Comprehensive variables were then generated including the information on treatment seeking assessed in closed variables as well as the coded answers from open ended questions (see Additional file 1: Table S2). For the evaluation of Saunders’ theoretical framework [17] we summarized the reported reasons in the following four categories: (1) ‘denial of the problem’; (2) ‘minimization of problem severity’; (3) ‘self-change’; and (4) ‘encounter barriers’. See Table 1 for an overview on broader categories, subcategories and classification according to Saunders’ framework.Table 1Categorization of reasons for not seeking treatment and matching of reasons reported in the present study to Saunders' theoretical frameworkSaunders’ frameworkPresent studyReasons related to the four steps of treatment seekingBroader categorySubcategoriesDenial of the problemLack of problem awarenessDrinking was no problemNo help neededNormal consumptionConsumption under controlNothing serious, no problem insightMinimization of problem severity, rationalizationOther problemOther problem was more prominentOther substance problem was more prominentCope aloneAcknowledgement of problem but not of its severitySelf-change, problem resolution without professional help, non-professional helpCope aloneWish to cope aloneReduction in drinkingNon-professional supportEncounter insurmountable barriers; delay or avoid treatment, ongoing self-change effortsStigma or shameFear of stigma and
