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To Attend or Not Attend? A Critical Review of the Factors Impacting on Initial Appointment Attendance from an Approach-Avoidance Perspective
Paige, L., & Mansell, W
Journal of Mental Health. 2013;22:72-82.
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Abstract
Background: A large proportion of initial therapy appointments are not attended.Whether this reflects service-user choice or an unmet need for therapy, non-attendance can impact on patients, therapists, services and research evaluation.Aims: To understand the complexities of this phenomenon, this paper reviews themental health literature to gain further insight into how predictor variables can influence professional help-seeking decisions.Methods: The review reveals a modest success at identifying specific demographicand psychological factors, yet methodological issues surrounding data collectiontechniques have often led to contradictory and inconclusive findings.Conclusions: This paper examines the possibility that approach-avoidance conflict(Kushner & Sher, 1989; 1991) could explain the contradictions in the literature because, in this model, different factors involved in driving engagement versus avoidance become more salient depending on a dynamic interplay of timing, the individual and their service context. The core principles behind this approach-avoidance conceptualisation are explained and further avenues for research are identified.