Hopelessness and the Anticipation of Positive and Negative Future Experiences in Elderly Parasuicidal Individuals

Conaghan, Susan (1999) Hopelessness and the Anticipation of Positive and Negative Future Experiences in Elderly Parasuicidal Individuals. D Clin Psy thesis, University of Glasgow.

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One of the most consistent challenges to Clinical Psychology departments across the country relates to the question of how to manage their resources, in light of increasing numbers of referrals and the shortage which exists in the numbers of qualified clinical psychologists available to provide services. Over the past six years for example, referrals to Clinical Psychology at Stobhill Hospital, Glasgow, have almost doubled - from 690 referrals in 1990 to 1345 referrals in 1996. A common method which psychology departments have used to deal with the problem of increasing numbers of referrals has involved the adoption of a waiting list system, which for patients, can involve a wait of up to one year before they are seen by a clinical psychologist. This waiting period is exacerbated by sizeable numbers of "wasted" appointments which result from patients failing to attend their first appointment, the late cancellation of appointments which cannot be allocated to other patients, and patients who "drop-out" of treatment following initial assessment. This represents a considerable waste of the clinical time of highly skilled therapists and adds to the length of time patients will have to spend on the waiting list before being seen. In the Clinical Psychology Department at Stobhill Hospital in Glasgow, figures collected over a four-month period in 1996 indicated the following rates of non-attendance, on average: Total DNA 23.3%; First appointment DNA 26.1%; Return appointment DNA 10.6%; Cancellations 11.7%. The above figures represent the overall prevalence, across Stobhill's catchment area, of non-attendance in 1996. However, there is considerable variation in rates of non-attendance between the three localities covered by Stobhill, with one locality experiencing a first time appointment DNA rate of 31.3% (Springbum/Possilpark). Research by Anderson & White (1994) has shown that the introduction of an "opt-in" system requiring patients nearing the top of the waiting list to confirm that they still wish to have an appointment with a clinical psychologist, can be effective in reducing the frequency of first appointment DNAs. Research by Balfour (1986) suggested that if patients have insufficient or incorrect information about a psychology service, this is likely to lead to increased numbers of first appointment DNAs and Webster (1992) found that these can be reduced by the provision of an information leaflet outlining to patients what they can expect during their contact with clinical psychology services. However, more recent studies, such as those of Markman & Beeney (1990) and Keen et al (1996) have suggested that although the provision of an information leaflet can be considered useful by patients and contributes to the overall quality of the clinical psychology service, in order for this approach to be effective in reducing rates of non-attendance, it should be combined with an opt-in system. In light of the length of clinical psychology waiting lists and rates of non-attendance, the Clinical Psychology Directorate of Greater Glasgow Health Board Community & Mental Health Services NHS Trust decided to make changes in line with some of the above-mentioned research. In 1997, the Directorate decided to implement an opt-in system of the type described above, combined with the provision to patients of an information leaflet, detailing the types of problems psychologists can help with and what to expect during the first and subsequent appointments. This research aims to evaluate the impact of the introduction of this opt-in system on rates of non-attendance across the catchment area of Stobhill Clinical Psychology Department in the north of Glasgow.

Item Type: Thesis (D Clin Psy)
Qualification Level: Doctoral
Additional Information: Adviser: Kate Davidson
Keywords: Clinical psychology
Date of Award: 1999
Depositing User: Enlighten Team
Unique ID: glathesis:1999-76242
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 19 Nov 2019 16:15
Last Modified: 19 Nov 2019 16:15
URI: https://theses.gla.ac.uk/id/eprint/76242

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