Premature termination: A clinical study

Bernard, Harold S.; Drob, Sanford L.

doi:10.1007/bf01456548

Cited by 11 publications

(6 citation statements)

References 9 publications

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“…Adequate preparation is a theme that was highlighted by Yalom [28] and Bernard et al [29], and it could be argued that some of the barriers identified here could be easily overcome by adequate preparation. Factors such as providing sufficient information or accessible venues were seen to be key as to how successful a group was and are relatively easy to implement.…”

Section: Discussionmentioning

confidence: 97%

“…Similarly, the idea of engaging in the group activities at will may be detrimental to the group process. Not all suggestions made by patients are actionable or even pragmatic within mental health services, and thus this reiterates the importance of having an overview of barriers and facilitators and categorising them in terms of ease of implementation, not just how preventable or unavoidable they are [29].…”

Section: Discussionmentioning

confidence: 99%

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Why do psychiatric patients attend or not attend treatment groups in the community: A qualitative study

et al. 2018

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BackgroundNon-attendance of treatment groups in the community has been a long-standing problem in mental health care. It has been found to have financial ramifications for services, worsen outcomes for those that do not attend and negatively impact on therapeutic group processes. There is a need to gain a better understanding of patients’ reasons for attending or not attending. This study aimed to explore patient views on facilitators and barriers to the attendance of treatment groups in the community.MethodsThe study used interview data collected as part of three studies that investigated treatment groups for psychiatric patients in the community. Sixty-seven interview transcripts were analysed using the framework method.ResultsFive themes relating to facilitators of group attendance were identified: opportunity for autonomy; self-acknowledging need and therapist encouragement; optimal group format and safe environment; interest in content and enjoyment; actual and expected benefits of attendance. Four themes related to barriers: not being sufficiently informed; concerns about social interactions and the unknown; limited accessibility; and negative group dynamics.ConclusionTo facilitate attendance and reduce attrition to treatment groups in the community clinicians should address patient’s wishes for information, capture their interest in the group modality, and potentially offer a ‘trial’ session. Furthermore, they should make the group location and time as accessible as possible and create a moderately sized group of six to eight patients. In these groups, mutual respect, feelings of safety and encouragement appear essential to make patients feel they can benefit from attendance.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Why do psychiatric patients attend or not attend treatment groups in the community: A qualitative study

et al. 2018

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“…In group treatments, failure to express negative feelings is often attributable to the group's having developed norms that preclude such expression. 54 Therapists themselves may contribute to such norms by shifting focus away from patients whom they perceive as negative influences. 54 Therapists should actively encourage patients to express their doubts and questions about therapy.…”

Section: Facilitation Of Affect Expressionmentioning

confidence: 99%

“…54 Therapists themselves may contribute to such norms by shifting focus away from patients whom they perceive as negative influences. 54 Therapists should actively encourage patients to express their doubts and questions about therapy. Furthermore, therapists should permit patients to exhibit negative transference.…”

Section: Facilitation Of Affect Expressionmentioning

confidence: 99%

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Strategies for Reducing Patient-Initiated Premature Termination of Psychotherapy

Ogrodniczuk¹,

Joyce

Piper

2005

Harvard Review of Psychiatry

182

188

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Rates of patient-initiated premature termination in different forms of psychotherapy are consistently high. Patient-initiated premature termination is recognized as a significant obstacle to the effective and efficient use of psychotherapy. The literature describes many strategies for preventing premature termination, but lacks integration. This review attempts to provide a concise and comprehensive summary of the strategies that research or clinical experience have suggested may be useful for minimizing patient-initiated premature termination. A search was conducted on the MEDLINE, PsycINFO, and EMBASE databases for literature published between January 1970 and March 2004. Retrieved articles were published in English in peer-reviewed journals and focused on psychotherapy for adults. Thirty-nine publications that discussed strategies for preventing or reducing patient-initiated premature termination of psychotherapy were identified. Surprisingly, only 15 of these were research studies. Most of the retrieved literature consisted of clinical descriptions. The strategies can be assigned to nine categories: pretherapy preparation, patient selection, time-limited or short-term contracts, treatment negotiation, case management, appointment reminders, motivation enhancement, facilitation of a therapeutic alliance, and facilitation of affect expression. Research supports some of the strategies for reducing premature termination. However, methodologically sound studies of prevention strategies remain few in number.

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A qualitative study of service user non‐engagement in psychological therapy groups on acute mental health wards

Harris

Lechevallier

Buhagiar

2020

Couns and Psychother Res

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Aims and method: Non-engagement with psychological therapy groups in mental health settings is a long-standing problem, with implications on group processes and service delivery. Little is known about service user-related factors hindering this engagement, especially on inpatient wards. We aimed to investigate the perspectives of service users on barriers to engagement with a therapeutic group facilitated by assistant psychologists. Experiences of therapy groups were explored via focus groups and in-depth semi-structured interviews with 16 participants on two acute wards.Data were analysed by means of thematic analysis adopting an inductive approach embedded in a constructivist paradigm.Results: The analysis identified three higher-order themes: ways that facilitators might encourage group attendance; a need for safe therapeutic conditions within the groups; and a need for good applicability of group content to recovery outside of hospital. The results are discussed with reference to psychological approaches, group therapy research and trauma-informed care. Conclusion:Findings bear implications on clinical practice within inpatient mental health settings, specifically: (a) the need to approach service users individually to invite to groups and establish role expectancies; (b) supervision for facilitators focussing on difficult group dynamics and creating robust groups agreements to facilitate containment; (c) working with teams to ensure stable, protected physical spaces for groups on wards, in turn avoiding the re-traumatising effects of disruption; (d) emphasising that participation does not require sharing difficult personal information, to prevent destabilisation and improve uptake of group offer; and (e) increasing focus on applicability of skills through consideration of potential obstacles to their real-life application. K E Y W O R D S engagement, group cohesiveness, inpatient psychology groups, qualitative research, service user perspectives | 371 HARRIS et Al.

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Premature termination: A clinical study

Cited by 11 publications

References 9 publications

Why do psychiatric patients attend or not attend treatment groups in the community: A qualitative study

Why do psychiatric patients attend or not attend treatment groups in the community: A qualitative study

Strategies for Reducing Patient-Initiated Premature Termination of Psychotherapy

A qualitative study of service user non‐engagement in psychological therapy groups on acute mental health wards

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