Users and “teasers”: Failure to follow through with initial mental health service inquiries in a child and family treatment center

Abstract

This article examines the experience of families who contacted a child and family community mental health treatment center, but then did not follow through to receive even one session of diagnosis or treatment at the agency. The paper reports the base rate for this behavior in a large (N = 2,358) sample of cases who either only made inquiry or who received treatment at the agency. The inquiry group, or “teasers,” tended to have children who were older than client groups, to have relatively more behavioral and fewer personality problems, to have demonstrated problems earlier than client groups, and to have parents who were slightly older. A follow‐up study was conducted with 100 inquiry and 100 client cases. The relative efficacy of telephone and written questionnaire methodologies are compared, demonstrating that the telephone approach was more effective. Client‐group children were reported to be only moderately better off at the time of follow‐up than the inquiry group, but conclusions about the effects of treatment are limited by the finding that many members of the inquiry group had sought treatment elsewhere after their brief contact with the agency. Implications of this study for community mental health administration and for future research in this area are discussed.

To attend or not attend? A critical review of the factors impacting on initial appointment attendance from an approach–avoidance perspective

“…For example, various researchers have been unable to find a significant association between wait time and initial appointment no-show (e.g. Beer, 1991;Carpenter et al, 1981;Hampton-Robb et al, 2003;Lowman et al, 1984), and inconsistencies have also been reported in numerous studies that have failed to replicate the relationships between missed first appointments and initiators who have lower incomes (e.g. Beer, 1991;Carpenter et al, 1981;McCabe, 2002), and lack transportation and have to travel further for treatment facilities (e.g.…”

The association between pretreatment change and unplanned termination in family therapy

“…This is significant since over 50% of clients who receive marital and family therapy have unplanned terminations (Anderson et al, 1985;Lowman et al, 1984;Talmon, 1990). Unplanned terminations are unilateral decisions by clients to terminate therapy without informing the therapist-for example, they fail to keep appointments or leave termination notice with the receptionist (Acosta, 1980;Baekland & Lundwall, 1975;Cross & Warren, 1984).…”

Dropping Out of Marriage and Family Therapy: A Critical Review of Research

“…Finally, a fairly serious limitation is the tendency of researchers to overlook the importance of asking clients why they discontinued treatment and if their needs were met by the therapy they received. Only four family therapy studies asked clients why they dropped out of therapy and whether or not they felt the need for continued treatment (Beck & Jones, 1974;Gould et al, 1985;Lowman, DeLange, Roberts, & Brady, 1984;Shapiro & Budman, 1973). These researchers found that clients who did not come for treatment (Lowman et al, 1984), as well as those who dropped out of treatment (Shapiro & Budman, 1973;Gould et al, 1985), were likely to report improvement in the presenting problem and a feeling that treatment was no longer necessary.…”