Effects of waiting time on appointment attendance with clinical psychologists and length of treatment

Abstract

Objective: With the increasing demand for clinical psychology services and the existing shortage of clinical psychologists, it is theoretically and clinically important to identify variables associated with non-attendance for clinical psychology appointments. The study reported here attempted to: (a) examine the effect of waiting time for an appointment on non-attendance to clinical psychology services; (b) investigate variables associated with prolonged waiting time; (c) explore the nature of the relationship between waiting time and length of psychological treatment.Method: The records of 49 3 patients offered an appointment to attend a clinical psychology service over a period of 24 months were analysed. Subsequently information on sex, age, type of referring problem, previous treatment history, treatment venue and waiting time for appointment, was collected and statistically analysed.Results: Non-attendance was significantly related to prolonged waiting time and young age. Controlling for the effects of waiting time and age, patients with complex problems and new patients wh o had never sought psychological treatment in the past were less likely to attend. Length of waiting time was higher in groups with previous treatment history, patients seen at a hospital based department, and patients with complex problems and anxiety disorders. Finally, length of psychological treatment (total number of sessions required) was not affected by prolonged waiting time.Conclusion: Non-attendance for clinical psychology appointments was associated with (a) young age, (b) prolonged waiting time (over six months), (c) complex psychological problems, and (d) new patients. The limitations and clinical implications of these findings are critically discussed.

What predicts failure to engage in or drop out from treatment for bulimia nervosa and what implications does this have for treatment?

“…Kirkley et al (1985), Merrill et al (1987) and Treasure et al (1998) found drop-outs tended to be younger than 'persisters'. This pattern is not unique to patients with BN (Baekland and Lundwall, 1975;Nicholson, 1994;Loumidis and Shropshire, 1997). However, where statistical analyses are reported, trends did not reach levels of significance.…”

“…Patients with personality disorders are less likely to attend psychological therapy services (Nicholson, 1994;Loumidis and Shropshire, 1997) and those with BPD are well known for dropping out of treatment (Gunderson et al, 1989). Those who do stay in treatment for BN may benefit (Bulik et al, 1998), but probably less so than patients who are not borderline (see for example Rossiter et al, 1993).…”

“…Some aspects of service delivery which are known to increase FTE or non-attendance in generic services include venue and, in particular, waiting time (Loumidis and Shropshire, 1997). The relative impact of these factors compared to those assessed in published studies is unknown.…”

What factors influence failure to engage in a supervised self‐help programme for bulimia nervosa and binge eating disorder?

“…These findings suggest there are subgroups of people who FTE. Loumidis and Shropshire (1997) examined the effects of waiting time on appointment attendance with clinical psychologists. FTEs had waited an average of 6 weeks longer than those who did attend.…”

“…Rates of FTE range from 14 to 28% in eating disorder services (Burket & Hodgin, 1993;Coker, Vize, Wade, & Cooper, 1993;Waller, 1997) and 21 to 57% in general mental health services (see e.g. Burgoyne, Acosta, & Yamamoto, 1983;Freund, Russell, & Schweitzer, 1991;Livianos-Aldana, Vila-Gomez, Rojo-Moreno, & Luengo-Lopez, 1999;Loumidis & Shropshire, 1997;Maclean, Greenough, Jorgensen, & Couldwell, 1989;Piancentini, Rotheram-Borus, Gills, & Graae, 1995). FTE therefore contributes to a substantial waste of health resources-administrative and clinical-as well as unnecessarily extending waiting lists.…”