Drug and Alcohol Dependence 87 (2007) 210–216 Intention to utilize formal help in a sample with alcohol problems: A prospective study Jennis Freyer a,∗ , Beate Coder a , Gallus Bischof b , Sebastian E. Baumeister a , Hans-J¨ urgen Rumpf b , Ulrich John a , Ulfert Hapke a a Ernst-Moritz-Arndt-University Greifswald, Institute of Epidemiology and Social Medicine, Walther-Rathenau-Str. 48, 17487 Greifswald, Germany b University of L¨ ubeck, Department of Psychiatry and Psychotherapy, Germany Received 30 March 2006; received in revised form 18 August 2006; accepted 18 August 2006 Abstract Background: Studies investigating factors of treatment entry have predominantly focussed on persons that have already taken an initial step in the process of help-seeking. With particular emphasis on intention to utilize help, this study aims to detect predictors for alcohol-related help-seeking among a non-help-utilizing sample. Methods: Using 312 individuals with diverse alcohol problems (dependence, abuse, at-risk drinking), intention to utilize help was assessed in addition to evidence based predictors for utilization of help (e.g. severity of alcohol problem, prior help-seeking). Results: In addition to prior utilization of help (OR = 9.76, CI: 4.60–20.74) and adverse consequences from drinking (OR = 1.13, CI: 1.02–1.25), intention to utilize help (OR = 4.84, CI: 2.04–11.51) was a central predictor for help-seeking. Among individuals who had not obtained prior help, individuals intending to seek help were 8.7 times more likely to utilize help than those not intending to seek help (CI: 1.05–72.2). Conclusions: In the past, intention to utilize help has been neglected from models investigating treatment entry. This study’s findings show that intention is a central factor for utilization of alcohol-specific formal help. Consequently, brief interventions focusing on enhancing motivation are expected to improve early help-seeking among general hospital patients with diverse alcohol problems. © 2006 Elsevier Ireland Ltd. All rights reserved. Keywords: Alcohol; Intention; Motivation; Utilization; Formal help; Treatment 1. Introduction Lack of help-seeking in persons with alcohol problems (e.g. Grant, 1996; Hingson et al., 1980; Rumpf et al., 1998) is a major concern. Over the past decades different predic- tors for alcohol-related treatment entry have been discussed in the literature. Contradictory findings were reported for social resources (e.g. Bannenberg et al., 1992; Hingson et al., 1980; Weisner, 1993), quantity of alcohol consumption (e.g. Tucker and Gladsjo, 1993; Weisner, 1993), severity of dependence (Bischof et al., 2000; George and Tucker, 1996; Weisner and Matzger, 2002; Weisner et al., 2002) and social pressure (e.g. Bischof et al., 2002; George and Tucker, 1996; Weisner and Matzger, 2002). For example, George and Tucker (1996) found that help-seeking (as opposed to non help-seeking) individu- ∗ Corresponding author. Tel.: +49 3834 867724; fax: +49 3834 867701. E-mail address: freyer@uni-greifswald.de (J. Freyer). als experience more pressure by family/friends. In contrast, a prospective study revealed that those who reported pressure from family/friends were less likely to enter treatment (Weisner and Matzger, 2002). Regarding the perceived severity of the alco- hol problem (Bardsley and Beckman, 1988; Finney and Moos, 1995), negative social or legal consequences from drinking (e.g. George and Tucker, 1996; Weisner et al., 2002), mental health problems (e.g. Hingson et al., 1982; Weisner et al., 2002), and prior help-seeking (e.g. Weisner and Matzger, 2002; Weisner et al., 2002) findings seem more consistent. Thus, treatment entry seems to result from perceiving the alcohol problem as severe, from an increased number of adverse consequences from drink- ing, mental health problems, and/or prior help-seeking. One model, the stress- and coping model by Finney and Moos (1995) is particularly promising. It provides an integration of three sets of predictors for alcohol related treatment entry: (a) impetus-factors including hardship or distress (severity of drink- ing problem and psychological distress), life stressors, and social pressure; (b) counteractive factors including social resources, 0376-8716/$ – see front matter © 2006 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.drugalcdep.2006.08.018