Skip to main content Accessibility help
×
Home

Pilot Study of an Investigation of Psychological Factors Associated with First Appointment Nonattendance in a Low-Intensity Service

  • Elizabeth Murphy (a1), Warren Mansell (a1), Sally Craven (a1), Joanne Menary (a1) and Phil McEvoy (a2)...

Abstract

Background: Nonattendance rates remain high for first therapy appointments, despite initiatives to increase access to psychological therapy. The reasons for nonattendance are poorly understood and studies of demographic and clinical predictors have produced conflicting findings. Aims: We aimed to pilot a method for investigating psychological factors associated with first appointment attendance in a primary care mental health service. Method: Questionnaires were completed by individuals at the point of referral to CBT with a low-intensity service in one general practice (n = 67), including a measure of beliefs, goals and attitudes towards therapy, as well as anxiety and depression scales. Subsequent attendance at the first appointment was used as an outcome. Results: Preliminary results showed that attendance was not associated with age or gender, severity of distress, or overall ratings for positive or negative attitudes towards therapy; although distress itself was associated with increased endorsement of negative attitudes. However, one specific psychological item, “Talking to a therapist will help me understand better how my mind works” had a significant association with subsequent attendance. Conclusions: The psychological factor that was associated with increased attendance may reflect the concept of psychological mindedness; however, this requires replication in a larger study. A full-scale study was deemed to be warranted based on this prospective design.

Copyright

Corresponding author

Reprint requests to Elizabeth Murphy, Trainee Clinical Psychologist, School of Psychological Sciences, 2nd Floor Zochonis Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. E-mail: elizabeth.murphy@manchester.ac.uk

References

Hide All
Amato, P. R. and Bradshaw, R. (1985). An exploratory study of people's reasons for delaying or avoiding help-seeking. Australian Psychologist, 20, 2131.
Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: does it matter. Journal of Health and Social Behavior, 36, 110.
Aubrey, R., Self, R. and Halstead, J. E. (2003). Early non-attendance as a predictor of continued non-attendance and subsequent attrition from psychological help. Clinical Psychology, 32, 610.
Bados, A., Balaguer, G. and Saldana, C. (2007). The efficacy of cognitive-behavioral therapy and the problem of drop-out. Journal of Clinical Psychology, 63, 585592.
Baekeland, F. and Lundwall, L. (1975). Dropping out of treatment: critical review. Psychological Bulletin, 82, 738783.
Barrett, M. S., Chua, W. J., Crits-Christoph, P., Gibbons, M. B. and Thompson, D. (2008). Early withdrawal from mental health treatment: implications for psychotherapy practice. Psychotherapy, 45, 247267.
Bayer, J. K. and Peay, M. Y. (1997). Predicting intentions to seek help from professional mental health services. Australian and New Zealand Journal of Psychiatry, 31, 504513.
Bebbington, P. E., Brugha, T. S., Meltzer, H., Jenkins, R., Ceresa, C., Farrell, M., et al. (2000). Neurotic disorders and the receipt of psychiatric treatment. Psychological Medicine, 30, 13691376.
Bebbington, P. E., Meltzer, H., Brugha, T. S., Farrell, M., Jenkins, R., Ceresa, C., et al. (2000). Unequal access and unmet need: neurotic disorders and the use of primary care services. Psychological Medicine, 30, 13591367.
Chasson, G. S., Vincent, J. P. and Harris, G. E. (2008). The use of symptom severity measured just before termination to predict child treatment dropout. Journal of Clinical Psychology, 64, 891904.
Department of Communities and Local Government (2011). The English Indices of Deprivation 2010. Retrieved 25th June, 2012, from http://www.communities.gov.uk/publications/corporate/statistics/indices2010
Department of Health (2008). Improving Access to Psychological Therapies Implementation Plan: national guidelines for regional delivery. London: Department of Health.
Farid, B. T. and Alapont, E. (1993). Patients who fail to attend their first psychiatric out-patient appointment: non-attendance or inappropriate referral? Journal of Mental Health, 2, 8183.
Fischer, E. H. and Farina, A. (1995). Attitude toward seeking professional psychological help: a shorted form and considerations for research. Journal of College Student Development, 36, 368373.
Fischer, E. H. and Turner, J. L. B. (1970). Orientations to seeking professional help: development and research utility of an attitude scale. Journal of Consulting and Clinical Psychology, 35, 7990.
Garfield, S. L. (1994). Research on client variables in psychotherapy. In Bergin, A. E. and Garfield, S. L. (Eds.), Handbook of Psychotherapy and Behavior Change (pp. 190228). New York: Wiley.
Grant, A. (2001). Rethinking psychological mindedness: metacognition, self-reflection, and insight. Behaviour Change, 18, 817.
Grant, A., Franklin, J. and Langford, P. (2002). The self-reflection and insight scale: a new measure of private self-consciousness. Social Behavior and Personality, 30, 821835.
Grant, K., McMeekin, E., Jamieson, R., Fairfull, A., Miller, C. and White, J. (2012). Individual therapy attrition rates in a low-intensity service: a comparison of cognitive behavioural and person-centred therapies and the impact of deprivation. Behavioural and Cognitive Psychotherapy, 40, 245249.
Hampton-Robb, S., Qualls, R. C. and Compton, W. C. (2003). Predicting first-session attendance: the influence of referral source and client income. Psychotherapy Research, 13, 223233.
Issakidis, C. and Andrews, G. (2004). Pretreatment attrition and dropout in an outpatient clinic for anxiety disorders. Acta Psychiatrica Scandinavica, 109, 426433.
Kourany, R. F. C., Garber, J. and Tornusciolo, G. (1990). Improving 1st appointment attendance rates in child psychiatry outpatient clinics. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 657660.
Kroenke, K., Spitzer, R. L. and Williams, J. B. W. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606613.
Kroenke, K., Spitzer, R. L., Williams, J. B. W., Monahan, P. O. and Lowe, B. (2007). Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146, 317325.
Kruse, G. R. and Rohland, B. M. (2002). Factors associated with attendance at a first appointment after discharge from a psychiatric hospital. Psychiatric Services, 53, 473476.
Kushner, M. G. and Sher, K. J. (1989). Fear of psychological treatment and its relation to mental-health service avoidance. Professional Psychology-Research and Practice, 20, 251257.
Kushner, M. G. and Sher, K. J. (1991). The relation of treatment fearfulness and psychological service utilization: an overview. Professional Psychology-Research and Practice, 22, 196203.
Mansell, W. (2010). The Initial Appointment Questionnaire: a measure of positive and negative beliefs, goals and attitudes towards therapy. Unpublished work.
Munro, J. and Blakey, R. (1986). A study of nonattendance in first appointments with clinical psychologists. Clinical Psychology Forum, 17, 1014.
Office for National Statistics (2011). Neighbourhood Statistics: resident population estimates by ethnic group (2009 estimates). Retrieved 25 June 2012, from www.neighbourhood.statistics.co.uk
Oliver, M. I., Pearson, N., Coe, N. and Gunnell, D. (2005). Help-seeking behaviour in men and women with common mental health problems: cross-sectional study. British Journal of Psychiatry, 186, 297301.
Owens, P. L., Hoagwood, K., Horwitz, S. M., Leaf, P. J., Poduska, J. M., Kellam, S. G., et al. (2002). Barriers to children's mental health services. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 731738.
Paige, L. and Mansell, W. (in press). To attend or not attend? A critical review of the factors impacting on initial appointment attendance from an approach-avoidance perspective. Journal of Mental Health.
Pina, A. A., Silverman, W. K., Weems, C. F., Kurtines, W. M. and Goldman, M. L. (2003). A comparison of completers and noncompleters of exposure-based cognitive and behavioral treatment for phobic and anxiety disorders in youth. Journal of Consulting and Clinical Psychology, 71, 701705.
Reis, B. F. and Brown, L. G. (2006). Preventing therapy dropout in the real world: the clinical utility of videotape preparation and client estimate of treatment duration. Professional Psychology-Research and Practice, 37, 311316.
Schomerus, G., Matschinger, H. and Angermeyer, M. C. (2009). Attitudes that determine willingness to seek psychiatric help for depression: a representative population survey applying the Theory of Planned Behaviour. Psychological Medicine, 39, 18551865.
Shaffer, P. A., Vogel, D. L. and Wei, M. F. (2006). The mediating roles of anticipated risks, anticipated benefits, and attitudes on the decision to seek professional help: an attachment perspective. Journal of Counseling Psychology, 53, 442452.
Sheeran, P., Aubrey, R. and Kellett, S. (2007). Increasing attendance for psychotherapy: implementation intentions and the self-regulation of attendance-related negative affect. Journal of Consulting and Clinical Psychology, 75, 853863.
Singleton, N., Bumpstead, R., O'Brien, M., Lee, A. and Meltzer, H. (2001). Psychiatric Morbidity Among Adults Living in Private Households, 2000. London: Office for National Statistics. www.statistics.gov.uk
Sparr, L. F., Moffitt, M. C. and Ward, M. F. (1993). Missed psychiatric appointments: who returns and who stays away. American Journal of Psychiatry, 150, 801805.
Spitzer, R. L., Kroenke, K., Williams, J. B. W. and Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 10921097.
SPSS Inc. (2008). SPSS for Windows, Version 16.0: Chicago, IL: SPSS Inc.
Vogel, D. L., Wade, N. G. and Hackler, A. H. (2008). Emotional expression and the decision to seek therapy: the mediating roles of the anticipated benefits and risks. Journal of Social and Clinical Psychology, 27, 254278.
Vogel, D. L. and Wester, S. R. (2003). To seek help or not to seek help: the risks of self-disclosure. Journal of Counseling Psychology, 50, 351361.
Vogel, D. L., Wester, S. R. and Larson, L. M. (2007). Avoidance of counseling: psychological factors that inhibit seeking help. Journal of Counseling and Development, 85, 410422.
Vogel, D. L., Wester, S. R., Wei, M. F. and Boysen, G. A. (2005). The role of outcome expectations and attitudes on decisions to seek professional help. Journal of Counseling Psychology, 52, 459470.
Wierzbicki, M. and Pekarik, G. (1993). A metaanalysis of psychotherapy dropout. Professional Psychology-Research and Practice, 24, 190195.

Keywords

Pilot Study of an Investigation of Psychological Factors Associated with First Appointment Nonattendance in a Low-Intensity Service

  • Elizabeth Murphy (a1), Warren Mansell (a1), Sally Craven (a1), Joanne Menary (a1) and Phil McEvoy (a2)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Pilot Study of an Investigation of Psychological Factors Associated with First Appointment Nonattendance in a Low-Intensity Service

  • Elizabeth Murphy (a1), Warren Mansell (a1), Sally Craven (a1), Joanne Menary (a1) and Phil McEvoy (a2)...
Submit a response

Comments

We encountered an error trying to retrieve Comments for this article. Please try again or contact Customer Services

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *