PATIENTS REQUESTS AND SATISFACTION WITH SERVICES IN AN OUTPATIENT PSYCHIATRIC SETTING

Objective: Patients in four major diagnostic categories were compared to determine: if their satisfaction with outpatient services varied. B oth overall satisfaction and the degree to which clients and therapist s agreed on the importance of 16 aspects of treatment were examined. M ethods: The Patient Request Form (PRF) and the Client Satisfaction Que stionnaire were used to interview 464 outpatients. The professional wh o was the primary contact for each patient filled out a therapist vers ion of the PRE Diagnoses were grouped into four major categories: anxi ety disorders, affective disorders, schizophrenia, and other psychotic disorders. Results: The diagnostic groups differed in overall satisfa ction with treatment, treatment characteristics, patients' reasons for coming to the clinic, therapists' descriptions of treatment, and pati ent-therapist agreement on the importance of differ,ent aspects of tre atment. Agreement between patients and providers was associated with h igher levels of patients' satisfaction. Patients with schizophrenia or with other psychotic disorders had the lowest level of agreement with their therapists and also were the least satisfied. In all patient ca tegories, therapists underestimated the importance to patients of havi ng a reliable source of help. Conclusions: The greater dissatisfaction expressed by patients with schizophrenia and other psychotic disorder s may be related to their therapists' undervaluing the nonbiological a spects of treatment such as social support. Combining medication with psychosocial approaches that have been adapted for patients with psych otic disorders is likely to improve those patients' satisfaction and c ompliance and increase the overall effectiveness of treatment.