TV portrayal of therapists turns viewers off psychotherapy

Network television programming might suggest that America is fascinated with the idea of psychological counseling.

Frasier Crane and his brother, Niles, both practiced psychiatry on the popular NBC sitcom "Frasier." Mob boss Tony Soprano had his therapist on HBO's hit show "The Sopranos." And HBO has even made therapy the focus of two recent shows — "Tell Me You Love Me" and "In Treatment."

But all of these TV portrayals may actually make viewers less likely to seek psychological services themselves. That's according to a new study by three Iowa State University psychologists.

ISU psychology professors David Vogel and Douglas Gentile collaborated with graduate student Scott Kaplan on the study of 369 Iowa State students. It explored how exposure to television shows may contribute to negative perceptions about psychological services that can lead to lower intentions to seek such services.

Kaplan has conducted a related content analysis on television portrayals of mental health professionals. It found that they're not favorable.

"Generally, it seems like therapists are portrayed unethically — like sleeping with the client, or implanting false memories, or talking about their clients outside the session," Vogel said. "These are things that almost never happen with real therapists, but on a show — because they're probably more exciting — they happen more frequently."

"Therapists also often are portrayed as buffoons," Gentile said. "That's either by being the jokester, like Frasier, or by being the butt of jokes. In either case, these are not positive portrayals. They do not show the skill, expertise and ethics of professional therapists."

But it's not just the portrayal of the therapists that may be keeping people out of therapy. It's also the portrayal of those who seek counseling on TV.

"If you examine the portrayal of the clients, it's probably as bad or worse," Vogel said. "So why would you seek therapy if you believe you're going to be perceived negatively and you're going to see someone who's incompetent and not able to help you?"

Because dramas and comedies are the two types of shows that often portray psychologists and psychotherapy, the ISU psychologists asked respondents how often they watched TV comedy and drama shows. They also asked them to assess perceptions of the stigma associated with seeking professional help, attitudes toward therapy, their intentions to seek therapy for psychological and interpersonal concerns, and their feelings of depression.

The study found a positive correlation between viewers' exposure to comedy and drama shows and their perceptions of stigma associated with seeking professional help. This stigma was then related to lower willingness to seek professional mental health services.

"One of the things that's important to note about this particular study is that we showed that TV exposure was related to your perceptions of the stigma associated with seeking help, which has been found to be one of the main factors found from inhibiting people from seeking that help," Vogel said. "So you perceive that yourself, and other people, would be crazy to go [to therapy]."

That's a problem for those people who could really benefit from professional mental health services. According to Vogel, the most recent studies in the mental health field have found that about half of population experiences a situation in their lives where psychological therapy could be helpful — about 20 percent in a single year. But in a given year, only about 10 percent of the people who could benefit from therapy will seek help from a psychologist or other mental health professional.

"Mental health services are already vastly underutilized, and this cultural stigma is part of the reason," Gentile said. "And this study suggests that this cultural stigma exists partly because of the way that psychologists and their patients are portrayed on television."

---

Vogel DL, Gentile DA, Kaplan SA. The influence of television on willingness to seek therapy. J Clin Psychol. 2008 Mar;64(3): 276-95.   [Abstract]