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What do patients do before it starts? Coping with mental health problems on a CBT waiting list

Published online by Cambridge University Press:  01 April 2008

Sylvia Helbig*
Affiliation:
Centre for Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany Department of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
Jürgen Hoyer
Affiliation:
Department of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
*
*Author for correspondence: S. Helbig, Dipl.-Psych., Centre for Clinical Psychology and Rehabilitation, University of Bremen, Grazer Str. 6, 28359 Bremen, Germany (email: [email protected]).

Abstract

Data from a patient survey on self-help and coping strategies during waiting time for CBT are reported. Individuals on an outpatient treatment centre waiting list received a short questionnaire assessing problem-related activities carried out in the interval before therapy (mean waiting time 69 days). A total of 306 patients with a wide range of reliably diagnosed mental disorders were assessed. Results showed that the vast majority of patients (~95%) instigated at least one form of coping or self-help activity related to their mental problem. Resource-orientated strategies were most often reported (88%), but ‘seeking information about the problem’ was also highly prevalent. About one third of persons reported additional health-care utilization. Higher rates of symptom distress and depression were associated with additional health-care utilization and with more passive coping strategies such as distraction. Active self-help strategies contributed to poorer depression outcome and were, thus, no indicator of good prognosis. Other coping strategies were not linked to outcome variables. It can be concluded that problem-related processes do start before treatment. A more systematic integration of self-help activities into the case-formulation and more systematic research on the related (motivational) processes are recommended.

Type
Service models and forms of delivery
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2008

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References

Beck, AT, Steer, RA (1987). Beck Depression Inventory – Manual. San Antonio: The Psychological Association.Google Scholar
Deane, FP, Spicer, J, Leathem, J (1992). Effects of videotaped preparation information on expectations, anxiety and psychotherapy outcome. Journal of Consulting and Clinical Psychology 60, 980984.CrossRefGoogle ScholarPubMed
Derogatis, LR (1993). Brief Symptom Inventory (BSI). Administration, Scoring, and Procedures Manual, 3rd edn.Minneapolis, MN: National Computer Systems Inc.Google Scholar
Drieschner, KH, Lammers, SMM, Van Der Staak, CPF (2004). Treatment motivation. An attempt for clarification of an ambiguous concept. Clinical Psychology Review 23, 11151137.CrossRefGoogle ScholarPubMed
Gould, RA, Clum, GA (1993). A meta-analysis of self-help treatment approaches. Clinical Psychology Review 13, 169186.CrossRefGoogle Scholar
Grawe, K (1998). Psychologische Psychotherapie. Göttingen: Hogrefe.Google Scholar
Greenberg, RP, Constantino, MJ, Bruce, N (2006). Are clients’ expectations still relevant for psychotherapy process and outcome? Clinical Psychology Review 26, 657678.CrossRefGoogle ScholarPubMed
Hardy, KJ, O'Brien, SV, Furlong, NJ (2001). Information given to clients before appointments and its effects on non-attendance rates. British Medical Journal 323, 12981300.CrossRefGoogle Scholar
Helbig, S, Hähnel, A, Weigel, B, Hoyer, J (2004). Waiting times in psychotherapy – and how to make use of them [in German]. Verhaltenstherapie 14, 294302.Google Scholar
Helbig, S, Hoyer, J (2007). A minimal intervention for waiting list patients in outpatient behaviour therapy [in German]. Verhaltenstherapie 17, 109115.CrossRefGoogle Scholar
Howard, KI, Lueger, RJ, Maling, MS, Martinovitch, Z (1993). A phase model of psychotherapy outcome: causal mediation of change. Journal of Consulting and Clinical Psychology 61, 678685.CrossRefGoogle ScholarPubMed
Hoyer, J, Ruhl, U, Scholz, D, Wittchen, H-U (2006). Clients’ feedback after computer-assisted diagnostic interviews for mental disorders. Psychotherapy Research 16, 357363.CrossRefGoogle Scholar
Johnson, LN, Nelson, TS, Allgood, SM (1998). Noticing pretreatment change and therapy outcome: an inital study. American Journal of Family Therapy 26, 159168.CrossRefGoogle Scholar
Lawson, D (1994). Identifying pre-treatment change. Journal of Counseling and Development 72, 244248.CrossRefGoogle Scholar
Lester, S, Harris, SM (2007). Factors associated with first session nonattendance at a university-based family therapy clinic. American Journal of Family Therapy 35, 363376.CrossRefGoogle Scholar
Norcross, JC (2006). Integrating self-help into psychotherapy: 16 practical suggestions. Professional Psychology – Research and Practice 37, 683693.CrossRefGoogle Scholar
Prochaska, JO, DiClemente, CC, Norcross, JC (1992). In search of how people change. American Psychologist 47, 11021114.CrossRefGoogle ScholarPubMed
Shuman, AL, Shapiro, JP (2002). The effects of preparing parents for child psychotherapy on accuracy of expectations and treatment attendance. Community Mental Health Journal 38, 316.CrossRefGoogle ScholarPubMed
Stone, WN, Klein, EB (1999). The waiting-list group. International Journal of Group Psychotherapy 49, 417428.CrossRefGoogle ScholarPubMed
Walitzer, KS, Dermen, KH, Connors, GJ (1999). Strategies for preparing clients for treatment. Behavior Modification 23, 129151.CrossRefGoogle ScholarPubMed
Westbrook, D (1995). Patient and therapist views of different waiting list procedures. Behavioural and Cognitive Psychotherapy 23, 169175.CrossRefGoogle Scholar
Whitfield, GE, Williams, C, Shapiro, DA (2001). Assessing the take up and acceptabilitiy of a self-help room used by clients awaiting their initial outpatient appointment. Behavioural and Cognitive Psychotherapy 29, 333343.CrossRefGoogle Scholar
Wittchen, HU (1994). Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. International Journal of Psychiatric Research 28, 5784.Google ScholarPubMed
Wittchen, HU, Lachner, G, Wunderlich, U, Pfister, H (1998). Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Social Psychiatry and Psychiatric Epidemiology 33, 568578.CrossRefGoogle ScholarPubMed
Wittchen, H-U, Pfister, H (1997). DIA-X-Interview: Manual für Screening-Verfahren und Interview. Frankfurt: Swets & Zeitlinger.Google Scholar
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