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
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