Date Approved


Date Posted


Degree Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department or School


Committee Member

Silvia von Kluge (chair)

Committee Member

Norman Gordon

Committee Member

Ellen Koch

Committee Member

Denise Reiling


The relatively low utilization of mental health care is a concern for psychology, as only 32% of individuals with a psychological disorder receive treatment (Andrews, Issakidis, & Carter, 2001). It is typically attitudinal rather than structural barriers that influence individuals when deciding to pursue treatment (Outram, Murphy, & Cockburn, 2004). This study utilized the theory of reasoned action as a model to test the relationship among variables hypothesized to contribute to the intention to seek therapy: public stigma, self-stigma, social support, self-efficacy, attitudes toward seeking therapy, and psychological distress. Both quantitative and qualitative methods were used to evaluate barriers to seeking therapy. Structural equation modeling was used to show that the theory of reasoned action provided a good fit to the data, as positive attitudes toward therapy was a stronger predictor of intentions to seek therapy than self-stigma. The statistical model that included all of the variables demonstrated that positive attitudes toward therapy and higher levels of social support were both direct predictors of higher intentions to seek therapy. In the qualitative interviews, the majority of barriers described by participants were attitudinal rather than structural. These individuals related experiences of shame, prejudice, and stigma related to seeking psychological treatment. However, participants described critically significant support and encouragement from their social network. Based on the results, recommendations are made for future studies and mental health advocacy efforts.