Barriers to psychotherapy among depressed and nondepressed primary care patients.

Barriers to psychotherapy among depressed and nondepressed primary care patients. Research Abstract Details 

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Barriers to psychotherapy among depressed and nondepressed primary care patients. Abstract Text:

David C Mohr,Stacey L Hart,Isa Howard,Laura Julian,Lea Vella,Claudine Catledge,Mitchell D Feldman,

BACKGROUND: Most primary care patients who experience depression state that they would prefer psychotherapy over antidepressant medications. However, when referrals for psychotherapy are made, only 20% ever follow up, and of these, half drop out of treatment. This suggests that there are substantial barriers to accessing psychotherapy. PURPOSE: The aim of this study was to investigate perceived barriers to psychotherapy in a sample of primary care patients and to test the hypothesis that these barriers would be more common among patients with depression. METHODS: Patients were sampled from a large primary care service and mailed a survey. The survey included evaluation of barriers using items identified in previous published research, which we refer to as Perceived Barriers to Psychotherapy (PBP). Depression was measured using the Perceived Health Questionnaire-9 (PHQ-9). RESULTS: Of the 904 surveys sent, 290 (32.1%) were returned. The PBP produced two factors-practical barriers and emotional barriers-explaining 58.2% of the variance with an internal reliability of alpha = .79. Among all patients, 59.5% reported at least one barrier that would make it very difficult or impossible to participate in psychotherapy. Depression was associated with increased frequency of perceived barriers, with 74.0% of depressed patients reporting one or more barriers, versus 51.4% of nondepressed patients (p = .008). One or more perceived practical barriers were reported by 56.6% of the sample, whereas only 11.1% reported perceived emotional barriers. Depression was consistently associated with increased emotional barriers. Practical barriers were not consistently associated with depression but were influenced by history of psychotherapy. CONCLUSIONS: The majority of primary care patients surveyed reported one or more perceived barriers that would interfere with or prevent initiation or regular attendance of psychotherapy. Perceived barriers were more common among depressed than nondepressed patients making depression both an indicator for psychotherapy and a barrier to receiving it.

Barriers to psychotherapy among depressed and nondepressed primary care patients. Publishing Authors By Initials

DC Mohr,SL Hart,I Howard,L Julian,L Vella,C Catledge,MD Feldman,

For similar behavior and behavior mechanisms: behavior: health behavior: treatment refusal research abstracts see: behavior and behavior mechanisms: behavior: health behavior: treatment refusal research

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Barriers to psychotherapy among depressed and nondepressed primary care patients. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Annals of behavioral medicine : a publication of t

VOLUME: 32

Page Numbers: 254-8

Journal Abbreviation:

ISSN: 0883-6612

DAY: 3

MONTH: Dec

YEAR: 2006

Barriers to psychotherapy among depressed and nondepressed primary care patients. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 8510246

Barriers to psychotherapy among depressed and nondepressed primary care patients. Keywords Mesh Terms:

KEYWORDS: Treatment Refusal

MESH TERMS: psychology

Chemical & Substance for Abstract: Barriers to psychotherapy among depressed and nondepressed primary care patients. Information

Substance Name: Antidepressive Agents

Registry Number: 0

Grant and Affiliation Information for Barriers to psychotherapy among depressed and nondepressed primary care patients.

AFFILIATION: University of California, Veterans Administration Medical Center, San Francisco, California, USA. david.mohr@ucsf.edu

Country: United States

AGENCY: United States NIMH

GRANT: R01 MH59708

ACRONYM: MH

MEDLINETA: Ann Behav Med

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