Psychopathology B 7

Question 1

What do researchers do in terms of success rates

Answer 1

researchers over-report success rates

Question 2

What is typically reported

Answer 2

114 accepted therapy, 75 completed (66%)

Question 3

However, how many people complete therapy

Answer 3

total referrals 497, opted in 338, attended diagnostic appointment 1 249, accept therapy 114, completed therapy 74 (15.1%)

Question 4

Determinants associated with attrition or drop out can be conceptualised as (3)

Answer 4

client’s 1) uncertainty about therapy; 2) lack of knowledge or understanding about therapy; 3) different expectations compared to therapist

Question 5

Strategies to overcome attrition (use of placebo effect) (5)

Answer 5

1) role induction (teach people to be clients); 2) motivational interviewing (focus on internal (locus of) change); 3) treatment models that are cost effective; 4) therapist feedback (patient versus problem focused); 5) quality of therapist-client alliance

Question 6

Patient characteristics and attrition (3)

Answer 6

1) age and gender have inconsistent findings; 2) education and low socio-economic status predicts attrition; 3) ethnic minorities predict attrition

Question 7

Enabling factors or barriers that predict attrition (5)

Answer 7

1) external referral source; 2) accessing mental health facilities; 3) distance to be travelled to facilities; 4) length of time on waiting list; 5) low income patients having to arrange child care and taking time off work

Question 8

Factors related to need that predict attrition (2)

Answer 8

1) psychiatric patients (severity or complexity) are more likely to drop out of treatment programs; 2) psychological literacy

Question 9

Psychological literacy and attrition

Answer 9

such as recognise presenting problem, psychological knowledge, acknowledge causal factors and less willingness to disclose personal information all predict attrition

Question 10

Therapeutic environment and attrition (2)

Answer 10

1) attrition occurs at all stages of the therapeutic process [referral, first phone contact, first [diagnostic] interview, and first or later treatment sessions; 2) Staff attitudes [to clients – see HOUNDs], clinic setting, clinic facilities etc all impact on attrition rates

Question 11

Perceptions of mental health influence on attrition rates (3)

Answer 11

1) Cultural and ethnic variation in terms of stigma attached to mental illness; 2) Perception of [causes of] mental health varies in terms of ethnicity; 3) Socialisation of family and role of parents varies across cultures

Question 12

Conclusion

Answer 12

therapists are aware of attrition, but most blame the client and do not become proactive

Question 13

On average how many clients are better after psychotherapy

Answer 13

On average, over 80% of clients are better off after psychotherapy (however, this doesn’t take into account relapse)

Question 14

Define relapse

Answer 14

Reverting to previous problem behaviours or violation of treatment objectives and loss of therapy induced gains

Question 15

Relapse is opposite to

Answer 15

Opposite to maintenance