Aim of the study:
The motives that bring people to psychotherapy vary widely; while some people come on their own volition, others may not care to be in psychotherapy at all, but feel compelled to seek services because of external pressures. A patient’s motivation for therapy is believed to influence the likelihood of becoming actively and meaningfully involved in the work of psychotherapy.

Subject or material and methods:
We surveyed 343 consecutively admitted psychiatric outpatients from three large, urban psychotherapy clinics about their motives (internal vs external) for seeking psychotherapy and their expected (lack of) involvement in the work of therapy.

Results:
While most patients appear to come for therapy on their own volition (76%), a significant proportion also feel compelled to seek services because of external pressures (38%).

Discussion:
The more patients were motivated by external forces to seek treatment, the more disinclined they were to become engaged in the work of therapy; greater endorsement of internal motives was associated with reduced unwillingness to work in therapy.

Conclusions:
Externally motivated patients may be particularly doubtful about the relevance and/or success of therapy and may require preparatory work to help instil a sense of hope and investment in the treatment process.