title: A comparison of walk-in counselling and the wait list model for delivering counselling services.
abstract: BACKGROUND
  Walk-in counselling has been used to reduce wait times but there are few controlled studies to compare outcomes between walk-in and the traditional model of service delivery.
  
  
  OBJECTIVE
  To compare change in psychological distress by clients receiving services from two models of service delivery, a walk-in counselling model and a traditional counselling model involving a wait list.
  
  
  METHODS
  Mixed-methods sequential explanatory design including quantitative comparison of groups with one pre-test and two follow-ups, and qualitative analysis of interviews with a sub-sample. Five-hundred and twenty-four participants ≥16 years were recruited from two Family Counselling Agencies; the General Health Questionnaire-12 assessed change in psychological distress.
  
  
  RESULTS
  Hierarchical linear modelling revealed clients of the walk-in model improved faster and were less distressed at the four-week follow-up compared to the traditional service delivery model. Ten weeks later, both groups had improved and were similar. Participants receiving instrumental services prior to baseline improved more slowly. The qualitative data confirmed participants highly valued the accessibility of the walk-in model, and were frustrated by the lengthy waits associated with the traditional model.
  
  
  CONCLUSIONS
  This study improves methodologically on previous studies of walk-in counselling, an approach to service delivery not conducive to randomized controlled trials.
authors.affiliation: a Faculty of Social Work, Wilfrid Laurier University , Kitchener, Ontario , Canada.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Stalker
authors.affiliation: b Department of Psychology, Wilfrid Laurier University , Waterloo, Ontario , Canada.
authors.forename: Manuel
authors.initials: M
authors.lastname: Riemer
authors.affiliation: a Faculty of Social Work, Wilfrid Laurier University , Kitchener, Ontario , Canada.
authors.forename: Cheryl-Anne
authors.initials: CA
authors.lastname: Cait
authors.affiliation: c Centre for International Governance Innovation, University of Waterloo , Waterloo, Ontario , Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Horton
authors.affiliation: a Faculty of Social Work, Wilfrid Laurier University , Kitchener, Ontario , Canada.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Booton
authors.affiliation: d KW Counselling Services , Kitchener, Ontario , Canada , and.
authors.forename: Leslie
authors.initials: L
authors.lastname: Josling
authors.affiliation: d KW Counselling Services , Kitchener, Ontario , Canada , and.
authors.forename: Joanna
authors.initials: J
authors.lastname: Bedggood
authors.affiliation: e Family Service Thames Valley , London, Ontario , Canada.
authors.forename: Margaret
authors.initials: M
authors.lastname: Zaczek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003376:Counseling / Q000379:methods* / Q000458:organization & administration; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D013315:Stress, Psychological / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: hierarchical linear modelling; outcomes; service delivery models; single-session therapy; walk-in counselling