Improving session attendance in mental health and substance abuse settings: a review of controlled studies

Patient nonattendance to scheduled sessions results in excessive costs to mental health and substance abuse providers and compromises the care of clients. This paper presents a comprehensive review of interventions that have been shown to increase session attendance rates in these settings. Unique to other review papers, reliability estimates were performed in the selection and evaluation of obtained studies. Reliability of article selection and evaluation strategies was excellent (.80 to .88). Study results indicate several attendance improvement methods appear to be particularly promising, such as scheduling appointments promptly, reminder letters and telephone calls, soliciting patient commitment, and helping to resolve obstacles to attending the session. The specific manner in which these interventions are implemented appears to influence session attendance rates. Moreover, some attendance improvement interventions are clearly effective in some settings, but not others. Specific recommendations are provided in light of the study findings.     

Treatment Participation among Children with Conduct Problems and the Role of Telephone Reminders

Children with antisocial, aggressive and disruptive behaviour problems are among the most frequent referrals to mental health services. These young people and their families present with a range of adverse contextual factors and can prove challenging to engage. We examined the characteristics of children with conduct problems, treatment participation, and the impact of telephone reminder calls. Consecutive referrals (N=262) to two child and youth mental health services were randomly assigned to either a reminder call condition or service as usual. In comparison to referrals without conduct problems, conduct problem children presented with greater sources of psychosocial adversity, attended fewer initial appointments and were at greater risk of treatment refusal. Importantly, telephone reminder calls significantly increased treatment attendance, though only for participants with elevated conduct problems. Telephone reminder calls, however, had no impact on treatment refusal, regardless of conduct problem status. The findings highlight a straightforward approach for enhancing treatment participation among a group that has been challenging for mental health services.     

Intrusiveness and Persuasive Impact of Three Communication Media1

Two field experiments compared the persuasive impact of communications delivered face-to-face, by telephone, or by letter. In both studies, letters did not differ from faccto-face contacts but telephone calls were less effective. In the second experiment, personalness interacted with communication medium such that addressing subjects by name reduced the impact of face-to-face encounters, increased that of letters, and had no effect on phone calls. A third sample of subjects rated the appropriateness of name usage by salespeople, indicating a salesperson should give his own name but was inappropriately personal when calling the subject by name. The findings support the notion that varying media and name usage varies the psychological distance between communicator and recipient. At appropriate psychological distances, communicators and communications have optimum effectiveness; at too great or too little distance, they lose impact. Thus, not only is selection of proper medium important to communicators but how the medium is used can affect impact.     

Clicking away at co-rumination: co-rumination correlates across different modalities of communication

Co-rumination is associated with positive friendship quality (thought to buffer against anxiety and depression) but paradoxically higher levels of anxiety and depression. With the increasing use of technology for communication among adults, there is little known about co-rumination effects across different modalities of communication. In the current study, we examined co-rumination through four methods (i.e. in person, phone calls, text messaging, and social media) in two separate samples - college students and participants from the community. Classic co-rumination effects were found for in-person communications, and we found that co-rumination by telephone as well as by texting, for a college student sample only, mirrors some of these findings for in-person co-rumination. In studies of co-rumination, evaluation of multiple modes of communication is warranted.     

A Follow-Up Study of Spring, 1966, High School Graduates in the State of Utah

This study presents some of the results of a study of youth potential and youth opportunity in the State of Utah. The findings suggest that the immediate post high school plans of high school seniors, when stated during the spring prior to graduation, are relatively accurate indicators of actual post high school activities, but plans stated during the preceding fall are relatively unrealistic; also unrealistic are estimates of years of college attendance by first-quarter freshmen. The findings also reveal that while practical considerations weigh most heavily in the choice of a college, colleges in Utah have images which likely influence prospective students' choices.     

Communicating by telephone: Views of a group of people with stuttering impairment

A study of the use of and attitudes towards the telephone by persons with stuttering impairment is presented. Data was collected by survey (postal questionnaire). Results indicate that making calls may be more problematic than answering them. Avoidance-like behaviours were more prevalent amongst younger adult stutterers than their older counterparts. Severe stutterers use the telephone least. Many stutterers surveyed see telephoning as being more problematic than ‘face-to-face’ communication and give a range of reasons for this. Telephoning difficulties can have wide ranging effects. Some implications of these findings are discussed.     

Evaluation of the 113Online Suicide Prevention Crisis Chat Service: Outcomes,Helper Behaviors and Comparison to Telephone Hotlines

Recognizing the importance of digital communication, major suicide prevention helplines have started offering crisis intervention by chat. To date there is little evidence supporting the effectiveness of crisis chat services. To evaluate the reach and outcomes of the 113Online volunteer‐operated crisis chat service, 526 crisis chat logs were studied, replicating the use of measures that were developed to study telephone crisis calls. Reaching a relatively young population of predominantly females with severe suicidality and (mental) health problems, chat outcomes for this group were found to be comparable to those found for crisis calls to U.S. Lifeline Centers in 2003–2004, with similar but not identical associations with specific helpers' styles and attitudes. Our findings support a positive effect of the 113Online chat service, to be enhanced by practice standards addressing an apparent lack of focus on the central issue of suicidality during chats, as well as by the development of best practices specific for online crisis intervention.     

Predictors of treatment attendance among adolescent substance abusing runaways: a comparison of family and individual therapy modalities

This study explored and compared predictors of session attendance among substance abusing runaway adolescents and their parents using three manual‐driven interventions: ecologically‐based family therapy (EBFT), motivational enhancement therapy (MET), and the community reinforcement approach (CRA). Individual and family‐level variables, as well as time between intake and first session were used as predictors of session attendance. Adolescents (N=179) between the ages of 12–17 years old were recruited from the only runaway shelter in Columbus, Ohio. The findings showed that adolescents assigned to EBFT were more likely to attend at least one therapy session than those assigned to either CRA or MET. Fewer days between intake and the first therapy session were associated with higher family therapy attendance. Overall, individual and family factors predicted therapy attendance but these factors differed depending upon the treatment modality.     

An evaluation of crisis hotline outcomes. Part 2: Suicidal callers

In this study we evaluated the effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' suicide state from the beginning to the end of their calls to eight centers in the U.S. and again within 3 weeks of their calls. Between March 2003 and July 2004, 1,085 suicide callers were assessed during their calls and 380 (35.0%) participated in the follow-up assessment. Several key findings emerged. Seriously suicidal individuals reached out to telephone crisis services. Significant decreases in suicidality were found during the course of the telephone session, with continuing decreases in hopelessness and psychological pain in the following weeks. A caller's intent to die at the end of the call was the most potent predictor of subsequent suicidality. The need to heighten outreach strategies and improve referrals is highlighted.     

Brief report: preliminary results of a suicide awareness mass media campaign in Cuyahoga County, Ohio

Little information is currently available concerning the effects of suicide awareness and prevention campaigns. This brief report provides preliminary information about the influence of such a media campaign on the number of suicide-related telephone calls to an emergency mental health service in Cuyahoga County, Ohio. Examination of the pattern of calls before, during, and between phases of the campaign suggests that the media campaign significantly increased telephone calls to the emergency service. We provide this information to catalyze similar sharing of data and experiences among those organizations and agencies working to prevent suicide.     

Is acoustic evaluation in a non-primate mammal,the tree shrew,affected by context?

Sound categorisation plays a crucial role for processing ecological and social stimuli in a species’ natural environment. To explore the discrimination and evaluation of sound stimuli in human babies and nonhuman primates, a reciprocal habituation-dishabituation paradigm has been successfully introduced into auditory research. We applied the reciprocal paradigm for the first time to a non-primate mammal, the tree shrew (Tupaia belangeri), to examine to what extent non-primate mammals share the ability to evaluate communication calls with primates. Playback stimuli were three types of communication calls, differing distinctively in context and acoustic structure, as well as two artificial control sounds, differing solely in frequency. We assessed the attention towards the playback stimuli by the latency to respond to the test stimulus. Subjects evaluated pairs of communication call types as well as the artificial playback stimuli. Attention towards the test stimuli differed significantly in strength for one pair of communication calls, with subjects dishabituating faster to one category than the other. The comparison of a second pair of communication calls did not show significant differences. Interestingly, subjects also evaluated the artificial control sounds. Findings are only partly in line with results on human and non-human primates. They provided first evidence that in non-primate mammals acoustic evaluation is not solely affected by the sound-associated context but is also linked to unusualness and acoustic cues, such as peak frequency.     

Intellectual development and its relationship to maturation during the college years

This study examines whether differences in the development of critical reasoning abilities among undergraduates can be attributed to factors other than college attendance, and specifically to differences in chronological maturation. Eight males and eight females were randomly selected and matched on ACT composite scores from each of four groups: 18-year-old freshmen; 22-year-old freshmen; 22-year-old seniors; and 26-year-old seniors. Theses 64 subjects were arranged within a non-assignable three factor design by age (adult and traditional), class level (freshman and senior), and sex. Subjects were administered the Reflective Judgment Interview, a structured interview format designed to measure the way individuals reason about intellectual problems. Two significant main effects were observed, with seniors scoring higher than freshman (p < .001), and males scoring higher than females. The class level main effect, in the absence of any significant difference of reflective judgment level due to age, suggests that college attendance does contribute to the development of critical reasoning beyond the factor of chronological maturation. An explanation for significant sex differences found is not clearly discernible from these data.     

Social complexity can drive vocal complexity: group size influences vocal information in Carolina chickadees

One hypothesis to explain variation in vocal communication in animal species is that the complexity of the social group influences the group's vocal complexity. This social-complexity hypothesis for communication is also central to recent arguments regarding the origins of human language, but experimental tests of the hypothesis are lacking. This study investigated whether group size, a fundamental component of social complexity, influences the complexity of a call functioning in the social organization of Carolina chickadees, Poecile carolinensis. In unmanipulated field settings, calls of individuals in larger groups had greater complexity (more information) than calls of individuals in smaller groups. In aviary settings manipulating group size, individuals in larger groups used calls with greater complexity than individuals in smaller groups. These results indicate that social complexity can influence communicative complexity in this species.     

Self-Selection, Church Attendance, and Local Civic Participation

Prior research has shown that church attendance affects voting participation, but has a negative or no effect on more demanding forms of political participation. I argue that this differential for nonelectoral activity partially results from biases in how scholars conceptualize and analyze church attendance variables. To properly measure the influence of church attendance on nonelectoral participation, scholarship needs to account for self-selection biases that hinder accurate analyses. Consistent with the literature, a selection model finds that once fundamentalism's motivating effect is considered, church attendance plays no role in a respondent's participation in local government meetings. The present work provides a partial explanation for why attendance has no effect on more demanding political activity. These findings demonstrate that scholarship should focus attention on prior factors that influence congregants' attendance decisions.     

Parceling Component Effects of a Multifaceted Prevention Program for Disruptive Elementary School Children

This study examined predictors and outcomes of attendance in two standard components of a multifaceted preventive intervention aimed at children with early-onset disruptive behavior after 3 years of intervention. Mean rate of attendance in the Family Program, but not the Summer School Program, differed by level of child disruptiveness (grouping variable). Although predictors of attendance (SES, single-parent status, child IQ) did not differ across high- and low-disruptive groups, predictors of outcome were moderated by level of child disruptiveness for academic achievement and aggression outcomes, but not for social competence. Higher attendance in the Summer Program was associated with higher child social competence at Year 3 for all children. For academic achievement, higher attendance in the Summer Program was associated with higher scores for mild/moderately disruptive children and lower scores for highly disruptive children in Year 3. Higher attendance in the Family Program was associated with lower aggression scores for mild/moderately disruptive children. Findings highlight the importance of matching intervention components to the assessed or expressed needs of client subgroups.     

Effects of trauma and religiosity on self-esteem

Self-esteem is often lower among persons who have experienced trauma, but religiosity may ameliorate these psychological effects. The purpose of this paper was to examine the relationships among religiosity, self-esteem, and childhood exposure to trauma, utilizing data from the National Comorbidity Survey, a large (N = 8,098) nationally representative population survey in the 48 contiguous states of the USA that assessed religious practices, self-esteem, and exposure to trauma. Exposure to trauma in childhood was assessed through self-report of presence or absence of childhood physical abuse, sexual abuse, or neglect. Religiosity was assessed as the sum of responses to 4 self-report items (religious service attendance, use of religion for comfort and guidance, and importance of religion). Self-esteem was assessed on 9 self-report items adapted from the Rosenberg Self-Esteem Scale. Analysis of variance compared scores for persons who reported exposure to childhood abuse and differed in the value they placed on various religious practices on self-esteem. Persons who reported physical abuse, sexual abuse, or neglect in childhood had significantly lower mean self-esteem than those who did not report these events. There was also a main effect for religiosity in a comparison of persons who reported childhood sexual abuse with those who reported none. The High Religiosity group had higher mean self-esteem than the Medium and Low Religiosity groups. There was a significant interaction as those who reported childhood sexual abuse had lower mean self-esteem than peers who reported none in the Low and Medium Religiosity groups. Mean self-esteem for those who reported childhood sexual abuse was comparable to that of those who reported none in the High Religiosity group.     

Relative status and interpersonal presumptuousness

Previous research has shown that, in status-discrepant dyads, the higher-status member's verbal behavior tends to be more presumptuous, that is, to have a higher proportion of utterances that imply a presumption of knowledge of the other, including Advisements, Interpretations, Confirmations, and Reflections as defined by a taxonomy of verbal response modes (VRMs). However, members of these dyads have differed in absolute status in an external social hierarchy as well as in relative status within the dyad. The present study was designed to distinguish relative status from absolute status. Eighteen senior psychology majors each participated in two similar conversations—one with a freshman and one with a professor. Conversations were coded using the VRM system. In freshman-senior dyads, seniors were more presumptuous and in senior-professor dyads, professors were more presumptuous, replicating previous findings. Seniors' presumptuousness was greater toward freshmen than toward professors, supporting the hypothesis that presumptuousness varies with relative status. Absolute status was not highly predictive of presumptuousness; there were no significant differences between seniors with freshmen and professors with seniors or between freshmen with seniors and seniors with professors.     

Numbers or apologies? Customer reactions to telephone waiting time fillers

The authors examined the effect of time perception and sense of progress in telephone queues on caller reactions to 3 telephone waiting time fillers: music, apologies, and information about location in the queue. In Study 1, conducted on 123 real calls, call abandonment was lowest, and call evaluations were most positive with information about location in the queue as the time filler. In Study 2, conducted with 83 participants who experienced a simulated telephone wait experience, sense of progress in the queue rather than perceived waiting time mediated the relationship between telephone waiting time filler and caller reactions. The findings provide insight for the management and design of telephone queues, as well as theoretical insight into critical cognitive processes that underlie telephone waiting, opening up an important new research agenda.     

The Use of Preliminary Information in Vocational Counseling

One hundred twenty-one clients seeking vocational counseling were assigned to three experimental groups representing audio, visual, and audiovisual methods of information presentation, or to a control group. After exposure to information relevant to their concerns, they were given an opportunity to return for a regular appointment. The audio and visual methods differed significantly in terms of percent of those who returned (audio = 69 percent, visual = 39 percent). Returnees in the visual group averaged fewer counseling sessions although the differences were not statistically significant. In general, returnees had indicated a somewhat greater number of problem areas and more frequently were sophomores and seniors. Results suggest that tape recordings (audio method) tend to induce clients to return for further counseling more readily than does the same information in mimeographed form (visual method). The likelihood of a client returning is seen as a function of the type and urgency of the problem as well as the preliminary information he receives.     

The Influence of Judgment Calls on Meta-Analytic Findings

Previous research has suggested that judgment calls (i.e., methodological choices made in the process of conducting a meta-analysis) have a strong influence on meta-analytic findings and question their robustness. However, prior research applies case study comparison or reanalysis of a few meta-analyses with a focus on a few selected judgment calls. These studies neglect the fact that different judgment calls are related to each other and simultaneously influence the outcomes of a meta-analysis, and that meta-analytic findings can vary due to non–judgment call differences between meta-analyses (e.g., variations of effects over time). The current study analyzes the influence of 13 judgment calls in 176 meta-analyses in marketing research by applying a multivariate, multilevel meta-meta-analysis. The analysis considers simultaneous influences from different judgment calls on meta-analytic effect sizes and controls for alternative explanations based on non–judgment call differences between meta-analyses. The findings suggest that judgment calls have only a minor influence on meta-analytic findings, whereas non–judgment call differences between meta-analyses are more likely to explain differences in meta-analytic findings. The findings support the robustness of meta-analytic results and conclusions.