Summary
In a survey of 137 new patients applying for treatment at a community mental health center over a 6-month period, 32% did not attend at all, and of the attenders 31% dropped out. Transfer of a patient from one clinician to another doubled (p<0.02) the probability of dropping-out before the eighth visit. It is suggested that a certain proportion of negotiations between a patient and a new clinician are unsuccessful and that these failures in negotiation contribute to the patient's dropping-out. Consequently, each time a patient meets a new clinician there is a probability of the patient's dropping-out. Clinics can reduce their drop-out rate by avoiding the practice of transferring patients.
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References
Baekeland, F., Lundwall L.: Dropping out of treatment: A critical review. Psychol. Bull.82, 738–783 (1975)
Blackwell, B.: Treatment adherence. Br. J. Psychiatry129, 513–531 (1976)
Boras, J.: Personal communication (1977)
Colton, T. C.: Statistics in Medicine, Boston: Little, Brown 1974
Dixon, W. J. (ed.): BMD-P: Biomedical Computer Programs, Berkeley: University of California Press 1975
Fiester, A. R., Rudestam, K. E.: A multivariate analysis of the early drop-out process. J. Consult. Clin. Psychol.43, 528–535 (1975)
Lazare, A., Cohen, F., Jacobson, A., Williams, M. W., Mignone, R. J., Sisook, S.: The walk-in patient as a “customer” — a key dimension in evaluation and treatment. Am. J. Orthopsychiatry42, 872–883 (1972)
Lazare, A., Eisenthal, S., Wassermann, L.: The customer approach to patienthood: Attending to patient requests in a walk-in clinic. Arch. Gen. Psychiatry.32, 553–558 (1975)
Miettinen, O. S.: Confounding and effect-modification. Am. J. Epidemiol.100, 350–53 (1974)
Rosenberg, C. M., Raynes, A. E.: Keeping patients in psychiatric treatment. Cambridge, MA: Ballinger 1976
Ryan, W. (ed.): Distress in the city: Essays on the design and administration of urban mental services. Cleveland: The Press of Case Western Reserve University 1969
Sandler, J., Holder, A., Dare, C.: Basic psychoanalytic concepts: II. The treatment alliance. Br. J. Psychiatry.116, 555–558 (1970)
Seigel, D. G., Greenhouse, S. W.: Multiple relative risk functions in case control studies. Am. J. Epidemiol.97, 324–331 (1973)
Straker, M.: Brief psychotherapy in an out-patient clinic: Evolution and evaluation. Am. J. Psychiatry124, 1219–1225 (1968)
Straker, M., Devenloo, H., Moll, A.: Psychiatric clinic drop-outs. Laval Med.38, 71–77 (1967)
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Dr. Klerman is on leave from Harvard Medical School where he is Professor of Psychiatry
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Tantam, D., Klerman, G. Patient transfer from one clinician to another and dropping-out of out-patient treatment. Soc Psychiatry 14, 107–113 (1979). https://doi.org/10.1007/BF00582175
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DOI: https://doi.org/10.1007/BF00582175