The role of social support in the effectiveness of counseling for international students

Previous studies on college counseling have shown that international student clients experience higher psychological distress and benefit less from individual psychotherapy in a university counseling center (UCC) setting compared to domestic student clients. International students face many challenges during adjustment to a foreign country, and social support plays a crucial role during this process and in their psychological well-being. This study aimed to compare the levels of pre-treatment symptoms and treatment outcomes between international and domestic student clients, and examine how perceived social support was related to these differences. The study used data collected from the Center for Collegiate Mental Health (CCMH), including 4876 clients treated by 1679 therapists in 98 UCCs, of which 2438 were international student clients from 142 countries. Multivariate general linear models were constructed to explore our research questions. International student clients reported lower perceived social network support and higher family support, and higher depression, academic distress and anger/frustration at pre-treatment than domestic student clients, but there were limited differences in treatment outcomes. Both perceived social network support and family support were predictive of pre-treatment symptoms, and family support was shown to be positively related to better treatment outcomes in patients with depression, anxiety and academic distress. Implications for clinical practice and future research are discussed.