Perceived Stigma and Barriers to Care for Psychological Treatment: Implications for Reactions to Stressors in Different Contexts

Britt, Thomas W.; Greene–Shortridge, Tiffany M.; Brink, Sarah; Nguyen, Quyen B.; Rath, Jaclyn; Cox, Anthony L.; Hoge, Charles W.; Castro, Carl A.

doi:10.1521/jscp.2008.27.4.317

Cited by 204 publications

(210 citation statements)

References 27 publications

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“…Factors that increase risk for suicidal ideation and attempts, such as low socio-economic status, which is associated with impediments in affording transportation and treatment; depression, which is characterized by low motivation; and borderline personality disorder, which is associated with difficulty interacting with others (Kessler, Borges, & Walters, 1999) may also serve as barriers to engaging in treatment. Social stigma associated with mental illness may also increase people's reluctance to enter and stay in treatment (Britt et al, 2008;Golberstein, Eisenberg, & Gollust, 2008). The ability to overcome these hurdles may be further compromised by the restricted cognitive functioning that is often associated with the suicidal state (for reviews, see Baumeister, 1990 andBeck, 2009).…”

Section: Motivation As a Central Issue In Suicide Preventionmentioning

confidence: 99%

Integrating Motivational Interviewing and Self-Determination Theory With Cognitive Behavioral Therapy to Prevent Suicide

Britton

Patrick

Wenzel

et al. 2011

Cognitive and Behavioral Practice

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Cognitive Behavioral Therapy (CBT) has been found to be effective in preventing suicide-related behavior. However, it is often difficult to engage patients who are at-risk in treatment. Motivational Interviewing (MI) has been shown to increase treatment engagement and improve treatment outcomes when it is used to complement other treatments. As a general theory of human motivation that is consistent with MI, Self-Determination Theory (SDT) provides a framework for understanding how MI may be added to CBT to increase treatment engagement and effectiveness. In this paper, we use SDT to explain how MI may complement CBT to reduce suicide-related behavior, provide a case example of using MI with a suicidal patient before CBT-based treatment, and explore future directions for research.In the United States, over 300,000 people died by suicide between 1995 and 2005, making suicide a major public health concern (Centers for Disease Control and Prevention, 2008). Although an estimated 90% of individuals who die from suicide suffer from one or more mental disorders, up to 65% never receive psychological or psychiatric treatment (Cavanagh, Carson, Sharpe, & Lawrie, 2003). Psychosocial interventions such as Cognitive Behavioral Therapy are effective in reducing suicide-related behaviors (CBT; Tarrier, Taylor, & Gooding, 2008); thus, it is important to use theoretically and empirically supported methods to ensure that at-risk clients receive effective mental health treatment. Motivational Interviewing (MI;Miller & Rollnick, 2002) has been shown to increase treatment engagement and improve treatment outcomes when it is used to complement other treatments (Hettema, Steele, & Miller, 2005). However, MI is a clinical approach that currently lacks an underlying theory to explain the mechanisms by which it functions. As a general theory of human motivation that is consistent with the underlying principles of MI, Self-Determination Theory (SDT; Deci & Ryan, 2002) provides a framework for understanding the manner in which MI can be integrated with CBT to increase treatment Correspondence concerning this article should be addressed to Peter C. Britton, Ph.D., Center of Excellence, Department of Veteran Affairs Medical Center, 14424. peter.britton@va.gov. U.S. Department of Veterans AffairsPublic Access Author manuscript Cogn Behav Pract. Author manuscript; available in PMC 2016 October 19. Cognitive Behavioral Therapy (CBT) to Reduce Suicidal BehaviorIn a recent meta-analysis of 28 randomized controlled trials (RCTs), CBT was found to reduce suicide-related behavior (i.e., death by suicide, suicide attempts, suicide intent and/or plans, and ideation) in the 3 months following treatment (Tarrier et al., 2008). The primary cognitive behavioral interventions that were represented in the study included Dialectical Behavioral Therapy (DBT), problem-solving therapy, and Cognitive Therapy (CT). Although the findings were promising, a review of the major studies suggested that attrition was a common problem. For example, in Brown's ...

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Section: Motivation As a Central Issue In Suicide Preventionmentioning

confidence: 99%

Integrating Motivational Interviewing and Self-Determination Theory With Cognitive Behavioral Therapy to Prevent Suicide

Britton

Patrick

Wenzel

et al. 2011

Cognitive and Behavioral Practice

View full text Add to dashboard Cite

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“…In addition, the perception of high public stigma could worsen stressed students' mental status and hinder recovery from mental illness (Britt et al, 2008).…”

mentioning

confidence: 99%

Comparing educational interventions: Correcting misperceived norms improves college students' mental health attitudes

Turetsky

Sanderson

2017

J Applied Social Pyschol

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This research targeted potential psychological contributors to college students' low levels of helpseeking for mental distress using a field experiment. Researchers randomly assigned 520 undergraduates to 15-min interventions: a novel, theory-driven social norms intervention correcting misperceived distress, stigma, and help-seeking norms; a general education intervention increasing mental health awareness; and a stress management active control condition. The norms intervention instilled more accurate perceptions of mental health norms and temporarily reduced perceived public stigma compared to other conditions. The norms and general education interventions improved attitudes toward seeking help for mental distress for at least 2 months, relative to the control. Effects on help-seeking behavior were not observed in this timeframe. This research elucidates the robustness of brief social psychological mental health interventions on college campuses.

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“…perspective, a lack of sense of control over these external barriers, due to lack of knowledge and resources, may prevent individuals from getting treatment, even when they obtain a positive attitude toward seeking treatment after weighing treatment benefits over perceived stigma (Britt et al 2008). On this note, there are also measures directly assessing beliefs about one's agency (or lack of agency) in getting services in regard to the barriers.…”

Section: Control Factors In Seeking Professionalmentioning

confidence: 99%

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families

Yasui

Pottick

Chen

2017

Clin Child Fam Psychol Rev

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Despite the central role culture plays in racial and ethnic disparities in mental health among ethnic minority and immigrant children and families, existing measures of engagement in mental health services have failed to integrate culturally specific factors that shape these families' engagement with mental health services. To illustrate this gap, the authors systematically review 119 existing instruments that measure the multi-dimensional and developmental process of engagement for ethnic minority and immigrant children and families. The review is anchored in a new integrated conceptualization of engagement, the culturally infused engagement model. The review assesses culturally relevant cognitive, attitudinal, and behavioral mechanisms of engagement from the stages of problem recognition and help seeking to treatment participation that can help illuminate the gaps. Existing measures examined four central domains pertinent to the process of engagement for ethnic minority and immigrant children and families: (a) expressions of mental distress and illness, (b) causal explanations of mental distress and illness, (c) beliefs about mental distress and illness, and (d) beliefs and experiences of seeking help. The findings highlight the variety of tools that are used to measure behavioral and attitudinal dimensions of engagement, showing the limitations of their application for ethnic minority and immigrant children and families. The review proposes directions for promising research methodologies to help intervention scientists and clinicians improve engagement and service delivery and reduce disparities among ethnic minority and immigrant children and families at large, and recommends practical applications for training, program planning, and policymaking.

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Perceived Stigma and Barriers to Care for Psychological Treatment: Implications for Reactions to Stressors in Different Contexts

Cited by 204 publications

References 27 publications

Integrating Motivational Interviewing and Self-Determination Theory With Cognitive Behavioral Therapy to Prevent Suicide

Integrating Motivational Interviewing and Self-Determination Theory With Cognitive Behavioral Therapy to Prevent Suicide

Comparing educational interventions: Correcting misperceived norms improves college students' mental health attitudes

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families

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