Millions of TV viewers tuned in to watch Dr. Jennifer Melfi tend to mob boss Tony Soprano on HBO's "The Sopranos," and many of them may have been turned off to therapy because of it, says new research in the Journal of Clinical Psychology (Vol. 64, No. 3).

Study authors David Vogel, PhD, Douglas Gentile, PhD, and graduate student Scott Kaplan, all at Iowa State University, analyzed the television viewing habits of 369 college students and how that affected their thoughts on therapy.

They found that the more comedy and drama programs, which frequently feature plots involving psychological or psychiatric treatment, students watched, the more they associated negative stigmas with seeking psychological or psychiatric help. These high-exposure students also reported that they anticipated little benefit from consulting a therapist. Consequently, they were less willing to seek mental health services.

Kaplan's related analysis of TV psychologist and psychiatrist characters might reveal why: Therapists, and those who see them, are often portrayed unflatteringly.

"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 says.

Melfi, for example, discusses Soprano with her colleagues and entertains vaguely romantic feelings for him.

Gentile adds that often the only people who see therapists in these shows have severe problems.

"It's also likely that the people seeking help are portrayed in very extreme ways, which may suggest to viewers that therapy is only for people at those extremes," he says.

With repeated exposure to these messages, they can become internalized, especially when viewers don't have much real-world experience with psychologists, Vogel says. They take TV psychologists and their clients at face value.

Armed with this information, Vogel and his colleagues hope to develop interventions to counteract these effects. In recent pilot studies, they found that when people watch shows that portray psychologists and clients in a positive light, such as "Dr. Phil" and "The Oprah Winfrey Show," they develop improved attitudes toward therapy. By promoting these positive portrayals, he hopes to neutralize the negative effects of less-realistic portrayals.

-M. Price