Predictors of Perceived Counseling Helpfulness Among Asian American Adults In a Subsidized Mental Health Network

Background and Purpose: Despite significant mental health needs, Asian American adults face substantial barriers to seeking and benefiting from counseling services. This study examined counseling barriers and predictors of perceived counseling helpfulness among Asian American adults who received counseling through a non-profit, community-based mental health resource network, Lighthouse Counseling Network (LCN). Through LCN, clients were able to receive up to 10 counseling sessions at a subsidized rate of $50 per session.

Methods: A cross-sectional survey was administered to Asian American adult participants (N = 114; Mage = 35.25, SD = 7.53) accessing counseling through the LCN. Measures assessed pre-counseling barriers (e.g., cost, stigma, cultural fit), counseling-related factors (financial subsidy importance, cultural knowledge of counselor, LCN organizational support), current mental health and stress levels, depression, and perceived counseling helpfulness. Descriptive statistics and hierarchical multiple regression were conducted using SPSS.

Results: Participants reported high pre-counseling reservations about cost (M = 4.07 out of 5), and the financial subsidy offered by LCN was rated highly important in their decision to seek services (M = 4.37). The counselor's shared cultural knowledge was also important (M = 4.01 out of 5). Approximately 30% of participants reported experiencing COVID-19-related racial harassment. Hierarchical regression suggested that the final model explained 39.1% of the variance in perceived counseling helpfulness (R² = .391, p < .001). Feeling supported by the LCN in connecting with a counselor was the strongest predictor (β = .537, p < .001), followed by current stress level (β = .273, p = .004) and gender (β = -.232, p = .012). Financial subsidy importance, counselor ethnic background matching, and cultural knowledge were not significant independent predictors when organizational support was accounted for.

Conclusions and Implications: Financial barriers and cultural fit concerns were prominent pre-counseling reservations among Asian American adults in this study sample, underscoring access challenges this population faces. However, once engaged in counseling, the factor that most strongly predicted perceived helpfulness was not counselor matching or financial assistance, but rather how supported participants felt by the organization in the connection process. These findings suggest that how well an organization supports clients through the intake and referral process may play a greater role in shaping counseling outcomes than counselor matching alone. Additionally, higher stress at the time of counseling was associated with greater perceived helpfulness, indicating that individuals in acute distress may be especially receptive to intervention. The findings also highlight the importance of strong rapport building and supportive referral processes within community mental health organizations serving Asian American populations, as these structural elements appear to meaningfully shape whether clients ultimately benefit from counseling.

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