In conclusion, overall the findings are positive in that the vast majority of elders expressed willingness to use some type of service for distress. This observation suggests that, whereas some groups may require additional psychoeducation and motivation, other factors may serve as larger barriers to service use than preferences. Perhaps the most important limitation to note is that people frequently do not do what they say they will do. Thus, future study of the decision-making process of older adults actually considering mental health services is critical. For example, one important factor may be whether older adults recognize their distress and believe it severe enough to warrant treatment. Older adults who believe that depression is a “normal” part of aging are less likely to seek services (Sarkisian, Lee-Henderson, & Mangione, 2003). With a better understanding of these decision-making processes, we can refine pre-treatment motivational strategies that address the most pertinent issues for distressed elders in need of assistance