Consumer Expectations and Attitudes About Psychotherapy: Survey Study

Although mental illness is common among adults in the United States, access to, and public perception of, mental health care continue to present as key barriers to care.

Given the importance of attitudes toward, and perceptions of, mental health treatment in the successful access to mental health care and treatment of mental health issues, the primary goal of this survey study was to further investigate consumer perspectives of psychotherapy among adults in the United States; specifically, adding to the literature by investigating perceptions of both the general public and patients receiving telehealth. More specifically, the aims were to better understand openness to, and satisfaction with, therapy; perceptions, preferences, and expectations around therapy; and perceptions of psychotropic medication.

An electronic survey was administered to current and former patients (those receiving psychotherapy) of Brightside, a nationwide telehealth company, as well as to the general public; both were convenience samples. Using the same survey questions, Brightside surveyed its own members (using Qualtrics; Qualtrics International Inc) and the general population (using SurveyMonkey's Audience tool; Momentive). This survey included questions about basic participant demographics, as well as questions about current mental health treatment, perceptions about therapy, and therapists' qualities.

A total of 714 people completed the survey. The data were fairly evenly split between those collected from Brightside patients (368/714, 51.5%) and those collected from the general public (346/714, 48.5%). Combining both samples, overall participation was 67.1% (479/714) women; 73.1% (522/714) White, 7.3% (52/714) Asian, 6.7% (48/714) African American, and 7.4% (53/714) Hispanic or Latinx; largely aged 25 to 34 years (255/714, 35.7%) or 35 to 44 years (187/714, 26.2%); from either the Mid-Atlantic (131/714, 18.3%) or South Atlantic (129/714, 18.1%) regions of the country; and most (402/714, 56.3%) earning annual salaries of US $30,000 to US $100,000. There were generally favorable perceptions of both psychotherapy and psychiatric medication. Selecting a therapist as well as cost and insurance are the common factors in therapy that are important to patients. The most commonly held perception of psychotherapy duration was indefinite (250/714, 35%). Very few (58/714, 8.1%) thought that therapy typically lasts 1 to 3 months. Most of the participants (414/714, 58%) thought that evidence-based practice was important.

Public education is needed to increase awareness of the typical duration and cost of psychotherapy. There seem to be generally favorable perceptions of both psychotherapy and psychotropic medication. Selecting a therapist as well as cost and insurance are the common factors in therapy that are important to patients. Practitioners and those marketing their services might consider using their marketing campaigns to counter some of the more common falsely held beliefs.