Does time between application and case assignment predict therapy attendance or premature termination in outpatients?

Reitzel, Lorraine R.; Stellrecht, Nadia E.; Gordon, Kathryn H.; Lima, Elizabeth N.; Wingate, LaRicka R.; Brown, Jessica; Wolfe, Amanda S.; Zenoz, Lisa M.; Joiner, Thomas E.

doi:10.1037/1541-1559.3.1.51

Cited by 36 publications

(45 citation statements)

References 33 publications

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“…In fact, some clients missed appointments scheduled within 24 h of completing intake, and one‐third of missed appointments were scheduled within a week. This contrasts with the clients' feedback of a need for faster processing time and with previous studies that reported a relationship between waiting time and nonattendance [14,17,18].…”

Section: Discussioncontrasting

confidence: 99%

“…found that 90% of those who had dropped out of treatment before attending a third session reported being satisfied with the overall service received [16], suggesting that service satisfaction may be of limited value in predicting nonattendance. In addition, their finding that 77% of clients reported improvement as a reason for discontinuing treatment is supported by other studies [11,17].…”

Section: Introductionsupporting

confidence: 59%

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Client‐reported reasons for non‐engagement in drug and alcohol treatment

Coulson

Geertsema

et al. 2009

Drug and Alcohol Review

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionsupporting

confidence: 59%

Client‐reported reasons for non‐engagement in drug and alcohol treatment

Coulson

Geertsema

et al. 2009

Drug and Alcohol Review

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“…Another study found that those attending outpatient psychological therapy were more likely not to attend the initial appointment if there was a longer delay, though there was no impact on engagement once therapy had started (Reitzel et al . (). Further research is needed to explore the impact of waiting times on engagement in CBT for psychosis.…”

Section: Discussionmentioning

confidence: 97%

Predictors of disengagement from cognitive behavioural therapy for psychosis in a National Health Service setting: A retrospective evaluation

Richardson

Dasyam

Courtney

et al. 2019

British J Clinic Psychol

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Objectives. To evaluate whether demographic and clinical variables are related to disengagement rates in cognitive behavioural therapy (CBT) for psychosis in a clinical setting.Methods. The medical records and symptom severity data (from Health of the Nation Outcome Scales) were analysed retrospectively for 103 referrals for CBT for psychosis in a National Health Service secondary care and Early Intervention in Psychosis team.Results. Overall, 42.7% (n = 44) disengaged from CBT. There was no impact of gender or ethnicity, and no impact of clinical variables such as risk history and comorbid diagnosis. However, risk of disengagement was significantly higher for those who were younger, F = 6.89, partial g 2 = .064, p = <.05; those with greater total HoNOS scores, F = 4.22, partial g 2 = .04, p < .05; more severe symptoms on the HoNOS items of overactive, aggressive, disruptive, or agitated behaviour, v 2 = 6.13, p < .01; problem drinking or drug taking, v 2 = 7.65, p < .05; depressed mood, v 2 = 7.0, p < .01; and problems with occupation and activities: v 2 = 3.68, p < .05. There was a non-significant trend for shorter waiting times to be associated with greater levels of disengagement. Conclusions.These results indicate that it may not be psychosis per se that disrupts engagement in CBT, but linked behavioural and emotional factors. A more assertive approach to these factorsoveractive, aggressive, disruptive, or agitated behaviour, problem drinking or drug taking, depressed mood, and problems with occupation and activities, particularly in younger peoplemay be valuable prior to or early on in therapy as a means of increasing engagement in CBT for psychosis. Practitioner PointsRisk of disengagement from CBT for psychosis increases with overactive, aggressive, disruptive, or agitated behaviour (54.9% vs. 30.8%), problem drinking and drug taking (61.1% vs. 32.8%), depressed mood (56% vs. 30.2%), and problems with occupation and activities (53.3% vs. 34.5%), with a trend for younger age.An assertive and motivational approach to engagement and a focus on addressing low mood and problematic behaviours, prior to or early in therapy, may be warranted, particularly for younger people. This evaluation is limited by small sample size and being retrospective. These results speak to the question of whether psychosis itself renders people inappropriate for CBT for psychosis, or whether problems arise due to behavioural and emotional factors that might be addressed to increase access to CBT for psychosis. Disengagement in psychosis 441

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“…Another shortage is the lack of patient perspective on their presenting problems, expectations and outcome. One of the strongest predictors of nonattendance to therapy, but not premature termination, the time between application, and case assignment (Reitzel et al, 2006), could not be studied. Several limitations of naturalistic studies are also applicable here, such as insufficient diagnostics, limited specification of treatments and no control of treatment integrity, and incomplete data.…”

Section: Advantages and Limitationsmentioning

confidence: 99%

Predictors of not starting and dropping out from psychotherapy in Swedish public service settings

Werbart

Wang

2012

Nordic Psychology

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This naturalistic study examines potential predictors of treatment attendance and discontinuation among patients in the three most common psychotherapy types in Swedish public health service settings. Patients who did not start psychotherapy after pretherapy assessment are compared with patients who started psychotherapy. Patients who discontinued psychotherapy are compared with those remaining in treatment. Data were collected over a 3-year period at 13 outpatient psychiatric clinics, using online patient and therapist questionnaires. Of the 1498 registered patients, 14% never started psychotherapy, 17% dropped out from treatment, 33% continued in treatment, while 36% dropped out from data collection. Being dangerous to others, having Axis I diagnosis according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), lower level of therapeutic alliance, organizational factors, having younger therapists, psychotic features, and being older were predictive of not starting treatment, while organizational factors, more acting out and criminality, less mental ill-health, and being younger predicted dropout from treatment. Significantly more nonstarters and dropouts were found at clinics with lower levels of organizational structure and stability. Organizational factors predicted both starting and continuing in treatment.

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Does time between application and case assignment predict therapy attendance or premature termination in outpatients?

Cited by 36 publications

References 33 publications

Client‐reported reasons for non‐engagement in drug and alcohol treatment

Client‐reported reasons for non‐engagement in drug and alcohol treatment

Predictors of disengagement from cognitive behavioural therapy for psychosis in a National Health Service setting: A retrospective evaluation

Predictors of not starting and dropping out from psychotherapy in Swedish public service settings

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