Counseling in audiology practice in Saudi Arabia: perceptions, confidence, training experiences, and barriers - a cross-sectional survey.

Background: Counseling is a core component of audiological practice, addressing both informational and psychosocial needs of individuals with hearing loss. Despite its recognized importance, audiologists often report limited confidence in delivering personal adjustment counseling. In Saudi Arabia, evidence on counseling preparedness remains limited. This study examined audiologists' perceptions, confidence, training experiences, and perceived barriers related to counseling. Methods: A cross-sectional electronic survey was distributed to licensed audiologists across Saudi Arabia. The questionnaire assessed perceptions of counseling importance, self-reported confidence, barriers, and training experiences. Descriptive statistics, non-parametric comparisons, correlation analyses, and multiple linear regression were conducted. Results: Ninety-seven audiologists completed the survey. Counseling importance was rated high, while confidence was moderate, particularly for personal adjustment counseling skills. Barriers were generally low, though patient resistance and limited family involvement were moderately challenging. Confidence was associated with age and years of experience and was positively correlated with perceived importance and negatively correlated with perceived barriers. In the multivariable model, a perceived need for training was associated with lower confidence, while workshop participation was associated with higher confidence. Adequate training was independently associated with fewer perceived barriers. Conclusions: Audiologists in Saudi Arabia strongly value counseling but report moderate confidence, highlighting the central role of structured education and professional development in strengthening counseling competence and supporting patient-centered audiological care. However, the findings should be interpreted with caution, as the sample was predominantly composed of early- and mid-career clinicians and relied on self-reported data, which may limit generalizability to the broader national workforce.