title: Choice of service provider: how consumer self-determination shaped a psychiatric rehabilitation program.
abstract: OBJECTIVE
  To document the impact of consumer self-selection of service providers on their service receipt and attendance in a psychiatric rehabilitation program.
  
  
  METHODS
  Staff (8 FTE) in a new drop-in resource center tracked their service activities and contacts with consumers using daily service logs. Consumers (N = 46) checked their service needs at enrollment, and recorded their attendance on daily sign-in sheets. Regression analyses were conducted to examine correlations between these service measures and each consumer's count of key providers, with key provider defined as any staff worker with whom the consumer logged the equivalent of more than a full workday of contact (9+ hours) during a 6-month study period.
  
  
  RESULTS
  Service log findings suggest that key service providers were chosen by consumers through informal social interactions with staff. Members who had more key providers were more active in the program and more likely to have checked a need for psychiatric care at enrollment. In spite of member choice of provider, caseloads remained small and staff were able to dedicate their time to services related to their specialty training.
  
  
  CONCLUSIONS
  Facility-based programs can encourage consumer self-selection of service providers without overloading staff or restricting specialty services if they provide ample time for staff and consumers to get to know one another in informal social interactions.
authors.affiliation: Behavioral Health and Academic Counseling, Harvard University Health Services, Cambridge, MA 02138, USA. pbarreira@uhs.harvard.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Barreira
authors.forename: Cathaleene
authors.initials: C
authors.lastname: Macias
authors.forename: Charles
authors.initials: C
authors.lastname: Rodican
authors.forename: Paul B
authors.initials: PB
authors.lastname: Gold
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003256:Community Participation; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008605:Mental Health Services; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010358:Patient Participation / Q000379:methods* / Q000523:psychology*; D026684:Personal Autonomy; D011369:Professional-Patient Relations