Date of Award


Document Type


Degree Name

Doctor of Psychology (PsyD)



First Advisor

William Meil, Ph.D.

Second Advisor

John Mills, Ph.D.

Third Advisor

Dasen Luo, Ph.D.


This study examined predisposing, enabling, and need barriers to utilizing substance abuse treatment resources in a sample of rural and urban outpatients. Fiftythree participants from rural (n=17) and urban (n=36) treatment centers were surveyed for quantitative and qualitative indicators of barriers to treatment. Results suggest rural outpatients were significantly younger and less racially/ethnically diverse than their urban counterparts. Rural participants also perceived treatment as being less available, but not less accessible than their urban counterparts. Multivariate analyses did not suggest significant differences in barriers to professional versus nonprofessional treatment; however there was limited power to detect such differences. Results from qualitative data analysis suggests rural outpatients were worried most about confidentiality concerns, whereas their urban counterparts worried most about illness/need related factors prior to seeking professional treatment. Taken together, data from this study suggests potentially unique barriers to treatment for persons coming from rural versus urban areas. Rural outpatients seem likely to have to overcome racial barriers, perceptions of low treatment availability and confidentiality concerns whereas urban outpatients seem likely to have to overcome gender barriers and perceptions of illness/need severity factors that act as barriers to treatment. Implications for defining geographic location and for overcoming barriers to science and practice in rural and urban areas with underserved groups are discussed.