Psychotherapy appointment no-shows: rates and reasons.

Patients who frequently miss or do not show for their scheduled psychotherapy appointments create administrative and clinical difficulties, and may not be receiving effective treatment. Prior research has predominately focused on either identifying demographic and administrative factors related to patient no-show rates or evaluating the effectiveness of administrative procedures for reducing no-shows. This paper attempts to identify rates of missed appointments in clinical practice and explore more specific clinical process factors related to patient no-shows. Psychotherapists (N = 24) and their patients (N = 542) in the outpatient department of a public safety-net hospital were surveyed to examine how frequently patients missed scheduled psychotherapy appointments and for what reasons. Findings indicate that the majority of missed appointments were accounted for by patients with occasional absences (approx. 1 per month), while only a small percentage of patients missed appointments with high frequency. Patients missed their psychotherapy appointments for a number of reasons, including clinical symptoms, practical matters, motivational concerns, and negative treatment reactions.