PREDICTORS OF ENGAGEMENT IN PSYCHODYNAMIC PSYCHOTHERAPY DERIVING FROM PRE‐ASSESSMENT QUESTIONNAIRES

Abstract

Patients attending the Maudsley Hospital Psychotherapy Unit complete a semi‐structured questionnaire as a matter of standard procedure prior to assessment. Clinical experience suggests that this instrument reveals important aspects of a patient's internal world, regularly borne out at the assessment interview. The questionnaire may thus contribute to predicting engagement in the therapeutic relationship. To evaluate this hypothesis we conducted a qualitative analysis of 40 questionnaires, 20 of patients who attended 20 sessions or more, the other 20 of patients who discontinued at or before the sixth session. We differentially explored characteristics that may indicate the probability of patients' engagement and, hence, help to predict outcome in terms of completion of the treatment. The results indicate that there are no strong discriminating factors discernable in the questionnaires for the prediction of engagement in psychotherapy. Two themes emerged from the analysis that seemed to have a moderate bearing on completion. These are the willingness of patients to observe themselves reflectively as well as the awareness that psychotherapy might be a difficult but necessary and beneficial undertaking.

ACKNOWLEDGEMENTS

This work was funded by the Health Services Research Initiative Committee, SlaM. The authors wish to thank Professor David Tuckett for his helpful comments and encouragement at the early stages of this project.