Skip to main content Accessibility help

Using SMS Reminders in Psychology Clinics: A Cautionary Tale

  • Bonnie A. Clough (a1) and Leanne M. Casey (a1)


Background: As healthcare services become progressively more stretched, there is increasing discussion of ways in which technological adjuncts may be used to deliver more cost-efficient services. Before widespread implementation, however, the use of these adjuncts requires proper scrutiny of their effects on psychological practice. Aims: This research examined the effectiveness of SMS reminders on client appointment attendance and dropout in a psychological treatment setting. It was predicted that the reminders would result in increased initial appointment attendance, increased total appointment attendance, and decreased client dropout. Method: A randomized controlled trial investigated the impact of SMS appointment reminders (two levels: present or absent) on client attendance (three levels: attended, rescheduled, or did not attend) and dropout (two levels: completed treatment or terminate early). Participants (N = 140) at an outpatient psychology clinic were randomly allocated to either receive an SMS appointment reminder one day before their scheduled appointment, or to receive no reminder. Results: No significant differences were found between the SMS and no SMS conditions in relation to appointment attendance. There were more client dropouts in the SMS compared to the no SMS condition. Conclusions: The SMS appointment reminders were not effective at increasing appointment attendance. The current research suggests that there is more to client non-attendance in psychological settings than the simple forgetting of appointments. Technological adjuncts may be useful in increasing the cost-efficiency of current services; however, this research highlights the importance of understanding the effects of technology before widespread implementation.


Corresponding author

Reprint requests to Bonnie A. Clough, School of Applied Psychology, Griffith University, Messines Ridge Road, Mt Gravatt, Queensland, Australia 4111. E-mail:


Hide All
Arnow, B. A., Blasey, C., Manber, R., Constantino, M. J., Markowitz, J. C., Klein, D. N., et al. (2007). Dropouts versus completers among chronically depressed outpatients. Journal of Affective Disorders, 97, 197202. doi: 10.1016/j.jad.2006.06.017
Barnett, J. E. and Scheetz, K. (2003). Technological advances and telehealth: ethics, law, and the practice of psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 40, 8693. doi: 10.1037/0033-3204.40.1-2.86
Barrett, M. S., Chua, W.-J., Crits-Christoph, P., Gibbons, M. B. and Thompson, D. (2008). Early withdrawal from mental health treatment: implications for psychotherapy practice. Psychotherapy: Theory, Research, Practice, Training, 45, 247267. doi:
Baruch, G., Vrouva, I. and Fearon, P. (2009). A follow-up study of characteristics of young people that dropout and continue psychotherapy: service implications for a clinic in the community. Child and Adolescent Mental Health, 14, 6975. doi:
Bender, K. G. and Koshy, M. K. (1991). Returning for follow up: attendance compliance in an Indian psychiatric clinic. International Journal of Social Psychiatry, 37, 173181.
Car, J., Gurol-Urganci, I., de Jongh, T., Vodopivec-Jamsek, V. and Atun, R. (2012). Mobile phone messaging reminders for attendance at healthcare appointments. Cochrane Database of Systematic Reviews, 7. doi: 10.1002/14651858.CD007458.pub2
Carrion, P. G., Swann, A., Kellertcecil, H. and Barber, M. (1993). Compliance with clinic attendance by outpatients with schizophrenia. Hospital and Community Psychiatry, 44, 764767.
Chariatte, V., Berchtold, A., Akre, C., Michaud, P. A. and Suris, J. C. (2008). Missed appointments in an outpatient clinic for adolescents, an approach to predict the risk of missing. Journal of Adolescent Health, 43, 3845. doi: 10.1016/j.jadohealth.2007.12.017
Chen, A. (1991). Noncompliance in community psychiatry: a review of clinical interventions. Hospital and Community Psychiatry, 42, 282287.
Chen, Z.-w., Fang, L.-z., Chen, L.-y. and Dai, H.-l. (2008). Comparison of an SMS text messaging and phone reminder to improve attendance at a health promotion center: a randomized controlled trial. Journal of Zhejiang University SCIENCE B, 9, 3438. doi: 10.1631/jzus.B071464
Clough, B. A. and Casey, L. M. (2011a). Technological adjuncts to enhance current psychotherapy practices: a review. Clinical Psychology Review, 31, 279292.
Clough, B. A. and Casey, L. M. (2011b). Technological adjuncts to increase adherence to therapy: a review. Clinical Psychology Review, 31, 697710.
Conduit, T., Byrne, S., Court, J. and Stefanovic, S. (2004). Non-attendance at a university-based psychology clinic: telephone appointment reminders versus no reminders. Australian Psychologist, 39, 6875. doi: 10.1080/00050060410001660362
Downer, S. R., Meara, J. G. and Da Costa, A. C. (2005). Use of SMS text messaging to improve outpatient attendance. Medical Journal of Australia, 183, 366368.
El-Mallakh, R. S., James, T., Khan, T., Katz, M., McGovern, B., Nair, S., et al. (2004). Follow-up after inpatient psychiatric hospitalization with partial control of the system responsiveness variable. Psychiatry-Interpersonal and Biological Processes, 67, 294298.
Faul, F., Erdfelder, E., Lang, A.-G. and Buchner, A. (2007). G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175191.
Guy, R., Hocking, J., Wand, H., Stott, S., Ali, H. and Kaldor, J. (2012). How effective are Short Message Service reminders at increasing clinic attendance? A meta-analysis and systematic review. Health Services Research, 47, 614632. doi: 10.1111/j.1475-6773.2011.01342.x
Hochstadt, N. J. and Trybula, J. (1980). Reducing missed initial appointments in a community mental health center. Journal of Community Psychology, 8, 261265.
Hoste, R. R., Zaitsoff, S., Hewell, K. and le Grange, D. (2007). What can dropouts teach us about retention in eating disorder treatment studies? International Journal of Eating Disorders, 40, 668671. doi: 10.1002/eat.20421
Kourany, R. F. C., Garber, J. and Tornusciolo, G. (1990). Improving first appointment attendance rates in child psychiatry outpatient clinics. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 657660.
Lefforge, N. L., Donohue, B. and Strada, M. J. (2007). Improving session attendance in mental health and substance abuse settings: a review of controlled studies. Behavior Therapy, 38, 122.
Leong, K. C., Chen, W. S., Leong, K. W., Mastura, I., Mimi, O., Sheikh, M. A., et al. (2006). The use of text messaging to improve attendance in primary care: a randomized controlled trial. Family Practice, 23, 699705. doi: 10.1093/fampra/cml044
Marini, M., Semenzin, M., Vignaga, F., Gardiolo, M., Drago, A., Caon, F., et al. (2005). Dropout in institutional emotional crisis counseling and brief focused intervention. Brief Treatment and Crisis Intervention, 5, 356.
Martinez, K. K. and Wong, S. E. (2009). Using prompts to increase attendance at groups for survivors of domestic violence. Research on Social Work Practice, 19, 460463. doi: 10.1177/1049731508329384
Melville, K. M., Casey, L. M. and Kavanagh, D. J. (2007). Psychological treatment dropout among pathological gamblers. Clinical Psychology Review, 27, 944958. doi: 10.1016/j.cpr.2007.02.004
Milne, R. G., Horne, M. and Torsney, B. (2006). SMS reminders in the UK national health service: an evaluation of its impact on “No-Shows” at hospital out-patient clinics. Health Care Management Review, 31, 130136.
Ogrodniczuk, J. S., Joyce, A. S. and Piper, W. E. (2005). Strategies for reducing patient-initiated premature termination of psychotherapy. Harvard Review of Psychiatry, 13, 5770.
Overholser, J. (2012). Adapting computerized treatments into traditional psychotherapy for depression. Studies in Health Technology and Informatics, 181, 3236.
Shivack, I. M. and Sullivan, C. W. (1989). Use of telephone prompts at an inner-city outpatient-clinic. Hospital and Community Psychiatry, 40, 851853.
Sims, H., Sanghara, H., Hayes, D., Wandiembe, S., Finch, M., Jakobsen, H., et al. (2012). Text message reminders of appointments: a pilot intervention at four community mental health clinics in London. Psychiatric Services (Washington, DC), 63, 161168.
Swenson, T. R. and Pekarik, G. (1988). Interventions for reducing missed initial appointments at a community mental-health center. Community Mental Health Journal, 24, 205218.
Tanke, E. D. and Leirer, V. O. (1994). Automated telephone reminders in tuberculosis care. Medical Care, 32, 380389.
Wolf, M., Chung, C. K. and Kordy, H. (2010). Inpatient treatment to online aftercare: e-mailing themes as a function of therapeutic outcomes. Psychotherapy Research, 20, 7185. doi: 10.1080/10503300903179799
Wolf, M., Maurer, W. J., Dogs, P. and Kordy, H. (2006). E-mail in psychotherapy: an aftercare model via electronic mail for psychotherapy inpatients. Psychotherapie Psychosomatik Medizinische Psychologie, 56, 138146. doi: 10.1055/s-2005–915340


Using SMS Reminders in Psychology Clinics: A Cautionary Tale

  • Bonnie A. Clough (a1) and Leanne M. Casey (a1)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Using SMS Reminders in Psychology Clinics: A Cautionary Tale

  • Bonnie A. Clough (a1) and Leanne M. Casey (a1)
Submit a response


No Comments have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *