The process of change in psychotherapy, regardless of the clinician’s orientation, length of treatment, or outcome measure, begins with this: The client must attend a first session. However, several national surveys in the past decade converge on a rate of approximately one-third of individuals diagnosed with a mental disorder receiving any professional treatment (Alegra, Bijl, Lin, Walters, & Kessler, 2000; Andrews, Issakidis, & Carter, 2001; Wang et al., 2005). A review of the literature surrounding mental health utilization reveals evidence that a complex array of psychological, social, and demographic factors influence a distressed individual’s arrival to a mental health clinic. Thus, developing effective strategies for decreasing barriers to care is a critical task for clinicians and administrators. The aim of this article was to review current research focused on appropriate utilization of mental health services and to use the Health Belief Model (HBM; Becker, 1974) as a parsimonious model for conceptualizing the current knowledge base, as well as predicting and suggesting future research and implementation strategies in the field.

First, it is important to address whether increasing mental health service use is an appropriate public health goal. A World Health Organization (WHO) survey comparing individuals with severe, moderate, or mild disorder symptoms indicated that approximately half of those surveyed went untreated in the past year (WHO World Mental Health Survey Consortium, 2004), with even less treatment among those with more severe symptoms. Many costs are associated with untreated mental disorders, including overuse of primary care services for a variety of reasons (Katon, 2003; White et al., 2008), lost productivity for businesses and lost wages for employees (Adler et al., 2006), as well as the negative impact of mental disorders on medical disorders, such as diabetes and hypertension (Katon & Ciechanowski, 2002). These combined expenses have been calculated to rival some of the most common and costly physical disorders, such as heart disease, hypertension, and diabetes (Druss, Rosenheck, & Sledge, 2000; Katon et al., 2008).

The consequences of providing additional services to address unmet need may vary by the cost-effectiveness of treatment, availability of providers, and the interaction of mental health symptoms with other illnesses. Medical cost offset and cost-effectiveness research address these questions (for further review, see Blount et al., 2007; Hunsley, 2003). Medical cost offset refers to the estimation of cost savings produced by reduced use of services for primary care as a result of providing psychological services. Reduced medical expenses could occur for several reasons: increased adherence to lifestyle recommendation changes such as diet, exercise, smoking, or taking medications; improved psychological and physical health; and reduction in unnecessary medical visits which serve a secondary purpose (e.g ., making appointments to fill social needs; Hunsley, 2003). In comparison with the indirect costs to society, the individual, and the health care system, costs for providing mental health treatment are quite low (Blount et al., 2007).

However, debate continues regarding how to facilitate mental health care utilization. Identification of mental health need through primary care screening for depression is one research area that highlights the complexity of this issue. Palmer and Coyne (2003) point out several important issues in developing a strategy for addressing this goal: First, several studies suggest that identification of depression in primary care is not enough, as outcomes for depression are similar in primary care patients who have detected depression and those who have not (e.g., Coyne, Klinkman, Gallo, & Schwenk, 1997; Williams et al., 1999). This is supported by research indicating a large gap between the number of individuals who are identified through screening and referred to care, and those who actually receive care (Flynn, O’Mahen, Massey, & Marcus, 2006). Second, it is critical to evaluate attempts to increase utilization, rather than to assume they will be successful, cost-effective, and targeting the appropriate individuals. Therefore, a theoretical framework that addresses both psychological and practical factors associated with treatment utilization will be a beneficial addition to this literature.

Little systematic research has been conducted on the specific topic of psychological factors related to seeking mental health services. However, extensive work has been conducted within two broad, related areas of research: help-seeking behavior and health psychology. Many models have been proposed to explain help-seeking and health-protecting behaviors, none of which has been accepted as wholly superior to the rest. The HBM (Becker, 1974; Janz & Becker, 1984; Rosenstock, 1966) is one of several commonly used social-cognitive theories of health behavior. This model will be reviewed, followed by a brief discussion of several other models. A discussion of the strengths of the HBM and its applicability to mental health treatment utilization research will follow.

Health Belief Model
The HBM (Rosenstock, 1966, 1974), based in a socio-cognitive perspective, was originally developed in the 1950s by social psychologists to explain the failure of some individuals to use preventative health behaviors for early detection of diseases, patient response to symptoms, and medical compliance (Janz & Becker, 1984 ; Kirscht, 1972; Rosenstock, 1974). The theory hypothesizes that people are likely to engage in a given health-related behavior to the extent that they (a) perceive that they could contract the illness or be susceptible to the problem (perceived susceptibility); (b) believe that the problem has serious consequences or will interfere with their daily functioning (perceived severity); (c) believe that the intervention or preventative action will be effective in reducing symptoms (perceived benefits); and (d) perceive few barriers to taking action (perceived barriers). All four variables are thought to be influenced by demographic variables such as race, age, and socioeconomic status. A fifth original factor, cues to action, is frequently neglected in studies of the HBM, but nevertheless provides an important social factor related to mental health care utilization. Cues to action are incidents serving as a reminder of the severity or threat of an illness. These may include personal experiences of symptoms, such as noticing the changing shape of a mole that triggers an individual to consider his or her risk of skin cancer, or external cues, such as a conversation initiated by a physician about smoking cessation. In addition, Rosenstock, Strecher, and Becker (1988) added components of social cognitive theory (Ba ndura, 1977a, 1977b) to the HBM. They proposed that one’s expectation about the ability to influence outcomes (self-efficacy) is an important component in understanding health behavior outcomes. Thus, believing one is capable of quitting smoking (efficacy expectation) is as crucial in determining whether the person will actually quit as knowing the individual’s perceived susceptibility, severity, benefits, and barriers.

Other health care utilization theories

Other models for health care utilization have been proposed and used as a guide for research. In general, these theories pull from a number of learning theories (e.g., Bandura, 1977a, 1977b; Lewin, 1936; Watson, 1925). Two such models, the Theory of Planned Behavior (TPB; Ajzen, 1991) and the Self-Regulation Model (SRM; Leventhal, Nerenz, & Steele, 1984), share many commonalities with the HBM. Ajzen’s TPB proposes that intentions to engage in a behavior predict an individual’s likelihood of actually engaging in the given behavior. Ajzen hypothesizes that intentions are influenced by attitudes toward the usefulness of engaging in a behavior, perceived expectations of important others such as family or friends, and perceived ability to engage in the behavior if desired (Ajzen, 1991). This theory has been applied to a variety of health behaviors and has received support for its utility in predicting health behaviors (Ajzen, 1991; Armitage & Conner, 2001; Godin & Kok, 1996). However, its relevance in predicting mental health care utilization has received relatively little attention (for two exceptions, see Angermeyer, Matschinger, & Riedel-Heller, 1999; Skogstad, Deane, & Spicer, 2006). Similarly, the SRM (Leventhal et al., 1984) focuses on an individual’s personal representation of his or her illness as a predictor of mental health treatment use. The SRM proposes that individuals’ representation of their illness is comprised of how the individual labels the symptoms he or she is experiencing, the perceived consequences and causes of the symptoms for the individual, the expected time in which the individual would expect to be relieved of symptoms, and the perceived control or cure of the illness (Lau & Hartman, 1983).

The HBM, TPB, and SRM are well-established socio-cognitive models with similar strengths and weaknesses. The models assume a rational decision-making process in determining behavior, which has been criticized for not addressing the emotional components of some health behaviors, such as using condoms or seeking psychotherapy (Sheeran & Abraham, 1994). There is substantial overlap in the constructs of these three models. For example, an individual’s perception of the normative beliefs of others can be seen more generally as a benefit of treatment (e.g., if I seek treatment my friends will support my decision) or as a barrier (e.g., my family will think I am crazy if they know I am seeking professional help). The SRM lacks a full description of the benefit and barrier aspects of decision making identified in the HBM. However, the illness perceptions about timeline, identity, and consequences do provide a more complete conceptualization of aspects of perceived severity, and in this way the SRM can inform the HBM with these factors.

Andersen’s Sociobehavioral Model (Andersen, 1995) and Pescosolido’s Network Episode Model (Pescosolido, 1992; Pescosolido, Brooks Gardner, & Lubell, 1998) emphasize the role of the health care and social network system in influencing patterns of health care use, while Cramer’s (1999) Help Seeking Model highlights the role of self-concealment and social support in decisions to seek counseling. In particular, the Network Episode Model hypothesizes that clear, independent choice is only one of several ways that clients enter treatment, along with coercion and passive, indirect pathways to care. According to Cramer’s model, individuals who habitually conceal personally distressing information tend to have lower social support, higher personal distress, and more negative attitudes toward seeking psychological help. Thus, according to this model, self-concealment creates high distress, which pushes an individual toward seeking treatment, but also creates negative attitudes toward treatment, pushing an individual away from treatment. The HBM includes system-level benefits and barriers to utilization, but these three models more fully emphasize the social-emotional context of decision making.

Critiques and limitations of the HBM

The HBM has received some criticism regarding its utility for predicting health behaviors. Ogden (2003), in a review of articles from 1997 to 2001 using social cognition models, questions whether the theory is disconfirmable. She found that two-thirds of the studies reviewed found one or more variables within the model to be insignificant, and explained variance accounted for by the model ranged from 1% to 65% when predicting actual behavior. Yet, Ogden writes, rather than rejecting the model, the majority of authors offer alternative explanations for their weak findings and claim that the theory is supported. While authors’ conclusions about their findings may be overstated in many cases, some explanations of insignificant findings are valid limitations of the model. For example, some (e.g., Castle, Skinner, & Hampson, 1999) point out that construct operationalization could be improved for the particular health behavior being studied. However, insignificant results should not be explained away without considering alternative models as well. Certainly, the HBM has received strong support in predicting some health behaviors (Aiken, West, Woodward, & Reno, 1994; Gillibrand & Stevenson, 2006), but questions remain as to its ability to predict all preventative health situations. The usefulness of the HBM in predicting mental health utilization has not adequately been tested to our knowledge.

The HBM may be limited further by its ability to predict more long-term health-related behaviors. For example, from an early review of preventive health behavior models including the HBM by Kirscht (1983), we can anticipate that the factors associated with initiating treatment, as discussed here, may differ from the factors that predict mental health treatment adherence and engagement. Thus, these outcomesattending one therapy appointment versus completing a full course of psychotherapy treatmentshould be clearly distinguished from each other.

Strengths of the HBM

Researchers have not explicitly investigated mental health utilization patterns using the HBM framework; however, much of the existing literature can be conceptualized as dimensions of severity, benefits, and barriers, indicating that the model may be a useful framework for guiding research in this area. For example, cultural researchers often examine barriers to treatment and perceived severity of symptoms and benefits of treatment in various ethnic populations (e.g., Constantine, Myers, Kindaichi, & Moore, 2004; Zhang, Snowden, & Sue, 1998). In general, the focus of these studies has been to examine cultural differences in beliefs about symptom causes (Chadda, Agarwal, Singh, & Raheja, 2001), changing perceptions of mental health stigma among various ethnic groups (Schnittker, Freese, & Powell, 2000), and cultural mistrust or perceived cultural insensitivity of mental health providers as a barrier to effective treatment (Poston, Craine, & Atkinson, 1991). These studies lay the groundwork for using the HBM as a framework for understanding mental health care utilization for all populations.

Parsimonious and Clear

The model’s use of benefits and barriers opposing each other provides a dynamic representation of the decision-making process. In this “common sense” presentation, the impact of each positive aspect is considered in the context of the negative aspects. The model in this way provides a parsimonious explanation of a variety of constructs within one clear framework.
Useful and Applicable

One strength of focusing on attitudes and perceptions related to treatment seeking is the clinical utility of such models. By identifying attitudes that may inhibit appropriate help seeking, psychologists can then use research findings to develop interventions for addressing maladaptive attitudes or inaccurate beliefs about mental health and its treatment. Therefore, socio-cognitive theory provides a useful focus for research that ultimately may result in programmatic changes to benefit clients. Once developed, perception-change interventions can be evaluated through changes in observed treatment utilization.

Within the HBM framework, three general approaches can be used to increase appropriate utilization: increasing perceptions of individual susceptibility to illness and severity of symptoms, decreasing the psychological or physical barriers to treatment, or increasing the perceived benefits of treatment. The following discussion will highlight how each perception can be increased or decreased, and the implications for such intensification of the perceptions. Examples of intervention strategies that can serve as individual or system-level “cues to action” will be reviewed within each domain of the model. In addition, where appropriate, the discussions will highlight how sociodemographic factors such as age, sex, and ethnicity impact the perceived threat from the disorder and the expectations for the benefits of therapy. The model we discuss assumes that the individual seeking therapy is autonomous in this decision making. That is, it is not directly applicable to those who are required to seek therapy by the judicial system, a spouse, or their place of employment, nor does it address children’s mental health care utilization. We will address some of these issues briefly later in our discussion.

Figure 1 is a visual representation of the model we propose for conceptualizing mental health care utilization using the HBM as a framework. The studies reviewed in each section below were designed primarily without use of the HBM framework. However, the model is a useful heuristic tool to organize and draw in research from a variety of disciplinesmarketing, public health, psychology, medicine, etc.

Sociodemographic variables in the HBM
Several demographic variables consistently predict utilization of mental health services. Despite similar levels of distress, some groups are less likely to seek professional treatment than others, creating a gap between need and actual use of outpatient mental health services. Groups identified as consistently underutilizing services include men, adults aged 65 and older, and ethnic minority groups in the United States (Wang et al., 2005). Within the HBM framework, these demographic variables are hypothesized to influence clients’ perceptions of severity, benefits, and barriers to seeking professional mental health services. Studies exploring the relationship between demographic variables and HBM constructs will be highlighted throughout this article.
Systems approaches to addressing perceived susceptibility and severity

According to the HBM, individuals vary in how vulnerable they believe they are to contracting a disorder (susceptibility). Once diagnosed with the disorder, this dimension of the HBM has been reformulated to include acceptance of the diagnosis (Becker & Maiman, 1980). In addition, increasing an individual’s perception of the severity of his or her symptoms increases the likelihood that he or she will seek treatment. In relation to mental health, perceived susceptibility goes hand in hand with perceived severity (i.e., Do I have the disorder and how bad is it?), and so they will be discussed together. In health-related decisions, the majority of consumers are dependent upon the expertise and referral of the medical professional, usually the trusted general practitioner (Lipscomb, Root, & Shelley, 2004; Thompson, Hunt, & Issakidis, 2004). Unlike decisions about the need for a new vehicle or a firmer mattress, determining whether or not feelings of sadness should be interpreted as normal emotional fluctuation or as indicators of depression is a decision often left to an expert in the area of mental health or a primary care physician. This places a great responsibility on practitioners, psychiatrists, psychologists, and other mental health service providers when discussing the severity of a client’s symptoms and options for treatment.

Ethical Considerations in Increasing Perceived Severity and Symptom Awareness

The American Psychological Association (APA) provides ethical guidelines for clinicians about how to inform the public appropriately about mental health services. According to the 2002 Ethics Code (American Psychological Association, 2002), psychologists are prohibited from soliciting testimonials from current therapy clients for the purpose of advertising, as individuals in such circumstances may be influenced by the therapistclient relationship they experience. Additionally, psychologists are prohibited from soliciting business from those who are not seeking care, whether a current or potential client. This may include a psychologist suggesting treatment services to a person who has just experienced a car accident or handing out business cards to individuals at a funeral home. However, disaster or community outreach services are not prohibited, as these are services to the community. Psychologists are prohibited from making false statements knowingly about their training, credentials, services, and fees, and are also prohibited from making knowingly deceptive or exaggerated statements about the success or scientific evidence for their services. In this way, limits are placed on the influence of practitioners on those in vulnerable situations.

Identification of Symptoms

What, then, does an ethical symptom awareness intervention look like? It would involve clearly differentiating between clinical and nonclinical levels of distress, with an indication of what types of intervention strategies may be most effective for each. For example, in cases of mild symptomatology, individuals may be encouraged to use a stepped care approach beginning with bibliotherapy, psychoeducation, and increases in social support. Also important is the provision of accurate, research-based information regarding symptoms of psychological disorders and treatment options. This may call for challenging our assumptions that psychotherapy is helpful for all psychological distress. Recent studies of grief counseling and postdisaster crisis counseling, for example, suggest there may be an iatrogenic effect of therapy for some individuals (Bonanno & Lilienfeld, 2008). On the other hand, some research indicates that individuals with subclinical levels of distress who receive treatment early may avoid developing more severe pathology (e.g., prodromal psychosis; Killackey & Yung, 2007). In programming for all components of health beliefs, not just severity, the credibility of psychotherapy is dependent upon ethical, appropriate public health statements and service marketing.

Many examples of mental health education campaigns have been discussed in the literature, often focusing simultaneously on increasing awareness of mental illness, destigmatizing individuals with mental illness, and increasing awareness of mental health resources. The Defeat Depression Campaign of the UK was designed with these goals in mind, and results of nationally representative polls before, during, and after the campaign indicated positive changes in public attitude toward depression and recognition of personal experiences of symptoms (Paykel, Tylee, & Wright, 1997). Similarly, more recent national campaigns in Australia have provided some evidence that education increases public accuracy in identifying mental illness (Jorm & Kelly, 2007). National screening day initiatives for depression, substance abuse, and other psychological disorders also aim to increase awareness of illness severity for individuals who may not recognize symptoms as signs of illness warranting treatment.

Approximately 71% (Lipscomb et al., 2004; Thompson et al., 2004) of individuals report looking to their primary care physician for mental health information, treatment, and referrals. However, many physicians lack the appropriate knowledge to identify mental health problems (Hodges, Inch, & Silver, 2001). After examining five decades (19502000) of articles evaluating the adequacy of physician training in detecting, diagnosing, and treating mental health, Hodges et al. (2001) offer several suggestions for improving primary care physicians’ training to effectively identify patients with mental health issues. Beyond learning the diagnostic criteria for the major disorders and providing appropriate medications when needed, however, physicians also need to be aware that they can act as a “cue to action” in the patient seeking psychotherapy. Such cues would alert the patient that his or her symptoms of distress or depression had reached severe levels and that the trusted family physician believes additional treatment is needed.

Influence of Demographic Variables on Perceived Severity

An individual’s personal label of the symptoms and illness are thought to contribute to perceived severity. In a study of four large-scale surveys of psychiatric help seeking, Kessler, Brown, and Broman (1981) found that women more often labeled feelings of distress as emotional problems than men did, a factor thought to help explain the consistent finding that men seek mental health services less often than women even when experiencing similar emotional problems. Similarly, Nykvist, Kjellberg, and Bildt (2002) found that among men and women reporting neck and stomach pains, women were more likely to attribute pains to psychological distress, while men were more likely to indicate no significant cause and little concern regarding the somatic symptoms.

Relatively little research has been conducted regarding how individuals of diverse backgrounds perceive the severity of their mental illness symptoms. However, some evidence suggests that individuals of different ethnic backgrounds appraise the severity of their illness symptoms differently, such that individuals from minority cultures are more influenced by their own culture’s norms about mental illness symptoms than White Americans (Dinges & Cherry, 1995; Okazaki & Kallivayalil, 2002). Cues to action from providers may be more effective if they are framed in a way that is congruent with individuals’ attributions about symptoms. In other cases, education about symptoms, provided in a culturally sensitive manner, may be necessary. This is an area where additional research is needed to determine practice.

Older adults are more likely to seek treatment when they perceive a strong need for treatment (Coulton & Frost, 1982). However, some aspects of aging may influence whether or not older adults perceive ambiguous symptoms as psychological in nature or due to physical ailments. For example, among older adults, particularly those experiencing chronic pain or illness, somatic symptoms of mental illness may be interpreted as symptoms of physical illness or part of a natural aging process, rather than as symptoms of depression or anxiety (Smallbrugge, Pot, Jongenelis, Beekman, & Eefsting, 2005). In this way, some depression symptoms may be overlooked by older individuals and the physicians who see them (Gatz & Smyer, 1992).

Systems approaches to addressing perceived benefits
Even if clients do view their symptoms as warranting attention, they are unlikely to seek treatment if they do not believe they will benefit from professional services. Thus, increasing perceived benefits of treatment is a second approach to increasing appropriate utilization.

Public Perceptions of Psychotherapy

In response to changing health care markets, the 1996 APA Council of Representatives called for the creation of a public education campaign to inform consumers about psychological care, research, services, and the value of psychological interventions (Farberman, 1997). Results of preprogram focus group assessments indicated that participants were frustrated with changes in health care service delivery in the United States and many participants did not know whether their health insurance policy included mental health benefits. Participants indicated that they did not know when it was appropriate to seek professional help, and often cited lack of confidence in mental health outcomes, lack of coverage, and shame associated with help seeking as main reasons for not seeking treatment. Participants reported that the best way to educate the public about the value of psychological services was to show life stories of how they helped real people with real-life issues. Informed by the focus groups and telephone interviews, APA launched a pilot campaign in two states using television, radio, and print advertisements depicting individuals who have benefited from psychotherapy, as well as an 800 telephone number, a consumer brochure, and a consumer information website. During the first six months of the campaign, over 4,000 callers contacted the campaign service bureau for a referral to the state psychological association to request campaign literature, with over 3,000 people visiting the Internet site weekly (Farberman, 1997). In sum, addressing perceived benefits of treatment means answering the question, “What good would it do?” When individuals are made aware of how treatment could improve their daily functioning, they may be more motivated to overcome the perceived barriers to treatment. Especially for individuals who have not previously sought mental health treatment, describing realistic expectations for treatment may be an essential first step in orienting individuals to make informed treatment decisions.

Public Preference for Providers of Care

Many different types of professionals serve as mental health service providers, and individuals’ beliefs about the relative benefit of seeking help from various lay and professional sources likely impact decisions to seek help. Roles have shifted in treatment over time, with the introduction of managed care and the increased role of the PsyD, master’s-level psychologist or counselor, and MSW as treatment providers. Counseling has been considered a primary role of clergy for many decades; however, specificity of counseling training has changed over time, with some clergy receiving specific training as counselors within seminary education. Primary care physicians have been relied upon for treatment through pharmacotherapy with the development of improved medications for depression, anxiety, and attention deficit hyperactivity disorder, among others. While few primary care physicians conduct traditional therapy sessions, many individuals report that they first share mental health concerns with their primary care physician, making this profession an important potential gateway for psychotherapy (Mickus, Colenda, & Hogan, 2000).

Level of distress may also influence where individuals seek help: Consumer Reports’ popular survey of over 4,000 participants found that individuals tend to see a primary care physician for less severe emotional distress and seek a mental health professional for more severe distress (Consumer Reports, 1995), while Jorm, Griffiths, and Christensen (2004) found that individuals with depressive symptoms were most likely to use self-help strategies in mild to moderate levels of severity and to seek professional help at high levels of severity.

Some support has been found for the importance of a match between individuals’ perceptions of the cause of symptoms and the type of treatment they seek. In a German national survey, perceptions of the cause of depression and schizophrenia significantly predicted preferences for professional or lay help. Those who endorsed a biological cause of illness reported they would be more likely to advise an ailing friend to seek help from a psychiatrist, family physician, or psychotherapist, and less likely to advise seeking help from a confidant. Perceptions of social-psychological causes of illness, such as family conflict, isolation, or alcohol abuse, were related to advising a confidant, self-help group, or psychotherapist rather than a psychiatrist or physician (Angermeyer et al., 1999).
Demographic Variables and Perceived Benefits

Perceptions of mental health treatment as beneficial are likely shaped by cultural influences as well as an individual’s personal experience. In a subset of randomly selected individuals from a nationally representative survey, Schnittker et al. (2000) compared Black and White respondents’ beliefs about the etiology of mental illnesses and their attitudes toward using professional mental health services. Black respondents were more likely than White respondents to endorse views of mental illness as God’s will or due to bad character, and less likely to attribute mental illness to genetic variation or poor family upbringing. These beliefs predicted less positive views of mental health services, and the authors found that more than 40% of the racial difference in attitudes toward treatment was attributable to differences in beliefs about the cause of mental illness.

Older adults’ reluctance to seek psychological services has been connected with more negative attitudes toward psychological services (Speer, Williams, West, & Dupree, 1991). Attitudes toward psychotherapy appear to improve by aging cohort, however. Currin, Hayslip, Schneider, and Kooken (1998) assessed dimensions of mental health attitudes among two different cohorts of older adults and found that younger cohorts of older adults hold more positive attitudes toward mental health services. Thus, attitudes among older adults may be less attributable to age than to changing cultural acceptance of mental illness over time. Older adults who have engaged in professional psychological treatment tend to see mental health treatment as more beneficial than their counterparts who have never sought treatment (Speer et al., 1991).

Across diverse religious orientations, beliefs in a spiritual cause of mental illness have been associated with preference for treatment from a religious leader rather than a mental health professional (Chadda et al., 2001; Cinnirella & Loewenthal, 1999). For individuals who interpret psychological distress symptoms as spiritually based, a religious leader may be viewed as a more beneficial provider than a traditional mental health professional. Some clients prefer to see clergy for mental health concerns. Some psychologists have formed relationships between religious organizations and mental health providers to foster collaboration and access to many care options for community members (McMinn, Chaddock, & Edwards, 1998). Benes, Walsh, McMinn, Dominguez, and Aikins (2000) describe a model of clergypsychology collaboration. Using Catholic Social Services as a medium through which collaboration took place, psychologists, priests, religious school teachers, and parishioners collaborated through a continuum of care beginning with prevention (public speaking about mental health topics, parent training workshops) through intervention (1-800 access numbers, support groups, and counseling services). The authors note that bidirectional referralsnot simply clergy referring to cliniciansand a sharing of techniques and expertise are keys to the success of such programs. Providing care to individuals through the source that they consider most credible or accessible is an innovative strategy for increasing perceived treatment benefits and decreasing barriers

Marketing Psychological Services

While the idea of marketing psychological services may seem unappealing to some psychologists, marketing strategies designed to encourage appropriate utilization may serve as both a strategy for the field of psychology as well as an outreach service to improve public health. In order to benefit from psychotherapy, individuals must view it as a legitimate way to address their problems. Strategies may include marketing psychological services at a national level, such as the APA’s 1996 public education campaign (Farberman, 1997); at a group level, such as a community mental health system providing rationale for increased funding; or at an individual level, such as an independent private practitioner seeking to increase referrals. Two theories, social marketing theory and problem-solution marketing, are useful models for developing effective mental health campaigns.

Social Marketing Theory

Rochlen and Hoyer (2005) identify social marketing theory as a framework for identifying strategies specifically aimed at changing social behaviors. Three principles define social marketing: negative demand, sensitive issues, and invisible preliminary benefits (Andreason, 2004). Negative demand describes the challenge of selling a product (psychotherapy, in this case) that the individual does not want to buy. In the case of individuals who see therapy as unhelpful or a frightening experience, addressing negative demand would include considering the viewpoint of a reluctant audience and perhaps utilizing the Stages of Change model (Prochaska & DiClemente, 1984), in which the goal of the marketing campaign would be to move an individual from the precontemplation stage to the contemplation stage of change. Social marketing theory also takes into account the degree of sensitivity in the task being encouraged; that is, seeking psychotherapy requires a greater amount of mental energy and vulnerability than less sensitive purchases, such as a new motorcycle. The principle of invisible preliminary benefit reminds those marketing psychological services that the benefits of choosing to seek psychological help are often not seen immediately, as they are when receiving a pain medication. Therefore, marketing strategies for mental health must make consumers aware of psychotherapy’s benefits and the long-term prospect of improving quality of life.

It is important that women keep themselves up to date with the latest advances in women’s health. Keeping themselves well versed with all the information and services that are currently available. Advances in our knowledge of women’s health has shown us now that women and men differ greatly on physiological basis and therefore need to be looked at different when considering treatments.

Our attention should be drawn to the primary areas of concern for all women such as reproductive health, heart disease, female cancers and diet.

Diet is an easy way to avoid some of the biggest killers around today. Most people suffering from heart disease are doing so primarily because they have been partaking in poor diet and little or no exercise. Other conditions such as infertility and diabetes are also brought about by poor diet. Changing this aspect of your lifestyle is vitally important if you wish to avoid the aforementioned conditions and stay healthy.

There has been good news when it comes to female cancers; specifically breast cancer. Early detection and survival rates have improved dramatically over the last few years by up to 2%.

Unfortunately some other cancers such as ovarian cancer is still claiming as many victims as it ever did. It is therefore vitally important for women to make themselves familiar with the rather ambiguous symptoms that sometimes present themselves with this condition. A feeling of fullness, changes in urine production, weight gain, pelvic pain and excessive gas can all indicate a need to be investigates further.

Heart disease is the nation’s leading cause of death. Men and women both suffer from this condition but it is worth noting that when cardiac arrest takes place, a woman is more likely to die from the event than a man. It is therefore of even more significance to eat a healthy diet and take the regular exercise we mentioned earlier for women in order to minimise any risk of heart disease.

There have been many changes in reproductive health over the years the latest now is a choice of intramuscular injections of patches worn to prevent pregnancy. There is also a new birth control pill that has a slow release dispenser. It releases the hormone over 84 days as opposed to 21, which means a women will only menstruate 4 times a year.

Concerned about the health of your parents? Why not keep a check on it all the time? It does sound a bit unrealistic but there is one thing that makes it easy for you to be able to do this- a health watch. Holistic health care is possible only through a health monitoring watchthat can keep a track of different aspects of your health. Even when your parents are thousands of miles away from you, you can keep a track on their health by a simple press of a button. With a simple click of a button on a medical health watch, one can get information about blood pressure, body fat, and EKG. This watch can also act as an oximeter.

Your parents and loved ones are special and it is thus your duty to make sure that they enjoy good health. Taking up a health care management plan for your parents from a good company will ensure that your parents stay hale and hearty and do not have to face problems when ill. Under the medical plan, your parents will be monitored by expert doctors 24 hours in a day and you will be able to get regular updates for the same. You can get these updates even when you stay thousands of kilometers away from your parents with the help of these medical alert watches
VESAG health watch is one such device that can help you keep a check on the health of your parents. This watch is portable and one can wear it on the wrist or as a pendant. The location of the wearer can be tracked with this watch through the built-in GPS tracker. This watch can also act as a medical monitor as reminders can be set in it to remind the patient of the time when he has to take some medicine or has to go in for some health check up. While the health is being monitored, an alarm from the watch can signal bad health. In case this happens, the elderly and your loved ones in problem can be taken to the hospital on time and their life can be saved. Web portals can be used to set reminders in the digital health monitoring watch.
Living with elderly people in home can be difficult when you have to go to your workplace on a daily basis. Elderly are prone to falls and if this happens, a serious situation can emerge. A health watch from Vesag can help you detect falls and offer them complete medical care as and when they need it. It is important to keep a check on the internet round the clock and this can only be made possible through devices like these medical alert watches. Doctors and even common people can use this watch and help their parents and patients enjoy good health.

Shot puts the famous track and field game has some meaning in its word. Shot put which implies that you have to put the ball which is short in nature from your hand. By playing shot puts your concentration power gets increased.

Health is wealth is the famous proverb. Nowadays more importance has been given to health activities and sports activities, since sports activities also enhance your health. Shot puts are the balls which are made of brass or cast iron. The ball is weight by its nature. By playing shot puts our physic gets stronger and hands get some grip.

Shot puts are the balls which are made of brass. Brass is an alloy of copper and zinc. Some grams of zinc are distributed through out our body. Zinc is needed by the human beings in order to heal. It plays an important role in cell division. It is naturally founded in our body. This is one of the minerals needed for strong and healthy muscles.

You can ask a question? By playing shot puts: the metal is only touched by us and not consumed. Yes we are not consuming this mineral when playing. Whenever we handle shot puts our body gets some minor benefits through some vibrational effects.

One more advantages of handling shot put balls are it is made of brass which does not allow bacteria. So while handling the shot put balls we are free from bacteria and its effects.

Generally there is a saying that women are weak in sports, now it has been changed due to shot puts. Women are participating in shot put events and securing prizes. Shot puts have made women healthier and strong. Shot puts have shown womens power to the world. By handling the shot put balls women get stronger physic and proper grip ness in their hands.

Throwing weights is a great training tool for shot puts. It improves the throwing skills and also physical ability of the sportsmen. Generally when we throw something we need to put some efforts. Throwing weights makes stability in the body and give some physical exercises to our shoulder.

Turned economy iron shot puts are the powerful shot puts which is suited for all shot put players. These shot puts are made of cast irons. Irons are also the essential minerals needed and it takes part in the biological oxidation and transport. In general we are handling the ball which is fully made of some metals which is essential for a human body. By handling shot put balls we are feeling the vibrant effect in our body.

Many different varieties of shot puts are there such as brass shot put; cast iron shot puts, stainless steel shot puts etc are the shot puts made of different metals and has some medicinal effects.

Shot puts enhance our health by giving physical strength, stiffness to the body and grip to withhold the things. The shot put which is made of various elements by its nature has some medicinal effects. Due to its different weights shot put balls are handled by all age group peoples.

Fenugreek tea is popular where it is naturally harvested, which is in nations adjoining the Mediterranean and onwards to India. Not only is it used to augment foods but also as a very popular refreshing drink.

The beverage itself contains only the fenugreek seeds. They are easily found in supermarkets, specialty supermarkets or your local health food store. It suffices to comment that the better the quality, the better the resulting beverage.

Brewing the tea is easy – a walk in the park, even, so don’t be worried that you have to make this drink with seeds as opposed to herbs. As a general rule, use one teaspoon of fennel seeds to one cup of water. Put them in a pot and boil them for at least five minutes. If you like a stronger taste, then boil them for up to ten minutes. This is something you can play around with until you come up with your perfect cup. Now just remove the pan from the heat and cover. Leave for another ten to fifteen minutse – the same principles apply – the longer you leave it, the stronger it will become so monitor this carefully. When you believe it is ready, strain the mixture into a mug or cup. You can now throw away the seeds as they have done their job. This drink tastes good hot or cold (try it with ice and lemon when it is hot outside).

Fenugreek is a really healthy choice. It is great for digestion and anything related to the digestive process. It actually has quite a lot of fiber which is why it is often used as a laxative. The fiber swells in the colon, and helps take away toxic waste from your body. Many people drink this tea to detoxify themselves or as part of a detox program. In fact you will find that many of the teas sold as “detox teas” have fenugreek as one of the main items. It is a great tea is you have a cough or any bronchitis related problems as fenugreek helps to get rid of excess mucus in the body. It can even be used to help new mothers increase their flow of milk.

This tea can also be used as a paste to help with skin irritation, swelling and insectstings. For the paste, just mix around three tablespooons of powdered fenugreek seeds to around one quart of boiled water. Let this mixture stand and when it is cold it will be of a thick consistency. You can either buy ground fenugreek seeds for this or you can do this yourself in a grinder or kitchen machine.

With all these benefits as well as a great taste, it is obvious that fenugreek tea should take a favorite place in your kitchen.

For millions of adults and children junk food and increased inactivity has led to obesity. For some people junk food has become a way of life, they are addicted to it and if everyone in your family for example eats junk food then it is very hard to eat healthy. But it is not impossible at all. So why junk food is bad for you?

There is so much talk about junk food. People know that it is unhealthy and makes people fat but what is the exact definition of junk food. Well Junk food is an informal term applied to some foods with little or no nutritional value, or to products with nutritional value but which also have ingredients considered unhealthy when regularly eaten, or to those considered unhealthy to consume at all. The term was coined by Michael Jacobson, director of the Center for Science in the Public Interest, in 1972.

Factors contributing to labeling as junk food are high levels of refined sugar, white flour, trans fat and saturated fat, salt, and additives such as preservatives and coloring agents. Others include lack of proteins, vitamins, fiber and other nutrients for a healthy diet. Junk food is associated with health problems including obesity, heart disease, Type 2 diabetes and dental cavities. Problems with fast food may not be apparent to children, hence advertising aimed at children has come under criticism.

Most kids and also adults who eat junk food are also inactive. If you combine these two, then you will get a very serious and unhealthy combination. Our modern lifestyle has caused all of the problems we have and once you have fallen into the trap of junk food and inactivity, then it is almost impossible to get out of it.

How many people do you know how have tried to eat healthy, lose weight and train, but have failed? Maybe you are one of them? The reason why so many people fail is that there is information overload. There are thousands of diets, magic pills, supplements, miracle weight loss exercise programs and what not. To be honest 95% of the information is junk and is made to rip you off with empty promises.

There is no magic pill that makes you lose weight and makes you look like a supreme athlete. You have to do it the hard way. It is very hard for people to change their lifestyle. But to be healthy and lose weight you have to change your lifestyle. It is the only way.

It is not impossible to change your habits and start living a healthier life. The most important factor about it all is knowledge. If you have the knowledge and you know what you have to do to be successful, then you have done most of the work already.

It is never to late to change your lifestyle. If you have the desire and motivation then nothing will stop you. People just have to stop finding silly excuses. You know junk food is bad for you and if you dont exercise you will have serious problems. Today could be the first day of the rest of your life. Make changes today not tomorrow. You will be surprised what you can actually accomplish.

When choosing a health care plan you have to keep certain things in mind. Some of the important points are as follows:
An individual health insurance cover, simply stated, is an agreement between you and the insurance firm, aimed at protecting you against any financial constraints on account of a medical emergency. The one pertinent question you need to ask yourself is -what are the factors to be analyzed before deciding on an individual health insurance policy?

It is indeed a fact that medical and preventive sciences have made rapid advancements in today’s world. Nonetheless, it would be prudent to arm yourself with the best individual health insurance cover to protect yourself against any unforeseen illness. Indeed, America’s best health insurance companies are vying with one another in putting together some of the most imaginative individual health insurance policies designed to overcome any medical contingency. If you are unemployed, or self-employed, an individual health insurance policy is the right choice.

Consult with your insurance company if you can have your individual health insurance policy incorporated in its group policy. You may be paying a higher rate but the terms would be more advantageous than if you had to buy your own individual health insurance policy. If you are married, find out if your spouse’s employer is willing to include you in its group policy. If you are left with no option, then it is wise to buy an individual health insurance policy. Even though the insurance cover may be limited and the rates high, you would still be ensuring protection for yourself or your family against financial problems if you are suddenly confronted with a serious illness or medical emergency. Search for a good health insurance professional to help you with the best individual health insurance policy that offers you good value for money.

You have plenty of choices while selecting individual health insurance plans – The PPO Plan or the Preferred Provider Organization, the HMO Plan or the Health Maintenance Organization, the HDHP or the High Deductible Health Insurance and HAS or the Health Savings Accounts Qualified High Deductible Plan.

When considering individual health insurance plans a worthwhile option may be a health savings account plan which has few unique benefits. With individual health insurance plans, you can trade lower deductible health insurance for a plan that has a higher deductible. This will help you save money each month by lowering your premium. Besides the lower cost, higher deductible health savings account plan also has the added benefit of a tax favored savings account. Yet another interesting aspect of these individual health insurance plans is that the money you save rolls over year after year.

Even if you are already covered by your employer’s insurance scheme, you may still need to get additional coverage through an individual health insurance plan. This becomes necessary because employer-sponsored programs often fall short of individual needs. Extensive coverage for self and family can be achieved through a separate individual health insurance plan.

Individual health insurance plans are of two types: – Indemnity plans – Managed care plans. Indemnity plans are costlier but best suited for those who have particular health issues and need to be treated by specific doctors. Managed care plans cost less because you will be visiting a doctor or a hospital that is provided under the plan. If the treatment requires you to visit a specialist, you will need special permission from the insurance service provider. This plan is best suited for individuals without specific health problems, and wanting to pay less.. If you have to choose a new physician from the health care plan then do a little bit of research work by calling the medical office she works for or checking with the AMA. Other factors like location and availability have to be considered while choosing a doctor.

Sometimes in life you may need a specialist for specific medical conditions you need to find out how you will be able to use a specialist. Find out do you have to contact your primary care physician first or find out if the current specialist you use is an in-network doctor. While choosing a health care plan many forget to confirm that their pre-existing condition will be covered. Pre-existing conditions can vary between plans from being excluded to being covered fully and sometimes somewhere in-between like being covered after a specific amount of time. Find out what type of emergency rooms and hospitals are covered on your plan. Also find out if you have to contact your primary care physician first before getting emergency care. Most of the managed care plans do provide regular physicals and health screenings yearly, but some independent insurance plans do not cover them at all. If youre using a prescription drug on a regular basis or you may need in the future, then choose a plan that has good prescription drug coverage. This coverage type can vary enormously from plan to plan. If youre visiting a gynecologist regularly, find out if your doctor is covered in the plan. Find out what additional benefits do the plan offers when comparing health plans like drug and alcohol rehabilitation, mental health care, counseling, home health care etc. After finding what you want in your health care plan you have to compare costs. Find out your deductibles, co-payment details etc. Co-payments are the fees you need to pay when visiting your doctor, hospital or emergency room. Do know your limits. Some plans have lifetime limits on how much the health care plan will pay and some have lifetime limits along with yearly limits. The last thing is the exclusions list. You will want to review each plans exclusions list to find out what is not covered and to see if any condition you currently have or expect to have in the future, is included on that list.

Pilates is an exercise which is commonly performed on a mat. It is an exercise without resistance. Beginners usually confused with the exercise since Pilates uses different method from other exercises. This exercise was developed by Joseph Pilates in 1900s. This exercise can result in weight loss and give emphasis to hips, lower back, abdominals, and thighs.
Pilates is an exercise method which is commonly done to gain better posture and increase muscle strength, core, coordination, and flexibility. Commonly the exercises are performed using Pilates workout exercise equipments or simply using a mat. The Pilates equipments are required to help beginners in finding core muscles. Nowadays, stability ball is also used to bring balance challenge. The balance challenge makes core muscle activated.
You might also find Pilates chair which is featured with pedals and platform. Beginner Pilates workout program can stand on the pedals while holding its platform. The proficiency of using Pilates chair will increase and you will not need to hold the platform. The common Pilates workout equipments are Cadillac, reformer, Wunda chair, arc barrel, total gym and cable, tower, stability ball, Bosu, and fitness circle.
Reformer is the most popular type of Pilates equipment. This unit has traps, moving carriage, jump board, and also foot bar. You can adjust the resistance level by removing or adding more springs. The springs are coded with color to know the resistance level of your workout progress.
Cadillac is usually called as trapeze table which has four poles. It comes with accessories attached to the poles. The accessories which you can find are bars, straps, and springs. This unit works for every part of your body.
Stability ball is good to bring balance challenge to you. This unit brings effective training on deep core musculature. The core is the basis of Pilates exercise technique. You can use the stability ball with resistance bands and cable for better stimulation.
Bosu is like an Arc barrel which is usually used for arc barrel exercises. You can also use Bosu for side-bending exercise. It can also be used for people who perform side-leg exercise to prevent discomfort when lying on the floor.
Commonly, the side-laying exercise is intended to train outer thigh which can cause muscular imbalance. It is crucial to activate inner thigh muscles for better knee and pelvic stability. We often see beginners of Pilates exercise have trouble with Pilates Roll-Up. The Pilates Roll-Up is a full sit up position which is a little hard to be performed by newbie. If you are using Pilates reformer you can wrap the band around your feet and try to roll to the upright position.
The benefits of doing this exercise are posture improvement, muscle toning, better flexibility, stronger core, great balance and coordination, and many more. You can also burn calories by doing Pilates workout. It is very healthy and useful to make you feel healthier for better quality of life.

The lifestyle of the working professionals in today’s era is different than what it used to be earlier and is more hectic. They work for extended hours. These extended working hours and sitting longer at their work stations are taking a physical toll on their body. The common problems encountered by the work force due to this kind of lifestyle are back aches, computer vision syndrome CVS, wrist pains, neck and shoulder pains or many other long term ill effects. The lack of time in everyone’s life is leading to reliance on fast food which is conveniently available instead of home-cooked food, similarly vegging out on the couch despite of going out for a walk. However, contrary to what most people think, eating well and staying physically active can be incorporated into the daily routine of working section of the country.

Now that you have realized the importance of staying fit and keeping your body in perfect shape, it is important for you to know the right way of doing it. Below are some health and fitness tips that will help working people discover ways to maintain a better and healthy lifestyle, and that will keep them away from common physical ailments;

As exercising offers so many benefits, make it a part of your routine even if you are at work. If your office is located nearby your home, you can take a walk to reach to your office. If you are inside the office, use stairs instead of using lift.

During work, take several 5-10 minutes of break at regular interval for just a walk or for quick run up and down the stairs. This helps keep the body fit, and mind rejuvenated.

Sitting at stretch in front of computers can be hard on the body. So standing up and stretching your body after every short interval will remove the occurrence of common problems like back ache and shoulder pain.

You can carry workout clothes with you while going to office so that after you leave office you can straight away go to the gym without the need of going home to carry your stuff. This will save your time and this saved time can be utilized in the exercise.

You should keep an option with you to be healthy and fit. Keep healthy snacks with you so that when you feel like eating anything you have an energy booster in front of you. Also sipping water throughout the day is a good way to keep yourself refreshed.

Just do not forget the need of stretching your body for two minutes after every hour of work. You can also set an alarm to go off every hour to remind yourself to stand up and move around.

As you know exercising helps in keeping you fit, you should not avoid it in any case even if you work for extended working hours or if you don’t get time. It’s time to work for staying fit, not for making excuses.