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Dissertation

Predicting non-attendance at initial session and lack of early response in a community mental health center

13 December 2002

Abstract

The demand and cost of mental health services is high, the community mental health resources are limited, and there are identifiable factors stressing these resources. This study examined early indicators of therapy failure, namely nonattendance to initial session and lack of early response to treatment, as strains on mental health resources. The present study addresses four questions related to predicting these early therapy failures. First, are brief phone measures of severity of symptoms and stage of readiness for change comparable to longer more time consuming self-report measures at intake? Second, does stage of change, duration of problem and severity of symptoms, as measured at initial call predict attendance at initial mental health appointment? Third, do these same questions predict early response to treatment as measured by reliable change and clinically significant change at sessions 3 and 5? Finally, does stage of change as measured by the SOC questionnaire at initial appointment predict early response to treatment as measured by reliable change and clinically significant change at sessions 3 and 5. This study also examines the usefulness of the stage of change measure for a community mental health setting. Brief questions given over the phone were statistically correlated with longer more time consuming measures completed at initial appointment, but did not predict attendance at initial appointment. There was little indication however that brief questions measured at initial call or self-report measures completed at initial appointment were predictive of early indicators of treatment failure.


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