Background Fatigue in inflammatory bowel disease (IBD) is poorly controlled, with few existing interventions. Psychotherapy interventions for IBD fatigue show promise; however, due to mixed findings in efficacy and attrition, current interventions need improvement. Some research shows beliefs about psychotherapy and stigma toward psychotherapy may impact engagement in psychotherapy interventions. Aims This study aimed to examine the effects of IBD activity, fatigue, mental health status, previous experience with psychotherapy, and stigma toward psychotherapy on willingness to use psychotherapy as a fatigue intervention. Methods An online cross-sectional survey was conducted, and linear regression models were used to examine willingness to engage in psychotherapy for fatigue. Results Overall, 834 participants completed the survey. Regression analysis examining demographics, mental health status, IBD activity, fatigue, pain, antidepressant use, psychotherapy experience, and self-worth intervention efficacy belief significantly explained 25% of variance in willingness to use psychotherapy for fatigue. Significant factors included antidepressant use ( b  = .21, p  < .01), pain ( b  = − .05, p  < .001), and self-worth intervention belief ( b  = − .27, p  < .001), which uniquely explained 18% of variance in the outcome. Conclusions Willingness to engage in psychotherapy for fatigue in IBD appears to be driven by expectations related to specific self-worth beliefs, rather than stigma, IBD activity, or any prior experience with psychotherapy. Clinicians should directly address these expectations with their patients.