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Table 1 Categorization of reasons for not seeking treatment and matching of reasons reported in the present study to Saunders' theoretical framework

From: Alcohol use disorder severity and reported reasons not to seek treatment: a cross-sectional study in European primary care practices

Saunders’ framework Present study
Reasons related to the four steps of treatment seeking Broader category Subcategories
Denial of the problem Lack of problem awareness Drinking was no problem
No help needed
Normal consumption
Consumption under control
Nothing serious, no problem insight
Minimization of problem severity, rationalization Other problem Other problem was more prominent
Other substance problem was more prominent
Cope alone Acknowledgement of problem but not of its severity
Self-change, problem resolution without professional help, non-professional help Cope alone Wish to cope alone
Reduction in drinking
Non-professional support
Encounter insurmountable barriers; delay or avoid treatment, ongoing self-change efforts Stigma or shame Fear of stigma and shame
Social pressure
Drinking is private issue
Encounter barriers Lack of possibility or knowledge
Lack of time
Asked for help but did not get any
Treatment was not affordable
Wish not to stop drinking
Treatment was not seen as an option
No trust in treatment system
The help needed was not offered