Brief Psychotherapy in an Outpatient Clinic: Evolution and Evaluation

Straker, M

doi:10.1176/ajp.124.9.1219

Cited by 23 publications

(8 citation statements)

References 8 publications

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“…The growth of the outpatient department psychiatric activity has been remarkable in the past decade. Brief therapy concepts have been adapted to outpatient work (10,11). Observations support an~confirm reports from other sources that this is a useful approach (1,6,15).…”

supporting

confidence: 57%

A Comprehensive Emergency Psychiatric Service in a General Hospital

Straker

Yung

Weiss

1971

Canadian Psychiatric Association Journal

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Rapid developments in general hospital outpatient psychiatry reflect increasing demands from the community for such setvices. Combining the outpatient caseload and Emergency Room psychiatric patients, nearly 2,500 patients per year were under care. To provide better care a new emergency intake service has been established, with a 72-hour limit of stay. This is a valuable therapeutic resource, and has made it possible to better study and treat selected acutely-ill patients. It is also a dynamic teaching setting. The establishment of this intensive-care unit has relieved pressure on the existing services. Suicidal patients, those with transient deliria and acutely disturbed patients have been accommodated. About 20 per cent of the casualty caseload has been admitted to the Short Stay Service, and nearly 50 per cent of such patients were able to return to their homes and community living within three days. These clinical experiences confirm the description of this unit as a ‘comprehensive emergency psychiatric service’ in a general hospital setting. The survival of the service is assured and encourages the establishment of similar units in other centres.

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supporting

confidence: 57%

A Comprehensive Emergency Psychiatric Service in a General Hospital

Straker

Yung

Weiss

1971

Canadian Psychiatric Association Journal

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“…In the past, several studies that compared dropout rates for open-ended and time limited therapies were often statistically and methodologically flawed (Swift & Greenberg, 2012). Often other variables besides the time limit were not held constant, such as the specific form of therapy or the characteristics of the patients participating (Sledge, Moras, Hartley, & Levine, 1990; Straker, 1968; Deykin, 1973). Because of these methodological shortcomings, it is uncertain if the differences in drop-out rates in these studies can be attributed to the time limit itself.…”

Section: Resultsmentioning

confidence: 99%

How Do Time Limits Affect Our Psychotherapies? A Literature Review

Geest¹,

Meganck

2019

Psychologica Belgica

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The application of time limits (i.e. restricting the amount of sessions before the beginning of psychotherapy) has become ingrained in psychotherapy research and in the context of managed care, mostly due to pragmatic and economic reasons. However, little is know on how this technique interferes with the psychotherapeutic process. Although several theorists have considered the possible advantages and drawbacks of the technique, research explaining these mechanisms is scattered. By conducting this review, we strived to answer two questions: (1) Does a time limit alter the psychotherapeutic process? And (2) In what way? In doing so, this study aspires to grant more insight into the mechanisms of time limited psychotherapy and aimes to contribute to a first understanding of the dynamics of a time restricted therapy process. We searched for articles in the databases of Web of Science and Pubmed. Our review identified 28 studies that provide empirical grounds to explain processes involved when applying a time limit to psychotherapy. Qualitative research suggests that a time limit exerts pressure on the therapy process and creates an expectancy effect, which can have both positive and negative consequences. Additionally, time limits can be associated to therapists taking on a more directive role in therapy. Results show that a time limit is anything but a neutral intervention; it is a technique that complexly interacts with therapy processes on multiple grounds. Further research is vital to determine which environment is appropriate for its application.

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“…Still, although treatment methods are usually at,least mentioned, if not actually described, we are usually told next to nothing about staffing and admission procedures. The importance of describing treatment methods and approaches is strikingly illustrated by the experience of a general psychiatric clinic that halved its dropout rate, from 62% to 32%, by changing its emphasis from long-term reconstructive psychotherapy to brief psychotherapy (10-12 half-hour sessions) (Straker, 1968).…”

Section: ^Treatment Variables Description Oj Treatment Settingmentioning

confidence: 99%

“…G. Meyer et al, 1967;Miller et al, 1968;Miller et al, 1970;Nagpaul et al, 1970;J. Newman & Sparer, 1956;Perkins & Blochj 1971;Rickels, 1968;Rickels & Anderson, 1965;Ripple, 1957;Ripple & Alexander, 1956;Robson et al, 1965;Ross & Lacey, 1961;Shelton & Sparer, 1956;Straker, 1968;Weiss & Schaie, 1958;Wieland & Novack, 1973;Williams & Pollack, 1964;Zax, 1962;Zax et al, 1961), whereas only 7 out of 41 studies (17.1%) cast dissenting votes (Dodd, 1971;Freedman et al, 1958;Garfield & Affleck, 1963;Gerrein et al, 1973;Levitt, 1958;Mayer et al, 1965;Sethna & Harrington, 1971). In some cases motivation was assessed in a global way; in others it was inferred by the authors or by us on the basis of the source of referral (institutional versus self), openly negative feelings about the form of treatment or the therapist, attitudes of noncompliance, and the like; In all this there is a good deal of lack of conceptual clarity.…”

Section: Motivationmentioning

confidence: 99%

Dropping out of treatment: A critical review.

Baekeland

Lundwall²

1975

Psychological Bulletin

1,016

554

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After a discussion of methodological issues of the past 20 years, literature on dropping out of treatment was critically reviewed in six areas: hospital treatment of general psychiatric and tubercular patients, outpatient treatment of internal medical conditions, alcoholism, heroin addiction, general psychiatric outpatient psychotherapy, and double-blind drug studies. Fifteen factors were found to predict dropping out in 100%, 83%-88%, and 60%-75% of the relevant studies: (a) social isolation and/or unaffiliation, therapist attitudes and behavior, discrepancies between patient and therapist treatment expectations; (b) passive-aggressive behavior, family attitudes and behavior, motivation, behavioral and/or perceptual dependence, psychological mindedness and/ or -denial, symptom levels and symptom relief, socioeconomic status, sociopathic features, alcoholism and/or drug dependence; (c) age, sex, and social stability.One of the most vexing problems facing the physician, whether he is a surgeon, internist, or psychiatrist, is that far too many of those entrusted to his care, both inpatients and outpatients, drop out of treatment before they have completed it to his satisfaction. Although the question of the dropout has most often engaged the attention of psychiatrists, it also crops up from time to time in papers by internists, for whom there is no reason to believe that it is any less serious a problem. Where studied, the dropout problem has usually been in the context of treating chronic conditions that require prolonged treatment. The extent of this problem can be inferred ^rom the fact that in general psychiatric clinics, 20%-57% of the patients fail to return after the first visit (Blenkner,

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Brief Psychotherapy in an Outpatient Clinic: Evolution and Evaluation

Cited by 23 publications

References 8 publications

A Comprehensive Emergency Psychiatric Service in a General Hospital

A Comprehensive Emergency Psychiatric Service in a General Hospital

How Do Time Limits Affect Our Psychotherapies? A Literature Review

Dropping out of treatment: A critical review.

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