Therapist ratings as predictors of therapy attendance

Abstract

Rated 200 clients who were attending a community mental health center outpatient clinic immediately after the initial therapy session. Therapist ratings consisted of a 21‐item scale that included descriptions of client behavior during the session and estimates of client duration of stay. In a sample comprised of the first 100 clients, a variety of items from the scale and client demographic variables were related significantly to subsequent attendance. A multiple regression equation derived from these data generated statistically significant predictions with regard to stay in the second sample of 100 clients.

Premature Termination of Psychiatric Contact

“…Previous findings regarding the relevance of age are conflicting. Some authorities (Cross & Warren, 1984;Roberts, 1985) failed to find an age effect on discontinuation, but others (Heisler et al 1982;Foulks et al 1986) found that younger patients discontinue prematurely. There are various possible explanations.…”

Whither the bias: The female client's "edge" in psychotherapy?

“…These results are provocative in light of the well-documented findings that there are more women in individual outpatient treatment (Garfield, 1978;Russo & Sobel, 1981), that they generally remain in treatment longer than men (Fabrikant, 1974), and are more preferred as clients (Parloff et al, 1978). Given the potential implications of these data for treatment outcome and "mini-outcome," for example, attendance (see Heisler et al, 1982) as well as for the process of treatment, it is important to document their reliability and generalizability. The present study does this by examining interpersonal evaluations of and gross outcome expectancies for new clients in an outpatient mental health agency.…”

Situational factors and behavioral self-predictions in the identification of clients at high risk to drop out of psychotherapy

“…The "Posttherapy Questionnaire" (25 items) contained items that pertained to client reactions to the first therapy session, as well as additional selfprediction and situational factors items. Finally, therapists were asked to predict client attendance via a modified form of the therapist prediction item developed by Heisler et al (1982). This item incorporated the expanded response choice format that was developed for use in the client self-prediction items and included 5 responses, which ranged from "the client probably won't return after today" to "the client will probably attend more than 8 sessions.…”

“…Under such circumstances, early defection from treatment deserves to become a matter of major concern to both psychotherapists and psychotherapy researchers alike. The identification of clients at high risk to drop out of therapy is an obvious preliminary step in the solution of the problem (Fraps, McReynolds, Beck, & Heisler, 1982). Attainment of this goal almost certainly would result in a better understanding of factors that are instrumental in the development and maintenance of stable attendance behavior.…”

“…Finally, an item that represented therapists' predictions of client attendance was added to the array of predictor variables. Although prior work in this area (Heisler, Beck, Fraps, & McReynolds, 1982) did not yield encouraging findings, the current form of the therapist item was modified from the original three-response choice format in order to incorporate the expanded format developed for use with the client prediction items.…”