Intention of Seeking Counselling
Inventory (ISCI; Cash et al., 1978) has 17 items related to issues that college
18 Coralie J. Wilson, Frank P. Deane, Joseph Ciarrochi, and Debra Rickwood

students bring to counselling (e.g., course-related, weight control, relationship

difficulties, self-confidence problems, drug and alcohol misuse, fear of failure).
Intentions for each item are rated on a Likert scale from 1 (“very unlikely”) to 6
(“very likely”). Cronbach’s alphas between .84 and .89 have been reported for
the measure (Cepeda-Benito & Short; Kelly & Achter).
Addressing both the strength of intentions and preference issues, Hinson and
Swanson (1993) used an elaborate matrix design to measure intentions to seek
professional psychological help. The researchers provided two personal-emotional
problem vignettes (one of high severity and one of low severity). Respondents
were asked to rate the following probe: “If you found yourself in the above
situation, what is the likelihood that you would seek help from a counselling
centre or mental health service?” on a Likert scale ranging from 1 (“not likely at
all”) to 7 (“very likely”). Respondents were also asked to indicate the order in
which they would seek help from a list of help sources (i.e., best male friend,
best female friend, faculty advisor or professional, mother, counsellor at
counselling centre, minister or clergy, father, yourself). Unfortunately, respondents
were not asked to rate the likelihood that they would seek help from these sources.
Although respondents’ preference for professional psychological help could be
compared to other sources, their intentions for a professional source could not.
Finally, in what appears to be the most promising intentions measure, Raviv,
Maddy-Weitzman, and Raviv (1992) attempted to address the strength of inten-
tions and preference issues by using a matrix-style rating scale to measure parents’
intentions to seek professional psychological help for dealing with adolescent
(child-rearing) problems. The measure comprised eight problem-types that ranged
from common to serious and problematic in nature (e.g., communication issues to
problems related to drug and alcohol misuse) and that were presented as hypo-
thetical situations at the start of the survey. For each problem-type, nine formal and
informal help sources were provided (e.g., grandparents, friends, psychologist,
teacher, counsellor, family doctor). Respondents rated the “likelihood that they
would seek help from each of the nine sources of help in the event that they were
to encounter the situation” (p. 120) on a Likert scale ranging from 0 (“would not
seek help”) to 4 (“definite likelihood of seeking help”).
In short, Raviv et al.’s (1992) measure highlights several desirable core
components for a comprehensive measure of help-seeking intentions. Raviv et
al.’s measure includes likelihood ratings, multiple help sources relevant to the
sample in question, and several target problem-types. However, there is no
psychometric data regarding the Raviv et al. method. In an effort to address this
gap, the present study aimed to provide reliability and validity data for the GHSQ.

  -  ()

The GHSQ uses a matrix format that can be modified according to purpose
and need. Within this format, help sources and problem-types can be modified
to meet sample characteristics and study requirements. From our review of the
Measuring Help-Seeking Intentions 19

literature, we suggest that a comprehensive measure of help-seeking intentions

would normally include formal and informal help source options, in addition to
“self ” or “no one” (e.g., counsellor, family, friends, no one).
Based on recommendations by Ajzen (2002), the GHSQ uses the following
standard problem probe within which targeted problem-types can be interchanged:
“If you were having [problem-type], how likely it is that you would seek help from
the following people?” For example, within the current study, the measure asks high
school students to report their formal and informal intentions to seek help from 11
targeted help sources (including “would not seek help”) for “personal-emotional”
problems and “suicidal thoughts” (see Table 1). Help sources were determined
following consultation with school welfare personnel and students, and have been
identified as salient in several supporting studies (Ciarrochi, Deane, Wilson, &
Rickwood, 2002; Ciarrochi, Wilson, Deane, & Rickwood, 2003).
Finally, our review of existing intention measures found that a Likert rating
scale was most frequently used, was easier than ranking procedures, and provided
the capacity to compare levels of intentions across sources and problems. Thus,
the GHSQ asks participants to respond to each problem-type by rating their
help-seeking intentions on a 7-point scale ranging from 1 (“extremely unlikely”)
to 7 (“extremely likely”) for each help source option including “no one.” Higher
scores indicate higher intentions. Within this format, help-seeking intentions
can be examined as individual scales by combining scores for different problem-
types. Similarly, given that help-seeking intentions are a “function of both the
particular issues in question and the source of help” (Raviv et al., 1992, p. 128),
information for individual help sources may also be of interest.
Preliminary Psychometric Properties of the GHSQ
The GHSQ has been used in several studies, but this is the first to focus on
the reliability and validity of the measure. Research using the GHSQ has
demonstrated positive associations with aspects of emotional competence
(Ciarrochi et al., 2002, 2003), in addition to retrospective help-seeking behaviour
(Ciarrochi & Deane, 2001) and prospective help-seeking behaviour (Deane,
Ciarrochi, Wilson, Rickwood, & Anderson, 2001). Deane et al. reported that
intentions to seek help from friends and intentions to seek help from a teacher/
school advisor were reliable predictors of future help-seeking behaviour. Greater
intentions to seek help from a teacher/school advisor and lower intentions to
seek help from a friend were associated with more requests to seek help from a
school counsellor.
In sum, preliminary evidence suggests that the GHSQ offers potential as an
adaptable matrix-style measure of help-seeking intentions. Construct validity of the
measure will be supported if, as theory would suggest, current help-seeking inten-
tions are related to future actual help-seeking behaviour. The current study aims to
describe the psychometric properties of the GHSQ, along with the help-seeking
intentions and source preferences of a sample of high school students for two types
of emotional problems. The following psychometric issues will be addressed:
20 Coralie J. Wilson, Frank P. Deane, Joseph Ciarrochi, and Debra Rickwood

1. Internal and test-retest reliability.

2. Predictive and construct validity will be supported if intentions correlate
with future actual help-seeking behaviours.
3. Support for convergent validity will be provided if intentions to seek
professional psychological help correlate with perceived quality of prior
counselling experience.
4. Divergent validity will be indicated by an inverse relationship between
intentions to seek help from formal mental health sources and ratings of
barriers to seeking professional psychological help.


Participants and Procedure
The study received ethical approval from the University Human Ethics
Committee and the New South Wales (NSW) Department of Education and
Training. Two hundred and eighteen students (n = 112 males, n = 106 females),
aged 12 to 19 (M = 16.39, SD = 1.49), took part in the study. Students were
recruited from Grades 7 to 12 of an NSW Australian public high school located
in an industrial area during weekly scheduled grade meetings (compulsory
administration meetings that include all students from within a particular grade).
Students were informed of the study through presentations to each grade meeting
by peer presenters and an accompanying information sheet. Both parental and
student consent was required prior to participation. The information sheet
explained the study procedure and stressed the voluntary nature of participation.
The research survey was completed anonymously by participating students during
grade meetings. Consistent with the method outlined by Millstein (1996) for
measuring the relationship between intentions and prospective behaviour in a
test of the Theory of Planned Behavior, surveys were re-administered using the
same methods after a three-week period. Unique identifiers were used to match
participant responses at both test times. Debrief information was supplied at the
completion of data collection, and school welfare personnel were available for
counselling and support if needed by students.
Measures
The research survey (administered at Times 1 and 2) comprised the GHSQ
as outlined, the Actual Help-Seeking Questionnaire (AHSQ; Rickwood &
Braithwaite, 1994), four items used in previous studies to measure prior
counselling experience (Carlton & Deane, 2000; Deane et al., 1999, 2001), and
a brief version of the Barriers to Adolescents Seeking Help scale (BASH; Kuhl,
Jarkon-Horlick, & Morrissey, 1997). In view of items that related to suicidal
thoughts, the University Human Ethics Committee wanted items regarding help-
seeking to occur at the end of the questionnaire; thus items were administered in
the same order at Times 1 and 2.
Measuring Help-Seeking Intentions 21

The AHSQ was derived from an earlier measure used by Rickwood and
Braithwaite (1994) and developed to measure recent actual help-seeking behaviour
from formal and informal sources. Help-seeking behaviour is measured by listing
potential help sources and asking whether or not help has been sought from
each source within a specified time-period for a specified problem. To ensure
that respondents are reporting their help-seeking behaviours in the appropriate
way, they are asked to briefly elaborate on the nature of the problem for which
help was sought. Respondents can also indicate that they have had a problem,
but have sought help from no one. Generally, this measure is reported as three
sub-scales: whether or not informal help has been sought; whether or not formal
help has been sought; and whether no help has been sought. However, information
for individual sources of help is often of interest, particularly if matched to
intentions to seek help from specific help sources as in the present study. The
AHSQ asked participants to indicate if they have sought help for either of the
problem-types identified in the GHSQ (personal-emotional or suicidal), within
the previous three weeks. Participants provide a “yes” or “no” response for each
help source option that matched those listed in the GHSQ. If help has been
sought, the AHSQ asks respondents to specify the help source (e.g., mother,
counsellor, priest) and indicate the category of the problem (e.g., personal-
emotional or suicidal).
The prior counselling measure comprises four items that have been used in
samples of prison inmates (Deane et al., 1999), high school students (Carlton &
Deane, 2000), and college students (Deane et al., 2001). The four items in the
current prior counselling measure included: “Have you ever seen a mental health
professional (e.g., counsellor, psychologist, psychiatrist) to get help for personal
problems?” (“Yes” or “No”), “How many visits did you have with the health
professional(s)?” “Do you know what type of health professional(s) you’ve seen
(e.g., counsellor, psychologist, psychiatrist)?” and “How helpful was the visit to
the mental health professional?” This evaluation was rated on a 5-point Likert
scale ranging from 1 (“extremely unhelpful”) to 5 (“extremely helpful”).
The brief version of the BASH was derived from the longer scale developed
by Kuhl et al. (1997). The abbreviated measure (BASH-B) contains 11 of the 37
self-report items included in the full scale and specifically targets barriers to seeking
professional psychological help (e.g., “A therapist might make me do or say
something that I don’t want to,” “If I had a problem and told a therapist, they
would not keep it a secret,” and “I think I should work out my own problems”).
Each item is rated on a 6-point scale (1 = “strongly disagree” to 6 = “strongly
agree”) so that greater scores indicate higher barriers to professional psychological
help-seeking. The full scale had satisfactory reliability and validity, but a high
Cronbach alpha for the full measure (α = .91) suggested there might be item
redundancy. The 11 items used in the present study were selected to reduce item
overlap and were based on pilot data with a high school sample that identified
those barriers most strongly endorsed by students. The brief 11-item BASH-B
had a Cronbach alpha coefficient of .83 in the present study.
22 Coralie J. Wilson, Frank P. Deane, Joseph Ciarrochi, and Debra Rickwood


Prior to analysis, scores for the GHSQ, AHSQ, BASH-B, and prior help-
seeking items were examined through SPSS programs for the extent to which
the data met the assumptions of the analyses conducted. BASH-B and quality of
prior help data met the assumptions of the analyses used. However, normality
could not be assumed for GHSQ or AHSQ data. GHSQ scores tended to range
between 5 and 7 for informal sources, 1 and 3 for formal sources, and 6 and 7
for seeking help from no one. AHSQ responses tended to be “yes” (scored as 1)
for informal sources and “no” (scored as 2) for formal sources. Transformation of
the data (e.g., log) improved the distributions however, when analyses were
conducted with both transformed and untransformed data, the patterns and
statistical significance of the findings were essentially the same. Consequently,
the analyses are reported with untransformed data to ease interpretation. As an
additional precaution, where possible, the multivariate analyses that were
conducted on the GHSQ data were replicated using non-parametric techniques.
Similarly, non-parametric analyses did not alter the significance or pattern of
findings. Therefore, parametric multivariate findings are reported but analyses
are interpreted conservatively. Correlational analyses were conducted using both
parametric and non-parametric techniques. Non-parametric analyses did not alter
the pattern of findings; however, in some cases, the levels of significance between
findings differed. Therefore, as a final precaution, non-parametric correlations
are reported.
As presented in Table 1, the means and standard errors of students’ help-seeking
intentions indicate that students were most willing to seek the informal help of
friends and family rather than formal help for personal-emotional and suicidal
problems. In order to determine whether measures of help-seeking intentions
might need to include different problem-types, further analyses examined whether
there were any differences in high school students’ preferred help source, and
whether there were any help-seeking differences across problem-types. A General
Linear Model repeated measures ANOVA was used to examine the impact of
help source (boyfriend/girlfriend, friend, parent, other relative, mental health
professional, phone help-line, general practitioner (GP), teacher, pastor/priest,
youth worker/youth group leader, no one) and problem-type (personal-emotional
problem and suicidal thoughts) on intentions to seek help. A repeated measures
analysis was used to increase the likelihood that the results found both within
and between each problem-type might be generalized to the general high school
population from which the participants were drawn (Rutherford, 2001, p. 61).
There was a significant main effect for helping source, F(10, 1460) = 67.53, p <
.001. However, this effect was qualified by a significant interaction with problem-
type, F(10, 1460) = 17.46, p < .001, confirming that high school students’
preferred source of help depended upon the type of problem they were facing.
To further evaluate the interaction between problem-type and help source,
pairwise comparisons were conducted using a Bonferroni adjustment to control
Measuring Help-Seeking Intentions 23

for Type I error at p < .05. These results are also presented in Table 1. Students
indicated they were most likely to seek help from friends for all types of personal
problems but less likely to seek help from friends for suicidal thoughts than non-
suicidal problems. Students indicated that when experiencing suicidal ideation
rather than non-suicidal problems, they were less likely to seek help from parents
and other relatives but more likely to seek help from mental health professionals
and telephone help lines. When experiencing suicidal and non-suicidal problems,
students indicated they would seek some form of informal help or mental health
care before that of no one, general practitioners, or teachers and other community
welfare help sources (Table 1).
Scale Reliability
The GHSQ items could be scored in two ways: first, as a single scale that
included all specific help source options for suicidal and non-suicidal problems
(Cronbach’s alpha = .85, test-retest reliability assessed over a three-week period =
.92). Second, the ANOVA results (Table 1) confirmed the need to distinguish
between problem types so items could be analyzed as two scales, one for each
problem-type: suicidal problems (Cronbach’s alpha = .83, test-retest reliability

Table 1
Means (M) and Standard Errors (SE) of Help-Seeking Intentions (GHSQ 1) for
Personal-Emotional Problems (Per-Emot), Suicidal Thoughts (Suicide-Thts), and
Different Sources of Help for a High School Sample (N = 218)
Problem type
Per-Emot Suicide-Thts
Help source M SE M SE
Partner (boy/girlfriend) 4.77a .16 4.03a** .19
Friend 5.13a .13 4.34a** .17
Parent 4.84a .15 3.56a,b** .19
Family (non-parent) 3.75 .16 3.12b,c,d** .16
Mental health 2.68b .13 3.05b,c,d* .17
Help line 2.14c .12 2.63c,d,e** .15
Doctor/GP 2.73b .14 2.63d .15
Teacher 2.64b .14 2.19e,f** .13
Pastor/priest 1.77c .12 1.72f .11
Youth worker 2.08c .13 2.08f .13
Would not seek help 2.86 .18 2.61 .17

Note. Evaluations were made on a 7-point scale (1 = “extremely unlikely”, 7 = “extremely likely”).
“Would not seek help” was not included in the contrasts. 1GHSQ refers to the General Help-
Seeking Questionnaire.
a,b,c,d,e Means within columns differ from each other at p < .05, with the exception of those that
share a letter.
** Means differ between personal-emotional problems and suicidal ideation in the same row at
p < .001 and *p < .01 using Bonferroni correction.
24 Coralie J. Wilson, Frank P. Deane, Joseph Ciarrochi, and Debra Rickwood

assessed over a three-week period = .88) and personal-emotional problems (Cron-

bach’s alpha = .70, test-retest reliability assessed over a three-week period = .86).
Validity
Overall help-seeking intentions and prospective help-seeking behaviours. The
relationship between intentions to seek help from different sources and actually
seeking help from that source in the following three weeks was examined.
Correlations were calculated between the initial ratings of help-seeking intentions
(Time 1) with reports of actual help-seeking three weeks later (Time 2). As shown
in Table 2, there were a number of positive and significant associations between
intentions and prospective help-seeking behaviour for both personal-emotional
and suicidal problems. It is notable that even with intentions limited to two
specific types of emotional problem and the sampling domain restricted to three
weeks, correlations between intentions and actual help-seeking behaviours were
moderate for several informal sources (e.g., rs(181) = .48, p < .001, intimate
partner; r s(218) = .42, p < .001, non-parent family). It is also notable that even
with a small number of participants reporting they had actually sought mental
health counselling for their emotional problems at Time 2 (see Table 2 for the
number and percentage of students who sought help), the correlation between
intentions to seek mental health care for personal-emotional problems and actually
seeking counselling was positive and significant, albeit small in magnitude (r s(218)
= .17, p < .05).

Table 2
Correlations (rs) between Help-Seeking Intentions and Self-Reported Actual
Help-Seeking Behaviour from Matched Help Sources in the Following Three
Weeks for Personal-Emotional Problems (P-E) and Suicidal Thoughts (S-T)
in a High School Sample
Self-reported help-seeking behaviour
Help-seeking intentionsa P-E S-T N (%)b
Intimate partner .48** .26** 53 (29)
Friend .31** .11 120 (55)
Parent .23* .11 120 (55)
Non-parent family .42** .23* 57 (26)
Mental health .17* .04 20 (9)
Phone help line .14 .14 7 (3)
Doctor/GP .10 .06 22 (10)
Teacher .15 .05 28 (13)
Religious leader .14 –.06 7 (3)
Youth worker .26* .22* 7 (3)
aN (intimate partner) = 181; aN (help sources other than partner) = 218. bNumber (and percentage
of total samplea) of participants who sought help from each source for personal-emotional problems
or suicidal thoughts at Time 2.
**p < .001, *p < .05.
Measuring Help-Seeking Intentions 25

Professional help-seeking intentions, prior help-seeking, and barriers. To test the

validity of the GHSQ with the focus on counselling, the possibility that intentions
to seek help from a “mental health professional” might be associated with
evaluation of prior counselling experience and barriers to seeking mental health
care was examined. The perceived quality of previous mental health care was
positively related to intentions to seek help from a mental health professional for
personal-emotional problems, r s(55) = .51, p < .001, and suicidal thoughts, r s(54)
= .57, p < .001. This indicates a favourable evaluation of prior mental health
care related to higher intentions to seek counselling in the future.
Finally, the 11 BASH-B items were averaged to form a single scale representing
participants’ perceived barriers to seeking counselling. A significant but modest
negative association was found between barriers and intentions to seek help from
a mental health professional for suicidal thoughts, rs(219) = -.22, p < .01, but
not for personal-emotional problems, rs(219) = -.09, p = .21.


The GHSQ appears to provide a sufficiently flexible and sensitive format for
measuring help-seeking intentions. Consistent with most prior studies, the high
school students in the current study reported higher help-seeking intentions for
informal compared with formal help sources. Intentions to seek help from friends
were significantly higher than for any other help source. Students reported they
were most likely to seek help from friends then family for problems that were
not suicide-related and most likely to seek help from friends then no one for
suicidal thoughts. Consistent with previous findings (Deane et al., 2001), students
reported intentions that were significantly different for suicide and non-suicide
related problems and intentions to seek help from formal health care sources
that were significantly lower than for friends or no one. Such findings support
the need to assess different help sources in a comprehensive measure of intentions,
and also indicate that the GHSQ is sufficiently sensitive to differentiate help-
seeking intentions for different problems and help sources. The findings also
highlight preferred help sources that can be promoted to increase the likelihood
that appropriate help-seeking will be carried out when it is required. In the current
study, with respect to formal help sources, the help of a doctor was most likely to
be sought for personal-emotional problems and the help of a mental health
professional was most likely to be sought for suicidal thoughts.
The benefits of each help source could be promoted among young people to
ensure these sources of help are considered when this population becomes
distressed. For example, recognition that doctors are viewed as likely sources of
professional help for personal-emotional problems led to the development of a
“GPs in Schools” program (Wilson, Deane & Fogarty, 2004). This program trains
GPs in presentation skills and a lesson plan so they can successfully deliver a
presentation in high school classrooms with the aim of breaking down targeted
barriers to young people accessing the help of general medical practitioners.
26 Coralie J. Wilson, Frank P. Deane, Joseph Ciarrochi, and Debra Rickwood

Moreover, the GHSQ makes it possible to identify whether seeking help from
someone is desirable for a particular problem and for which sources the preferences
and degrees of intentionality change as the nature of problems change.
The study provided preliminary support for the reliability and validity of the
GHSQ. Convergent and divergent validity were supported with positive
correlations found between students’ intentions to seek counselling and the
perceived quality of their prior mental health experience, and by a negative
correlation between the students’ intentions to seek counselling and their self-
reported barriers to seeking professional psychological help.
Significant associations between help-seeking intentions and actually seeking
help from the corresponding source in the following three weeks support the pre-
dictive and construct validity of the measure. Such a finding is consistent with
theory indicating that intentions predict behaviour (Ajzen, 1991). While the mag-
nitude of the association was only modest for a number of help sources (most of
the correlations were around the .25 level), this was likely due to the relatively low
frequency of actual help-seeking from some help sources over the three-week per-
iod. Alternatively, it may reflect actual differences in the strength of the intention-
behaviour relationship dependent on the problem for which help was being sought.
Although coefficients were modest, they are comparable with predictive validity
coefficients of other well-established psychological measures. For example, the
relationship between IQ and job performance is .25 (Meyer et al., 2001).
In sum, the matrix structure of the GHSQ appears to provide a suitable method
for measuring help-seeking intentions and supports the specification of different
problem-types and different help sources. Future research is needed to assess the
extent that the GHSQ is useful in other populations, different target problems,
and different help sources. Research by Raviv et al. (1992) using parents suggests
that the matrix structure of measures like the GHSQ appears generalizable to
other contexts.
The GHSQ offers potential as a method to assist clinical practice and mental
health promotion or prevention initiatives. Appropriate help-seeking is viewed as
a protective factor given the potential to reduce psychological distress and improve
mental health. Within the context of suicide prevention, by formally assessing an
individual’s help-seeking intentions, it is possible to identify preferred sources of
help. The GHSQ responses may provide structure and prompts to discuss appro-
priate sources of help or the need to implement additional preventative strategies
to increase the probability an individual might seek help. Modification of help-
seeking intentions is also a common goal for a range of health promotion programs
and the GHSQ provides a flexible method for such assessment.
Acknowledgments
This research was supported by the National Health and Medical Research
Council of Australia (Grant YS060; Deane, Rickwood, Wilson, & Ciarrochi,
2000). The authors thank the NSW Department of Education and Training for
their support, and the students and staff who assisted in the data collection.
Measuring Help-Seeking Intentions 27

Particular thanks go to Anna Richardson, Naomi Ireland, Salli Hart, John Wilson,
and Helen Clancy.
References
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision
Processes, 50, 179–211.
Ajzen, I. (2002). Constructing a TPB questionnaire: Conceptual and methodological considerations.
University of Massachusetts Amherst, Office of Information Technologies. Retrieved No-
vember 22, 2004, from <http://www-unix.oit.umass.edu/~aizen/tpb.html>.
Armitage, C. J., & Conner, M. (2001). Efficacy of the Theory of Planned Behaviour: A meta-
analytic review. British Journal of Social Psychology, 4, 471–499.
Benson, P. L. (1990). Help seeking for alcohol and drug problems: To whom do adolescents
turn? Journal of Adolescent Chemical Dependency, 1, 83–94.
Boldero, J., & Fallon, B. (1995). Adolescent help seeking: What do they get help for and from
whom? Journal of Adolescence, 18, 193–209.
Carlton, P. A., & Deane, F. P. (2000). Impact of attitudes and suicidal ideation on adolescents’
intentions to seek professional psychological help. Journal of Adolescence, 23, 35–45.
Cash, T. F., Kehr, J., & Salzbach, R. F. (1978). Help seeking attitudes and perceptions of coun-
sellor behavior. Journal of Counselling Psychology, 25, 264–269.
Cepeda-Benito, A., & Short, P. (1998). Self-concealment, avoidance of psychological services,
and perceived likelihood of seeking professional help. Journal of Counselling Psychology, 45,
58–64.
Ciarrochi, J. V., & Deane, F. P. (2001). Emotional competence and willingness to seek help
from professional and nonprofessional sources. British Journal of Guidance and Counselling,
29, 233–246.
Ciarrochi, J., Deane, F. P., Wilson, C. J., & Rickwood, D. (2002). Adolescents who have trou-
ble identifying, describing, and managing their emotions are the least willing to seek help for
emotional problems. British Journal of Guidance and Counselling, 30, 173–188.
Ciarrochi, J., Wilson, C. J., Deane, F. P., & Rickwood, D. (2003). Emotional competence and
age as predictors of willingness to seek help from formal and informal sources. Counselling
Psychology Quarterly, 16, 103–120.
Cohen, B. (1999). Measuring willingness to seek help. Journal of Social Science Research, 26, 67–82.
Conner, M., & Norman, P. (1996). The role of social cognition in health behaviours. In M.
Conner & P. Norman (Eds.), Predicting health behaviour (pp. 1–22). Buckingham, England:
Open University Press.
Deane, F. P., & Chamberlain, K. (1994). Treatment fearfulness and distress as predictors of pro-
fessional psychological help seeking. British Journal of Guidance and Counselling, 22, 207–
217.
Deane, F. P., Ciarrochi, J., Wilson, C. J., Rickwood, D., & Anderson, S. (2001, July). Do high
school students’ intentions predict actual help seeking from school counsellors? Paper presented at
the eighth annual conference of Suicide Prevention Australia, Sydney, Australia.
Deane, F. P., Skogstad, P., & Williams, M. (1999). Impact of attitudes, ethnicity and quality of
prior therapy on New Zealand male prisoners’ intentions to seek professional psychological
help. International Journal for the Advancement of Counselling, 21, 55–67.
Deane, F. P., & Todd, D. M. (1996). Attitudes and intentions to seek professional psychological
help for personal problems or suicidal thinking. Journal of College Student Psychotherapy, 10,
45–59.
Deane, F. P., Wilson, C. J., & Ciarrochi, J. (2001). Suicidal ideation and help-negation: Not
just hopelessness or prior help. Journal of Clinical Psychology, 57, 1–14.
Hinson, J. A., & Swanson, J. L. (1993). Willingness to seek help as a function of self-disclosure
and problem severity. Journal of Counseling and Development, 71, 465–470.
Kelly, A. E., & Achter, J. A. (1995). Self-concealment and attitudes toward counselling in uni-
versity students. Journal of Counseling Psychology, 42, 40–46.
 28 Coralie J. Wilson, Frank P. Deane, Joseph Ciarrochi, and Debra Rickwood

Kim, M., & Hunter, J. E. (1993). Relationships among attitudes, behavioral intentions, and
behavior: A meta-analysis of past research: II. Communication Research, 20, 331–364.
Kuhl, J., Jarkon-Horlick, L., & Morrissey, R. F. (1997). Measuring barriers to help seeking
behavior in adolescents. Journal of Youth and Adolescence, 26, 637–650.
Lopez, F. G., Melendez, M. C., Sauer, E. M., Berger, E., & Wyssmann, J. (1998). Internal working
models, self-reported problems, and help seeking attitudes among college students. Journal
of Counselling Psychology, 45, 79–83.
Meyer, G. J., Finn, S. E., Eyde, L. D., Kay, G. G., Moreland, K. L., Dies, R. R., et al. (2001).
Psychological testing and psychological assessment: A review of evidence and issues. Ameri-
can Psychologist, 56, 128–165.
Millstein, S. G. (1996). Utility of the Theories of Reasoned Action and Planned Behavior for
predicting physician behavior: A prospective analysis. Health Psychology, 15, 398–402.
Naginey, J. L., & Swisher, J. D. (1990, December/January). To whom to adolescents turn with
drug problems? Implications for school professionals. High School Journal, 80–85.
Offer, D., Howard, K. I., Schonert, K. A., & Ostrov, E. J. D. (1991). To whom do adolescents
turn for help? Differences between disturbed and nondisturbed adolescents. Journal of the
American Academy for Child and Adolescent Psychiatry, 30, 623–630.
Raviv, A., Maddy-Weitzman, E., & Raviv, A. (1992). Parents of adolescents: Help-seeking in-
tentions as a function of help sources and parenting issues. Journal of Adolescence, 15, 115–
135.
Rickwood, D. J., & Braithwaite, V. A. (1994). Social-psychological factors affecting seeking
help for emotional problems. Social Science and Medicine, 39, 563–572.
Rutherford, A. (2001). Introducing AVOVA and ANCOVA: A GLM approach. London: Sage.
Schonert-Reichl, K. A., & Muller, J. R. (1995). Correlates of help seeking in adolescence. Jour-
nal of Youth and Adolescence, 25, 705–731.
Tinsley, H. E. A., de St. Aubin, T. M., & Brown, M. T. (1982). College students’ help seeking
preferences. Journal of Counselling Psychology, 29, 523–533.
Wilson, C. J., Deane, F. P., & Fogarty, K. (2004). GPs in schools: Building bridges to general
practice (2nd ed.). Participant training manual for “youth friendly” general practitioners in
strategies for classroom presentation and outreach. Wollongong, Australia: Illawarra Divi-
sion of General Practice.
Windle, M., Miller-Tutzauer, C., Barnes, G. M., & Welte, J. (1991). Adolescent perceptions of
help seeking resources for substance abuse. Child Development, 62, 179–189.

About the Authors

Dr. Coralie Wilson is a teacher, psychologist, and an Honorary Fellow with the Illawarra Insti-
tute for Mental Health, University of Wollongong. Coralie has major research interests in the
areas of youth health and help-seeking.
Dr. Frank Deane is a clinical psychologist, professor of psychology, and director of the Illawarra
Institute for Mental Health, University of Wollongong. Frank has major research interests in the
areas of help-seeking and processes of psychotherapy.
Dr. Joseph Ciarrochi is a social psychologist, senior lecturer, and director of the Centre for Per-
sonal Development, Department of Psychology, University of Wollongong. Joseph’s major re-
search interests lie in the area of emotional competence and personal development.
Dr. Debra Rickwood is a social psychologist and an associate professor in the Centre for Applied
Psychology, University of Canberra. Debra’s major research interests also lie in the area of youth
health and help seeking.
Address correspondence to Coralie Wilson, c/o Illawarra Institute for Mental Health, Building
22, University of Wollongong, Wollongong, NSW 2522, Australia,
e-mail <[email protected]>.

View publication stats