How does family face relate to intention to seek therapist-guided and digital self-guided psychological interventions? mediating effects of interdependent stigma and help-seeking attitudes

Purpose The present study aimed to investigate the association between family face concern and help-seeking intention for therapist-guided and digital self-guided psychological interventions in four cultures, with possible mediation of interdependent stigma of help-seeking and attitudes towards seeking help. Methods Using online questionnaires, six-hundred and forty-five responses (Mean age = 21.25, SD = 4.65; 70% women) were collected from college students in four regions, including Canada ( n = 172), United Kingdom ( n = 158), India ( n = 160), and Hong Kong ( n = 155). Levels of family face concern (adapted from the Face Concern Scale), interdependent stigma of help-seeking (Interdependent Stigma of Seeking Help Scale), attitudes towards therapist-guided and digital self-guided psychological intervention (adapted Face-to-Face Counselling Attitude Scale), intention to seek these interventions (items adapted to measure intention to seek help), and depressive symptoms (Patient Health Questionnaire-9) were assessed. Results Using R (version 4.4.1) to conduct the path analysis, results showed that after controlling for depressive symptoms, family face concern was negatively associated with the intention to seek therapist-guided psychological intervention through the perception of higher social stigma on family members and negative attitudes towards the intervention. However, such a mediating effect was not significant for the intention to seek digital self-guided psychological intervention. Conclusions The present study highlighted the potential negative influence of family face concern on one’s intention to seek psychological help. It also highlighted that digital self-guided psychological intervention may be less subject to the influence of family face concern and stigma.