title: A systems analysis of a failure to test the effectiveness of waiting-list group therapy.
abstract: 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.
authors.affiliation: Psychology Department, University of Cincinnati, USA. edward.klein@uc.edu
authors.forename: E B
authors.initials: EB
authors.lastname: Klein
authors.forename: W N
authors.initials: WN
authors.lastname: Stone
authors.forename: D J
authors.initials: DJ
authors.lastname: Reynolds
authors.forename: J S
authors.initials: JS
authors.lastname: Hartman
mesh_terms: D006279:Health Maintenance Organizations; D008605:Mental Health Services / Q000592:standards* / Q000600:supply & distribution*; D011615:Psychotherapy, Group; D014850:Waiting Lists