Time from Initial Contact to First Appointment Related to Therapy Attendance

It is not always easy for someone to reach out to a medical professional and ask for help. When an individual expresses interest in getting some assistance with psychological problems, they do so because they are motivated to change. However, that motivation is often short lived. The many barriers to therapy, including stigma, fear and cost, can quickly outweigh the motivation for recovery. According to results of a recent study led by Joshua K. Swift of the Department of Psychology at the University of Alaska, the length of time between initial contact and first appointment is directly related to first appointment attendance.

Swift conducted research aimed at determining if treatment outcome expectations influenced first appointment attendance. He used a sample of 57 individuals from training clinics and assessed their levels of hope, optimism, and distress at the time they were referred for treatment. Then, Swift examined how the length of time between referral and initial appointment was related to attendance. He found that although expectations were somewhat indicative of attendance, lag time between referral and appointment was a much stronger indicator. In fact, every day of wait time led to a 150% increase in absenteeism. Also, Swift found that prior therapy experience was highly associated with attendance. Specifically, the participants who had been in therapy had a tenfold increase in attendance rates when compared to those with no previous therapy experience.

Upon further examination, high levels of distress had a minimal relationship with attendance, but hope had a strong association. Regardless of whether people were highly distressed, if they were optimistic about treatment, they were more likely to attend the first appointment. Although these results did not support Swift’s theory of expectations and attendance, he believes these results demonstrate how important it is for those at the first point of contact to instill hope in clients. Every effort should be made to minimize the time between referral and appointment to increase the chance of attendance. “Further research is needed to empirically test whether early expectation-enhancing strategies are effective in increasing appointment attendance and early changes in therapy,” Swift said.

Swift, Joshua K., Jason L. Whipple, and Patricia Sandberg. A prediction of initial appointment attendance and initial outcome expectations. Psychotherapy 49.4 (2012): 549-56. Print.

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  • Junie


    December 23rd, 2012 at 12:44 PM

    I concur that there can’t be a whole lot of time between the initial outreach to seek out therapy and the time that the appointment is given. I like to know that when I am motivated enough to call somewhere to get an appointment that they will find a way to get me in quickly. Otherwise, if you have to wait then many will lose the motivation to even go and give it that first try. You have to strike while the proverbial iron is hot.

  • stacy


    December 23rd, 2012 at 12:45 PM

    this may not seem like something very important but it can have its own implications.it sends out a strong message that we need better appointment availability AND decrease in wait times for clients.because a lot of people stay away from treatment for different reasons.if and when they do decide to get treated,they should be welcomed.putting them on a waiting list may change their opinion and they may ever return.

  • martin


    December 24th, 2012 at 8:48 AM

    I can see how this works out…It takes some amount of courage and certainty to walk into a therapist’s office..And if that feeling dwindles,there is going to be a no-show…

    To help this I think availability and encouragement to attend would be the key.Also,maybe the appointment-seeker could be given a web link or something else that has resources to self-help and also showing the effectiveness of therapist.This may keep their interest and belief in therapy and hence push up the attendance!

  • Tay Tay

    Tay Tay

    December 24th, 2012 at 10:15 AM

    If you are already hopeful that this could lead to change for the better, then there is such a greater likelihood that you will go to your appointment even if you have to wait for it.
    Most of us are already certain whether or not we want this to work.
    It’s those who are a little more wishy washy about whether they even think that this will be the right move for them are the ones who will have a harder time just getting there.

  • Remi


    December 24th, 2012 at 4:29 PM

    @Tay tay:there r a lot of people who r unsure about going to therapy.often when they do decide to take an appointment they r still unsure if they want to go or not.if there is a delay they may well drop out of it,thereby causing an immense loss to them.Such people could definitely benefit from knowing that therapy can definitely be beneficial to them.

  • lacie


    December 24th, 2012 at 11:57 PM

    things can certainly be better if we could somehow keep these people in waiting involved.it could be emails with benefits of therapy or it could be a call to remind them of their appointment.or maybe even the therapist calling them for a few minutes to hear a brief of their problem and giving a reassurance.get innovative therapists,these people may miss out on something that could well be the difference between a life filled with doubts and a normal good life.

  • andrew robinson

    andrew robinson

    December 25th, 2012 at 11:56 AM

    c’mon,those that r ready to drop out between taking an appointment n seeing the doc r not really serious in d first place!they r unsure themselves n need time to reach a decision.or maybe a friend could back them up and keep them on d right path.it really isnt that hard!

  • Leo


    December 26th, 2012 at 7:13 PM

    Appointment seekers could be asked to fill a questionnaire.If that shows they are at risk of avoiding the appointment with change in mood then they need to be prioritized in the appointment list.It would be surprising to see the number of such people,many go seek help only because of others’ advice and would want an excuse to avoid the same,which is not a good thing at all.

  • PJ


    December 27th, 2012 at 4:18 AM

    In a perfect world we would all be able to secure a same day or next day appointment.
    But I know of very few doctors who have that ability to see patients that quickly, not the good ones anyway.

  • Sam S

    Sam S

    December 28th, 2012 at 7:45 AM

    This is an interesting point:

    Also, Swift found that prior therapy experience was highly associated with attendance. Specifically, the participants who had been in therapy had a tenfold increase in attendance rates when compared to those with no previous therapy experience

    It makes sense that people who had been to therapy before have a realistic expectation for what therapy will look and feel like. Going to therapy for the first time can be a very scary thing, so I can see why people would end up canceling or not showing if they have a long time between making the appointment and the appointment itself. The anxiety that can build should not be underestimated.

  • Dipu


    December 28th, 2012 at 7:48 AM

    Coming from the therapist’s perspective, cancelled/no show appointments are so frustrating. I got into the business to help people and to truly make a difference. If someone is going to just cancel last minute or not show up for an appointment, why do they even bother to call in the first place? I have clients that could have used that time to make some serious headway with their issues rather than having a therapist with nothing to do and no one to see.

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