Perceived Barriers and Facilitators to Psychotherapy Utilisation and How They Relate to Patient’s Psychotherapeutic Goals
1.1. Empirical Findings for Barriers and Facilitators
1.2. Aims and Research Questions
2. Materials and Methods
2.1. The Field of Research
2.3. Data Collection
2.5. Data Analysis
2.5.1. Content Analysis
2.5.2. Across-Group Comparison
3.1. Description of Categories
3.1.1. External Barriers
(…) I thought, “I cannot afford this right now”. We [my husband and I] are self-employed, work in the arts and culture sector, and are massively affected by Covid. Moreover//um//I thought//um//the insurance pays a little extra, but it is marginal. So, therapy is something you must be able to afford (-)//be able//. So that was an issue. And I thought to myself, no, I cannot afford it now. And now I think, “yes, but I have to afford it” (female, age 45).
How did I get to my new therapy now? Well, it was pretty tricky. In the end, I did not go for treatment for half a year because, at that time, I was feeling terrible, really//shit//[not good]. At this time, I went to men’s counselling for a while (male, age 28).
I said: hey, I need something that gives me pleasure. Something that invigorates. And I sort of started dancing hip-hop. (--) And after one and a half years of hip-hop, it became breaking. Well, that is usually called breakdancing. (--) And that is when I found myself again (male, age 39).
… feels that now a therapist is allying//herself with his wife against him (female, age 45).
… I had an awful lot of first interviews, far too many, and I just did not manage to (-). I was completely overwhelmed with what was offered in Vienna because there were far too many therapists. I was utterly overwhelmed by the range of schools on offer because I did not know which type of therapy I should choose (male, age 28).
(…) I find that//I find it somehow tricky. The search, and also finding someone. What criteria should be followed (female, age 34)?
3.1.2. Internal Barriers
I also saw this therapist who just nodded the whole time, like “mhm,//mhm//mhm” I mean, he is not bad or anything. Still, the others also said that they did not like it, that he nods all the time, and so on.//Mhm//But I can understand it; it was just, he had a lot of work probably, a lot with Corona, too (female, age 20).
The problem was that he (-) gave me the feeling that I was treating him instead of him treating me. So, he rambled a lot and had many theories; I could not do anything with that. I think that was because of his orientation; it did not fit (male, age 43).
For us here, it [psychotherapy] is a somewhat notorious story. And I think almost no one in my circle has ever done one. Or just not told it, you know. It’s more of a secret discovery if someone finds out (laughs) (female, age 26).
I am one of those people for whom everything has to fit. Otherwise, if there is disharmony, if something does not run smoothly, I end things or just tell them what they want to hear, and that is not the purpose of therapy.//mhm//(female, age 36).
3.1.3. External Facilitators
And//mhm//I have a pretty good friend, yes, he is part of the family now, um, who regularly sees a therapist because he has epilepsy, and it is severe. And then we talked about it a bit. And that was then maybe all together, where I said, OK, now you tackle it and look for help.//mhm, mhm, yes//Yes (female, age 36).
My boss is accommodating, his ears are open to such things, and then we said together that it would not be a mistake//ah//if I make sure that I get help (male, age 31).
Um, the hospital was not open or did not pick up the phone, and then I called the//ahm//the telephone, the telephone helpline (-). And a trauma therapist picked up the phone. And I told her in a few minutes what was going on with me. And she said that I had emotional childhood trauma. She recognised it quickly and told me to seek body-oriented individual therapy (male, age 30).
Well, how I chose her was simple, I saw a picture of her, and I liked that. And her homepage was appealing. And with the others, I felt more like//ahm//I did not know if they would suit me because they were for older people, not younger people. And with her, I immediately felt that (-) we would fit (female, age 29).
I think it is essential that a therapist comes from the same region. Because she [the psychotherapist] has the same//um//background, she has grown up in the same circumstances//living the same village life (female, age 26).
We do it like this, um, I can do it via Skype,//aha//which helps me terribly because it’s a twenty-kilometre drive into the city. And with the children and my husband working shifts and then a shared car,//mhm, mhm//And she [the psychotherapist] only has certain days she is available, which narrows it down a lot. (…) It is very convenient for me that I can do it via Skype. And, um, I think that also helped with Corona greatly (female, age 36).
3.1.4. Internal Facilitators
It impressed me that she said: You do not have to stay here [in psychotherapy] only to visit. You may say: this does not fit me. Alternatively, you can always say it does not work for me anymore. So, I felt I could tell her that at any time. (-) And that//I think//already inspired much trust in me when I first saw her (female, age 26).
There are things I only want to discuss with a woman.//mhm, mhm//where I certainly do not need a man’s point of view (female, age 48).
I remember that last autumn, there was this lockdown, and I had the feeling that now we have, I do not know, two or three weeks where you can reflect on yourself (-). So you use this dark time of year, my birthday, it is always like that, and//ahm//to reflect, look at things that you do not usually get to, and tidy up from the inside. And that started this process (female, age 48).
Yeah, so, having done therapy before in 2019, I have known that it helps me (female, age 22).
Once I came to her, my priorities at that time were already bodywork and feeling understood; those were priorities number one (male, age 28).
I have never//wished//[to be in psychotherapy] as much as I did back then because I just knew it would help me (male, age 28).
3.1.5. Patients’ Psychotherapeutic Goals
I wanted to learn ways to work on specific memories, associations or experiences. They were always there anyway, but I never actively worked on them. It always felt very stagnant, and with psychotherapy, I learned to bring things into a flow (male, age 28).
I want to be able to go back to work and learn from my mistakes so that I do not slip into the old patterns again (female, age 37).
3.2. Distribution of Barriers, Facilitators and Psychotherapeutic Goals
3.2.1. Distribution per Case
3.2.2. Distribution per Case in Two Groups
4.1. Discussion of Categories
4.1.1. External Barriers
4.1.2. Internal Barriers
4.1.3. External Facilitators
4.1.4. Internal Facilitators
4.1.5. Psychotherapeutic Goals
4.2. Discussion of Distribution of Barriers, Facilitators and Psychotherapeutic Goals
4.3. Limitations and Strengths
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Age in years|
|Highest level of education|
|Fully funded by insurance||4||19.0|
|Fully privately funded||2||9.5|
|Partial reimbursement through insurance||15||71.4|
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Schaffler, Y.; Probst, T.; Jesser, A.; Humer, E.; Pieh, C.; Stippl, P.; Haid, B.; Schigl, B. Perceived Barriers and Facilitators to Psychotherapy Utilisation and How They Relate to Patient’s Psychotherapeutic Goals. Healthcare 2022, 10, 2228. https://doi.org/10.3390/healthcare10112228
Schaffler Y, Probst T, Jesser A, Humer E, Pieh C, Stippl P, Haid B, Schigl B. Perceived Barriers and Facilitators to Psychotherapy Utilisation and How They Relate to Patient’s Psychotherapeutic Goals. Healthcare. 2022; 10(11):2228. https://doi.org/10.3390/healthcare10112228Chicago/Turabian Style
Schaffler, Yvonne, Thomas Probst, Andrea Jesser, Elke Humer, Christoph Pieh, Peter Stippl, Barbara Haid, and Brigitte Schigl. 2022. "Perceived Barriers and Facilitators to Psychotherapy Utilisation and How They Relate to Patient’s Psychotherapeutic Goals" Healthcare 10, no. 11: 2228. https://doi.org/10.3390/healthcare10112228