Patients' self-perceived treatment needs and their relationship to background variables

Specificity of patients requests in the initial interview

The concept of the patient's request is described in detail in relation to a negotiated approach to conduct an initial interview in a walk-in clinic and in relation to other related concepts such as patient's goals. The verbalization of specific requests of 363 patients to the psychiatric walk-in clinic of a general hospital was investigated, using a structured pre-intake interview. Although a majority of the patients (69.5%) verbalized a specific request, it was significantly less than the percentage (93%) who endorsed at least one request on the Patient Request Form. Specificity was related to socialization in the mental patient role, conditions of entry into the mental health system, and presenting complaint, but not related to demographic measures. The nonspecific patient is likely to come to the clinic at the suggestion of someone else, to be new to the clinic, having no past treatment history, and having general or situational complaints. The implications of these results for the conduct of an initial interview using the negotiated approach were discussed.

Treatment effectiveness as judged by successfully and unsuccessfully treated alcoholics

Thirty-seven successfully and 46 unsuccessfully treated male alcoholics were asked to judge the effectiveness or ineffectiveness of six treatment methods routinely offered by a state hospital. For each treatment method, the total frequencies of judgments of most and least helpful, respectively, were as follows: detoxification (16%, 14%), lectures (16%, 20%), group therapy (54%, 7%), individual counseling (26%, 6%), work therapy (17%, 22%) and family therapy (13%, 14%). The two groups of subjects differed significantly in the frequencies of treatment methods judged to be "least helpful", but not in the frequencies of "most helpful" treatment. The similarity between the judgments of successfully and unsuccessfully treated alcoholics might reflect the positive effects of previous treatment in the unsuccessful group.