Psychotherapy appointment no-shows: Clinicians' approaches

Missed psychotherapy appointments and eleventh hour cancellations contribute to financial burdens, reduced scheduling efficiency, and lowered effectiveness of the therapeutic services delivered. This paper attempts to explore more specific clinical process factors related to patient no-shows. Psychotherapists and their patients in the outpatient psychiatry department of a public safety-net hospital were surveyed to examine how frequently patients missed scheduled psychotherapy appointments and for what reasons. Clinicians with the lowest rates of patient no-shows (n = 12) were asked to discuss their approaches to psychotherapy attendance and provided clinical examples. Clinicians' responses were thematically grouped into five aspects of negotiating missed appointments and no-shows. Clinicians identified the importance of improving patient motivation, developing a positive therapeutic alliance, setting an established treatment frame, communicating about no-shows throughout the course of treatment, and maintaining their own scheduling accountability as important factors in their approaches to managing patient non-attendance. © 2012 Springer Science+Business Media, LLC.