Strategies for preparing clients for treatment - A review

Substantial numbers of mental health clients do not return following their initial therapy visits or drop out of treatment prematurely Two general cla sses of strategies designed to reduce premature attrition and enhance treat ment participation are reviewed. Research on psychotherapy preparatory tech niques (role induction, vicarious therapy pretraining, and experiential pre training) indicates that these educational techniques are effective in redu cing early treatment attrition and may be especially effective with populat ions at high risk for dropout (e.g., lower socioeconomic groups, chronicall y mentally ill clients, and institutionalized juvenile delinquents). Motiva tional interviewing, a technique originally developed for clients with alco hol problems, is designed to reduce client ambivalence toward therapy and c hange and enhance commitment to and motivation for treatment. Research in t he alcohol field suggests that a session of pretreatment motivational inter viewing enhances treatment outcome. Both motivational interviewing and psyc hotherapy preparatory techniques are relatively brief and easy to incorpora te into existing mental health care.