The Role of Treatment-Seeking Stigma on Treatment Engagement and Outcome
Bibliographic record
Abstract
Mental Health treatment-seeking stigma (TSS) is a significant barrier to accessing mental health services prolonging clients’ distress (Breslau et al., 2008; Livingston & Boyd, 2010). Clients continue to express concerns about stigma even after they have entered therapy (Owen et al., 2013), yet little is known about the impact of TSS once clients have begun treatment. Using archival data from a study on the efficacy of cognitive behavioural therapy (CBT) and process experiential-emotion-focused therapy (PE-EFT) for depression, this study sought to elucidate the relationship between TSS, client engagement in therapy and treatment outcome. The findings provided support that TSS remains a barrier during the course of treatment. Higher TSS predicted less change in treatment outcomes from pre- to post-therapy. The relationship between TSS and treatment outcome was not mediated by client engagement as assessed by clients’ depth of experiencing, but it was completely mediated by the working alliance. Additionally, TSS declined over the course of treatment and the decline was predicted by therapists’ empathy. The findings suggested that TSS continues to be an issue even after clients have entered the therapy room highlighting the importance of ongoing research examining TSS and its impact during treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.045 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".