A comparison of walk-in counselling and the wait list model for delivering counselling services.

BACKGROUND: Walk-in counselling has been used to reduce wait times but there are few controlled studies to compare outcomes between walk-in and the traditional model of service delivery. AIMS: To compare change in psychological distress by clients receiving services from two models of service delivery, a walk-in counselling model and a traditional counselling model involving a wait list. METHOD: Mixed-methods sequential explanatory design including quantitative comparison of groups with one pre-test and two follow-ups, and qualitative analysis of interviews with a sub-sample. Five-hundred and twenty-four participants ≥16 years were recruited from two Family Counselling Agencies; the General Health Questionnaire-12 assessed change in psychological distress. RESULTS: Hierarchical linear modelling revealed clients of the walk-in model improved faster and were less distressed at the four-week follow-up compared to the traditional service delivery model. Ten weeks later, both groups had improved and were similar. Participants receiving instrumental services prior to baseline improved more slowly. The qualitative data confirmed participants highly valued the accessibility of the walk-in model, and were frustrated by the lengthy waits associated with the traditional model. CONCLUSIONS: This study improves methodologically on previous studies of walk-in counselling, an approach to service delivery not conducive to randomized controlled trials.

Appointment choice and outcome at a supported employment agency.

A 3-month study of 94 clients at a supported employment agency in London, Ontario, examined the significance of appointment choice in successful job placement. Clients who had been in conflict with the law were least likely to be appointment compliant, while social assistance recipients mandated to attend were the most likely to put off their initial agency visit and also most likely to terminate contact with the employment support service within 60 days. Younger clients were given more choice selecting a meeting time in the study than were older clients. Likewise, clients with a developmental delay or learning disability had more choice in selecting an initial appointment than did those with no disability, a physical challenge, or a mental health issue. It was observed that clients who were given a choice of meeting dates who selected an earlier rather than a later initial appointment did not have greater success in finding employment compared to those who opted for a later meeting date.