Browsing by Author "Grandell, Leena Johanna"

Aims. Non-attendance reduces the effectiveness of psychotherapies and wastes resources in the health sector. It comprises both treatment refusal and drop-out. This study aims at investigating the association between patients’ psychological suitability to psychotherapy and treatment non-attendance. Methods. The study sample consisted of 326 Finnish adult outpatients suffering from mood or anxiety disorders and participating in the Helsinki Psychotherapy Study (HPS).The patients were randomized in three study groups: solution-focused therapy (n=97, 12 sessions), short (n=101, 20 sessions) and long (n=128, 3 years) psychodynamic therapies. Psychological suitability was measured with Suitability for Psychotherapy Scale (SPS) total score and seven subscores. Refusing the offered therapy after randomization was considered treatment refusal. Drop-out occurred if patient terminated therapy unilaterally before its anticipated length. Statistical analysis were carried out with linear model and Cox model. Results and Conclusions. The risk of treatment refusal was associated with therapy length and highest in long-term psychodynamic psychotherapy, which might be related to the randomization. As expected, poor suitability measured with SPS total score predicted treatment non-attendance. This was most notably seen in case of poor reflective ability, problems in interaction and problematic self-concept in relation to ego ideal. Patients with poor suitability were more likely to drop-out from solution-focused therapy and long psychodynamic therapy than from short psychodynamic therapy.