Effects of intake procedures on continuance and expectations of psychiatric outpatients

Abstract

This study sought to compare client satisfaction, expectancy reality discrepancy (ERD) and continuation among three different initial psychiatric interviews with two levels of pathology. The sample was 90 of 190 consecutive clients who came to an outpatient clinic of a community mental health center in central Texas during a nine month period. The 90 clients were assigned to one of three interview approaches. Each approach saw 30 clients. The first was a Traditional interview in which the client gave his or her problems and what he or she wished from the center. After staffing the case the interviewer offered outpatient psychotherapy. The second was an Expectation interview which was identical to the Traditional interview with the addition of the client receiving a written list of seven expectations of psychotherapy at the end of the interview. The third approach was a Negotiation interview in which client and interviewer negotiated on what the client expected from the center and what the interviewer felt was clinically appropriate to be given. Both client and interviewer actively participated in discussing and contributing to a mutually agreeable course of action for treatment in psychotherapy. The dependent variables were satisfaction with the interview, expectancy-reality discrepancy (ERD) and continuation in therapy which were measured respectively by a post interview satisfaction questionnaire, pre and post interview expectancy questionnaires, and a records check for return to the next scheduled appointment. The independent variables were the type of interview and high or low level of pathology. Level of pathology was measured by the use of the Brief Psychiatric Rating Scale (BPRS). No significant differences among the three interviews and two levels of pathology were found. One ancillary investigation found the Negotiated interview had significantly higher goals met or number of return visits than either the Traditional or Expectation interviews. A second ancillary investigation compared ERD to continuance with no significant findings...