What Are the Best Ways to Increase Therapy Attendance?

According to a new study conducted by Mary Oldham of the Department of Psychology at the University of Sheffield in the United Kingdom, offering clients their choice of appointment time and providing simple reminders are two easy yet effective ways of increasing therapy attendance. Treatment refusal (TR) and premature termination (PT) are two events that can cause harm to a client and therapist. Clients who end their treatment early or refuse treatment never receive the full benefits of therapy and often continue to struggle with persistent emotional and psychological problems. Therapists who experience high rates of PT and TR may lose confidence in their abilities to provide meaningful services to their clinical population. Both of these scenarios result in negative outcomes for the clients, providers, and the community at large. Individuals who need help but do not receive it are less productive citizens and may need to rely on social services for financial aid.

Oldham examined the most effective ways to increase treatment adherence by studying 31 trials dedicated to that very topic. The trials provided data from 4,422 individuals who had a history of TR or PT. She found that interventions designed to address PT worked as well as interventions targeted at TR. The most effective strategies were the simplest. Offering clients their choice of appointment date and time and their choice of therapist reduced TR and PT. Additionally, interventions that educated and motivated clients resulted in lower rates of PT and TR. Another factor that reduced negative treatment adherence was being diagnosed with only one problem. Individuals with multiple diagnoses tended to have lower rates of treatment adherence than those with a single diagnosis. Finally, Oldham found that reminding the clients of upcoming appointments was the easiest and the most effective method for reducing PT and TR. She hopes that her results motivate clinicians and their staff members to adopt these tactics to increase treatment retention. She added, “This review indicates that attendance is a more tractable problem than previous reviews have suggested.”

Reference:
Oldham, M., Kellett, S., Miles, E., Sheeran, P. (2012). Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0029630

Related articles:
The Healing Power of the Therapeutic Relationship
The Secret That All Clients Should Know but Few Therapists Share
Why See a Therapist When You Can Just Talk to Your Friends?

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  • P. Russel

    August 22nd, 2012 at 7:51 PM

    I tell people that ending therapy sessions early is akin to stopping antibiotics before the doctor says to. Both can be more destructive then not seeking treatment at all. This is because clients that don’t finish treatment may form the misconception that their disorder isn’t treatable. It kills me to see people terminate treatment after seeing some decent progress, just because they don’t have time to continue the sessions. Either therapists need to realize that their strict schedule leads to termination or patients need to understand that their mental health is the most important thing to invest time into.

  • @drsusannah

    August 23rd, 2012 at 2:04 AM

    In the Middle East, biggest problem is no shows. We’ve worked on this issue in a variety of ways with varying degrees of success, however as long as seeking mental health care is still widely stigmatized, it is likely to remain a therapeutic issue. It has helped significantly to offer a 30 minute free consultation because there is so much misinformation and ignorance regarding mental health and therapy. TR is common for the same reason, but we’ve lowered PT rates by strongly emphasizing relationship building, clearly explaining the benefits and process of therapy, and working in six-session “blocks” – no matter what modality is utilized by the individual therapist. It’s slow going, but it’s a privilege to be a part of positively impacting cultural and social perceptions about therapy.

  • E.P.

    August 23rd, 2012 at 3:10 AM

    I can understand why people don’t want to begin the process, it’s painful. And to have the motivation to get out of bed in the morning could be a struggle. It’s also the case of finding the right therapy for the right person.

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