Processes underlying ambivalence in help‐seeking: The loss of valued control model.

Abstract

A substantial proportion of people who are referred to therapy either do not attend their initial appointments or drop out early on. This problem indicates ambivalence toward attending therapy in the population suffering from mental health problems. We review the factors thought to underlie this problem. A new integrative framework, termed the loss of valued control model, is presented. This model draws on the principles of perceptual control theory and provides a processfocused view that integrates the barriers to therapy under a common control process. Our article divides the model into three core components and thereafter provides empirical evidence in support of the model, as well as suggestions of how the model can be used to inform clinical practice and future research.

Improving access to mental health care in an Orthodox Jewish community: a critical reflection upon the accommodation of otherness

“…The culturally specific understanding and position of the mental health worker within relatively closed communities, may help to diffuse or exacerbate feelings of threat, vulnerability and shame. Different factors are likely to be salient for each individual person, depending upon the particular issues they have, the trajectory of their exposure towards mental health services and their previous life experiences [ 87 , 88 ].…”

Science and Practice of Transdiagnostic CBT: A Perceptual Control Theory (PCT) Approach

“…Based on the principles of PCT, Schauman and Mansell (2012) presented the loss of valued control model. This draws upon evidence for factors underlying the ambivalence and nonattendance of therapy.…”

Can Low‐Cost Strategies Improve Attendance Rates in Brief Psychological Therapy? Double‐Blind Randomized Controlled Trial

“…This viewpoint highlights that therapy help seeking is not only influenced by approach factors, such as positive expectations of therapy, but also by avoidance factors, such as treatment fearfulness, which can contribute to nonattendance closer to the time of the appointment (Vogel, Wester, & Larson, ). Drawing upon perceptual control theory (Powers, 1977), Schauman and Mansell () highlight the need to understand the individual's personal preferences or goals and perceptions of therapy if we are to understand the problem of nonattendance. According to this model, the same individual may hold some goals that encourage help seeking (e.g.…”

“…In this study, applying a simple implementation intention (a structured instruction asking patients to formulate an “if… then…” plan to manage distress) induction embedded within a postal questionnaire attenuated the anticipated negative feelings and resulted in greater first therapy appointment attendance among those who also had positive expectations of therapy. This latter study offers a particularly compelling theoretical link by highlighting the importance of positive expectations about the benefits of therapy (Constantino et al., ) while also dealing with conflicting avoidance motives (Schauman & Mansell, ) using a simple intervention to regulate negative affect.…”