| Depression is a common mental health concern, and psychotherapy has been shown to effectively treat depression. However, many individuals with depression do not seek psychotherapy. The current study used a behavioral economic model to predict psychotherapy use among individuals with depression. Non-treatment-seeking participants (N = 253) with moderate-severe depression symptoms reported their symptom severity, the positive and negative consequences they anticipated from psychotherapy (i.e., gains and losses), the amount of effort they anticipated seeking psychotherapy would require, and their behavioral sensitivity to gains, losses, and effort (i.e., effort discounting). They also reported their help-seeking behavior and intentions at a 3-month follow-up. Depression symptom severity was associated with higher anticipated losses of
sychotherapy at baseline, such as concerns about feeling embarrassed or receiving a serious diagnosis. In turn, losses negatively predicted help-seeking intentions and psychotherapy use during the follow-up period. Anticipated gains of psychotherapy, such as getting useful advice or feeling better, did not predict psychotherapy use. However, gains and sensitivity to gains interacted to predict help-seeking intentions: gains had a positive effect on intentions among those with high sensitivity to gains but a negative effect for those with low sensitivity to gains. Effort and effort discounting also interacted to predict intentions, but only among those who responded systematically on the effort discounting measure. This suggests that help-seeking interventions for individuals with depression may be most effective by reducing the perceived losses of psychotherapy. Effects of modifying the gains and effort of psychotherapy may differ depending on sensitivity to these factors. |