Psychological support - knowing when to seek help

How long does it take to know that you need psychological support and then to take the first step in seeking it? Only a fraction of people who know that they need psychological support and want to receive support actually take the step in seeking it. A new study published in Clinical Psychology & Psychotherapy documents the processes in making a decision to seek psychological support (Research Digest, The British Psychological Society, October 7, 2015).

A European survey published in 2009 found that 9,000 people showed evidence of significant depression or anxiety, and only 33% thought that mental health services could help them. The new 2015 study takes the research further by analyzing the processes people go through when deciding that therapy could be useful – and actually arranging an initial appointment.

Katherine Elliot and colleagues assessed 155 people who had made initial contact with psychological services at a university training clinic. The researchers asked the participants how long they had their current mental health problem, how long it took to decide that therapy could help them, how long it took them to decide to seek help, and how long it took them to arrange their first appointment. The participants were followed up after their third therapy session and again when they completed their course of therapy.

The participants’ current mental health issues included anxiety, depression-related, anger management, and sexual issues.

The results showed that participants had their current issue for an average of 10.5 years. They said the most difficult step in starting therapy was deciding that therapy could be beneficial for them. They were undecided or not convinced that therapy would work, and would therefore be a waste of time and money, and cause further anxiety.

Once participants knew that their problem was at a stage where they needed help and support, it took 44% of them an average of 4 months to decide that therapy might help. However 40% said it took them a year or more to take the next step, and 16% said that they decided straight away, once they realised).

Once participants thought that psychological support and therapy could help them, each subsequent step in getting help became progressively quicker and easier. The time it took to actually make an appointment was just a few weeks. But of those who made an appointment, 25% did not go.

Once participants began therapy, those that found it difficult to decide whether to make an appointment, and found it difficult to initiate an appointment, also expected the therapy to be difficult. In other words, they were still worried that it would not help them because they thought their problem was insurmountable: beyond help. However Elliot’s study found that there was no correlation between expectations of difficulty in being helped and the participants’ level of commitment in wanting to be helped. In other words, once in therapy, the participants did not resist help, and were cooperative in receiving help.

There is no data on whether the therapy was successful. There is also no data on those people who did not seek help. This study was only conducted on people who did seek help – i.e. people who made initial contact. Therefore there are no insights into why people don’t seek support – and therapy is not the only solution to resolving issues – so there is no study on alternative options and decisions. In addition, this study of 155 participants is a small sample.

What the study did show was that the most challenging and time-consuming part was: (1) arriving at a point in deciding that the issue required a solution – i.e. recognising that help was needed, and (2) arriving at the decision that therapy could be beneficial to solve the problem.

Elliott, K., Westmacott, R., Hunsley, J., Rumstein-McKean, O., & Best, M. (2015). The Process of Seeking Psychotherapy and Its Impact on Therapy Expectations and Experiences Clinical Psychology & Psychotherapy, 22 (5), 399-408 DOI: 10.1002/cpp.1900

http://digest.bps.org.uk/2015/10/the-psychology-of-realising-that-you.html

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