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Approach-Avoidance Attitudes Associated with Initial Therapy Appointment Attendance: A Prospective Study

  • Elizabeth Murphy (a1), Warren Mansell (a1), Sally Craven (a1) and Phil McEvoy (a2)

Abstract

Background: Initial therapy appointments have high nonattendance rates yet the reasons remain poorly understood. Aims: This study aimed to identify positive and negative attitudes towards therapy that predicted initial attendance, informed by a perceptual control theory account of approach-avoidance conflicts in help-seeking. Method: A prospective study was conducted within a low intensity CBT service using first appointment attendance (n = 96) as an outcome. Measures included attitudes towards therapy, depression and anxiety scales, and demographic variables. Results: Endorsement of a negative attitude item representing concern about self-disclosure was independently predictive of nonattendance. Positive attitudes predicted increased attendance, especially endorsement of motives for self-reflection, but only among less depressed individuals. Conclusions: Self-disclosure concerns contribute to therapy avoidance and having goals for self-reflection may represent approach motivation for therapy; however, the latter has less impact among more highly depressed people.

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Corresponding author

Reprint requests to Elizabeth Murphy, The Psychosis Research Unit, GMW Mental Health NHS Foundation Trust, Harrop House, Bury New Road, Prestwich M25 3BL, UK. E-mail: elizabeth.murphy@gmw.nhs.uk

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An extended version is also available online in the table of contents for this issue: http://journals.cambridge.org/jid_BCP

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References

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Grant, A., Franklin, J. and Langford, P. (2002). The self-reflection and insight scale: a new measure of private self-consciousness. Social Behavior and Personality, 30, 821835.
Murphy, E., Mansell, W., Craven, S., Menary, J. and McEvoy, P. (2013). Pilot study of an investigation of psychological factors associated with first appointment nonattendance in a low-intensity service. Behavioural and Cognitive Psychotherapy, 41, 458469.
Schauman, O. and Mansell, W. (2012). Processes underlying ambivalence in help-seeking: the Loss of Valued Control Model. Clinical Psychology: Science and Practice, 19, 107124.
Sheeran, P., Aubrey, R. and Kellett, S. (2007). Increasing attendance for psychotherapy: implementation intentions and the self-regulation of attendance-related negative affect. Journal of Consulting and Clinical Psychology, 75, 853863.
Trew, J. (2011). Exploring the roles of approach and avoidance in depression: an integrative model. Clinical Psychology Review, 31, 11561168.
Vogel, D. and Wester, S. (2003). To seek help or not to seek help: the risks of self-disclosure. Journal of Counseling Psychology, 50, 351361.

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Approach-Avoidance Attitudes Associated with Initial Therapy Appointment Attendance: A Prospective Study

  • Elizabeth Murphy (a1), Warren Mansell (a1), Sally Craven (a1) and Phil McEvoy (a2)

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Approach-Avoidance Attitudes Associated with Initial Therapy Appointment Attendance: A Prospective Study

  • Elizabeth Murphy (a1), Warren Mansell (a1), Sally Craven (a1) and Phil McEvoy (a2)
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