Processes Underlying Ambivalence in Help-Seeking: The Loss of Valued Control Model


Address correspondence to Warren Mansell, School of Psychological Sciences, Coupland I, University of Manchester, Oxford Road, Manchester M13 9PL, UK. E-mail:


A substantial proportion of people who are referred to therapy either do not attend their initial appointments or drop out early on. This problem indicates ambivalence toward attending therapy in the population suffering from mental health problems. We review the factors thought to underlie this problem. A new integrative framework, termed the loss of valued control model, is presented. This model draws on the principles of perceptual control theory and provides a process-focused view that integrates the barriers to therapy under a common control process. Our article divides the model into three core components and thereafter provides empirical evidence in support of the model, as well as suggestions of how the model can be used to inform clinical practice and future research.