Help-Seeking Behavior

Historical Background

Healing practices across cultures to relieve emotional or relational distress are not new. The act of engaging in a relationship, however, whereby one person, a couple, or a family relate to another person in a professional setting for behavioral or cognitive change and emotional or relational relief, is a relatively new, 20th-century, Western phenomenon. This development is due, in part, to sociopolitical changes the century brought to individuals and families in the West as a result of the Industrial Revolution, including the decline of extended family proximity in urban centers, the decline of authority over the life of the family, and the adjustments needed as a result of shifts in gender roles. In the first five decades of the 20th century, clients sought relief from emotional or psychological distress with the only professionals available at the time, that is, psychoanalysts or psychiatrists. Mentally ill patients were often hospitalized, sometimes for the rest of their lives, without their consent. Outpatient [Page 1157]treatments existed but were limited to individuals who could afford the private practice fees of psychoanalysts and psychiatrists.

Increases in client demand for counseling professionals started to occur in the United States in the 1960s and 1970s as a result of important legislative initiatives. The Community Mental Health Act of 1963, for example, funded the establishment of mental health centers across the country. This law and others that followed, including the deinstitutionalization of state mental hospital patients that took place in 1975, initiated an increase in demand for outpatient services, substance abuse services, family counseling, and other clinical services.

In the latter half of the 20th century, three historical shifts affected help-seeking behavior. The feminist movement spearheaded feminist counseling in the 1970s and resulted in women's demand for counseling that would help them to challenge assumptions related to the nature of their mental health, their suffering, and their position in the family. Systemic ideas influenced the development of couple and family counseling, in responding to couples or families seeking help on a variety of clinical issues. Changing immigration patterns in the last three decades of the 20th century resulted in an increased demand for counseling on the part of immigrant communities.

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