Developing an Emic-Etic Scale for Barriers to Psychological Treatment Seeking

Abstract

Within the Arab region, barriers to psychological treatment seeking have been construed and measured by adopting either an etic-based approach (e.g., through the use of instruments that were initially developed in non-Arab cultures) or an emic approach (e.g., anthropological work). However, because these barriers are rooted in a culture’s values and belief systems, etic-based instruments may run the risk of construct bias (under-representation) and item bias. Conversely, emic approaches lack quantitative rigor and generalizability. To our knowledge, there is no tool that comprehensively measures all barriers to treatment seeking, within the Arab world and Lebanon specifically. The current study examined the literature in Arab and non -Arab cultures and identified eight major barriers which were used to construct a tool that adequately captures these obstacles in a combined sample of American University of Beirut (AUB) students and a community sample. Results indicated that barriers to psychological treatment seeking may be conceptualized along six factors. These are: I- Attitudes to Psychotherapy, II- Perceived Accessibility Barriers, III- Perceived Stigma, IV- Mental Health Literacy, V- Attitudes to Psychiatric Services, and VI- Perceived Need for Help.