The influence of individual and congregational religiousness on seeking psychotherapy: A multilevel analysis.

Abstract

Religious individuals are less likely to seek treatment than their nonreligious counterparts; however, what accounts for this disparity remains unclear. Some have suggested that variation between congregations may explain this effect; yet, few studies have examined these factors due to the difficulty of conducting congregation-level research. Using a sample of 298 participants recruited from 20 congregations across three major religions (Islam, Christianity, Judaism), we used multilevel modeling to examine how individual and congregational factors effect psychotherapy seeking behavior. Guided by Ajzen's (1985) theory of planned behavior, we examined treatment seeking and two related outcomes: attitudes to seeking treatment and subjective norms around treatment seeking. We found individuals' scripture reading and service attendance unrelated to either attitudes or subjective norms. When scripture reading and service attendance were aggregated as congregation-level variables, they proved negatively related to attitudes and treatment visits, though these effects disappeared after accounting for race/ethnicity. Congregational efforts to destigmatize mental illness were unrelated to attitudes, subjective norms, or treatment visits. Intraclass correlations indicate that congregation-level factors account for a small-to-medium percentage of variation in treatment-seeking indicators. Taken together, our results indicate that congregational factors may play a role in treatment seeking; however, the relationship may be mediated by demographic features of the congregation. We encourage therapists and advocates to utilize congregations as loci of intervention to encourage treatment seeking. Clinical Impact StatementOur research suggests that characteristics of congregations may relate to the likelihood that their congregants seek psychotherapy. We encourage researchers, therapists, and advocates to consider congregations as useful sites of intervention to address mental health concerns.