Background: Initial therapy appointments have high nonattendance rates yet the reasons remain poorly understood. Aims: This study aimed to identify positive and negative attitudes towards therapy that predicted initial attendance, informed by a perceptual control theory account of approach-avoidance conflicts in help-seeking. Method: A prospective study was conducted within a low intensity CBT service using first appointment attendance (n = 96) as an outcome. Measures included attitudes towards therapy, depression and anxiety scales, and demographic variables. Results: Endorsement of a negative attitude item representing concern about self-disclosure was independently predictive of nonattendance. Positive attitudes predicted increased attendance, especially endorsement of motives for self-reflection, but only among less depressed individuals. Conclusions: Self-disclosure concerns contribute to therapy avoidance and having goals for self-reflection may represent approach motivation for therapy; however, the latter has less impact among more highly depressed people.
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