Attrition After Intake at a University Counseling Center: Relationship Among Client Race, Problem Type, and Time on a Waiting List

Abstract

The present study examined the relationship between attrition after intake and the length of time that clients spent on a waiting list by client race and problem type. Participants were 1,461 clients who completed an initial intake evaluation at a large, Mid-Atlantic counseling center over a 6-year period. Fullfactorial hierarchical logistic regression analyses revealed that African American clients were less likely to return for counseling than were European American clients, regardless of the problem type. ********** A Challenge all too familiar for staff at university counseling centers is meeting the demand for services in an appropriate and timely fashion. Because the demand for services may outweigh available staff resources, certain administrative procedures, such as the creation of a client waiting list, may become necessary (Anderson, Hogg, & Magoon, 1987). Reports from the College and University Counseling Centers Data Bank (Magoon, 2001) and other research (e.g., Clack, Stone, & Thurman, 1984) indicate the pervasiveness of waiting list procedures. Although the reality is that waiting lists are pervasive, particularly at large university counseling centers, concerns remain regarding the adverse impact of waiting lists. The potential adverse impact of waiting lists may be particularly poignant for members of racial and ethic minorities, who may view this administrative procedure as a form of institutional racism (Ridley, 1995). Previous research on waiting list attrition has failed to examine the possible influences of racial differences. For example, Anderson et al. (1987) found no significant difference in waiting list attrition between those who had a long wait and those who had a short wait between intake and the first session. However, a limitation of this study was that group differences were examined only between those who had a long wait for services and those who had a short wait for services. In describing the demographic data of the participants, it was simply stated that the groups did not differ appreciably with regard to racial and ethnic makeup (Anderson et al., 1987). Thus, any racial difference in waiting list attrition is not known. The present study was designed to begin to fill that void in the literature. Waiting List Research: An Overview The efficacy and appropriateness of waiting lists have long been areas of inquiry. Early research on waiting lists has suggested increased dissatisfaction among clients who had to wait for services (Levy, 1963; Sinnett & Danskin, 1967). Some findings suggest that clients' dissatisfaction with being on a waiting list is related to failure to return for services (i.e., attrition), especially for those individuals rated as more psychologically dysfunctional by the intake interviewer (e.g., Whittemore, 1985). However, other scholars contend that the waiting list itself is not problematic, citing that dissatisfaction is more related to clients' perception of whether something is being done to address their concerns (Shueman, Gelso, Mindus, Hunt, & Stevenson, 1980). For example, Obetz, Farber, and Rosenstein (1997) found that students who perceived that they had waited longer were less likely to believe their needs were met by the counseling center; however, no relationship between actual length of wait and satisfaction with counseling was found. A prevailing theme in the literature is that length of time on a waiting list is not a significant factor in client attrition after intake for the majority of clients, regardless of the types of problems (e.g., emotional or vocational) with which clients present (Anderson et al., 1987; Archer, 1981, 1984; Krauskopf, Baumgardner, & Mandracchia, 1981; May, 1990; Obetz et al., 1997). In fact, research suggests that most clients do not report negative reactions or effects from being on waiting lists (Archer, 1984). For example, May found that for clients not needing immediate intervention, the majority (63%) of those who failed to follow through with services stated they either no longer needed counseling or were undecided about pursuing counseling. …