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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 1/2015

01-01-2015 | Original Paper

Acceptability of psychological treatment to Chinese- and Caucasian-Australians: Internet treatment reduces barriers but face-to-face care is preferred

Authors: Isabella Choi, Louise Sharpe, Stephen Li, Caroline Hunt

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 1/2015

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Abstract

Purpose

Internet treatments have the potential to improve access, especially for cultural groups who face considerable treatment barriers. This study explored the perceived barriers and likelihood of using Internet and face-to-face treatments for depression among Chinese and Caucasian Australian participants.

Methods

Three-hundred ninety-five (289 Chinese, 106 Caucasian) primary care patients completed a questionnaire about depression history, previous help-seeking, perceived barriers to Internet and face-to-face treatment, and likelihood of using either treatment for depressive symptoms.

Results

Internet treatment reduced perceived barriers (including stigma, lack of motivation, concerns of bringing up upsetting feelings, time constraints, transport difficulties, and cost) for both groups to a similar degree, except for time constraints. There were heightened concerns about the helpfulness, suitability, and confidentiality of Internet treatments. Chinese participants and individuals with a probable depression history reported increased perceived barriers across treatments. Both Chinese and Caucasian groups preferred face-to-face treatment across depression severity. However, when age was controlled, there were no significant concerns about Internet treatment, and face-to-face treatment was only preferred for severe depression. Only 12 % of the entire sample refused to try Internet treatment for depression. Endorsement of perceived Internet treatment barriers (including concerns of bringing up upsetting feelings, that treatment would be unhelpful or unsuitable, lack of motivation, cost, cultural sensitivity, and confidentiality) reduced the likelihood to try Internet treatments.

Conclusions

Internet treatment reduced perceived treatment barriers across groups, with encouraging support for Internet treatment as an acceptable form of receiving help. Negative concerns about Internet treatment need to be addressed to encourage use.
Literature
1.
Titov N (2007) Status of computerized cognitive behavioural therapy for adults. Aust N Z J Psychiatry 41:95–114PubMedCrossRef
2.
Kaltenthaler E, Brazier J, De Nigris E, Tumur I, Ferriter M, Beverley C, Parry G, Rooney G, Sutcliffe P (2006) Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation. Health Technol Assess 10(33):1–168CrossRef
3.
Bower P, Gilbody S (2005) Stepped care in psychological therapies: access, effectiveness and efficiency: narrative literature review. Br J Psychiatry 186:11–17PubMedCrossRef
4.
5.
Andersson G, Cuijpers P (2009) Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cogn Behav Ther 38:196–205PubMedCrossRef
6.
Cuijpers P, Marks IM, van Straten A, Cavanagh K, Gega L, Andersson G (2009) Computer-aided psychotherapy for anxiety disorders: a meta-analytic review. Cogn Behav Ther 38:66–82PubMedCrossRef
7.
Andersson G, Hedman E (2013) Effectiveness of guided internet-based cognitive behavior therapy in regular clinical settings. Verhaltenstherapie 23:140–148CrossRef
8.
Warmerdam L, Smit F, van Straten A, Riper H, Cuijpers P (2010) Cost-utility and cost-effectiveness of Internet-based treatment for adults with depressive symptoms: randomized trial. J Med Internet Res 12:40–50CrossRef
9.
Gerhards SA, de Graaf LE, Jacobs LE, Severens JL, Huibers MJ, Arntz A, Riper H, Widdershoven G, Metsemakers JF, Evers SM (2010) Economic evaluation of online computerised cognitive-behavioural therapy without support for depression in primary care: randomised trial. Br J Psychiatry 196:310–318PubMedCrossRef
10.
11.
Kaltenthaler E, Sutcliffe P, Parry G, Beverley C, Rees A, Ferriter M (2008) The acceptability to patients of computerized cognitive behaviour therapy for depression: a systematic review. Psychol Med 38:1521–1530PubMedCrossRef
12.
Waller R, Gilbody S (2009) Barriers to the uptake of computerized cognitive behavioural therapy: a systematic review of the quantitative and qualitative evidence. Psychol Med 39:705–712PubMedCrossRef
13.
Gun SY, Titov N, Andrews G (2011) Acceptability of Internet treatment of anxiety and depression. Australas Psychiatry 19:259–264PubMedCrossRef
14.
Carper MM, McHugh RK, Barlow DH (2013) The dissemination of computer-based psychological treatment: a preliminary analysis of patient and clinician perceptions. Admin Policy Mental Health 40:87–95CrossRef
15.
Mohr DC, Siddique J, Ho J, Duffecy J, Jin L, Fokuo JK (2010) Interest in behavioral and psychological treatments delivered face-to-face, by telephone, and by internet. Ann Behav Med 40:89–98PubMedCentralPubMedCrossRef
16.
Mitchell N, Gordon PK (2007) Attitudes towards computerized CBT for depression amongst a student population. Behav Cogn Psychother 35:421–430CrossRef
17.
Kazdin AE (2000) Perceived barriers to treatment participation and treatment acceptability among antisocial children and their families. J Child Fam Stud 9:157–174CrossRef
18.
Sentell T, Shumway M, Snowden L (2007) Access to mental health treatment by English language proficiency and race/ethnicity. J Gen Intern Med 22(Suppl 2):289–293PubMedCentralPubMedCrossRef
19.
Abe-Kim J, Takeuchi D, Hong S, Zane N, Sue S, Spencer MS, Appel H, Nicdao E, Alegria M (2007) Use of mental health-related services among immigrant and US-born Asian Americans: results from the National Latino and Asian American Study. Am J Public Health 97:91–98PubMedCentralPubMedCrossRef
20.
Boufous S, Silove D, Bauman A, Steel Z (2005) Disability and health service utilization associated with psychological distress: the influence of ethnicity. Mental Health Serv Res 7:171–179CrossRef
21.
Snowden LR, Yamada AM (2005) Cultural differences in access to care. Annu Rev Clin Psychol 1:143–166PubMedCrossRef
22.
Scheppers E, van Dongen E, Dekker J, Geertzen J (2006) Potential barriers to the use of health services among ethnic minorities: a review. Fam Pract 23:325–348PubMedCrossRef
23.
Tiwari SK, Wang J (2008) Ethnic differences in mental health service use among White, Chinese, South Asian and South East Asian populations living in Canada. Soc Psychiatry Psychiatr Epidemiol 43:866–871PubMedCrossRef
24.
Parker G, Chan B, Tully L, Eisenbruch M (2005) Depression in the Chinese: the impact of acculturation. Psychol Med 35:1475–1483PubMedCrossRef
25.
Gonzàlez HM, Tarraf W, Whitfield KE, Vega WA (2010) The epidemiology of major depression and ethnicity in the United States. J Psychiatr Res 44:1043–1051PubMedCentralPubMedCrossRef
26.
Ho KP, Hunt C, Li S (2008) Patterns of help-seeking behavior for anxiety disorders among the Chinese speaking Australian community. Soc Psychiatry Psychiatr Epidemiol 43:872–877PubMedCrossRef
27.
Chen S, Sullivan NY, Lu YE, Shibusawa T (2003) Asian Americans and mental health services. J Ethn Cult Divers Soc Work 12:19–42CrossRef
28.
Parker G, Gladstone G, Chee KT (2001) Depression in the planet’s largest ethnic group: the Chinese. Am J Psychiatry 158:857–864PubMed
29.
Hsu LKG, Wan YM, Chang H, Summergrad P, Tsang BYP, Chen H (2008) Stigma of depression is more severe in Chinese Americans than Caucasian Americans. Psychiatry 71:210–218
30.
Mellor D, Carne L, Shen Y-C, McCabe M, Wang L (2012) Stigma toward mental illness: a cross-cultural comparison of Taiwanese, Chinese immigrants to Australia and Anglo-Australians. J Cross Cult Psychol 44:352–364CrossRef
31.
32.
Tieu Y, Konnert C, Wang J (2010) Depression literacy among older Chinese immigrants in Canada: a comparison with a population-based survey. Int Psychogeriatr 22:1318–1326PubMedCrossRef
33.
Kung WW (2004) Cultural and practical barriers to seeking mental health treatment for Chinese Americans. J Community Psychol 32:27–43CrossRef
34.
Li PL, Logan S, Yee L, Ng S (1999) Barriers to meeting the mental health needs of the Chinese community. J Public Health Med 21:74–80PubMedCrossRef
35.
Blignault I, Ponzio V, Ye R, Eisenbruch M (2008) A qualitative study of barriers to mental health services utilisation among migrants from mainland China in South-East Sydney. Int J Soc Psychiatry 54:180–190PubMedCrossRef
36.
Lu SH, Dear BF, Johnston L, Wootton BM, Titov N (2013) An internet survey of emotional health, treatment seeking and barriers to accessing mental health treatment among Chinese-speaking international students in Australia. Couns Psychol Q:1–13
37.
Chang T, Chang R (2004) Counseling and the Internet: Asian American and Asian international college students’ attitudes toward seeking online professional psychological help. J Coll Couns 7:140–149CrossRef
38.
Choi I, Zou J, Titov N, Dear BF, Li S, Johnston L, Andrews G, Hunt C (2012) Culturally attuned Internet treatment for depression amongst Chinese Australians: a randomised controlled trial. J Affect Disord 136:459–468PubMedCrossRef
39.
Lopez-del-Hoyo Y, Olivan B, Luciano-Devis J, Mayoral F, Roca M, Gili M, Andres E, Serrano-Blanco A, Collazo F, Araya R, Banos R, Botella C, Magallon R, Campayo J (2013) Low intensity vs. self-guided Internet-delivered psychotherapy for major depression: a multicenter, controlled, randomized study. BMC Psychiatry 13:21. doi:10.​1186/​1471-244X-13-21 PubMedCentralPubMedCrossRef
40.
Ince BÜ, Cuijpers P, van’t Hof E, van Ballegooijen W, Riper H, Christensen H (2013) Internet-Based, culturally sensitive, problem-solving therapy for Turkish migrants with depression: randomized controlled trial. J Med Internet Res 15(10):e227. doi:10.​2196/​jmir.​2853 CrossRef
41.
Choi I, Andrews G, Sharpe L, Hunt C (2014) Help-seeking characteristics of Chinese- and English-speaking Australians accessing Internet-delivered cognitive behavioural therapy for depression. Soc Psychiatry Psychiatr Epidemiol (under review)
42.
Kessler RC, Ustun TB (2004) The World Mental Health (WMH) survey initiative version of the world health organization (WHO) composite international diagnostic interview (CIDI). Int J Methods Psychiatr Res 13:93–121PubMedCrossRef
43.
Burgess PM, Pirkis JE, Slade TN, Johnston AK, Meadows GN, Gunn JM (2009) Service use for mental health problems: findings from the 2007 national survey of mental health and wellbeing. Aust N Z J Psychiatry 43:615–623PubMedCrossRef
44.
Mohr DC, Ho J, Duffecy J, Baron KG, Lehman KA, Jin L, Reifler D (2010) Perceived barriers to psychological treatments and their relationship to depression. J Clin Psychol 66:394–409PubMedCentralPubMed
45.
Marques L, LeBlanc NJ, Weingarden HM, Timpano KR, Jenike M, Wilhelm S (2010) Barriers to treatment and service utilization in an internet sample of individuals with obsessive–compulsive symptoms. Depress Anxiety 27:470–475PubMedCrossRef
46.
47.
48.
Klein B, Cook S (2010) Preferences for e-mental health services amongst an online Australian sample. Eur J Appl Psychol 6:27–38
49.
Casey LM, Joy A, Clough BA (2013) The impact of information on attitudes toward E-mental health services. Cyberpsychol Behav Soc Netw 16:593–598PubMedCrossRef
50.
Rochlen AB, Zack JS, Speyer C (2004) Online therapy: review of relevant definitions, debates, and current empirical support. J Clin Psychol 60:269–283PubMedCrossRef
51.
Wells M, Mitchell KJ, Finkelhor D, Becker-Blease KA (2007) Online mental health treatment: concerns and considerations. Cyberpsychol Behav 10:453–459PubMedCrossRef
52.
Andersson G, Carlbring P, Ljótsson B, Hedman E (2013) Guided internet-based CBT for common mental disorders. J Contemp Psychother 43:223–233CrossRef
53.
Gerhards SAH, Abma TA, Arntz A, de Graaf LE, Evers SMAA, Huibers MJH, Widdershoven GAM (2011) Improving adherence and effectiveness of computerised cognitive behavioural therapy without support for depression: a qualitative study on patient experiences. J Affect Disord 129:117–125PubMedCrossRef
54.
Mohr DC, Hart SL, Howard I, Julian L, Vella L, Catledge C, Feldman MD (2006) Barriers to psychotherapy among depressed and nondepressed primary care patients. Ann Behav Med 32:254–258PubMedCrossRef
55.
Parker G, Cheah YC, Roy K (2001) Do the Chinese somatize depression: a cross-cultural study. Soc Psychiatry Psychiatr Epidemiol 36:287–293PubMedCrossRef
56.
Yeung A, Chang D, Gresham RL Jr, Nierenberg AA, Fava M (2004) Illness beliefs of depressed Chinese American patients in primary care. J Nerv Mental Dis 192:324–327CrossRef
Metadata
Title
Acceptability of psychological treatment to Chinese- and Caucasian-Australians: Internet treatment reduces barriers but face-to-face care is preferred
Authors
Isabella Choi
Louise Sharpe
Stephen Li
Caroline Hunt
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 1/2015
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-014-0921-1

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