The current study examined the associations among clients’ perceptions of self- and social stigma for seeking help, session outcomes, and working alliance. Ninety-one clients were treated by 26 therapists, at a large university counseling center. All clients were currently in therapy. We expected that clients’ perceptions of self- and social stigma would be negatively associated with session outcomes and working alliance, after controlling for number of sessions, psychological well-being, and client and therapist race/ethnicity and sex. The results showed that clients’ perceptions of self-stigma (but not social stigma) were negatively associated with working alliance. Counter to our expectations, clients’ perceptions of social stigma were positively associated with session outcomes. Although clients’ perceptions of self-stigma did not have a direct association with session outcomes, there was an indirect effect between self-stigma and session outcomes via working alliance.
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