[Predictors of successful psychotherapy referral in a psychotherapy outpatient clinic and subsequent psychotherapeutic outcome].
OBJECTIVE
Many patients are referred to psychotherapy by outpatient units of psychiatric hospital departments. This study investigates predictors of success and outcome of subsequent psychotherapy in this group of patients.


METHODS
Two years after referral, 140 out of an initial sample of 215 patients of a psychotherapy outpatient unit were followed up by means of a telephone interview and questionnaires (GHQ, IIP). In addition, their therapists were interviewed.


RESULTS
57.1% of the patients actually began psychotherapy; of these, 67.5% completed or were continuing the treatment. Predictors of referral success were younger age, female gender, higher levels of depression, a less competitive, subassertive, nurturant, and expressive personality style, and a preexisting high motivation for psychotherapy. In the total sample of 140 patients there was a significant improvement of psychopathology (0.54 < d < 0.99), interpersonal problems (0.25 < d < 0.33), and subjective experience of symptoms (d = 0.26). Patients who began psychotherapy did not show a significantly better outcome after two years compared to those who were non-compliant.


CONCLUSIONS
Randomized-controlled studies are not comparable to regular outpatient treatment. Patients who did not begin psychotherapy despite referral might have been stabilized by the initial brief intervention they received at the psychotherapy outpatient unit, and consequently did not feel the need for any additional psychotherapy. This group of patients should be identified before being referred and offered a short-term psychotherapy at the outpatient unit.
Rumpold
Gerhard
G
Klinik für Medizinische Psychologie und Psychotherapie, Leopold-Franzens-Universität, Innsbruck, Austria. Gerhard.Rumpold@uibk.ac.at
Janecke
Nicola
N
Smrekar
Ulrike
U
Schüssler
Gerhard
G
Doering
Stephan
S
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001242:Assertiveness; D001317:Austria; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010045:Outpatients; D011237:Predictive Value of Tests; D011613:Psychotherapy / Q000379:methods; D012017:Referral and Consultation; D012107:Research Design; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome