Client Attendance Research Articles

Evaluation of a young person's sexual health service in a commercial setting

ObjectiveTo determine the acceptability and accessibility of a sexual health service for young people in a city centre pharmacy.DesignProspective qualitative survey of clients attending a new sexual health service, including...

Measuring client participation in individual programme planning meetings

SummaryClients should participate in their individual programme planning (IPP) meetings, but the question is: Do they? It would help staff in supporting their clients if a simple method were available for measuring client participation. The present article describes the development of such a method and its use with one client in a routine IPP meeting. An IPP participation checklist (IPPPC) was developed to assess the participation of one client, Mr B, who has limited verbal communication skills, at his IPP meeting. A questionnaire for staff was also devised to gauge their perceptions of Mr B's participation at the same meeting. Mr B actively participated in much of the meeting; the IPPPC highlighted areas in which he did not participate. Staff members' ratings of his participation were in close agreement. Client attendance at a meeting does not guarantee active participation. The IPPPC shows how far the client has participated in specific aspects of a meeting. It may be possible to increase client participation by the introduction of keyworker meetings, management support and IPP guidelines. The regular use of the IPPPC described in the present paper will guide staff in what to look for when assessing participation and may be especially valuable during staff training.

Predicting therapy duration from therapist experience and client psychopathology.

This study examined the relationships among therapist experience, the cost of therapy services, the degree of client psychopathology, and the number of therapy sessions clients attended following intake. The closed files of 407 clients at a university-based psychology outpatient clinic were examined. Results indicated that the duration of therapy was predicted from the experience of the graduate-student therapist, with higher levels of therapist experience predicting fewer therapy sessions. Although measures of client psychopathology did not directly predict therapy duration, therapist experience became only a marginally significant predictor when client psychopathology was allowed to act as a covariate. Fees paid for therapy did not predict therapy duration. These findings emphasize the importance of accounting for therapist and client characteristics when examining client attendance in therapy.

Prediction of academic and clinical performance of occupational therapy students in an entry-level master's program.

The relationships between clinical outcomes and predictors used to screen applicants for entrance into a Master in Occupational Therapy (MOT) program were examined. MOT student records from 1986 to 1992 were used to gather data for three dependent variables and six predictor (independent) variables. The dependent variables used to gauge student success were grade point average in occupational therapy courses (OT-GPA), client attendance at an on-site clinic, and therapy outcomes of clients at that clinic. The predictor variables were undergraduate GPA, scores on the three sections of the Graduate Record Examination, reference forms, and essays. The models used to predict OT-GPA and therapy outcomes were significant (p < .05), and the incremental validity of several predictors was established. The model used to predict client attendance was not significant. The findings regarding OT-GPA support the continued use of all the predictors except the reference forms. Although it was possible to develop a model to predict client outcomes, the usefulness of the model is difficult to interpret.

"What We Want to Know About HIV/AIDS:" An Analysis of Questions Asked by Substance Abuse Clients Attending AIDS Education Classes in Puerto Rico

An analysis of the questions about human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) asked by intravenous drug users attending AIDS education classes at a public detoxification center in San Juan Puerto Rico provided guidelines for the design of future educational programs. Of the 13007 AIDS cases reported in Puerto Rico by April 1994 an estimated 57% were associated with contact with contaminated drug injecting equipment. The clinics mandatory AIDS education program is comprised of three loosely structured one-hour sessions in which active participation is encouraged. The present study analyzed 372 AIDS-related questions raised by 230 clients in the 50 one-hour sessions that occurred in June-October 1992. 62% of clients reported previous exposure to at least one AIDS education presentation. The questions fell into the following topic areas: HIV transmission and prevention 55.2%; natural history of HIV infection 24.5%; HIV testing 10.5%; treatment 7.0%; and other (e.g. epidemiology legal issues) 3.0%. Common were questions about modes of HIV transmission that while biologically plausible are highly unlikely (e.g. tears sweat saliva or urine). Also raised were questions about the likelihood of virus elimination during the process of heating drugs in a cooker and the use of bleach and alcohol for cleaning injection equipment. There was interest in why exposed individuals vary in their susceptibility to HIV as well as in the effect of illegal drug use on HIV progression. Clients pressured the educators to assign numerical ratings to different types of high-risk activities reflecting their need to pinpoint what constitutes an acceptable risk. As a result of this analysis AIDS educators at the center are now providing demonstrations with injecting equipment that illustrate the potential risk at different moments in the injecting process as well as procedures that eliminate or reduce this risk.

Psychological problems and client engagement in methadone treatment.

Client attendance at individual counseling sessions in community-based methadone treatment programs was more frequent among clients with self-reported psychological problems at intake. These problems included anxiety, depression, suicidal ideation, and other symptoms suggesting psychopathology (hallucinations, difficulty controlling violence, etc.). The sample consisted of 462 clients in treatment at least 90 days, divided into two groups of no psychological problems reported at intake (no problems group, N = 341) and two or more problems reported (high problems group, N = 121). The high problems group was twice as likely to attend the treatment program's recommended minimum number of individual counseling sessions (two per month) than was the no problems group, and was more likely to discuss psychological issues in their individual counseling sessions. The high problems group showed significant decreases in drug use and illegal activity in the first 3 months after admission and did not differ significantly from the no problems group on drug-positive urines or illicit activity at month 3. Within the high problems group, clients who attended at least two individual sessions per month reported less cocaine and speedball use during treatment than those who attended fewer sessions.

The impact of waiting-list times on client attendance for relationship counselling

Abstract The impact of waiting-list times on subsequent attendance for appointments has received extensive attention within the area of health, but hitherto has received relatively little interest from counselling services. Given the current pressure on all welfare agencies for accountability and efficient use of resources, counselling organisations need to consider resource usage and barriers to efficiency. A study was therefore made of one aspect of this issue: the impact of short v. long time-delays between initial referral and first appointment for relationship counselling. It was found that clients offered appointments within two weeks of referral were significandy more likely to attend for first appointment than were clients whose appointment came between 4 and 12 weeks post-referral. The implications of these results for organisational policy are discussed.

The impact of waiting-list times on client attendance for relationship counselling

Abstract The impact of waiting-list times on subsequent attendance for appointments has received extensive attention within the area of health, but hitherto has received relatively little interest from counselling services. Given the current pressure on all welfare agencies for accountability and efficient use of resources, counselling organisations need to consider resource usage and barriers to efficiency. A study was therefore made of one aspect of this issue: the impact of short v. long time-delays between initial referral and first appointment for relationship counselling. It was found that clients offered appointments within two weeks of referral were significandy more likely to attend for first appointment than were clients whose appointment came between 4 and 12 weeks post-referral. The implications of these results for organisational policy are discussed.

A therapeutic group for clients with acute mental health problems.

A therapeutic group for clients with acute mental health problems is described using a case study research design. The setting of the group is a British community mental health centre. Theoretical and research approaches to brief therapeutic work with clients are discussed. Results include qualitative descriptions of the group from the perspective of various respondents and quantitative descriptions of client attendance. The group was evaluated positively by respondents and high attendance rates indicated that the group met clients' needs. The group was primarily utilized by professionals as an addition to present services rather than as an alternative to in-patient hospitalization. However, in practice many of the clients needed some degree of professional support after ceasing to attend the group. In this study, the establishment of a therapeutic group for clients with acute mental health problems improved inter-professional relations. The ability to facilitate therapeutic groups is an important competence for mental health nurses.

Correlates of Therapist Prediction of Therapy Duration

In the study presented here I investigated therapist perceptions of client attractiveness, anxiety, and disturbance as they relate to therapist prediction of the number of sessions the client will attend and actual client attendance. Therapists were five professionals and five practicum students at a university counseling center. Their clients were 249 college students. After the initial session, therapists completed the Therapist Personal Reaction Questionnaire (Davis, Cook, Jennings, & Heck, 1977) and items to assess client anxiety and disturbance. Therapists preferred less anxious clients, but actual numbers of sessions were only related significantly and positively to client disturbance.

The Effects of a Multi-Facetted Intervention on the Offense Activities of Juvenile Probationers

Abstract This study investigated whether expanding juvenile court services to include job preparation, outdoor experiential, and family skill building components would significantly reduce the offense activities of probationers in comparison to the effects of traditional probation supervision. The intervention sought to curtail illegal activities by enhancing integration to conventional social institutions as well as by transforming the negative influence of the delinquent peer group. Client attendance and participation were monitored throughout the project. Self-reported delinquency and official offense data derived from a two-factor experimental pre-test-posttest design indicated that the intervention failed to yield the desired effects over an 18 month follow-up period. The only significant result was the finding that select experimental subjects with extensive backgrounds of crime displayed fewer offenses during the follow-up than did select control subjects with comparable backgrounds. Findings are d...

Effects of client and counselor sex on client attendance at counseling

The present study examined the relationship between sex of client, sex of counselor, client's presenting problem, and the length of time the counseling dyad stayed together. Dyads engaged in personal counseling had significantly more sessions than dyads engaged in vocational counseling or test feedback. Clients receiving personal counseling were more likely to terminate unilaterally than clients receiving vocational counseling or test feedback.

Parole/Probation Therapy Group

Abstract A non-lractitional outpatient group was instituted to improve services to parole/probation clients. The group uses various techniques to optimize potential for client success. A one-year study indicates the group is cost-effective, may improve client attendance and has improved relations between parole/probation and mental health staff.

Alternative Modes of Delivering Family Planning Services

Various components of family planning programs are analyzed. Recommendations are made about preferred methods under different circumstances. Communication with the patient including promotion and referral to encourage registration and follow-up is 1 of the most problematic elements of a family planning program. Persons can be attracted to a family planning clinic through discussion with nurses in maternity wards or prenatal and postpartum clinics; referrals from organizations professionals and friends; outreach personnel; and advertising. Once a woman has become a patient in a family planning clinic the major role of the formal communication effort is to encourage her to remain enrolled in the program as an effective user of a good contraceptive method. Data suggest that it is cheaper to try simple methods to reenroll a dropout than it is to recruit a new patient. Many of the reasons for dropping out suggest that there is insufficient instruction and motivation of women during their first visit. There are advantages to having the family planning service located at the same site as other health services. Experience has shown that the farther removed such services are from each other the more significant the attrition rate in family planning referrals. In a hospital setting the postpartum clinic is better than the outpatient clinic as a setting for the family planning services. The eligibility and fee schedule influences the expense of a program and the ability to attract clients. Staff attitude clinic hours and waiting time also significantly influence client attendance at the clinic.