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Managing Stress and Maintaining.

Weil-Being: Social Support, Problem-Focused
Coping, and Avoidant Coping
Ruth Chu-Lien Chao
Br”his sfudy tested a model fhaf links stress, social support, problem-focused coping, and well-being. First, if looks af
how high support significantly moderated the associafion between stress and well-being. Next, the students’ problemfocused
coping was seen as mediafing this moderated association. Finally, a 3-way inferaction of stress, social support,
and avoidant coping revealed fhaf only frequenf use of avoidanf coping accelerated fhe association between stress
and well-being in a negative way af both low and high support.
Life is full of stress for college students (Roberti, Harrington,
& Storch, 2006). For students to manage their stress, positive
social support and useful coping are essential. Bear in mind
that students manage stress differently; they assess stress, seek
support from families and friends, and execute their coping
all in their own ways.
However, although many researchers report that social support
and coping are posidvely associated with well-being (Ben-
Zur, 2009), there are two pitfalls in applying these associations
to students. One, social support is unstable or even decreasing
for some students in the recent decade (Arria et al., 2009), so it
is important to see how low support may change the associadon
between stress and students’ well-being. Two, not all coping
strategies are effective; some are fiincdonal and useful, whereas
others are less so (Carver, Scheier, & Weintraub, 1989). This
study aims to examine the moderating roles of social support
and coping on the associadon between stress and well-being.
From both theoretical and practical perspectives, there
is lack of clear understanding of the factors that can predict
the well-being of college students surrounded by a multitude
of Stressors (Skowron, Wester, & Azen, 2004). Thus, in this
article I seek to address this gap by providing theoredcal,
empirical, and practical insight into the condidons under
which stress is linked to the well-being of college students.
I integrate theories of social support and coping to propose
that the association between stress and well-being will be
buffered when students perceive high support that enhances
their problem-focused coping; in contrast, the association will
be deteriorated when students frequently use avoidant coping
when they perceive low support.
A particularly useful framework for understanding the potendal
protecdve nature of social support and coping is Lazarus
and Folkman’s (1984) stress, appraisal, and coping theory. This
theory focuses on perceived stress (a reladonship between the
person and environment that is appraised as exceeding available
resources), appraisal (one’s percepdon and assessment of social
support in the situation), and coping (effortful or purposeful
thoughts and acdons to manage or overcome stressful situadons;
Frydenberg, 1997; Lazarus & Folkman, 1984). Lazarus and
Folkman characterized coping as problem-focused, referring
to attempts to engage, act on, or change the perceived stress
(Carver et al., 1989). This overarching conceptual framework
has often served as a useful framework for tinderstanding college
students’ stress experiences.
erceived Stress and Well-Being of
College Students
Because college students are in transition fTom living at home
to living in a new city, in a new school, or with new roommates,
their developmental needs could be specifically related
to their college life. Their perceived stress can be attributed
to a multitude of social, academic, and emotional Stressors
(AUgower, Wardle, & Steptoe, 2001), ranging from academic
difficulties to uncertainty about the ftiture, conñicts with
friends, or problems with dating. Moreover, daily constant
Stressors in college life are more detrimental to well-being
than episodic or change-related Stressors (Lepore, Miles, &
Levy, 1997). What comes out as a major issue is how much
the students themselves feel their lives are unpredictable,
uncontrollable, and overloaded (S. Cohen, Kamarck, &
Mermelstein, 1983; Weinstein, Brown, & Ryan, 2009). S.
Cohen et al. (1983) added that the stress “can be viewed as
assessing a state that places people at risk of, i.e., is anteced-
Ruth Chu-Lien Chao, Counseling Psychology Program, University of Denver. Correspondence concerning this article should be
addressed to Ruth Chu-Lien Chao, Counseling Psychology Program, Morgridge College of Education, University of Denver, 1999
East Evans Avenue, Denver, CO 80208 (e-mail: [email protected]).
© 2011 by the American Counseling Association. All rights resen/ed.
Journal of Counseling & Development • Summer 2011 • Volume 89
Managing Stress and Maintaining Weil-Being
ent to, clinical psychiatric disorder” (p. 394) and encouraged
scholars to “determine whether social support protects one
from the pathogenic effects of sfressftil events . . . appraised
stress causes an illness outcome” (p. 393). Lazarus and Folkman
(1984) suggested that the sfress perceived as harmful
or threatening may exacerbate the impact of stress and may
be associated with lower well-being. Thus, the present study
measures college students’ perceived stresses that involve a
variety of Stressors and are negatively associated with wellbeing
(Schwitzer, 2008; Wang & Castaneda-Sound, 2008;
Weinstein et al, 2009).
•Social Support and Problem-Focused
According to Brown, Brady, Lent, Wolfert, and Hall (1987), satisfaction
with social support is a fijnction of the match between
the strength of one’s interpersonal needs and the social resources
provided to fulfill those needs. It was fiirther hypothesized that
dissatisfled interpersonal environment would be accompanied
by behavioral, emotional, and physiological sfrain. In short, the
present study focuses on how much college students are satisfied
with the social support they receive (Brown et al., 1987).
Moreover, research on social support and coping has shown
that satisfaction with social support is related to problemfocused
coping (Sarid, Anson, Yaari, & Margalith, 2004).
Indeed, social support has been found to be related to coping
behaviors in college female students, and perceived satisfactory
support will positively associate with students’ use of
problem-focused coping (Asberg, Bowers, Renk, & McKinney,
2008). I thus draw on theories of social support (Brown et al.,
1987) and coping (Carver et al., 1989) to propose that students’
satisfied support may be related to their use of problem-focused
coping. Figure 1 shows four hypotheses of the study.
Hypothesis 1 : Social support is positively associated with
students’ problem-focused coping.
(I report each hypothesis after reviewing relevant literature.
Concretely, Hypothesis 1 follows the literature review on
social support and problem-focused coping.)
Model of Four Hypotheses
Wofe.The model links perceived stress, social support, problem-focused
coping, and avoidant coping to psychological well-being. H = hypothesis.
•Social Support, Problem-Focused
Coping, and Well-Being of College
Social support is negatively related to mental problems
(Brown et al., 1987). In addition, although many students live
sfressflil lives, some appear to handle sfressors better than
their peers. For instance, some seek and obtain support from
families and/or friends to manage stress to maintain wellbeing,
whereas others may lack support and feel devastated
(Heftier & Eisenberg, 2009; Lee, Keough, & Sexton, 2002).
Uneven levels of social support cannot always buffer stress and
facilitate growth; low social support is incapable of buffering
the negative impact of sfress on well-being. Among the few
studies on low social suppori that are negatively associated
with well-being (e.g., Vermeulen & Mustard, 2000), individuals
with low social support were found more likely to engage
in less healthy activities such as sedentary behavior, alcohol
use, too much or too little sleep, and fatigue (Thorsteinsson
& Brown, 2008). Worse, people with low social support were
found linked to life dissatisfaction, even suicidal behavior
(Allgower et al., 2001). In interviews with 1,249 college
students, 6% reported having suicidal ideation, and low social
support was a predictor of suicidal ideation (Arria et al.,
2009). Taken together, data show that when people perceive
insufficient social support, they would lack a buffer against
life sfress that deteriorates well-being (Hefher & Eisenberg,
2009). That is, when encountering sfress, the college students
who have high social support may have a buffer to moderate
the association between sfress and well-being, whereas
those with low social support lack the buffer against stress. It
seems likely that during times of increased stress associated
with the transition to college, social support may be a useful
way of insulating the individual from the harmftjl impact of
sfress. According to Lazarus and Folkman ( 1984), a mismatch
between appraisal of available social support and perceived
sfress can result in negative outcomes, whereas the appraisal
of adequate social support can serve as a buffer against perceived
sfress on well-being.
Hypothesis 2: Social support moderates the relation
between sfress and well-being. High social support
may buffer against perceived stress that negatively
associates with well-being.
I then propose that by strengthening students’ use of
problem-focused coping, social support will further protect
the students’ well-being. Past research on college students has
revealed positive relationships between the use of problemfocused
coping and well-being (Sarid et al., 2004). Specifically,
students who use problem-focused coping tend to be
more optimistic and persistent (Sarid et al., 2004). Because
stressed college students struggle to maintain their well-being.
Journal ofCounselingôc Development • Summer 2011 • Volume 89 339
their ability to achieve well-being is heavily dependent on
their use of problem-focused coping. Students with lower
levels of stress, in contrast, may be less concemed about using
problem-focused coping to buffer the association between
stress and well-being. Thus, problem-focused coping maintains
the well-being of stressed college students by enabling
them to deal with Stressors with effective coping (Carver et al.,
1989; Sarid et al., 2004). These arguments suggest that social
support is likely to protect the well-being of stressed college
students by enhancing their use of problem-focused coping.
When people perceive stress, they appraise social support
and seek out coping resources. Lazarus and Folkman’s (1984)
theory characterized such coping as problem-focused, that is,
engaging, acting on, or changing the perceived stress (Carver
et al., 1989) so as to manage and/or overcome it.
Lazarus and Folkman (1984) suggested that coping effectiveness
plays an important role in the impact of perceived
stress on psychological outcomes: Effective coping strategies
such as problem-focused coping result in “[managing]
situations in a way such as to mitigate stress when it occurs”
(p. 198). Carver et al. (1989) further explained that problemfocused
coping aims at problem-solving or doing something to
alter the perceived stress. One might expect that, on the basis
of Lazarus and Folkman’s theoretical model, problem-focused
coping would buffer the impact of stress by influencing individuals’
accurate appraisals of available coping resources and
using specific coping efforts that mitigate stress.
Hypothesis 3a: Problem-focused coping moderates the relationship
between stress and well-being. The stronger
the problem-focused coping is, the greater the buffer
effect is on the relationship.
Next, I propose that social support buffers the association
between stress and well-being by enhancing students’ use of
problem-focused coping. Lopez, Mauricio, Gormley, Simko,
and Berger (2001) found that there are mediating roles for
coping in the relationship between attachment orientations
and current distress. Furthermore, problem-focused coping
was found to significantly mediate the relationship between
social support and well-being (Chen, Ma, & Fan, 2009). Thus,
I go further than Lazarus and Folkman’s (1984) theory and
Lopez et al.’s (2001) finding to predict that the moderating
effect of support on the relationship between stress and wellbeing
is mediated by problem-focused coping. According to
Frazier, Tix, and Barron (2004), mediated moderation refers to
instances in which a mediator variable (i.e., problem-focused
coping) explains the relation between an interaction term (i.e.,
social support) in a moderator model and an outcome (i.e.,
well-being). Because mediated moderation is present when a
moderating effect is explained by a mediating process (e.g.,
Edwards & Lambert, 2007), my arguments suggest the following
Hypothesis 3b: The moderating effect of social support
on the relationship between stress and well-being is
mediated by problem-focused coping.
•Avoidant Coping
Lazarus and Folkman (1984) stated that the effectiveness of a
coping strategy depends on the extent to which it is appropriate
to internal and/or external demands ofthe situation. Carver et
al. (1989) elaborated that certain responses to stress may tend
to be maladaptive. Specifically, the tendency to focus only on
venting frustration may be less useful to meet the demands of
the situation. Avoidant coping refers to the strategies with little
orno effectiveness (Roth & Cohen, 1986). Avoidant coping includes
three aspects: (a) focusing on and venting of emotions,
(b) behavioral disengagement, and (c) mental disengagement
(Carver et al., 1989). Focusing on and venting of emotions
indicates how distress is central in emotions without adaptive
behaviors. Behavioral disengagement stops one’s struggling
to deal with stress, and the stress still remains. For instance,
sleeping away stress is an avoidant coping behavior (Carver
et al., 1989). Mental disengagement puts stress out of sight
by various activities (“out of sight, out of mind”).
Avoidant coping may also serve as an important sotirce
of information about college students’ well-being. Coping
theorists have long argued that in addition to relying on social
support to manage stress, college students sometimes use
avoidant coping (Ben-Zur, 2009; Brown et al., 1987; Lopez
et al., 2001). Thus, it is important to understand avoidant
coping because it is prevalent among current college students
(Brougham, Zail, Mendoza, & Miller, 2009). For example, to
reduce stress, the five most frequent coping strategies among
students were browsing the Internet, sleep and rest, using
instant messaging, complaining, and watching television or
movies (Sideridis, 2008).
Individual differences in avoidant coping—^the tendency to
distract from Stressors (Carver et al., 1989)—appear to play a
critical role in shaping how students process the social support
they receive and translate that information into the association
between stress and well-being. Drawing on theories of coping,
I propose that high avoidant coping may deteriorate the effect
of perceived social support or further weaken the association.
General support for this proposition appears in Carver et al.’s
(1989) model of coping. I predict that, when students lack
support, high avoidant coping may further deteriorate the relationship
between stress and well-being. The logic underlying
this idea is that students who lack social support may also be
deprived of resources, protection, and role modeling, which
are crucial buffers to stress. When social support is low, the
buffer is also low, and students are more vulnerable to stress,
especially when they frequently use avoidant coping. Besides,
students who perceive low support and fi-equently use avoidant
coping may have the lowest scores in well-being.
340 Journal of Counseling & Development • Summer 2011 • Volume 89
Managing Stress and Maintaining Well-Being
It is interesting to note that even with high social support,
some college students may still use their own avoidant coping
to manage their stress. Carver et al. (1989) suggested
that some individuals habitually use avoidance or distraction
to cope with stress. Lopez et al. (2001) found that avoidant
coping is convenient, easy, and quick to use. Thus, I predict
that even in the presence of sufficient social support, high
avoidant coping would exacerbate the association between
stress and well-being, and low avoidant coping would make
no difference on the association because students did not have
many avoidant behaviors.
Hypothesis 4: There will be a three-way interaction of
stress, support, and avoidant coping in predicting
well-being, such that the association will be weakest
when the support is low but avoidant coping is high.
•The Present Study
In this study, I constructively tested the four hypotheses (see
Figure 1) with a sample of nonclinical college students. This
study examines how college students handle stress and aims
to determine (a) whether social support relates to problemfocused
coping; (b) whether social support moderates the
association between stress and well-being; (c) whether
problem-focused coping mediates the moderation of support
on the association; and (d) whether there is a three-way
interaction among stress, support, and avoidant coping. It is
my hope that the findings will assist college students to deal
with stress and help advance knowledge on avoidant coping
in the face of life stress. Because college students’ well-being
could be confounded with three covariates (age, year in college,
and psychotherapy), I controlled these covariates. Note
that, first, previous studies reported that age might influence
the study results if it was not controlled (e.g., Nilsson, Leppert,
Simonsson, & Starrin, 2010; Noor, 2008). Next, senior
students have more college years and are more familiar with
college life, and so may have higher levels of well-being
(Bettencourt, Charlton, Eubanks, Kemahan, & Fuller, 1999).
Finally, psychotherapy undergone by students might be a
confounding variable for their well-being (Colbert, Jefferson,
Gallo, & Davis, 2009) because they may know more than
students without therapy how to increase well-being. For
these reasons, I examine these three variables as covariates.
A total of 459 college students responded to the online survey;
390 (85%; were Caucasian White, 32 (7%) were Afiican
American, 23 (5%) were Latino, and 14 (3%) were Asian
American. Among these participants, 239 (52%) were men
and 220 (49%) were women at a large public university, with
a mean age of 20.23 years old (SD = 3.45, range = 18-35
years old). These participants included 120 (26%) freshmen,
115 (25%) sophomores, 110 (24%) juniors, and 114 (25%)
seniors. Among them, 12% (n = 55) reported having had
therapy or counseling.
Perceived Stress Scale. The Perceived Stress Scale (PSS;
S. Cohen et al., 1983) is a 10-item measure, with a 5-point
Likert scale ranging ti-om 1 {not at all satisfied) to 7 {very
satisfied), to assess the degree to which individuals perceive
their lives as stressful. Higher scores indicate greater perceptions
of life stress, and lower scores reflect lower perceptions
of stress. The PSS showed adequate coefficient alphas, .84
and .85 for two college samples (S. Cohen et al., 1983); in
this study, the coefficient alpha was .85. The PSS has been
positively correlated with life-event scores, depressive and
physical symptomatology, social anxiety, and maladaptive
health-related behaviors such as increased smoking (S. Cohen,
Sherrod, & Clark, 1986). These pieces of evidence indicate
the construct and concurrent validity of the PSS. Furthermore,
Kuiper, Olonger, and Lyons (1986) found the PSS to
be associated with people’s greater vulnerability to depressive
symptoms related to stressful life events.
Social Support Inventory. The Social Support Inventory
(SSI; Brown et al., 1987) is a 39-item questionnaire that
assesses satisfaction with support and help received from
others over the previous month. Ratings are made on 7-point
Likert-type scales ranging trom 1 {not at all satisfied) to 7
{very satisfied). The SSI has five subscales: Acceptance and
Belonging, Appraisal and Coping Assistance, Behavioral and
Cognitive Guidance, Tangible Assistance and Material Aid,
and Modeling. Brown et al. (1987) suggested that the total
score can be obtained by summing up ratings over 39 items.
Higher scores indicate higher perception of and satisfaction
with support received. Brown et al. conducted a factor analysis
of SSI among 340 college students ii-om three universities and
reported satisfactory coefficient alphas of the five subscales,
fi-om .79 to .91. For the total score, the coefficient alpha was
.95 in Brown et al. and .90 for the present sample. The SSI had
appropriate construct validity, being positively related to other
social support measures and negatively related to depression
measures (Brown et al., 1987).
Coping. Problem-focused coping and avoidant coping were
measured with the COPE Inventory (Carver et al., 1989),
which assesses different ways of responding to stress. The 60-
item self-report measure uses a 4-point Likert scale ranging
from 1 (/ usually don’t do this at all) to 4 (/ usually do this a
lot) to assess 13 patterns of coping, including problem-focused
coping and avoidant coping. Among these 13 patterns of coping,
problem-focused coping is composed of five scales: Active
Coping, Planning, Suppression of Competing Activities,
Restraint, and Use of Instrumental Social Support. Avoidant
Coping has three scales: Focus on and Venting of Emotions,
Journal ofCounseling& Development • Summer 2011 • Volume 89 341
Behavioral Disengagement, and Mental Disengagement. High
scores of particular patterns indicate high tendency to use
these coping patterns in sfress. Carver et al. (1989) reported
that coefficient alphas of the scales were adequate for both
problem-focused coping (.83) and avoidant coping (.80); my
sample had a coefficient alpha of .85 for problem-focused
coping and .84 for avoidant coping. Convergent validity has
been demonsfrated with numerous personality measures, including
optimism, confrol, self-esteem, intemality, hardiness,
self-monitoring, and anxiety. The COPE Inventory has also
been used to assess strategies for coping with specific life
events (Carver & Scheier, 1994). Previous studies have shown
that the COPE Inventory fit the original factor structures well,
with adequate convergent and discriminant validity. The COPE
Inventory is correlated with various measures, including
hassles and uplifts, physical symptoms, degree of satisfaction
with life, positive affectivity, and negative affectivity (Clark,
Borman, Cropanzano, & James, 1995).
Mental Health Inventory. The Mental Health Inventory
(MHI; Veit & Ware, 1983) is a 38-item measure assessing both
disfress and weU-being among adults. Ratings are made on a
5-point Likert scale. The MHI has two scales: Psychological
Disfress and Psychological Well-Being. The present study used
the Psychological WeU-Being scale, which Veit and Ware ( 1983)
reported as appropriate as an outcome measure. The MHI has
been used extensively in studies of nonpsychiatric samples, and
its psychometric adequacy has been weU established (Siegel,
Karus,Raveis,& Hagen, 1998; Veit & Ware, 1983). My sample
was found to have a coefficient alpha of .89. Concurrent and
convergent validity for the MHI-Psychological WeU-Being
scale have been estabUshed through positive correlations with
measures on positive affect (Siegel et al., 1998).
Demographic information. The demographic information
includes questions on participants’ ethnicity/race, age,
sex, year in college, and whether they have had therapy or
Participants completed answering an online questionnaire
package containing the PSS, SSI, COPE problem-focused and
COPE avoidant scales, MHI-Psychological Well-Being scale,
and a demographic questiotmaire. Immediately after completion
of the questionnaire, participant data were stored in a
password-protected data file on a networked computer. Participants’
login details were immediately placed in a separate
file; these files could not be combined to identify individual
participants’ responses. However, the login data file was used
to verify individual student participation; these data were also
used to verify that participants only participated once.
Before the survey began, a research coordinator announced
the study project in psychology classes, such as infroductory
psychology, psychological assessment, personality theory,
experimental psychology, and statistics. The research coordinator
then e-mailed 500 students an invitation and a reminder.
Four hundred and eighty-five students agreed to participate,
479 students completed the survey, and 20 students responded
to a validity item inaccurately. So, the completed data of 459
participants (a response rate of 92% [459/500 = 92%]) were
used in the analyses. Those who agreed to participate received
an invitation e-mail with a survey link. Participants were informed
that the goal of the study was to identify factors that
can change weU-being among college students. The online
survey indicated to the participants that by completing the
survey, they had consented to participate in the study. After
the survey was completed, a debriefing form was provided.
Also, in addition to receiving their research credit, participants
could provide their contact information, which would
be stored in a separate data file, to enter a drawing for one of
ten $20 cash prizes.
Preliminary Analyses and Descriptive Statistics
The descriptive statistics, internal consistency reliability
estimates, and correlations among variables of interest were
examined for the study. The zero-order correlations among
the variables indicated that both perceived sfress and avoidant
coping were related negatively to overall psychological
well-being, but social support and problem-focused coping
were related positively to well-being. A series of analyses of
variance (ANOVAs) were then conducted on weU-being to
examine whether the dependent variable varied as a function
of participants’ sex and ethnicity. None of these demographic
variables had significant effects on well-being: sex, F(l, 458)
= 0.69,p > .05, and ethnicity, F(4,455) = 0.7S,p > .05. Thus,
in general, the dependent variable did not differ significantly
in terms of these demographic variables (all ps > .05). Yet, to
college students, sfress may be perceived differently according
to differences in age, year of college, and psychotherapy (Thorsteinsson
& Brown, 2008), therefore it was critical to confrol
these factors before conducting multiple regression analyses.
Another issue with multiple regression analysis is normality,
because substantial departures from normality can
adversely affect the analyses, and thus the data need to meet
regression asstimptions of normality, linearity, and homoscedasticity
(J. Cohen, Cohen, West, & Aiken, 2003). Results of
multiple regression analyses indicated that the skewness of
residuals ranged from-0.17 (Z = -l.33,p> .05) to-0.19 (Z
= -1.54, p > .05) and the kurtosis of residuals ranged from
0.54 (Z= 1.65,p > .05) to 0.57 (Z= 1.68,;? > .05); the results
indicated no statistical departure from normality.
Two-Way Interaction of Stress and Social Support
To test the four hypotheses (see Figure 1) in the link between
perceived stress and psychological weU-being, I followed
Dawson and Richter’s (2006) recommendation and used
hierarchical multiple regression analyses to test moderator
effects. I followed Aiken and West’s (1991) suggestion and
342 Journal ofCounseling& Development • Summer 2011 • Volume 89
Managing Stress and Maintaining Well-Being
used centered variables (i.e., mean deviation scores) to reduce
multicollinearity between interacdon terms and main effects
when testing for moderator effects.
In support of Hypothesis 1, social support was positively
associated with problem-focused coping (B = 1.58, SE =
0.32, ß = .23, t = 4.97, p < .001). The results of analyzing Hypothesis 2 are displayed in Table 1, Steps 1, 2, and 3. Step 1 indicated that no covariate (i.e., age, year in college, and psychotherapy) significantly accounts for the variance of psychological well-being in college students. In Step 2, perceived stress and social support accounted for 40% of well-being. In Step 3, the two-way interactions significantly predicted well-being (AÄ^ = .01, /? < .05). In addidon, the regression coefficient for the two-way interaction of Perceived Stress X Social Support was statistically significant (see Table 1). Champoux and Peters (1987) comprehensively reviewed social science literature and reported that interaction terms typically account for approximately 1% to 3% of the variance, although J. Cohen (1992) indicated that an R^ value of .01 indicates a small effect size. After a significant two-way interacdon effect was found, the next step was to interpret the interacdon by plotting social support scores for stress scores of one standard deviadon above and below the mean (Aiken & West, 1991). To check whether the slopes of simple regression lines at high and low social support significantly differed fiom zero, I conducted simple regression analyses outlined by Aiken and West ( 1991 ). This regression model's criterion variable (i.e., well-being) is regressed on the predictor (i.e., stress), the moderator (i.e., social support) at a condidonal value (e.g., high or low), and the Predictor x Moderator interacdon. The t test for the regression coefficient of the predictor variable in this equadon did reflect the significance of the simple slope (i.e., whether the slope is significantly different from zero). The results indicated that the slope with high social support was insignificantly different from zero (5 = -0.52, Sff=0.61, ß = -.05, t = -0.86, p = .39), but the slope with low social support was significantly different from zero (B = -2.80, SE = 0.58, ß = -.25, í = -4.85, p < .001). These results indicate that high social support served as a buffer for college students to keep up their well-being, whereas low support was not a buffer against stress. The difference between these two regression lines was also significant, as indicated by the significant regression coefficients found for the interaction terms in the tests of the moderator effects, according to the procedure recommended by Aiken and West ( 1991 ). Test of Mediated Moderation by Problem-Focused Coping Next, I sought to examine whether problem-focused coping mediated the moderating effect of social support on the relationship between stress and well-being. To do so, I used the path analysis framework developed by Edwards and Lambert (2007). Because my previous results supported the link between social support and problem-focused coping, I turned to Hypothesis 3a, which stated that problem-focused coping would moderate the associadon between stress and well-being. Following recommendations from Edwards and Lambert, I tested this hypothesis with a hierarchical regression analysis in which I first controlled for stress, support, and the interaction product of stress and support (see Table 1, Step 3) and then entered problem-focused coping and the interacdon product of stress and problem-focused coping (see Table 1, Steps 4 and 5). The result in Table 1, Step 5, showed that, as hypothesized, the interaction of Perceived Stress x Problem- Focused Coping significantly predicted psychological wellbeing of college students. TABLE 1 Hierarchical iUluitiple Regression Anaiysis Predicting Psychoiogicai Weii-Being: Test of Hypotheses 2 and 3a step and Variable Step 1 Age College year Previous counseling Step 2 Perceived stress Social support Step 3 Perceived Stress x Social Support Step 4 Problem-focused coping Step 5 Perceived Stress x Problem-Focused Coping S 0.24 -0.63 2.46 -1.32 6.98 -0.01 1.54 0.96 SEB 0.19 0.53 2.77 0.47 0.44 0.00 0.45 0.45 ß .06 -.06 .04 -.12 .60 -.57 .13 -.08 f 1.25 -1.19 0.89 -3.97*** 15.89*** -2.80** 3.45** -2.06* .01 .41 .42 .43 .44 AfP .01 .40 .01 .01 .01 AF 1.03 140.25*** 7.86* 11.87** 4.25* df (1,426) (2, 424) (3, 423) (1,422) (1,421) Note. N = 459. 'p < .05. **p < .01. ***p < .001. Journal of Counseling & Development • Summer 2011 • Volume 89 343 I interpreted the interaction by plotting the simple slopes for the relationships between stress, problem-focused coping, and well-being at one standard deviation above and below the mean. The simple slopes indicated that sfress was more negatively associated with well-being when college students reported low rather high problem-focused coping. Similar to the pattern observed for social support, the simple slopes for the relationship between stress and well-being were negative and differed significantly from zero at low levels of problemfocused coping {B = -3.40, SE = 0.79, ß = -.30, / = -4.28, /? < .001) but did not differ significantly from zero at high levels of problem-focused coping (.S = -0.71, 5£' = 0.72, ß = -.06, t = -0.98, p = .33). These results indicate that, in suppori of Hypothesis 3a, problem-focused coping did buffer the relationship between students' stress and well-being, and students who had high problem-focused coping had significantly higher well-being than those with low problem-focused coping. Hypothesis 3b predicted that problem-focused coping would mediate the moderating effect of social support on the association between stress and well-being. I completed the test of mediation following the recommendations from Edwards and Lambert (2007) and estimated the indirect effects of the Perceived Stress x Social Support interaction through problem-focused coping. I used the coefficients from the prior analyses and then applied bootstrapping methods to construct bias-corrected confldence intervals on the basis of 1,000 random samples with replacement from the ftill sample. Mediation occurs when the size of an indirect effect diners significantly from zero (MacKinnon, Fairchild, & Fritz, 2007). The size of the indirect effect from the full sample was -3.24 (1.58 X -2.05), and the 95% confidence interval [-5.33, -1.15] excluded zero. Thus, in support of Hypothesis 3b, perceived task significance mediated the moderated effect of social support on the relationship between stress and well-being. Chao Three-Way Interaction of Perceived Stress, Social Support, and Avoidant Coping I tested Hypothesis 4 by examining the three-way interaction among perceived stress, social support, and avoidant coping. All terms (all predictors and two-way interactions) were entered, followed by the three-way interaction term, in the regression analyses. Data in Table 2 show that, in Step 4, a three-way interaction was found to significantly contribute to the variance of well-being {hR} = .01,/> < .05). After seeing that Step 4 showed significant three-way interaction, I then used the same procedure described earlier to plot the three-way interaction. As illustrated in Figure 2, among students who reported high levels of social support, the association between stress and well-being was not significantly different from zero for those who only infrequently used avoidant coping {B = 0.78, SE = 0.96, ß = .07, í = 0.81 /? > .05) but was significantly
different for those who frequently used avoidant coping (5
= -1.86, SE = 0.73, ß = -.16, / = -2.54,/? < .05). The results indicate that even with high social support, frequent use of avoidant coping would still affect the association between stress and well-being in a negative way (see Figure 2). Lower social support relates to lower well-being than does higher support, and a similar finding appears on the patterns of interaction of sfress and avoidant coping (see Figure 2). When students perceived low support, those with frequent avoidant coping had the lowest scores on well-being (Ä = -3.88, SE = 0.95, ß = -.33, t = -4.02,p < .001). In contrast, even perceiving low support, those who used less avoidant coping exhibited a pattern in which the association between sfress and well-being was not signiflcantly different from zero (B = 0.40, SE = 0.79, ß = .04, í = 0.51,;? > .05). These results
indicated that college students who reported low social support
and frequent use of avoidant coping were most vulnerable to
Hierarchical Multiple Regression Analysis Predicting Psychological Well-Being From Perceived Stress,
Social Support, Dysfunctional Coping, and Their Interaction: Test of Hypothesis 4
step and Variable 8 SEB ß df
Step 1
College year
Previous counseling
Step 2
Perceived stress
Social support
Avoidant coping
Step 3
Perceived Stress x Social Support
Perceived Stress x Avoidant Coping
Social Support x Avoidant Coping
Step 4
Perceived Stress x Social Support x
Avoidant Coping
– . 1 2 ”
.01 1.03 (1, 426)
.40 95.58*** (3,423)
.01 2.88* (3,420)
.01 4.32* (1,419)
Note. N = 459.
*p<.05. **p<.01.***p<.001. 344 Journal ofCounselingôc Development • Summer 2011 • Volume 89 Managing Stress and Mainfaining Weil-Being 60- ; High Support/Low Avoidance : High Support/High Avoidance : Low Support/Low Avoidance : Low Support/High Avoidance 55 — i-be 1m îhoioj QL 50 — 45 — 40 — 35 — 30—1 = 0.78 8 = 1.86* -o B= 0.40 = -3.88*** I I Low (1 SD below) High (1 SD above) Perceived Stress FIGURE 2 Three-Way Interaction of Stress, Sociai Support, and Avoidance Coping on Psychological Weli-Being "p < .01. ***p < .001. stress, and infrequent use of avoidant coping would not worsen the association between stress and well-being. •Discussion The results provide initial support for Hypotheses 1, 2, 3a, 3b, and 4. Social support appears to buffer the relationship between perceived stress and psychological well-being of college students, and this moderating effect is mediated by problem-focused coping. In addition, as predicted in the three-way interaction, avoidant coping deteriorates the association between stress and well-being, especially when there is low social support. Specifically, students using high avoidant coping in a low social support environment may have the lowest well-being when they are in stress. Taken together, the present study offers important contributions to research on stress, social support, coping, and well-being in three ways. First, the study extends a growing body of research on stress and well-being. Rather than assuming that stress is always negatively associated with well-being, I examined the conditions under which stress would be more and less likely to predict these outcomes. In doing so, my findings provide novel insights into the role of social support and a significant two-way interaction between stress and social support. When in stress, college students need assurance that others (e.g., friends, family) are willing to listen and talk. Unfortunately, some students may feel dissatisfied with the social support they receive (Arria et al., 2009). Not surprisingly, students with unsatisfactory support in their social environment were quite vulnerable, showing a low level of well-being. Moreover, many college students live at the crossroads of various Stressors, struggling for independence, problems with roommates or friends, worries about dating, and concerns about grades. All these Stressors can make students feel as if things happen to them unpredictably, unexpectedly, and overwhelmingly. For instance, who could provide them support by serving as models on how to bounce back to Grade A afler they fail a midterm exam? How could they see hope and love afler breaking up with a loved one? Students face a long list of daily Stressors. Rather than detailing Stressors, scholars, educators, and counselors must understand that low levels of support diminish well-being, and as I have specifled, particular components of support moderate the association between stress and well-being. Second, problem-focused coping in the present study serves two roles regarding stress and well-being. On the one hand, a high level of problem-focused coping helped students maintain their well-being when in stress, whereas a low level of problem-focused coping affected this association in a negarive way. Simply put, when students face Stressors, dealing with the problems may be a good way to keep "peace of mind" while postponing or not solving the problem may take a mental or emotional toll on their well-being. On the other hand, problem-focused coping significantly mediates the moderation of support on the association between stress and well-being. In other words, when individuals feel supported by family and friends, concentrating on solving problems may further help them maintain their well-being. Third, a significant three-way interaction of Perceived Stress X Social Support x Avoidant Coping significantly contributes to the variance of college students' well-being. High avoidant coping reduces well-being at both high and low social support (see Figure 2); however, low avoidant coping does not affect the association between stress and well-being in a negative way at high and low support. Thus, taken together, the findings highlight the significance of avoidant coping. Specifically, even as students perceive high levels of social support, continuing avoidant coping will lower their wellbeing. In other words, avoidant coping may overpower social support to reduce well-being. Worse, in recent years, avoidant coping has been used by some college students (Brougham et al., 2009) and appears to weaken well-being, but to date, not much scholarly attention is paid to this problem. These findings have advanced the knowledge on college students' mental health in two ways. First, social support is indispensable to the students. Students' well-being wanes without social support buffering harmful stress, and the moderation effect of support is mediated by problem-focused coping. Second, high divorce rate, unsteady family income, and absentee parents are indexes to low social support that fail to alleviate students' stress at school and in relationships with others (Bulduc, Caron, & Logue, 2007). The findings suggest that when support is low, students are more vulnerable Journal of Counseling & Development • Summer 2011 • Volume 89 345 Chao to avoidant coping. The study's results of the exacerbating effects of low social support and avoidant coping on stress and well-being contribute to the understanding of college life. Limitations The present study has four limitations. One, the findings describe current college students' social support, problemfocused coping, avoidant coping, and well-being based on the theories of Lazarus and Folkman ( 1984), Brown et al. ( 1987), and Carver et al. (1989) and cannot be generalized to other populations. People of different ages and status of leaming may have different or even contrasting perceptions on stress and well-being. For example, seniors may embrace the value of "toughing out" stress, whereas some young adults may prefer to have fun (Sideridis, 2008). Two, the study examined two types of coping, problem-focused and avoidant, to better describe that people may use more than one type of coping to manage stress; however, the study does not focus on the relation between these two types of coping. The findings did not examine when and how students use a particular type of coping over the other, although it is understood that students may simultaneously use problem-focused coping academically and avoidant coping (e.g., venting emotions) for other issues. Three, the findings may only explain the avoidant coping of students in the United States and do not demonstrate that avoidant coping is cross-culturally universal in deteriorating the well-being of all students. Fortunately, this limitation could be resolved by fiiture studies. Four, there is a potential monomethod bias based on using self-report measures alone. The participants were recruited in classrooms and then followed up with e-mails, and so the sampling process could be limited in external validity. Future Research Directions There are four recommendations for future research. First, I recommend replicating this study among students in different cultures. For example, I found that social support is critical for students, but students of different cultures may need other types of support, such as financial help (Olson, Garriott, Rigali-Oiler, & Chao, 2009). Appreciating the role of a specific component of social support in a specific cultural framework is essential for counselors who attempt to provide effective help to students of various cultures. Second, it may be beneficial to examine how college students in different cultures use problem-focused and/or avoidant coping. Specifically, some Asian students were found to use behavioral disengagement more often than U.S. students did, whereas US. students used problem-focused coping more often than students in other countries (Connor-Smith & Flachsbart, 2007; Cross, 1995) did. Thus, it is necessary to know how problem-focused and avoidant coping interweave with culture. Third, the present study relies on self-report measures, so the connections between the variables need to be further evaluated by other types of research. I suggest that future studies examine social support and avoidant coping via other methodologies (such as qualitative research). For example, students' subjective reflection may prove or disprove my results, offer information I may not be aware of, or extend my results to provide a better understanding how college students cope with stress. It is equally important to further evaluate interventions based on the model in the present study. For instance, fiiture study could examine the effectiveness of interventions, such as social support as a buffer or problem-solving coping as a mediator between stress and well-being. Fourth, how to maintain well-being in the face of stress has been a challenge for college students (Schwitzer, 2008; Wang & Castaneda-Sound, 2008). The present study examines a nonclinical sample, and so it appears appropriate to take well-being, not distress, as an outcome variable. Future studies may need to include distress as an outcome variable to see how social support, problem-solving coping, and avoidant coping relate to psychological distress. Implications for Counseling This study has three implications for counseling. To begin with, as the literature review shows, when students perceive low levels of social support, they may have less of a buffer against stress. So, counselors would do well to invite the students to talk about how they perceive their social support rather than assuming that most students enjoy a highly supportive life. For students with low social support or lack of a buffer against stress, counselors can help them explore which specific component(s) of social support was so low as to render them quite vulnerable. Next, counselors can facilitate students' problemfocused coping. Enhancing problem-focused coping could help students in stress in crucial ways. For example, counselors can offer psychoeducation to help students make plans, such as breaking problems into workable steps or having mentors to guide in academic work. Leaming how to solve problems to work through stress could very possibly increase their well-being. Or students can learn to cultivate self-assurance and hope, thereby buffering their stress. Shapiro, Oman, Thoresen, Pante, and Flinders (2008) reported that increased mindfulness mediated reductions in perceived stress and rumination. Furthermore, counselors can allow college students to describe what, why, how, and when they use avoidant coping. The more counselors understand the function of this type of coping in students' life, the more effective counselors' interventions would become. For instance, some students may stmggle with academic stress without knowing how to take notes or make reading plans, to the point that they avoid problems by resorting to listening to music, complaining, or mentally disengaging. Counselors' resources on study skills could enable the students to reduce avoidant coping. Thus, low avoidant coping, especially combined with high levels 346 Journal ofCounseling& Development • Summer 2011 • Volume 89 Managing Stress and Maintaining Well-Being of support, will help students maintain their weU-being and make them less vulnerable to sfress (see Figure 2). In sum, in addition to the moderating effect of social support on the association between stress and well-being, this study advanced knowledge on coping. Problem-focused coping significantly mediates the moderating effect of social support on the association between sfress and well-being, but avoidant coping has a negative effect on association. eferences Aiken, L., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage. AUgower, A., Wardle, J., & Steptoe, A. (2001). Depressive symptoms, social support, and personal health behaviors in young men and women. Health Psychology, 20, 223-227. doi:10.1037/0278-6133.20.3.223 Arda, A. M., O'Grady, K. E., Caldeira, K. M., Vincent, K. B., Wilcox, H. C, & Wish, E. D. (2009). Suicide ideation among college students: A multivadate analysis. Archives of Suicide Research, 13, 230-246. doi:10.1080/13811110903044351 Asberg, K. K., Bowers, C, Renk, K., & McKinney, C. (2008). A structural equation modeling approach to the study of stress and psychological adjustment in emerging adults. Child Psychiatry & Human Development, 39,481-501. doi:10.1007/sl0578-008-0102-0 Ben-Zur, H. (2009). Coping styles and affect. International Journal of Stress Management, 16, 87-101. doi:10.1037/a0015731 Bettencourt, B. A., Charlton, K., Eubanks, J., Kemahan, C, & Fuller, B. (1999). Development of collective self-esteem among students: Predicting adjustment to college. Basic and Applied Social Psychology, 21, 213-222. Brougham, R. R., Zail, C. M., Mendoza, C. M., & Miller, J. R. (2009). Stress, sex differences, and coping strategies among college students. Current Psychology, 28, 85-97. doi: 10.1007/ S12144-009-9047-0 Brown, S. D., Brady, T, Lent, R. W, Wolfert, J., & Hall, S. (1987). Perceived social support among college students: Three studies of the psychometdc charactedstics and counseling use of the Social Support Inventory. Journal of Counseling Psychology, 34, 337-354. doi:10.1037/0022-0167.34.3.337 Bulduc, J. L., Caron, S. L., & Logue, M. E. (2007). The effects of parental divorce on college students. Journal of Divorce & Remarriage, 46, 83-104. doi:10.1300/J087v46n03_06 Carver, C. S., & Scheier, M. F (1994). Situational coping and coping dispositions in a stressñil transaction. Journal of Personality and Social Psychology, 56, 267-283. doi:10.1037/0022- 3514.56.2.267 Carver, C. S., Scheier, M. F, & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56,161-19,31. doi:10.1037/0022- 3514.56.2.267 Champoux, J. E., & Peters, W. S. ( 1987). Form, effect size and power in moderated regression analysis. Journal of Occupational Psychology, 60, 243-255. Chen, L.-F, Ma, S.-B., & Fan, C.-X. (2009). A structural equation model of stress, coping style, social support and subjective well-being for college students. Chinese Journal of Clinical Psychology, 17, 266-268. Clark, K. K., Borman, C. A., Cropanzano, R. S., & James, K. (1995). Validation evidence for three coping measures. Journal of Personality Assessment, 65,434-455. doi:10.1207/sl5327752jpa6503_5 Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155-159. doi:10.1037/0033-2909.112.1.155 Cohen, J., Cohen, P, West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral science (3rd ed.). Mahwah, NJ: Erlbaum. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385-396. doi: 10.2307/2136404 Cohen, S., Sherrod, D. R., & Clark, M. S. (1986). Social skills and the stress-protective role of social support. Journal of Personality and Social Psychology, 50, 963-973. doi:10.1037/0022- 3514.50.5.963 Colbert, L. K., Jefferson, J. L., Gallo, R., & Davis, R. (2009). A study of religiosity and psychological well-being among AfHcan Amedcans: Implications for counseling and psychotherapeutic process. Journal of Religion and Health, 48, 278-289. doi:10.1007/ S10943-008-9195-9 Connor-Smith, J. K., & Flachsbart, C. (2007). Relations between personality and coping: A meta-analysis. Journal of Personality and Social Psychology, 93, 1080-1107. doi: 10.1037/0022- 3514.93.6.1080 Cross, S. E. (1995). Self-construals, coping, and stress in crosscultural adaptation. Journal of Cross-Cultural Psychology, 26, 673-697. doi:10.1177/002202219502600610 Dawson, J. F, & Richter, A. W. (2006). Probing three-way interactions in moderated multiple regression: Development and application of a slope difference test. Journal of Applied Psychology, 91, 917-926. doi:10.1037/0021-9010.9L4.917 Edwards, J. R., & Lambert, L. S. L. (2007). Methods for integrating moderation and mediation: A general analytical framework using moderated path analysis. Pyyc/io/ogica/A/eí/iocís, 12, -ll. doi:10.1037/1082-989X.12.1.1 Frazier, P A., Tix, A. P, & Barron, K. E. (2004). Testing moderator and mediator effects in counseling psychology research. Journal of Counseling Psychology, 51,115-134. doi:10.1037/0022-0167.5I.L115 Frydenberg, E. ( 1997). Adolescent coping: Research and theoretical perspectives. London, England: Routledge. Hefner, J., & Eisenberg, D. (2009). Social support and mental health among college students. American Journal of Orthopsychiatry, 79, 491-^99. doi:10.1037/a0016918 Kuiper, N. A., Olonger, J., & Lyons, L. M. (1986). Global perceived stress level as a moderator of the relationship between negative life events and depression. Journal of Human Stress, 12, 149-153. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York, NY: Spdnger. Journal of Counseling & Development • Summer 2011 • Volume 89 347 Chao Lee, R. M., Keough, K. A., & Sexton, J. D. (2002). Social connectedness, soeial appraisal, and perceived stress in college women and men. Journal of Counseling & Development, 80, 355-361. Lepore, S., Miles, H., & Levy, J. S. (1997). Relation of chronic and episodic Stressors to psychological distress, reactivity, and health problems. International Journal of Behavioral Medicine, 4, 39-59. doi:10.1207/sl5327558ijbm0401_3 Lopez, F. G., Mauricio, A. M., Gormley, B., Simko, T., & Berger, E. (2001). Adult attachment orientations and college student distress: The mediating role of problem coping styles. Journal of Counseling & Development, 79, 459—464. MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593-614. doi:10.1146/annurev.psych.58.110405.085542 Nilsson, K. W., Leppert, J., Simonsson, B., & Starrin, B. (2010). Sense of coherence and psychological well-being: Improvement with age. Journal of Epidemiology and Community Health, 64, 347-352. doi:10.1136/jech.2008.081174 Noor, N. M. (2008). Work and women's well-being: Religion and age as moderators. Journal of Religion and Health, 47,476-490. doi: 10.1007/s 10943-008-9188-8 Olson, A., Garriott, P. O., Rigali-Oiler, M. E., & Chao, R. (2009, August). Debt, class, and coping: A model for counseling psychology trainees. Poster presented at the Annual Convendon of the American Psychological Association, Toronto, Ontario, Canada. Roberti, J. W., Harrington, L. N., & Storch, E. A. (2006). Further psychometric support for the 10-item version of the Perceived Stress Scale. Journal of College Counseling, 9, 135-147. Roth, S., & Cohen, L. J. (1986). Approach, avoidance, and eoping with stress. American Psychologist, 41, 813-819. doi: 10.1037/0003-066X.41.7.813 Sarid, O., Anson, O., Yaari, A., & Margalith, M. (2004). Coping styles and ehanges in humoural reaction during academic stress. Health and Medicine, 9, 85-98. Schwitzer, A. M. (2008). College student health, mental health, and well-being. yo«rna/o/Co//ege Counseling, II, 99-100. Shapiro, S. L., Oman, D., Thoresen, C. E., Pante, T. G., & Flinders, T. (2008). Cultivating mindñilness: Effects on well-being. Journal of Clinical Psychology, 64, 840-862. doi:10.1002/jclp.20491 Sideridis, G. D. (2008). The regulation of affect, anxiety, and stressful arousal from adopdng mastery-avoidance goal orientations. , Stress and Health. 24, 55-69. doi: 10.1002/smi. 1160 Siegel, K., Kanis, D., Raveis, V H., & Hagen, D. (1998). Psychological adjustment of women with HIV/AIDS: Racial and ethnic comparisons. Journal of Community Psychology, 26, 439-455. doi: 10.1002/(SICI) 1520-6629( 199809)26:5<439: : AIDJCOP4>
Skowron, E. A., Wester, S. R., & Azen, R. (2004). Differendation of
self mediates college stress and adjustment. Journal of Counseling
<& Development, 82, 69-78. Thorsteinsson, E. B., & Brown, R. F. (2008). Mediators and moderators of the stressor-fatigue relationship in nonclinical samples. Journal of Psychosomatic Research, 66, 21-29. Veit, C. T, & Ware, J. E. (1983). The structure of psychological distress and well-being in general populations. Journal of Consulting and Clinical Psychology, 51,730-742. doi: 10.1037/0022-006X.51.5.730 Vermeulen, M., & Mustard, C. (2000). Gender differences in job strain, social support at work, and psychological distress. Journal of Occupational Health Psychology, 5, 428—440. doi: 10.1037/1076-8998.5.4.428 Wang, C.-C. D. C, & Castaneda-Soun4 C. (2008). The role of generational status, self-esteem, academic self-efficacy, and perceived stress in college students' psychological well-being. Journal of College Counseling, 11, 101-118. Weinstein, N., Brown, K. W., & Ryan, R. M. (2009). A muld-method examination of the effects of mindfulness on stress attribution, coping, and emotional well-being. Journal of Research in Personality, 43, 374-385. doi:10.1016/j.jrp.2008.12.008 348 Journal ofCounseling& Development • Summer 2011 • Volume 89 Copyright of Journal of Counseling & Development is the property of American Counseling Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY AND GET AN AMAZING DISCOUNT 🙂

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