Date of Award

Summer 8-2017

Document Type


Degree Name

Doctor of Psychology (PsyD)



First Advisor

William Meil, Ph.D.

Second Advisor

Laurie Roehrich, Ph.D.

Third Advisor

Dasen Luo, Ph.D.


Psychotherapy has been shown to effectively reduce the impact of mental illness on a variety of individual and societal variables. Despite this, the number of people who seek psychotherapy is relatively low. Treatment utilization is especially low in rural areas where practical and psychological factors dissuade individuals from seeking help. Teletherapy has been proposed as one method of reducing avoidance of treatment due to stigma because it allows clients to make their treatment more private and eliminates the practical barrier of transportation. Direct to consumer advertising (DTCA) has been used effectively by the pharmaceutical industry to improve attitudes toward medication as a mental health treatment. The purpose of the current study was to evaluate the effect of a brief DTCA manipulation on the intentions to seek treatment (as measured by a modified version of the General Help Seeking Questionnaire) on a sample of 202 college students’ coming from rural and non-rural backgrounds. Participants were categorized into either rural or non-rural groups based on the area in which participants had resided the longest. The Self Stigma of Seeking Help (SSOSH) scale was used to measure self-stigma, the Perceived Public Stigma (PPS) scale as used to assess public stigma, and the Attitudes toward Mental Health Treatment (ATMHT) scale was used to assess general attitudes toward mental health treatment. Intentions to seek treatment were measured using the General Help Seeking Questionnaire. Regression analysis was used to evaluate the relationship between measures of self-stigma, perceived public stigma, and attitudes toward mental health on the intentions to seek mental health treatment. A series of analyses of variances (ANOVA) was used to assess the impact of 3 levels of DTCA and rurality on intentions to seek mental health treatment in general, and teletherapy specifically. Hypotheses included that stigma would be negatively related to intentions to seek treatment, rural participants would show higher levels of stigma, a brief DTCA intervention could improve intentions to seek treatment, and that rural participants’ attitudes toward teletherapy would increase to a greater extent than non-rural participants. Results demonstrated that stigma was generally related to intentions to seek treatment in the predicted manner; however, the results did not demonstrate that participants from rural areas reported higher rates of stigma. Though a brief DTCA intervention failed to have an overall effect on intentions to seek treatment, intentions of rural participants to seek teletherapy were significantly improved compared to non-rural participants. Results suggest that teletherapy may benefit rural populations through increasing privacy more than through addressing stigma or other psychological variables.

Included in

Psychology Commons