Perceived barriers to psychological treatments and their relationship to depression.

In spite of repeated calls for research and interventions to overcome individual and systemic barriers to psychological treatments, little is known about the nature of these barriers. To develop a measure of perceived barriers to psychological treatment (PBPT), items derived from 260 participants were administered to 658 primary care patients. Exploratory factor analysis on half the sample resulted in 8 factors, which were supported by confirmatory factor analysis conducted on the other half. Associations generally supported the criterion validity of PBPT scales, with self-reported concurrent use of psychotherapy and psychotherapy attendance in the year after PBPT administration. Depression was associated with greater endorsement of barriers. These findings suggest that the PBPT may be useful in assessing perceived barriers.

[1]  John E. Ware,et al.  SF-36 physical and mental health summary scales : a user's manual , 1994 .

[2]  C. Mackenzie,et al.  An Adaptation and Extension of the Attitudes Toward Seeking Professional Psychological Help Scale1 , 2004 .

[3]  R. Spitzer,et al.  The PHQ-9: validity of a brief depression severity measure. , 2001, Journal of general internal medicine.

[4]  M. Browne,et al.  Alternative Ways of Assessing Model Fit , 1992 .

[5]  V. Strecher.  Internet methods for delivering behavioral and health-related interventions (eHealth). , 2007, Annual review of clinical psychology.

[6]  Marc B Rosenman,et al.  Telephonic case-finding of major depression in a Medicaid chronic disease management program for diabetes and heart failure. , 2005, General hospital psychiatry.

[7]  J. Endicott,et al.  Barriers to seeking treatment for major depression , 1996, Depression and anxiety.

[8]  M. Dewey,et al.  Assessing effectiveness of treatment of depression in primary care. Partially randomised preference trial. , 2000, The British journal of psychiatry : the journal of mental science.

[9]  Weddington Ww.  Adherence by medical-surgical inpatients to recommendations for outpatient psychiatric treatment , 1983 .

[10]  Terry L. Schell,et al.  Barriers to mental health care utilization for U.S. Cambodian refugees. , 2006, Journal of consulting and clinical psychology.

[11]  David C Mohr,et al.  The Effect of Telephone-Administered Psychotherapy on Symptoms of Depression and Attrition: A Meta-Analysis. , 2008, Clinical psychology : a publication of the Division of Clinical Psychology of the American Psychological Association.

[12]  M. Gerrity,et al.  Screening for depression and suicidality in a VA primary care setting: 2 items are better than 1 item. , 2004, The American journal of managed care.

[13]  T. Strine,et al.  The PHQ-8 as a measure of current depression in the general population. , 2009, Journal of affective disorders.

[14]  C. Sherbourne,et al.  Treatment preferences among depressed primary care patients , 2000, Journal of General Internal Medicine.

[15]  David J Miklowitz,et al.  Psychosocial intervention development for the prevention and treatment of depression: promoting innovation and increasing access , 2002, Biological Psychiatry.

[16]  J. H. Steiger.  Statistically based tests for the number of common factors , 1980 .

[17]  H. Flynn,et al.  Preferences and perceived barriers to treatment for depression during the perinatal period. , 2008, Journal of women's health.

[18]  Anthony L. Cox,et al.  Perceived Stigma and Barriers to Care for Psychological Treatment: Implications for Reactions to Stressors in Different Contexts , 2008 .

[19]  R. de Graaf,et al.  Perceived barriers to mental health service utilization in the United States, Ontario, and the Netherlands. , 2007, Psychiatric services.

[20]  Andrew Lee,et al.  Treating depression in general practice: factors affecting patients' treatment preferences. , 2000, The British journal of general practice : the journal of the Royal College of General Practitioners.

[21]  N. Anderson,et al.  Encyclopedia of health & behavior , 2004 .

[22]  J. Alvidrez,et al.  Distressed women's clinic patients: preferences for mental health treatments and perceived obstacles. , 1999, General hospital psychiatry.

[23]  M. Wierzbicki,et al.  A meta-analysis of psychotherapy dropout. , 1993 .

[24]  D. Mohr,et al.  Barriers to psychotherapy among depressed and nondepressed primary care patients , 2006, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[25]  J. Sareen,et al.  Older adults' help-seeking attitudes and treatment beliefs concerning mental health problems. , 2008, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[26]  D. Brody,et al.  Patients' perspectives on the management of emotional distress in primary care settings , 1997, Journal of General Internal Medicine.

[27]  E. Mayo-Wilson.  Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. , 2007, Psychological medicine.

[28]  H. Pincus,et al.  Overcoming barriers to reducing the burden of affective disorders , 2002, Biological Psychiatry.

[29]  R G Priest,et al.  Lay people's attitudes to treatment of depression: results of opinion poll for Defeat Depression Campaign just before its launch , 1996, BMJ.

[30]  F. Goodwin,et al.  The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. , 1993, Archives of general psychiatry.