Strategies for Preparing Clients for Treatment

Walitzer, Kimberly S.; Dermen, Kurt H.; Connors, Gerard J.

doi:10.1177/0145445599231006

Cited by 166 publications

(163 citation statements)

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“…During the past 10 years, three qualitative reviews have evaluated the evidence that intervention strategies are effective at increasing attendance at psychotherapy (Barrett et al, 2008;Ogrodniczuk et al, 2005;Walitzer et al, 1999). Barrett et al (2008) and Walitzer et al (1999) included studies of both child/family and adult psychotherapy services, whereas Ogrodniczuk et al, (2005) focussed on adult psychotherapy.…”

Section: The Present Reviewmentioning

confidence: 99%

“…Barrett et al (2008) and Walitzer et al (1999) included studies of both child/family and adult psychotherapy services, whereas Ogrodniczuk et al, (2005) focussed on adult psychotherapy. All three reviews discussed the pros and cons of diverse attendance strategies and agreed that interventions to reduce TR and PT did show promise.…”

Section: The Present Reviewmentioning

confidence: 99%

“…High PT rates are troubling in light of evidence that PT is associated with poor clinical outcome (Barrett, Chua, Crits-Christoph, Gibbons & Thompson, 2008; Lambert, 3007). Clearly, successfully starting and finishing a course of psychotherapy is no certainty, with Walitzer et al (1999) noting that TR and PT rates remain disturbingly high and unchanged over time, context and modality.Knowledge of the patient factors associated with TR and PT remains piecemeal (Self, Oates, Pinnock-Hamilton & Leach, 2005; Johansen, Lumley & Cano, 2011). Reis and Brown (1999) concluded that only lower socioeconomic status (SES) and membership of an ethnic minority group were consistent predictors of PT.…”

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confidence: 99%

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Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials.

Oldham¹,

Kellett²,

Miles³

et al. 2012

Journal of Consulting and Clinical Psychology

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Objective: Rates of non-attendance for psychotherapy hinder the effective delivery of evidencebased treatments. Although many strategies have been developed to increase attendance, the effectiveness of these strategies has not been quantified. The aim of the present study was to undertake a meta-analysis of rigorously controlled studies to quantify the effects of interventions to promote psychotherapy attendance.Method: The inclusion criteria were that studies (1) concerned attendance at individual or group psychotherapy by adults, (2) used a randomised controlled trial design to test an attendance strategy, and (3) used an objective measure of attendance. Computerised literature searches and hand searching resulted in a total of 31 RCTs that involved 33 independent tests of strategies for reducing treatment refusal and premature termination (N = 4,422). Effect sizes from individual studies were meta-analysed and moderator analyses were conducted.Results: Interventions had a small-to-medium effect on attendance across studies (d + = .38).Interventions to reduce treatment refusal and premature termination were similarly effective (d + = .37 and .39, respectively). Choice of appointment time or therapist, motivational interventions, preparation for psychotherapy, informational interventions, attendance reminders, and case management were the most effective strategies. Diagnosis also moderated effect sizes; samples with a single diagnosis benefited more from attendance interventions than samples that had a variety of diagnoses.Conclusions: Interventions to increase attendance at adult psychotherapy are moderately effective.However, relatively few studies met the strict study inclusion criteria. Further methodologically sound and theoretically informed interventions geared at increasing attendance are required. META-ANALYSIS OF PSYCHOTHERAPY ATTENDANCE 3Interventions to Increase Attendance at Psychotherapy:A Meta-Analysis of Randomised Controlled Trials A substantial proportion of clinical time is wasted because of patient non-attendance at scheduled adult psychotherapy appointments (Pekarik, 1985). The financial costs of nonattendance are marked (Hicks & Hickman, 1995; Kleine, Stone, Hicks & Pritchard, 2003), with patients not receiving help (Joshi, Maisami & Coyle, 1986) and therapists losing confidence as a result (Sledge, Moras, Hartley & Levine, 1990). Service efficiency is impaired when nonattendance rates are high (Rusius, 1995). Garfield (1994) noted that some patients fail to attend at assessment and essentially reject treatment. Hampton-Robb, Qualls, and Compton (2003) estimated that such treatment refusal (TR) occurs for 40% of referrals, on average. Premature termination (PT) occurs when patients fail to complete agreed treatment contracts (i.e., they 'drop-out' of therapy). A meta-analysis of 123 studies reported a PT rate of 46.8% (Wierzbicki & Pekarik, 1993) across treatment modalities. High PT rates are troubling in light of evidence that PT is associated with poor clinical outcome (Barret...

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Section: The Present Reviewmentioning

confidence: 99%

Section: The Present Reviewmentioning

confidence: 99%

mentioning

confidence: 99%

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Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials.

Oldham¹,

Kellett²,

Miles³

et al. 2012

Journal of Consulting and Clinical Psychology

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“…Premature termination of psychological treatment is also a major problem (Walitzer, Dermen, & Connors, 1999). Onequarter to one-half of all potential clients fail to attend even one session following intake and two-thirds terminate prematurely after less than ten sessions (Garfield, 1994).…”

Section: Concluding Commentsmentioning

confidence: 99%

Commitment to change from locomotion motivation during deliberation

Scholer

Higgins

2011

Motiv Emot

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The factors that motivate commitment to behavioral change (e.g., quitting smoking) are important in understanding self-regulation processes. The current research examines how an individual's motivational orientation during deliberation affects the likelihood that they will commit to change. Building on the insights of regulatory mode theory (Higgins, Kruglanski, & Pierro, 2003), we propose that increased commitment to change can result from increased locomotion motivation in the deliberation phase. Three studies provide evidence that increased commitment to change is related to locomotion motivation arising either from a chronic orientation or from a movement-focused deliberation tactic that intensifies that orientation.Although locomotion motivation is typically associated with goal pursuit, the current work highlights the impact that locomotion motivation can have on commitment to change in the initial deliberation phase. As most of us can attest, change is hard. Quitting smoking, starting exercising, and changing careers are all examples of difficult self-regulatory decisions in which individuals must decide whether to continue with their current state (smoking, not exercising, working in a cubicle) or change to some new state (not smoking, exercising, pursuing one's art). Furthermore, as most of us also can attest, we sometimes fail to change despite our desire to do so. While some people start to change but fail to stick with it (failures of goal pursuit), there are also the quieter failures of those who desire change but never muster the courage to commit to it (failures of deliberation). The current research explores how an individual's motivational orientation affects the likelihood that people will commit to change in the deliberation phase of selfregulation, particularly when deliberating about difficult, ambivalence-evoking change decisions.Traditional phase models of self-regulation distinguish between the preactional, deliberation phase and the actional goal pursuit phase, each involving different self-regulatory concerns (e.g

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“…Precisamente en el campo de las conductas adictivas, donde podrían situarse los trastornos alimentarios, este abandono supone un problema importante para la eficacia del tratamiento. Concretamente, entre un 20 y un 57% de los pacientes no vuelve a terapia después de la primera sesión y entre el 31 y 56% no asiste a más de cuatro sesiones (Walitzer et al, 1999).…”

Section: Discussionunclassified

Proceso Psicoterapéutico Desde la Perspectiva de Terapeutas que Tratan Trastornos Alimentarios: Un Estudio Cualitativo

Besser

Moncada

2013

Psykhe (Santiago)

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La presente investigación tuvo como objetivo conocer la evaluación subjetiva de la terapia y el proceso de cambio terapéutico, así como los elementos que lo hacen posible, desde la perspectiva de 8 terapeutas mujeres que trabajan con pacientes mujeres con anorexia nerviosa, tanto en centros especializados como en atención particular. Se utilizó una metodología cualitativa, aplicando entrevistas episódicas, las que fueron analizadas según los fundamentos de la grounded theory. Los resultados proponen la existencia de 3 etapas, denominadas psicoeducación, interpretativa y mantención, que estarían contribuyendo a la explicación de la evolución del proceso psicoterapéutico en este tipo de pacientes, así como los factores que estarían facilitando u obstaculizando la consecución de cambios terapéuticos. Entre los facilitadores, se establece la alianza como el factor primordial que promueve el cambio terapéutico, mientras que las características propias de la anorexia, tales como la resistencia al cambio, se presentan como el mayor obstaculizador. Se discuten los hallazgos encontrados a la luz de la proposición de un modelo explicativo del fenómeno. Palabras clave: proceso psicoterapéutico, cambio terapéutico, trastorno alimentario, terapeutaThis study aimed to understand the subjective evaluation of therapy and the process of therapeutic change, as well as the elements that make this possible, from the perspective of 8 women therapists working with patients with anorexia nervosa, both in specialized centers and private practice. A qualitative methodology was applied, using episodic interviews, which were analyzed using the principles of grounded theory. The results suggest the existence of 3 stages that have been labeled psychoeducation, interpretative, and maintenance, which may help to explain the evolution of the psychotherapeutic process in these patients, as well as the factors that facilitate or hinder the achievement of therapeutic changes. Among the facilitators, alliance is established as the primary factor that promotes therapeutic change, while the characteristics of anorexia, such as resistance to change, are presented as the strongest hindering factors. The findings are discussed in light of a proposed explanatory model of the phenomenon.Keywords: psychotherapeutic process, therapeutic change, eating disorders, therapist Los trastornos alimentarios constituyen en la actualidad cuadros de gran relevancia social, especialmente en la población de más alto riesgo: mujeres jóvenes y adolescentes de países desarrollados o en vías de desarrollo (Peláez, Labrador & Raich, 2005). Se trata de enfermedades psicosomáticas que figuran entre los problemas de salud que se presentan con mayor frecuencia entre los adolescentes y cuya letalidad es la más alta entre los problemas psiquiátricos (Cruzat, Ramírez, Melipillán & Marzolo, 2008). A esto se suma que la incidencia de la anorexia nerviosa María Cecilia Besser Spichiger, Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile; Laura Moncada Ar...

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Strategies for Preparing Clients for Treatment

Cited by 166 publications

References 49 publications

Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials.

Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials.

Commitment to change from locomotion motivation during deliberation

Proceso Psicoterapéutico Desde la Perspectiva de Terapeutas que Tratan Trastornos Alimentarios: Un Estudio Cualitativo

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