Patients' perception of user involvement in psychiatric outpatient treatment: Associations with patient characteristics and satisfaction.

BACKGROUND: The patient's right to be involved in treatment decisions is anchored in guidelines and legislation in many countries. Previous research suggests challenges in the implementation of user involvement across different areas of health care, including mental health. However, little is known about psychiatric outpatients' experiences of being involved in their treatment. OBJECTIVE: To investigate how psychiatric outpatients after treatment rate the degree to which they were included in the treatment and explore the associations between perceived user involvement, demographic characteristics of the sample and patient satisfaction. DESIGN: Cross-sectional. SETTING AND PARTICIPANTS: The sample consisted of 188 psychiatric outpatients (67% female, mean age 42.2 years) who were discharged in the two years prior to data collection. MAIN VARIABLES STUDIED: Perceived user involvement in psychiatric outpatient treatment and patient satisfaction as measured by the Psychiatric Out-Patient Experiences Questionnaire. RESULTS: About half of the participants rated the overall degree of involvement in their treatment as high or very high. The lowest percentage of participants reporting high or very high involvement was found for sufficient information to contribute to treatment decisions (36%). Female gender, higher education and, to a small degree, younger age were associated with more involvement. Perceived user involvement was strongly associated with treatment satisfaction. DISCUSSION AND CONCLUSION: The findings suggest that user involvement in psychiatric outpatient treatment can be improved. Patient information that facilitates user involvement should be given more attention. PATIENT OR PUBLIC CONTRIBUTION: The hospital's user panel was involved in the development of items assessing user involvement.

Effectiveness of cognitive behavioral group therapy for depression in routine practice.

BACKGROUND: Previous research has shown that cognitive- behavioral group therapy (group CBT) is an effective treatment for depression. However, the effectiveness of this approach in routine care needs more research. The current study retrospectively examines the outcomes of patients who received group CBT for depression at a psychiatric outpatient clinic between 2003 and 2013. METHODS: Based on patient records, 143 patients were identified as having received the treatment, and 88 patients were included in the outcome analyses. The Beck Depression Inventory (BDI-II) score was the main outcome measure. RESULTS: The dropout rate was 17.5%. The average BDI-II score decreased from 28.5 to 18.5 from pre-treatment to post-treatment and remained stable at 3-months follow-up. The effect sizes at post-treatment and follow-up were large (d = .97 and d = 1.10, respectively). At post-treatment, 44% of the patients showed a significant improvement in depression, including 30% who recovered; at follow-up, the proportions increased to 57% and 40%, respectively. No predictors of dropout or treatment response were found. CONCLUSIONS: Group CBT for depression can be delivered in routine care settings with good results. However, there are still many patients who drop out or do not benefit from treatment.