A systems analysis of a failure to test the effectiveness of waiting-list group therapy.
This nonexperimental effectiveness study attempted to evaluate the utility of a brief waiting-list group. The setting was a university clinic providing treatment for an inner-city population. Health delivery and staff dynamics made it difficult to conduct clinical research in this treatment-oriented setting. The nonrandom design allowed for patient choice, with few clients attending more than two group sessions, thus decreasing its impact. Managed-care pressures decreased staff cooperation with our research objectives, resulting in very low return rates in testing and follow-up data. A social systems analysis, highlighting staff and institutional ambivalence, is used to understand the failure to adequately test the effectiveness of waiting-list group therapy. Recommendations are offered to investigators who contemplate conducting clinical research with limited resources.
Klein
E B
EB
Psychology Department, University of Cincinnati, USA. edward.klein@uc.edu
Stone
W N
WN
Reynolds
D J
DJ
Hartman
J S
JS
D006279:Health Maintenance Organizations; D008605:Mental Health Services / Q000592:standards* / Q000600:supply & distribution*; D011615:Psychotherapy, Group; D014850:Waiting Lists